In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
“It is quite difficult to choose a solid top pick for probiotics because different strains have been shown to help different clinical issues,” says Rachel Fine, MS, RD, CSSD, a dietitian in New York City. “However, this supplement is a great option, with 50 billion strains.” It’s one of the best probiotics for women and supports vaginal, digestive, and immune system health. “It is best to choose a product that is well within its expiration date to ensure a higher number of viable cells,” advises Fine.
According to a 2014 meta-analysis, probiotics benefit diabetics by improving insulin sensitivity and decreasing the autoimmune response found in diabetes. The authors suggest that the results were significant enough to conduct large, randomized, controlled trials (the “gold standard” of scientific studies) to find if probiotics may actually be used to prevent or manage diabetes symptoms. Combining probiotics with prebiotics may also help manage blood sugar, particularly when blood sugar levels are already elevated. (87)
Possibly the most popular probiotic food is live cultured yogurt or greek yogurt made from the milk of cows, goats or sheep. Yogurt, in most cases, can rank at the top of probiotic foods if it comes from raw, grass-fed animals. The problem is there is a large variation on the quality of yogurts on the market today. When buying yogurt, look for three things: First, that it comes from goat’s, sheep milk or A2 cows milk; second, that it’s grass-fed; and third, that it’s organic.
There are two key issues when choosing a probiotic: the first is to ensure that the product contains enough bacteria to have an effect (107 to 1010 probiotic cells per gram); the second is to ensure that it survives the acidic environment of the stomach in order to reach the large intestine. Examples of probiotics that meet this criteria include Alforex, Yakult, Symprove and VSL #3.  Each of these is designed to treat different symptoms, so if you are thinking about taking a probiotic, seek advice from a specialist dietitian or GP to ensure you take the correct one. 
“Aside from the beneficial probiotics, this has plant-based compounds like ginger to soothe upset stomachs and support healthy digestive function,” says Beth Warren, MS, RDN, a dietitian in New York City. It also has prebiotics, which encourage the growth of healthy bacteria that support the well being of pregnant and breastfeeding women, she explains. “The formula has L. rhamnosus HN001, which has been shown to support the child’s developing immune system during the last trimester and early breastfeeding period.”
The current probiotic push lends itself to the question, "If humans got along fine without taking a probiotic supplement for thousands of years, why are they so important now?" Although there is no definitive answer to this question, there have been some significant cultural changes that have had an impact on the gut flora (the population of organisms that populate our intestines). These include the use of antibiotics, diets lacking in gut-healthy plant food, refrigeration and improved sterilization of foods. What we don't yet know is true is if probiotics actually turn around these changes and support the health of your gut flora.

Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
^ Wu, G. D.; Chen, J.; Hoffmann, C.; Bittinger, K.; Chen, Y.-Y.; Keilbaugh, S. A.; Bewtra, M.; Knights, D.; Walters, W. A.; Knight, R.; Sinha, R.; Gilroy, E.; Gupta, K.; Baldassano, R.; Nessel, L.; Li, H.; Bushman, F. D.; Lewis, J. D. (2011). "Linking Long-Term Dietary Patterns with Gut Microbial Enterotypes". Science. 334 (6052): 105–8. Bibcode:2011Sci...334..105W. doi:10.1126/science.1208344. PMC 3368382. PMID 21885731.
Research suggests probiotics work better as a team. Even pairs are more effective than individuals. Take the strains Lactobacillus Acidophilus and Bifidobacterium Bifidum BB-12, for example. When combined, this duo-force has been shown to help treat GI-specific ailments. In fact, one survey found 75 percent of studies that compared the effect of a strain mixture with a single-strain supplement showed a mixture was more effective at improving irritable bowel symptoms, immune function, and digestive health.
Sauerkraut and kimchi are fermented foods that are rich in beneficial probiotics that provide a wide range of health benefits. Sauerkraut is fermented cabbage. If you buy sauerkraut at the store, purchase the unpasteurized variety. Pasteurization destroys beneficial bacteria. Probiotics in kimchi inhibit the growth of H pylori. They may also help prevent cancer, obesity, inflammatory bowel disease (IBD), dermatitis, food allergies, and obesity. Probiotics in kimchi produce valuable B vitamins, riboflavin and folic acid. These foods contain vitamins that boost immunity and help ward off infection.
^ Jump up to: a b Hill, C; Guarner, F; Reid, G; Gibson, GR; Merenstein, DJ; Pot, B; Morelli, L; Canani, RB; Flint, HJ; Salminen, S; Calder, PC; Sanders, ME (August 2014). "Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic". Nature Reviews. Gastroenterology & Hepatology. 11 (8): 506–14. doi:10.1038/nrgastro.2014.66. PMID 24912386.
I have been taking probiotics for several years now. When I first started taking them, I had been getting increasing attacks of gout, but I didn't take them for that reason. Soon, I realised that I had stopped getting gout, except for the very occasional attack if I had been taking antibiotics, so it wasn't all in the mind, because I hadn't expected the attacks to stop. I get mine from the well-known health shop and they need refrigerating after opening.
Studies have shown some benefits linked to Lactobacillus and treating and/or preventing yeast infections, bacterial vaginosis, urinary tract infection, irritable bowel syndrome, antibiotic-related diarrhea, traveler's diarrhea, diarrhea resulting from Clostridium difficile, treating lactose intolerance, skin disorders (fever blisters, eczema, acne, and canker sores), and prevention of respiratory infections.

Now researchers are finding evidence that the effects of bacteria in the gastrointestinal (GI) system send signals to the central nervous system, linking the gut with the brain. This could account for some known connections between GI illness and mental illness. For example, a higher-than-average number of people with irritable bowel syndrome also develop depression and anxiety.


"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.
Further, there’s still a lot we don’t know. A recent study published in Cell compared how the microbiome of the gut reconstituted itself after antibiotic treatment with and without probiotic administration. The researchers found that probiotics (which might have improved diarrhea symptoms) led to a significant delay in microbiome reconstitution, if it occurred at all. And — again — this study was with purified strains of bacteria, which is not what you’re getting in probiotic-containing food.
"People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial; we wanted to determine whether probiotics such as the ones you buy in the supermarket do colonize the gastrointestinal tract like they're supposed to, and then whether these probiotics are having any impact on the human host," says senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel. "Surprisingly, we saw that many healthy volunteers were actually resistant in that the probiotics couldn't colonize their GI tracts. This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement. Instead, they could be tailored to the needs of each individual."

The manipulation of the gut microbiota is complex and may cause bacteria-host interactions.[7] Though probiotics are considered safe, some have concerns about their safety in certain cases.[7][40] Some people, such as those with immunodeficiency, short bowel syndrome, central venous catheters, cardiac valve disease and premature infants, may be at higher risk for adverse events.[5] In severely ill people with inflammatory bowel disease there is a risk of the passage of viable bacteria from the gastrointestinal tract to the internal organs (bacterial translocation) as a consequence of bacteremia, which can cause adverse health consequences.[7] Rarely, consumption of probiotics by children with lowered immune system function or who are already critically ill may result in bacteremia or fungemia (i.e., bacteria or fungi in the blood), which can lead to sepsis, a potentially fatal disease.[6]
Like adults, children also require the proper balance of flora in the stomach to remain in good health. A major health care study conducted by the American Academy of Pediatrics concluded that probiotic supplements could be beneficial for children under certain circumstances. More research is needed. However, the study indicates that children who take probiotics at the first signs of viral diarrhea exhibit symptoms for shorter periods of time than those who do not. The study also found positive evidence that probiotics reduce the chances of diarrhea caused by antibiotic use in kids. More research is required to confirm these results. However, many pediatricians already recommend probiotics to parents based on the data.
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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