Can you take one probiotic for digestive health and a different one for vaginal health? “Unless recommended otherwise by a healthcare professional, I would recommend staggering intake within a day,” says Anthony Thomas, PhD, director of scientific affairs at Jarrow Formulas. In other words, take one probiotic with breakfast and the other at lunchtime.
Other uses. Many other claims are made for probiotics—that they lower cholesterol, alleviate allergic skin conditions (like eczema), treat ulcers and urinary tract infections, improve vaginal health, reduce the risk of colon cancer, ease anxiety and depression, and ward off traveler’s diarrhea. Good evidence to support these claims is lacking. Research on probiotics for weight loss has yielded inconsistent results, and even studies with positive results have mostly found very small benefits, as was seen in an analysis of 15 clinical trials in Obesity Reviews in 2018.
Questions and concerns have been raised, however, about the safety of probiotic administration in the setting of a severe illness. Probiotic sepsis is the most feared complication related to probiotic administration [Boyle et al. 2006]. Lactobacillus is a rare but documented cause of endocarditis in adults [Cannon et al. 2005]. There are several reports in the literature of bacteremia in adults and children in the setting of probiotic administration [De Groote et al. 2005; Land et al. 2005; Kunz et al. 2004, 2005; Mackay et al. 1999; Rautio et al. 1999]. In addition, several cases of Saccharomyces boulardii fungemia have been reported in the literature [Cherifi et al. 2004; Henry et al. 2004; Cassone et al. 2003; Lestin et al. 2003; Riquelme et al. 2003; Lherm et al. 2002; Cesaro et al. 2000; Hennequin et al. 2000; Perapoch et al. 2000; Rijnders et al. 2000; Niault et al. 1999; Bassetti et al. 1998; Fredenucci et al. 1998; Pletincx et al. 1995], including two series in which the fungi spread to neighboring patients who were not taking the probiotic [Cassone et al. 2003; Perapoch et al. 2000]. This spread was thought to be due to contamination of central catheters in patients who had intestinal surgery (jejunostomy) or chronic illnesses (valvular heart disease), and who were immunocompromised. Only one case of probiotic sepsis was thought to have been directly fatal [Lestin et al. 2003]. A randomized, double-blind, placebo-controlled trial was performed using probiotic prophylaxis (six different strains of viable bacteria: L. acidophilus, L. casei, L. salivarius, L. lactis, B. bifidum, and B. lactis) in a total daily dose of 1010 bacteria orally twice daily for 28 days in patients hospitalized with severe acute pancreatitis. This showed no decrease in infectious complications but increased mortality (16%) in the probiotics group in comparison with the placebo group (6%, relative risk [RR] 2.53, 95% confidence interval [CI] 1.22–5.25). Nine of the 152 patients in the probiotics group developed bowel ischemia, eight of whom died, compared with none in the placebo group [Besselink et al. 2008].
Bacteria die out over time. Some supplements list the potency when they were manufactured (before they rode in a truck, sat on the shelf at the grocery store, or hung out in the kitchen cupboard for a few months). In this case, there could be dramatically fewer viable bacteria by the time you consume them than when they were first encapsulated, and good bacteria are no good to you dead.
"Probiotics help with constipation, diarrhea, colitis, irritable bowel syndrome, abdominal pain, Crohn's disease, and flatulence," says Shapiro. "Probiotics work to increase the number of immunoglobulin cells and cytokine-producing cells in the intestine. They improve the healthy bacteria population in the GI tract by repopulating the gut to help with digestion."

In the first study, 25 human volunteers underwent upper endoscopies and colonoscopies to sample their baseline microbiome in regions of the gut. 15 of those volunteers were then divided into two groups. The first group consumed generic probiotic strains, while the second was administered a placebo. Both groups then underwent a second round of upper endoscopies and colonoscopies to assess their internal response before being followed for another 2 months.
Probably the first person of Western medicine to publish on the topic of probiotics in the early 20th century was the Russian Nobel Prize winner Ilya Metchnikoff, when he described longevity in people in Eastern Europe who lived largely on milk fermented by LAB. He theorized that proteolytic microbes in the colon produced toxic substances responsible for the aging process and proposed that consumption of fermented milk would coat the colon with LABs, decreasing intestinal pH, suppressing proteolytic bacteria and thus leading to slowing of the aging process [Gordon, 2008]. Metchnikoff and his followers ingested milk fermented with this ‘Bulgarian Bacillus’ and reported health benefits [Vaughan, 1965].
She totally did, but you may have noticed that you don't see those yogurt commercials anymore. That’s because in 2010, the Federal Trade Commission in conjunction with 39 states' attorney generals banned those ads, finding that the Dannon Company had no scientific evidence to back up their claims,. Dannon had to pay $21 million to resolve the associated investigations.
The 16 strains found in Swanson Probiotic for Digestive Health were carefully selected based on their specific roles in supporting digestive health.* For example, it features 9 strains of Lactobacillus, including L. acidophilus, one of the most extensively researched strains when it comes to digestive health, and L. rhamnosus, which provides invaluable GI tract protection for travelers. Commonly found in fermented foods like sauerkraut and kefir, these lactic acid producing bacteria aid in the breakdown of lactose and other sugars, reducing gassiness to support intestinal comfort.* The formula also includes five Bifidobacterium strains, which work in harmony with L. casei, L. reuteri, Streptococcus thermophilus and Lactococcus lactis to support digestive function throughout the alimentary canal.* Combined they constitute a broad spectrum source of natural support for digestive health.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047
We started our search with the most popular products from major supplement retailers like Amazon, Drugstore.com, GNC, and Whole Foods. That gave us over 200 supplements. With so many options, we then narrowed our search to 70 probiotics whose purity, potency, and projected efficacy have been vetted by an independent lab like ConsumerLab, Labdoor or the National Science Foundation (NSF). Those labs test — among other things — supplements’ actual composition against labels, verifying ingredient lists are truthful and that contaminants aren’t present. Because supplement claims aren’t regulated by the Food and Drug Administration (FDA), we wanted to make sure someone was testing whether they worked as described.
But other research, especially in healthy adults, shows little benefit from taking probiotics. And in fact, it may even introduce new symptoms: One small study of 30 subjects, published in the journal Clinical and Translational Gastroenterology, showed that taking a lot of probiotics can result in symptoms like brain fog and bloating in those using them for GI complaints.

Probiotics are live microorganisms that are thought to have health benefits, as the National Institutes of Health (NIH) reports. These bacteria and yeast are believed to help populate our guts with beneficial microbes, according to Mayo Clinic, and can be found in fermented or unpasteurized foods including yogurt, kefir, sauerkraut, and kimchi, as well as, yes, supplements.


Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens. 
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