“Since brain fog, weight gain, and skin problems can stem from poor gut health, it was important for me to have a probiotic I can recommend to my patients,” says Will Cole, DC, a functional medicine practitioner in Pittsburgh. “I developed this probiotic with 100 billion CFUs per capsule and four strains of beneficial bacteria, including the extensively studied HN019 strain of B. lactis.” Bowel issues and brain fog are two of the fibromyalgia symptoms you might be ignoring.

The side effects of antibiotic use are often not trivial. Many people experience discomfort and a change in bowel habits, but some experience more severe infections, such as opportunistic colonization of the gut with bacteria such as Clostridium difficile (C.diff), which affected half a million Americans in 2015 and was directly responsible for at least 15,000 deaths.


I’ve been taking a Jamieson Probiotic for weeks now for my IBS. I’m not really getting results. It has 10 billion cells and about 14 strains. I tried taking it every day but then I was crampy, bloated and almost constipated. A friend suggested taking every other day so I did that and it was just the opposite. I’ve been trying to eat a low fodmaps diet as well. Can you tell me how long its supposed to take to work and also if I should possibly try something else? This probiotic was inexpensive so I’m wondering if you get what you pay for.

Prebiotics are fuel for the good bacteria (probiotics) in your gut; without prebiotics, probiotics can’t do their job. There are tons of prebiotics in whole fruits and vegetables, including onions, garlic, bananas, asparagus, and artichokes. If you’re worried you’re not getting five to 20 grams per day (more on prebiotic-rich foods here), consider taking a prebiotic supplement, usually a powder or drink mix.

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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].
Bottom Line: Eating foods rich in probiotics can boost the healthy bacteria in your digestive tract, which can help you fend off indigestion and improve immunity. For individuals who either don't like probiotic-rich foods or don't get enough probiotics from foods, taking daily probiotic supplements may be beneficial. However, an overall healthy diet is still the key to maintaining optimal gut health.
Got your gut on your mind? Then you’re probably up on the health benefits of probiotics. From boosting immunity to improving digestion, probiotics have been touted as the “superhero” of the gut bacteria underworld. And yet, there’s a lot we still don’t know about probiotics because the research is just heating up. To date, most studies that have been done on probiotics are on the Lactobaccilus, Bifidobacterium and Streptococcus thermophilus strains. Meanwhile, there are, oh, upwards of 100 trillion gut-friendly bacteria out there — some of which are popping up in trendy new waters, chocolates, nut butters and more. Here’s what you need to know before giving your gut the royal treatment.
Probiotics are the bacterial powerhouses that help change or repopulate gut bacteria to optimize the health of the gastrointestinal (GI) tract. These live cultures are found naturally in the body. However, we can also consume probiotics from food, beverages, and supplements. In addition to helping maintain the balance of our gut flora, probiotics are also praised for their ability to boost immunity, manage symptoms of irritable bowel syndrome, mitigate certain allergy symptoms, and lessen symptoms of lactose intolerance.
The authors discuss the need for “pscyhobiotics” (probiotics that impact brain function) in handling the development of these conditions. This anti-inflammatory quality is what seems to interest researchers most. While no studies have been conducted in humans, early research suggests that, in animals, probiotic supplements may help alleviate symptoms of anxiety by reducing inflammation along this gut-brain connection.
As for probiotics, fermented foods such as sauerkraut, kimchi, kombucha, kefir, and yogurt are naturally rich sources of live and active cultures (as well as digestive enzymes, which may be equally important for normal digestion). “Humans have eaten lots of different kinds of fermented foods throughout our history, for many thousands of years,” says Dr. Rawls. “That’s where the original idea for probiotic supplements came from.”
Antibiotic-associated diarrhea (AAD) may be prevented by coadministration of probiotics, as suggested by several randomized controlled trials (RCTs). Several comprehensive meta-analyses, recently published, all show that probiotics significantly decreased incidence of AAD (RR 0.39–0.43) [McFarland, 2006; Szajewska and Mrukowicz, 2005; Cremonini et al. 2002; D’Souza et al. 2002]. The effects were similar across all categories and formulations of probiotics and treatment durations. The most commonly used probiotics were S. boulardii, LABs, and several combinations of LABs, given in doses from 107 to 1011, for durations of 5–49 days, generally paralleling the duration of antibiotic therapy. One of the meta-analyses found that S. boulardii, L. rhamnosus, and multiple mixtures of two different probiotics were the most protective against AAD [McFarland, 2006]. Other specific preparations have been studied to a lesser extent and that may be why their efficacy has been found to be less significant. One randomized, double-blind, placebo-controlled trial in individuals over the age of 50 using combination L. casei, L. bulgaricus, and S. thermophilus twice daily during a course of antibiotics and for 1 week after the completion of antibiotic therapy showed reduction in the incidence of AAD [Hickson et al. 2007].
“There can always be differences between the species, things we don’t anticipate, which is why it’s really important we investigate thoroughly with human trials,” says Jennifer L. Pluznick, Ph.D., assistant professor of physiology at the Johns Hopkins University School of Medicine. For example, gut bacteria may bring blood pressure down in one scenario but affect metabolism and immune responses in unexpected ways. “I’m hoping that in the next couple of years, we’ll start seeing how these all these factors and findings apply to humans,” Pluznick says.
It’s not just about vanity! Your skin is your largest organ, and it protects your body from countless external threats. But, what many people don’t realize is that your skin is an important reflection of your internal health. Skin problems can result from nutritional and hormonal imbalances, as well as immune system disruptions, all issues that begin in the gut.

We also found strains linked to five other health benefits like weight loss and lowering cholesterol. We feature options for those cases below, but they aren’t top picks because those use cases aren’t as heavily researched as immune health or IBS relief. Still, chances are any probiotic supplement is going to make some improvement to your digestive health, so don’t be afraid to experiment.


If you want more specific instructions, when you fill your plate with food, imagine that it's divided into quarters. Fill one-quarter of your plate with protein and healthy, omega-3-rich fats (like wild-caught fatty fish, grass-fed meats, humanely raised and antibiotic-free chicken, and avocado), and fill the other three-quarters with raw, baked, or steamed greens and veggies. This simple rule will ensure that you get the right balance of proteins, fats, and carbs without the stress of having to weigh your food or count calories. Now you can simply enjoy the act of eating.
"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 U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.

Additionally, it's a good idea to take note of the number of colony-forming units (CFUs) that are in the supplement you're considering, Angelone says. CFU count tells you the number of viable, active bacteria present in a tablet, she explains, and one billion (yes, seriously) is a typical dose. However, if you're struggling with a specific health condition, you may need more than that, Warren says. Your doctor can help you decide whether that's the case and may be able to steer you toward a good supplement to get you started. Here are a few to consider if you decide that probiotics are right for you.
Unless you know that your body is lacking in a particular type of probiotic, you should just look for broad-spectrum probiotics that contain a mix of different strains of bacteria, Warren says: "We have billions of bacteria in our gut, so by taking a supplement with a range of different strains, you will ensure you are not overdoing or missing one type." Keatley also stresses the importance of finding a supplement with a diversity of bacteria strains to keep overgrowth of any one strain in check. "Providing too much of an advantage to one strain of probiotic may push out another strain we didn't know was important until it's too late," she points out.
“Bifidobacterium is a type of probiotic well known for its antibacterial abilities and vaginal health help,” says Kristin Gustashaw, MS, RDN, an advanced clinical dietitian at Rush University Medical Center in Chicago. “Like Lactobacillus, it helps boost your immune system. It also improves the absorption of iron, calcium, magnesium, and zinc. Align is a good supplement that contains Bifidobacterium.” As an added bonus, it may even enhance your mood; Bifidobacterium makes the list of the best supplements for depression.
Because of the way bacteria spread from the rectum to the vagina and urinary tract in women, probiotics have been a proposed remedy for urinary tract infection (UTI) in women. A 2012 review confirmed that probiotics seem to be effective in preventing recurrent UTIs, but more research is required before a determination can be made. The healthy strains of bacteria that help achieve this are also somewhat less common, which means proper treatment could be logistically complicated.
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.
According to the World Health Organization/Food and Agriculture Organization, probiotics are live micro-organisms that, when administered in adequate amounts, confer a health benefit. Probiotics are typically considered the “good” bacteria that supplement your body’s natural gut flora, or microbiome. Commonly found in some yogurts and kombuchas, Probiotics® by Tropicana can now be found in the mainstream juice aisle for the very first time.

They then tested different doses of the 10-bacterial probiotic blend in mice, as well as in a slurry of human feces meant to mimic the environment of a human digestive system. The scientists found that even single doses maintained the healthy microbial balance and increased SCFA production in both the mice and the feces medium, the researchers reported.
This is one of the newer areas of probiotic research. Described as the “gut-brain axis,” researchers believe that the communication between the gut and the brain affects not just physical but also mental health and behavior. For example, a recent study found that probiotics can reduce anxiety, relieve stress and improve mental outlook. Another study found that the probiotics L. helveticus and Bifidobacterium longum reduced depression, anger, hostility and self-blame and improved problem-solving ability. Another study showed a difference in brain activity between women consuming yogurt and those consuming a placebo. More research needs to be done to confirm the effect of probiotics on mental and emotional health.
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
Probiotics have been shown to help reduce duration of pediatric acute diarrhea, decrease symptoms associated with taking antibiotics, manage symptoms of irritable bowel syndrome, reduce crying time in infants with colic and reduce relapses of ulcerative colitis. Certain probiotics may also inhibit the growth of Helicobacter pylori, bacteria that colonize the stomach and can cause ulcers and stomach cancer.
Yogurt: It can contain Streptococcus thermophilus, Lactobacillus bulgaricus, L. acidophilus, and Bifidobacterium bifidum. Research has shown links with yogurt to have positive effects on the gut microbiota and is associated with a reduced risk for gastrointestinal disease and improvement of lactose intolerance (especially among children), type 2 diabetes, cardiovascular disease, allergies and respiratory diseases, as well as improved dental and bone health.
Prebiotics are non-digestible food components that promote the growth of healthful bacteria in your gut. In essence, they are "good" bacteria promoters. In addition to improving digestive health, prebiotics can also enhance calcium absorption. Prebiotics are components of nondigestible fibers and are found in many plant foods. Rich sources of prebiotics include garlic, onion, leeks, asparagus, dandelion greens, and sunchokes. Prebiotics and probiotics work synergistically to optimize gut health. Hench, meals or products that combine these together have a symbiotic effect.
Probiotic supplements come in tablet, powder, capsule, and liquid forms. They do not provide the nutritional boost that probiotic foods do, but they are another option to promote a healthy mix of gut bacteria. Different probiotics may be recommended to different individuals. Ask your doctor if probiotic supplements are recommended for you. Some people who have immune system disorders or weak immune systems should be cautious about taking probiotic supplements. Follow your healthcare provider's advice.
Step No. 1 is consume more sour foods — it’s the top way probiotics benefits can be accessed. Embrace what I call “the power of sour” with sour foods like apple cider vinegar and fermented vegetables. They contain some probiotics, but also they contain certain types of acids like gluconic acid and acetic acid, healthy acids that support the function of probiotics (even functioning like prebiotics in some cases).
Ulcerative colitis (UC). Several trials have been published examining probiotics in the induction and remission of UC, however, only few of these are RCTs. Most are with different probiotic formulations and overall have been performed in a relatively small number of patients (Table 3). For induction of remission, the first and largest controlled trial to date published by Remnacken showed no additional efficacy of E. coli Nissle 1917 than steroids, mesalazine, and antibiotics [Rembacken et al. 1999]. Three additional trials, all small in number of patients and of short duration of therapy and with variable standard of care, showed improvement in various measures of disease activity and even cytokine profiles [Furrie et al. 2005; Kato et al. 2004; Tursi et al. 2004]. Mallon and colleagues performed a Cochrane database systematic review, but no formal meta-analysis was possible due to differences in probiotics, outcomes and methodology, and concluded that probiotics when combined with other therapies did not improve remission rates [Mallon et al. 2007]. However, this analysis showed a reduction in disease activity in mild to moderately severe UC. A second systematic review published recently also suggested a similar efficacy profile between probiotics and anti-inflammatory agents [Zigra et al. 2007]. With regard to maintenance of UC remission, probiotics have been tested in a larger number of patients (Table 3). One trial by Kruis and colleagues tested E. coli Nissle 1917 and found no difference in relapse rates in patients on a probiotic versus mesalamine [Kruis et al. 2004]. A trial by Zocco and colleagues also found no difference in relapse rates at 6 or 12 months when comparing Lactobacillus GG with mesalamine with a combination of the two [Zocco et al. 2006]. Those patients who took the probiotic did appear to have a longer time to relapse. All of these studies support the idea that probiotics may be as effective as mesalamine in maintaining remission in the short-term trials.
"Want to feel happier, get off SSRIs? You have to mind your gut," I told Dawn before explaining the often-overlooked gut-brain connection. It isn’t just depression that gut health affects but headaches, migraines, allergies, autoimmunity, weight gain, acne, skin rashes, yeast infections, hormonal imbalances, fatigue, immune challenges, and even the way you sense pain can be linked to your gut health. So as a medical doctor who specializes in gut health, when I say things start in your gut—I really mean it!
Probiotics are clearly incredibly supportive, but they can't do their work alone. To make sure that you're getting the most out of your microbes, it's important that you give them the support they need to work. You've got lots of options for supporting your gut health, from dietary changes to probiotic supplementation, but make sure you're at least covering the following bases.
The National Institute of Health (NIH) is sponsoring the Human Microbiome Project (HMP), which is developing research resources to enable the study of the microbial communities that live in and on our bodies and the roles they play in human health and disease. The NIH has funded many more medical studies using HMP data and techniques, including the role of the gut microbiome in Crohn's disease, ulcerative colitis, and esophageal cancer; skin microbiome in psoriasis, atopic dermatitis, and immunodeficiency; urogenital microbiome in reproductive and sexual history and circumcision; and a number of childhood disorders, including pediatric abdominal pain, intestinal inflammation, and necrotizing enterocolitis, a severe condition in premature infants in which the intestine tissue dies due to lack of oxygen.

Most of the prebiotics identified are oligosaccharides. They are resistant to the human digestive enzymes that work on all other carbohydrates. This means that they pass through the upper GI system without being digested. They then get fermented in the lower colon and produce short-chain fatty acids that will then nourish the beneficial microbiota that live there. Oligosaccharides can be synthesized or obtained from natural sources. These sources include asparagus, artichoke, bamboo shoots, banana, barley, chicory, leeks, garlic, honey, lentils, milk, mustards, onion, rye, soybean, sugar beet, sugarcane juice, tomato, wheat, and yacón. The health benefits from these oligosaccharides is a topic of ongoing research.

The gut microflora of every individual consists of various microorganisms (bacteria, yeast and fungi) that live in the intestinal tract. When the intestinal microflora is out of balance, that imbalance may affect overall health. This balance can be disturbed during times of stress, with age, in menopause, when taking medications, with an unbalanced diet, and in the event of acute or chronic intestinal disease.1,2,3

Hi Joan, it’s possible, but not ideal because most pill form probiotic supplements are designed to be protected from stomach acid until the capsule reaches the intestines. It’s impossible to say how many probiotic microorganisms would survive by taking them this way, but certainly less than if you swallow the pills. I would recommend trying a probiotic gummy product or some other probiotic that comes in something other than pill form rather than opening up the capsules.
Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
As for probiotics, fermented foods such as sauerkraut, kimchi, kombucha, kefir, and yogurt are naturally rich sources of live and active cultures (as well as digestive enzymes, which may be equally important for normal digestion). “Humans have eaten lots of different kinds of fermented foods throughout our history, for many thousands of years,” says Dr. Rawls. “That’s where the original idea for probiotic supplements came from.”

Probiotics have received renewed attention in the 21st century from product manufacturers, research studies, and consumers. The history of probiotics can be traced to the first use of cheese and fermented products, that were well known to the Greeks and Romans who recommended their consumption.[52] The fermentation of dairy foods represents one of the oldest techniques for food preservation.[53]
Fecal microbiota transplants (FMT), or "poop transplants," can treat a type of gut disorder with an infusion of diverse bacteria from a healthy digestive system, distilled from a donor's poop. This helps to correct imbalances of microbial diversity when the gut microbiome is dominated by the bacteria Clostridium difficile (C. diff), which can lead to serious gut disorders. 
This is also known as S. boulardii and is the only yeast probiotic. Some studies have shown that it is effective in preventing and treating diarrhea associated with the use of antibiotics and traveler's diarrhea. It has also been reported to prevent the reoccurrence of C. difficile, to treat acne, and to reduce side effects of treatment for H. pylori.

Premature babies are at risk for this serious disease. Tissue in the intestines starts to die. The intestines get inflamed and a hole can form. Recent studies show that using Lactobacillus rhamnosus GG with the supplement bovine lactoferrin can help keep it under control. Bifidobacterium infantis combined with Lactobacillus acidophilus may also help stave off this problem in sick newborns.
While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.
Because chronic inflammation is at the root of many diseases and health conditions, the fact that probiotics exert this effect in the gut, where 80 percent of the immune system lies, is crucial. The immune-boosting benefits of probiotics seem to be particularly helpful for the quality of life of seniors. Currently, research is underway to test whether probiotics can “reduce inflammation and improve gut immune health in HIV-positive individuals” who haven’t yet undergone treatment.
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