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How to Choose the Best Probiotic Supplement

Probiotics have received a lot of attention recently.

These living organisms have been credited with providing all
kinds of health benefits related to gut function and beyond
(1).

If you’re looking to use them to boost your own health, it’s
important to make sure you take the right probiotic supplements
to get the results you’re after.

This article takes a detailed look at the effects of probiotics
and provides recommendations for supplements that address
specific health issues.

Three Types of Supplements

What Are Probiotics?

Your gut contains bacteria acquired at birth and onward in a
process called colonization.

Many of these bacteria are considered beneficial or “friendly.”
Their functions include converting fiber into short-chain fatty
acids, synthesizing certain vitamins and supporting your immune
system (2).

Taking probiotics
may help boost the numbers of these healthy bacteria.

The formal definition of probiotics is, “live microorganisms
which when administered in adequate amounts confer a health
benefit on the host” (1).

Basically, probiotics are microorganisms that
provide beneficial effects
when you consume them in the
right amounts.

Probiotics can be consumed in supplement form or in
fermented foods
like sauerkraut, kefir and yogurt.

They should not be confused with prebiotics,
which are types of fiber that serve as a food source for the
bacteria living in your colon (3).

Summary: Probiotics are health-promoting
bacteria found in supplement form and some foods. Taking
probiotics can help increase the number of beneficial
bacteria that reside in your gut.

Certain Probiotics May Have Specific Benefits

Brown Pills in a Brown Bottle

Your gut microbiome, or gut flora, consists of a wide variety
of bacteria.

Its exact composition is unique to you.

Your colon contains billions of bacteria with types from over
500 different species (4).

Probiotics that have been found to provide health benefits
include various strains of Bifidobacterium,
Lactobacillus and Saccharomyces. Many
probiotic supplements contain a combination of different
strains in the same supplement.

Research has shown that some strains seem to be more effective
than others for treating certain conditions.

Therefore, you’re more likely to get good results by taking
probiotics that have been shown to achieve specific effects,
such as controlling diarrhea.

In addition, it’s important to consume probiotics in sufficient
amounts.

Probiotics are typically measured in colony-forming units
(CFU). Generally, higher doses have been found to produce the
best results in most studies (5).

However, some probiotics may be effective at dosages of 1–2
billion CFU per day, while others may require at least 20
billion CFU to achieve the desired effects.

Taking extremely high doses hasn’t been found to cause harm.
One study gave participants up to 1.8 trillion CFU per day.
However, it’s expensive and doesn’t appear to provide any
additional benefits (5).

Importantly, scientists still don’t know everything about
probiotics. Although research has rapidly expanded within the
past several years, there is much left to explore.

Summary: Different types of probiotic
bacteria may provide health benefits. Taking a sufficient
amount of the right probiotic is important for achieving the
desired effects.

Probiotics That May Help Relieve Constipation


Constipation
is characterized by bowel movements that are
hard, difficult to pass and infrequent. Everyone experiences
constipation once in a while, but in some people it becomes a
chronic problem.

Chronic constipation is most common among the elderly and
adults who are bedridden, although it can also occur in
children.

In addition, some people with irritable bowel syndrome (IBS)
experience persistent constipation as their main symptom. This
is known as constipation-predominant IBS.

Conventional treatments include laxatives and stool softeners.
However, in recent years, dietary changes and probiotic
supplements have become increasingly popular alternative
approaches (6).

A number of studies have shown that supplementing with certain
probiotic strains can reduce constipation in both adults and
children (7, 8, 9, 10, 11, 12).

In a study comparing probiotics and prebiotics in children with
IBS, B. lactis was shown to provide significant
constipation relief.

The probiotics group also experienced less belching, abdominal
fullness and
bloating
after meals than the prebiotics group (8).

Other probiotics that may improve constipation include B.
longum
, S. cerevisiae and a combination of L.
acidophilus
, L. reuteri, L. plantarum,
L. rhamnosus and B. animalis (10, 11, 12).

Recommended Probiotics for Constipation

Summary: Several probiotic strains have been
shown to provide relief from constipation in children and
adults when taken alone or together.

Probiotics That Are Effective Against Diarrhea

Herbal Capsules

Diarrhea is defined as loose-to-liquid bowel movements that
occur more frequently than normal.

It is typically short-lived, but can become chronic in some
people.

Probiotics have been found to reduce stool frequency in the
infection-related diarrhea that occurs with food poisoning and
gastroenteritis, commonly known as “stomach flu” (13).

A large review of 34 studies found that probiotics reduced the
risk of diarrhea from various causes by 34%.

Effective strains included Lactobacillus rhamnosus GG,
Lactobacillus acidophilus and Lactobacillus
bulgaricus
(14).

Antibiotic use is another common cause of diarrhea. When
antibiotic therapy kills harmful bacteria that cause infection,
beneficial bacteria are destroyed as well. The shift in
bacterial balance can lead to inflammation
and diarrhea.

Studies in children and adults have shown that taking
probiotics can help decrease the diarrhea that may happen as a
result of antibiotic therapy (15, 16).

A large review of 82 controlled studies found that taking
probiotic supplements reduced the risk of developing
antibiotic-associated diarrhea by 42%. However, the most
effective probiotic strains weren’t discussed (16).

Although some people with IBS struggle with constipation,
others experience frequent episodes of diarrhea, which is known
as diarrhea-predominant IBS.

Research suggests that certain probiotics seem to be especially
effective for diarrhea-predominant IBS, including B.
coagulans
, S. boulardii and a combination of
several Lactobacillus and Bifidobacterium
strains (17, 18, 19, 20).

However, one study did not find any significant improvement in
diarrhea among IBS patients who were treated with S.
boulardii
(21).

Recommended Probiotics for Diarrhea

Summary: Probiotic therapy has been shown
help reduce the severity and frequency of diarrhea related to
infection, antibiotic use and IBS, among other causes.

Probiotics That May Improve IBS Symptoms

Woman Holding Her Stomach

Sometimes the main symptoms of IBS aren’t related to stool
consistency or frequency. Instead, some people experience
bloating, gas, nausea and lower abdominal pain on a regular
basis.

A review of 19 studies found that while some people reported
improvement in IBS symptoms while taking probiotics, results
varied between individuals. Researchers couldn’t determine
which probiotics were most effective (22).

In addition, because the symptoms of IBS are so diverse,
sometimes one symptom improves while others do not.

For instance, one study of people with constipation-predominant
IBS found that although S. cerevisiae improved
constipation, it didn’t have much of an effect on abdominal
pain or discomfort (11).

In another study, participants with diarrhea-predominant IBS
were given a supplement known as VSL#3, which contains
Lactobacillus, Bifidobacterium and
Streptococcus strains.

Bowel movement frequency and consistency didn’t improve, but
bloating did (23).

Another study found significant reductions in pain and bloating
during treatment with VSL#3. Researchers believe the probiotics
led to an increase in melatonin, a hormone involved in
digestive function (24, 25).

Recommended Probiotics for IBS

Summary: Certain probiotics have been shown
to help relieve bloating, abdominal pain and other symptoms
of irritable bowel syndrome. However, taking probiotic
supplements may not improve all symptoms.

Probiotics That Might Help You Lose Weight

Orange and Yellow Capsules on Scales

There is growing evidence that the balance of bacteria in your
gut can profoundly
affect body weight
(26).

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Some studies suggest that taking probiotic supplements may be
helpful for achieving weight loss and a healthier body
composition.

Animal and human studies have found that certain bacterial
strains may decrease the amount of fat and calories your gut
absorbs, promote a healthy balance of gut bacteria and reduce
weight and belly fat (27, 28, 29, 30, 31, 32).

According to a 2014 analysis of several studies, probiotics
that seem to be effective for fat loss include
Lactobacillus gasseri, Lactobacillus
rhamnosus
and the combination of Lactobacillus
rhamnosus
and Bifidobacterium lactis (33).

In one study, obese men who took L. gasseri for 12
weeks experienced significant reductions in body weight and
body fat, including up to an 8.5% decrease in belly fat. By
contrast, the placebo group had very little change in body
weight or body fat (31).

In another study, obese women who took L. rhamnosus
for three weeks lost twice as much weight as those who received
a placebo.

What’s more, they continued losing weight during the
maintenance phase of the study, whereas the placebo group
gained weight (32).

Taking probiotic supplements may also help limit weight gain
during times of high calorie intake.

In a four-week study, lean young men ate 1,000 excess calories
per day. Those who took the probiotic formulation VSL#3 gained
less weight than the control group (34).

However, because results from some studies haven’t been
impressive, researchers feel there isn’t enough evidence at
this time to draw firm conclusions about the benefits of
probiotics for weight loss (35).

Recommended Probiotics for Weight Loss

Summary: Results from several studies
suggest that certain probiotics may promote fat loss in obese
subjects. However, further research is needed.

Probiotics to Support Brain Health

There is a strong connection between gut and brain health.

The bacteria in your colon digest and ferment fiber into
short-chain
fatty acids
that nourish the gut. Research has shown that
these compounds may also benefit
the brain
and nervous system (36).

A review of 38 studies on animals and humans found that various
probiotics helped improve symptoms of anxiety, depression,
autism, obsessive-compulsive disorder and poor memory (37).

The strains most commonly used in these studies were
Bifidobacterium longum, Bifidobacterium
breve
, Bifidobacterium infantis,
Lactobacillus helveticus and Lactobacillus
rhamnosus
.

Probiotics appear to be effective for both generalized anxiety
and anxiety related to specific causes (38, 39, 40).

One study found that when throat cancer patients took
probiotics for two weeks prior to surgery, they had lower
levels of stress hormones in their blood and their anxiety
decreased by 48% (40).

In other studies, probiotics have been shown to improve overall
mood and reduce sadness in healthy individuals and people with
chronic fatigue syndrome (41, 42, 43).

Taking probiotic supplements also appears to help people
struggling with depression, including those with major
depressive disorder (44, 45).

In an eight-week study of patients with major depression, those
who took L. acidophilus, L. casei and B.
bifidum
had a significant decrease in depression.

What’s more, they experienced reductions in insulin levels and
inflammatory markers (45).

Recommended Probiotics for Brain Health

Summary: Brain and gut health are strongly
connected. Taking certain probiotics may promote better
mental health by reducing anxiety, sadness, depression and
other symptoms.

Probiotics That May Improve Heart Health

Red Heart, Health Concept

Taking probiotics may help reduce the risk of heart disease.

Several studies have found that certain bacteria in yogurt or
probiotic supplements may lead to favorable changes in heart
health markers.

These include a decrease in “bad” LDL cholesterol and an
increase in “good”
HDL cholesterol
(46, 47, 48, 49, 50).

Specific bacterial strains that seem to be effective at
lowering cholesterol levels include Lactobacillus
acidophilus
, Bifidobacterium longum and
Lactobacillus reuteri.

An analysis of 14 studies found that probiotics led to an
average reduction in LDL cholesterol, a slight increase in HDL
and a decrease in triglycerides (50).

There are probably several processes responsible for these
effects on LDL cholesterol, including changes in fat metabolism
and decreased absorption of cholesterol in the gut (51).

Probiotics may also help lower blood pressure.

One review of nine controlled studies found a modest reduction
in blood pressure among those who took probiotics. However,
only treatment longer than eight weeks at doses higher than 10
billion CFU per day had significant effects (52).

Recommended Probiotics for Heart Health

Summary: Taking certain probiotic
supplements may help lower LDL cholesterol, raise HDL
cholesterol and decrease blood pressure.

Probiotics to Boost Immunity

Studies suggest that taking probiotic supplements may shift the
balance of gut bacteria in a way that increases your body’s
defenses against allergies, infections and cancer (53).

Of particular note are the strains Lactobacillus GG,
Lactobacillus crispatus, Lactobacillus
gasseri
, Bifidobacterium bifidum and
Bifidobacterium longum.

These types of bacteria appear to reduce the risk of
respiratory illness and eczema in children, as well as urinary
tract infections in adult women (54, 55, 56).

In addition, probiotics have been shown to reduce inflammation,
a known risk factor for many diseases.

In one study, older adults consumed a blend of
Lactobacillus gasseri, Bifidobacterium
bifidum
and Bifidobacterium longum or a placebo
for three weeks each.

After taking probiotic supplements, their inflammatory markers
decreased, anti-inflammatory markers increased and gut bacteria
balances became more like the type seen in young, healthy
people (57).

Certain probiotics may also help prevent gingivitis, or gum
infection.

A 14-day study looked at adults who refrained from brushing and
flossing while being treated with Lactobacillus brevis
or a placebo.

Gingivitis progressed more rapidly in the placebo group,
suggesting the probiotics helped protect against infection
(58).

Recommended Probiotics for Immune Health

Summary: Taking probiotics may help
strengthen your immune system and help reduce the risk of
infection and illness.

Probiotics for General Health

White Capsules in the Lid of a Pill Bottle

In addition to targeting specific diseases and conditions, you
can also take probiotics to promote overall health.

A recent study in healthy adults showed that taking
Bifidobacterium bifidum for four weeks helped boost
production of beneficial short-chain fatty acids (59).

There’s also some evidence suggesting that probiotics may
promote better aging by reducing inflammation that typically
occurs as you grow older (60, 61).

Of course, it’s important to make sure you’re consuming a
healthy diet and practicing other health-promoting behaviors as
well. Otherwise, you can’t expect probiotics to provide much
benefit.

In addition, although probiotics are safe for most people, they
may cause harm in people who are extremely ill or have
compromised immune systems, including those with HIV or AIDS
(62).

Recommended Probiotics for General Health

Summary: Probiotics may help support
wellness in healthy people. However, taking probiotic
supplements may be dangerous for people who are very ill or
have compromised immune systems.

The Bottom Line

Having a healthy gut microbiome is extremely important.

Although research is still emerging, probiotics appear to
provide beneficial effects for a number of different conditions
and may also support better general health.

Taking the right type of probiotics may help you target
specific health issues and improve your overall health and
quality of life.

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