A STUDY BY Reviews.com
You’re not living alone in your body.
In the humble human gut, there are hundreds of trillions of bacterial occupants, and they’re not just living there — they’re working for you.
In addition to their more infamous duties of keeping the GI trains running on time, that gut flora makes up 70–80 percent of the human immune system and plays a central role in regulating inflammation in the body. The best probiotic supplement has bacteria strains proven to be clinically effective and contain no junk ingredients. Even better, they’re guaranteed to have viable doses; after all, we want those guys alive, not dead.
A small but growing body of research on our gut tenants suggests that hacking your microbiome can not only improve the digestive process but also contribute to a laundry list of ancillary health benefits. We’re talking weight loss, lower cholesterol, decreased anxiety, improved immune function, fewer seasonal allergy symptoms, and relief from a host of gastrointestinal malities, from irritable bowel syndrome to travelers diarrhea. We’re in! But we’re also skeptical.
How we found the Best Probiotic Supplement
We started our search with the most popular products from major online retailers like Amazon, Drugstore.com, and GNC, and a handful of health food stores and local organic co-ops. We also included product recommendations from nutrition specialists, bloggers, and third-party lab tests. That initial list had 277 top-rated probiotic supplements.
Cut out 1 strain varieties.
From there, we cut any probiotic supplement that only contained one strain of bacteria. Though it may seem like a targeted assault would be the way to go, research suggests that probiotics actually work better as a team than on their own. Even pairs can be more effective than individuals, as is the case with Lactobacillus Acidophilus and Bifidobacterium Bifidum BB-12. When combined, this duo-force has been shown to have a positive effect against an extremely nasty and antibiotic-resistant GI infection.
Selecting a multi-strain probiotic is also consistent with the theory that if you cram your gut with enough good bacteria, it will outcompete any bad bacteria for the same space and resources — in the same way introducing a predator into an environment can help manage another species. The more diversified that good bacteria is, the harder it is for the baddies to gain a foothold.
We looked for guaranteed viability — that is, bacteria that will still be alive when we swallow it. Bacteria die out over time. Some supplements list the potency when it was manufactured (before it rode in a truck, sat on the shelf at the grocery store, or hung out in the kitchen cupboard for a few months). There may 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.
Better probiotic manufacturers will list their potency (in Colony Forming Units, or CFUs) at the time of expiration, ensuring that you get the dosage that you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times best-sellers Brain Maker and Grain Brain puts it this way:
“Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf-life.”
We cut any junk ingredients.
We ditched artificial sweeteners Sucralose and Splenda, as well as the sugar alcohol Xylitol. There’s nothing beneficial about them and they might even be harmful. There’s also no room for titanium dioxide — a whitening agent — in our probiotics. Who cares about the color of the pills or powder? This isn’t a beauty contest.
We cut probiotics that contained a prebiotic.
Lots of probiotics tout these prebiotics as a symbiotic partner to probiotics (some even call them “synbiotics”). Prebiotics are carbohydrates or sugars that the normal human gut flora has a hard time breaking down — but that probiotics go crazy for. The cluster of simple sugars found in legumes (oligosaccharides) is a good example. Probiotics don’t just love these carbs; they need them to grow their colonies.
So why did we nix them? You need at least five grams of them to make an impact — way more than the one-quarter gram that fits in a probiotic capsule. At these levels, it’s just marketing hype. And if you have a decent diet, you’re probably already eating enough of them anyway. “The reality is that probiotics thrive on the natural sugars and fiber present in plant-based foods like fruits, vegetables, legumes, and grains,” said board-certified Doctor of Natural Medicine Michelle Schoffro Cook.
“Eating real food and taking probiotic supplements is a far better way to go than worrying about getting enough prebiotics too.”
To make matters worse, prebiotics can also aggravate certain conditions like Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD), and Small Intestine Bacterial Overgrowth (SIBO), for which you might be taking probiotics to treat in the first place.
Our Picks for the Best Probiotic Supplement
Maybe you don’t have a specific pathology or health goal in mind, but you do want to get more probiotics in your diet to bolster the amount of good bacteria floating around your system. Dr. Perlmutter recommends starting at a minimum of eight to 10 different bacterial species, including the core five.
The core 5 bacteria species
- L. Plantarum
- L. Acidophilus
- L. Brevis
- B. Lactis
- B. Longum
Here are the brands we recommend:
- Best for General Health: Garden of Life RAW Probiotics Colon Care
- Best for General Health (Runner Up): MegaFlora Probiotics
- Best for Antibiotic Recovery: Custom Probiotics 11 Strain Probiotic Powder
- Best Immune Booster / Best for Anxiety and Seasonal Allergies: Renew Life Ultimate Flora Extra Care 30 Billion
- Best for IBS, IBD, and Acute Infectious Diarrhea: VSL#3
- Best for Lowering Cholesterol: Innovix Labs Multi-Strain Probiotic
- Best for Weight Loss: MegaFlora Probiotics
- Best for Lactose Intolerance: Bio-Kult Advanced Probiotic Multi-Strain Capsules
- Best for Women’s Health: Garden of Life RAW Probiotics Ultimate Care
Did You Know?
- There is still a surprisingly small amount of research on probiotics.
- Although the idea of beneficial bacteria has been around since the late 1800s, and probiotic supplements have been around since the 1930s, there haven’t been many human clinical trials.
- We do know that probiotics produce enzymes that help break down chemicals that the normal human gut has a hard time with, such as the oligosaccharides in legumes. That digestive assistance results in less gastrointestinal distress and better absorption of nutrients.
- Probiotics also elicit an immune response in the intestines that can help your body deal with certain harmful pathogens and other GI problems. There is actually a mechanism we learned about called cross-talk where, through chemical signals, the bacteria communicate with your body and your body communicates back.
- What you read on the probiotics label is part truth, part hype, and part marketing.
- As internationally recognized probiotic microbiologist Dr. Mary Ellen Sanders told us, “There’s often a gap between the hype and the science; the hypothesis versus what’s been demonstrated. People like to tell stories: My probiotic will survive stomach acid and others won’t. Instead look at the clinical benefit.”
- Unlike the clinical studies, the bottles don’t have to tell the whole truth. “Dietary supplements are marketed for the general population. They are not marketed for at-risk or patient populations, and companies are not obligated to establish safety for these populations,” Dr. Sanders said.
- This is because probiotics are classified as Dietary Supplements by the FDA, meaning that manufacturers “are not required by FDA to undergo rigorous premarketing evaluations for efficacy or safety.” In fact, every bottle of probiotics on the market invariably has this fun little disclaimer printed on it:
- These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
- This is caveat emptor (“let the buyer beware”) times a thousand. The burden is entirely on you to take the label’s claims that it’ll “balance your gut bacteria” or “boost your immunity” with a grain of salt, and to talk with your doctor before you start popping capsules.
Generally, it’s best to start out with a lower CFU count and ramp up as needed. Starting out with the high-proof stuff can cause unpleasant physical side effects, like cramps and bloating, as well as monetary ones — higher potency supplements are almost universally more expensive. Of course, follow your doctor’s guidance. The verdict on ideal colony count is still out .
Take your probiotic with a meal
This raises the pH in your stomach, which means more bacteria will make it through to your gut, including the few non-acid-resistant strains like S. Thermophilus. And take them with plenty of water; that will further dilute the acidity of gastric juices.
Get your prebiotics in
There are tons of the simple carbs probiotics love in whole fruits and vegetables, including onions, garlic, bananas, asparagus, unpasteurized apple cider vinegar, and artichokes. If you’re worried you might not be getting between five to 20 grams per day, consider taking a prebiotic supplement, usually a powder or drink mix. (Dr. Perlmutter recommends acacia gum.)
Keep up your probiotic routine
Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits.
This is an edited version of the original article posted on reviews.com