Probiotics play a central role in the digestive process. They complement the work of digestive enzymes while nourishing the immune system, regulating hormone production, and much more.
Most everyone enjoys a healthy gut microbiota when they are young. But over time age, illness, injury, a poor diet, and more can disrupt the integrity of the digestive tract. That’s where probiotic supplements come in.
Probiotic supplements are a simple, convenient way to restore order to your digestive system and, in the process, give your overall health a significant boost. The following are the best probiotics of 2020.
Rankings
1. 1MD Complete Probiotics
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A common problem with probiotic supplements is that they are often consumed by stomach acid before they have a chance to reach the intestines where they do the bulk of their work. 1MD puts an end to that with their coated vegan capsules.
What we like: 1MD Complete Probiotics contain 11 probiotic strains representing all the most important species. In total, there’s an astonishing 51 billion CFUs. 1MD is also free of gluten, soy, and GMOs and certified vegan and vegetarian.
Flaws: Make sure you store them in the fridge.
2. Nature’s Way Fortify Women’s Probiotic
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Nature’s Way Fortify Women’s Probiotic targets the cause of UTIs and yeast infections with its powerful combination of 9 lactobacillus strains and two bifidobacteria strains. If you suffer recurring UTIs, this should be on your shopping list.
What we like: With 11 strains and 50 billion CFUs in total, Nature’s Way is not pulling any punches in their effort to restore order. As an added plus, these probiotic capsules are guaranteed to retain their potency even if you forget to refrigerate them.
Flaws: Sorry guys. This one is for the ladies.
3. Garden of Life RAW Probiotics for Women
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Garden of Life markets their Raw Probiotics for Women as being, well, for women. But it will actually pay plenty of dividends for men as well. That’s because, in addition to a dozen strains of lactobacillus, GoL adds a half dozen other species as well.
What we like: Despite its emphasis on lactobacillus, this is a well-rounded probiotic supplement. In all, there are 85 billion CFUs and a total of 32 strains involved. All of the bacteria included here is gleaned from natural sources as well.
Flaws: 85 billion CFUs might be too much of a good thing for some.
4. BioSchwartz Advanced Strength Probiotic
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The scientists at BioSchwartz are well aware that stomach acid is the enemy of probiotics. As such, they have devised a patented method of protecting their capsules so that they pass through the stomach largely intact.
What we like: Each serving contains 40 billion CFUs of the most important probiotic species, along with prebiotics to make sure they have something to eat. BioSchwartz supplements are gluten and dairy-free and contain no artificial ingredients.
Flaws: They say no refrigeration required. But because they’re not freeze-dried, you would be wise to keep them in the fridge.
5. Nature’s Bounty Ultra Probiotic 10
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Nature’s Bounty Ultra Probiotic includes 10 probiotic strains designed to balance the microbiota in the gut and enhance immune system health. The capsules are vegetarian safe, easy to swallow, and free of genetically modified organisms.
What we like: All the probiotic strains employed here have been exhaustively studied and proven their value. The folks at Nature’s Bounty also include 200 mg of the prebiotic inulin to ensure the probiotics are well-nourished and able to perform.
Flaws: The variety of strains is not as extensive as some others.
6. NOW Probiotic 10
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NOW Probiotic 10 contains 10 different strains of the most potent probiotics. The formulation here is focused on restoring the balance of good and bad bacteria in the digestive tract rather than addressing any particular acute condition such as diarrhea or UTIs.
What we like: This is a solid all-around probiotic supplement that will serve men and women equally well. It’s specifically formulated to restore intestinal balance so that your digestive tract can perform its vital work more effectively and efficiently.
Flaws: They’re called shelf-stable, but you should refrigerate them anyway.
7. NewRhythm Probiotics 50 Billion CFU
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NewRhythm Probiotics provides a generous dose of 50 billion CFU in every serving. The 20 strains here represent six of the most important probiotic species and are specially coated to withstand the harsh stomach environment.
What we like: NewRhythm contains a good mix of some important strains and species. The dosage is impressive, and the fact that they’re likely to make it to the intestine more or less intact is also a big plus. No artificial anything.
Flaws: They have a unique smell some might find off-putting.
8. Align Probiotic
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Not everyone needs 50 billion CFUs of a dozen strains of probiotics. Some folks just need something to counteract occasional gas and bloating. That’s where Align Probiotic comes in. It provides a modest dose of bifidobacterium longum to settle unsettled stomachs.
What we like: If you experience upset stomachs more than most, or are beset by gas Align Probiotics should be able to help. It’s a thoughtfully formulated supplement that doesn’t set out to change your life, just smooth out some rough edges.
Flaws: One of the more expensive probiotics on our list.
9. Healthy Origins Probiotic
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Healthy Origins Probiotic is another well-rounded supplement that will provide multiple short and long-term benefits to both men and women. With 30 billion CFUs spread out over a half dozen strains, it touches most of the important digestive bases.
What we like: Healthy Origins Probiotic will restore efficient digestive system function, help you fend off chronic health problems, and enable you to eat less while enjoying greater nutrition. Not much more you can ask of a supplement than that.
Flaws: The capsules are pretty large.
10. Udo’s Choice Super Bifido Plus
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Udo’s Choice may not be a household name in the supplement space, but their Super Bifido Plus makes a strong argument that they should be. SBP provides an incredible 102 billion CFUs of probiotic power spread across eight potent probiotic strains.
What we like: Super Bifido Plus uses lab-tested probiotic strains that restore the gut microbiota and bolster the immune system. Super Bifido Plus capsules are free of food allergens, certified vegetarian, and devoid of GMOs and artificial ingredients.
Flaws: Not the cheapest probiotic out there.
Who Needs Probiotics?
Probiotics are like vitamins. They’re too small to see with the naked eye, and yet they impact virtually every aspect of our physiology. They help with the processing and distribution of nutrients, they prop up the immune system, they influence mood, regulate blood sugar, regulate hormone production, and much more. Without them our bodies would break down quickly and completely.
So, in a very real way, everyone needs probiotics. But that does not mean everyone needs probiotic supplements. People in their 20s who have enjoyed a lifetime of proper nutrition, never experienced a serious illness, taken antibiotics, or gone on a fad diet probably don’t need to take probiotics. Just about everyone else, however, will likely glean either a direct or indirect benefit from taking probiotic supplements on a regular basis.
How We Ranked
There are almost as many probiotic supplements available today as there are multivitamins. So trying to determine which ones are worth the money and which are not isn’t always easy. The fact that some probiotics are regulated by the FDA could have thrown an additional wrench into the evaluation process. So to keep things simple, we stuck with unregulated dietary supplements for the purposes of this list.
The first thing we looked at was the species and strain of a given probiotic supplement. We want more from probiotic supplements than we get from something like yogurt, which typically includes only a single strain or a single species (lactobacillus acidophilus). A high-quality probiotic supplement should include all or most of the important probiotic species. That means lactobacillus, bifidobacterium, enterococcus, bacillus, saccharomyces, escherichia coli, pediococcus, leuconostoc, and streptococcus. If a given supplement included multiple strains of these important species, then even better.
Next, we looked at the number of Colony Forming Units, or CFUs. There is open disagreement about what constitutes a practical ceiling regarding the number of CFUs. Some scientists argue anything more than 20 billion just creates probiotic-rich pee. (They also worry that too many probiotics can actually aggravate digestive problems. Although there is little evidence to support that notion.)
Others take the view that more CFUs are always better and openly advocate for 50 billion or more. Still others agree that more is better, but for a different reason. Since probiotics tend to die off if not stored correctly, more CFUs increase the odds that at least some will survive, even if you store them improperly. Because some people have a pressing need for probiotics, and others take them just as a precaution, we included supplements with a wide range of CFUs.
Finally, we weighed storage considerations. Most probiotics need to be refrigerated or they will die off pretty quickly (as much as 10% or more per month). That is not the case with probiotics that have been freeze-dried. You can store them however you want, and they will last for years as long as you keep them away from moisture. Thing is, freeze-drying costs money and increases the price of the supplement. So not many companies produce freeze-dried probiotics.
Benefits
Probiotics promote a healthy gut microbiota. The digestive tract is cobbled together from more than a half dozen parts. None of those parts would be worth much, though, if it weren’t for the bacteria that inhabit them (1). Those bacteria extract the nutrients from the food you eat and make them available to your cells. They exist in the trillions, and together they make up the gut microbiota. Probiotics bolster the health of the microbiota, with the result being you get more from the food you eat.
Probiotics restore gut flora after antibiotic use. Antibiotics have saved millions of lives since they first became available to the public in the 1940s. But, like everything else, antibiotics have their downside. In this case, we’re talking about the fact that they tend to kill off that beneficial bacteria that makes up the gut microbiota (2). Fortunately, taking probiotics after you finish a course of antibiotics can go a long way toward restoring a healthy gut.
Probiotics can reduce incidents of acid reflux. Anyone afflicted with acid reflux, or GERD, (3) will attest to its unpleasant nature. Reflux occurs when acid leaks out of the stomach into the lower portion of the esophagus. Typically, it produces heartburn. But when it occurs during sleep, it can produce a feeling that you are suffocating. While probiotics alone will not ‘cure’ acid reflux disease, they can, for some people, reduce its frequency and severity.
Probiotics may help reduce blood pressure. The CDC estimates that high blood pressure contributes to nearly 500,000 deaths per year in the US. If you have high blood pressure, bringing it under control is of paramount importance. Recent studies indicate that over the course of a couple of months, probiotics are able to effectively lower blood pressure in most people (4). The results, while promising, are considered preliminary, though. Meaning larger studies are needed before definitive conclusions can be drawn.
Probiotics strengthen your immune system. Without a functioning immune system, most people would not last a week. Most of us enjoy robust immunity in young adulthood. But over time, the immune system begins to lose its effectiveness. Science has established that the gut microbiota has a complex symbiotic relationship with the immune system (5). One that can only be enhanced by taking probiotics on a regular basis.
Probiotics can help lower cholesterol levels. Elevated cholesterol levels are a major contributing factor in heart disease (6). That’s the bad news. The good news is that studies have shown probiotics can reduce total serum cholesterol by a significant degree (7). That equates to better blood flow, less strain on the heart muscle, and a reduced chance of having a stroke.
Probiotics have the ability to regulate hormones. The relationship between the gut and hormone production has been established for some time (8). A healthy microbiome helps reduce inflammation. That, in turn, helps promote hormonal balance. Hormonal balance, in turn, can help stabilize blood glucose levels. This is true for both men and women, young and old.
Probiotics can help restore normal sexual function. As we just saw, the gut microbiota plays a key role in hormone production. That has many health implications for both women and men. In men, a healthy gut microbiome is essential if they are to produce the amount of testosterone necessary to support sexual function (9). Probiotic supplements can help ensure testosterone levels are where they should be.
Probiotics may help with migraines. The notion that the gut microbiome may have a role to play in brain function has gained a lot of scientific traction in recent years. Because of this, some have wondered aloud whether there might be a connection between gut health and migraines. And whether probiotics may be a useful migraine treatment. A couple of small studies have been conducted, and one of them strongly suggested probiotics can, in fact, reduce both the number and severity of migraines (10).
Probiotics restore proper pH balance in the gut. pH balance plays an important role in overall gut health. An out of whack pH balance can lead to all kinds of digestive problems and contribute to yeast infections and urinary tract infections. One of the unheralded benefits of probiotics is their ability to restore proper pH levels to the gut. This is one reason why probiotics are often suggested for women with chronic yeast infections and for people who suffer from acid reflux.
Probiotics are good for your bones. Bones need adequate infusions of calcium, vitamin D, magnesium, phosphorus, potassium, and more if they are to maintain their strength and flexibility (11). An unhealthy gut microbiota will not process nutrients as effectively. Over time the effect will be small, brittle bones, osteoporosis, and devastating fractures late in life. Taking probiotics now can prevent those things from happening.
Probiotics can improve urinary tract health. Urinary tract infections are far more common in women than men. But both sexes are susceptible. UTIs have many potential causes, including an imbalance in the pH balance of the gut caused by an inefficient gut microbiome. Probiotic supplements can restore gut health and, in the process, short circuit at least one cause of troublesome urinary tract infections.
Probiotics can alleviate symptoms of chronic skin conditions. Most chronic skin conditions such as eczema and psoriasis have their roots in either inflammation or immune system dysfunction or both. An unhealthy gut microbiome is known to contribute to inflammation (12) and negatively impact the immune system. Probiotic supplements can restore a healthy gut microbiome and, in the process, alleviate some of the worst symptoms of chronic skin conditions (13).
Probiotics are good for your eyes. Most people don’t think much about how their diet affects their eyes. But the eyes are like every other part of your body. They rely on proper nutrition to work effectively and to hold up over the long haul. Probiotics that enhance the gut microbiome ensure that more nutrients – including the all-important beta carotene (14), which the body converts into vitamin A – get to your eyes.
Probiotics can alleviate diarrhea and constipation. One of the most common reasons people suffer from chronic diarrhea or constipation is an unhealthy gut environment. When probiotic levels are off in the digestive tract, food is not processed effectively and the entire process of absorption and waste expulsion is thrown into chaos. Probiotics can help alleviate both acute and chronic diarrhea in people of all ages (15).
Probiotics are good for your mind. The gut plays a major role in hormone production, as we mentioned earlier. That includes the hormones melatonin, cortisol, and serotonin, which are used by the brain to regulate mood, sleep, and more (16)(17). By taking probiotic supplements, you ensure a healthy gut microbiome, which, in turn, helps ensure proper amounts of these important hormones get to your brain.
Probiotics can help you lose weight. People who drastically reduce the amount of food they eat in an effort to lose weight often flirt with malnutrition. This is especially true if their digestive tract is not in good working order with plenty of probiotics on hand. You can correct the problem and ensure more efficient absorption of nutrients by taking a probiotic supplement. This will enable you to obtain higher levels of nutrition without having to eat more food.
Probiotics can help stabilize blood glucose levels. This is maybe one of the most surprising benefits of probiotic consumption. But it’s more than just a marketing claim. Numerous scientific studies have confirmed that probiotic supplements can regulate, that is, stabilize, blood glucose levels (18). This is an important finding for diabetics and the millions considered to be in a pre-diabetic (19) state.
Probiotics may play a role in preventing cancer. This is another finding that is likely to surprise many people. But it makes sense when you consider the big picture. Probiotics, as we have seen, can reduce chronic inflammation (20). Chronic inflammation is believed to increase the risk of cancer (21). Therefore, anything that helps to reduce chronic inflammation will likely also reduce the risk of developing cancer.
Probiotics may help you breathe easier. Speaking of inflammation, asthma, pneumonia, bronchitis, and other lung ailments are typified by inflammation of the airways. Corticosteroids have long been the go-to treatment for these types of conditions. However, probiotics, with their anti-inflammatory capabilities, are forcing a reassessment. Indeed, studies strongly suggest that they can be put to use treating chronic lung ailments (22).
FAQs
Q: What are probiotics?
A: Probiotics are ‘good’ bacteria that live in the digestive tract. Over millions of years, they have evolved to play a central role in digestion by extracting nutrients and making those nutrients available to cells for absorption. Without probiotics, we would starve to death in short order. Sometimes the balance between beneficial bacteria and harmful bacteria in the gut can be thrown out of balance by a poor diet, illness, antibiotic use, age, and other causes. When this happens, nutrition suffers, and a person becomes susceptible to health problems.
Q: If I take prebiotics do I still need probiotics?
A: Prebiotics (23) are not the same as probiotics. Prebiotics themselves do not play a role in nutrient absorption. Instead, they are food for probiotics. They help ensure the probiotics in your gut have plenty to eat so that they can fulfill their role in the digestive process. If a person only takes prebiotics they may seem some small benefit. But it is more helpful to take pre and probiotics at the same time.
Q: Aren’t probiotics a women’s supplement?
A: Probiotics are necessary for the human digestive system to function properly. That means men and women, children and adults, regardless of size, race or any other considerations. You will often hear probiotics mentioned in relation to women for the simple reason that women are more susceptible to UTIs than men, and probiotics can help them fend off such infections. But men need probiotics too. Without them, illness and starvation await.
Q: What are CFU’s?
A: CFU is short for ‘colony forming units’. Because it is impossible to get an accurate count of microorganisms, CFU is the only reliable method for making a halfway guess about how many probiotics are present. When it comes to CFUs, the general rule is that more is better, up to a point. Most scientists believe that once you get above 20 billion CFUs, the law of diminishing returns sets in (24).
Q: If you eat yogurt do you still need probiotics?
A: It’s a common misconception that if you eat yogurt you don’t need to take probiotics. To a certain extent, it’s understandable why people would think so. After all, yogurt is typically rich in the probiotic L acidophilus. But there are many types of probiotics (25) with L acidophilus being only one. Most probiotic supplements will include at least a half dozen of the most common types. Some will include 11 or 12 or more. The bottom line is that yogurt can be helpful, but by itself, it is not enough.
Q: Which probiotic strain is most effective?
A: That depends on which benefit you are hoping to obtain. Bifidobacterium, for example, is important for preventing irregular bowel movements and for promoting better overall digestion. Lactobacillus, on the other hand, plays a crucial role in bolstering the immune system. Saccharomyces boulardii promotes liver health and also promotes stable blood glucose levels. Other probiotic strains produce different benefits. The best approach is to take a probiotic supplement that covers as many bases as possible.
Q: How long before I see results from taking probiotics?
A: Again, it depends upon what type of result you are looking for. Probiotics don’t waste any time getting to work. So, if you are hoping to alleviate chronic constipation, chances are you will see results in a few days. If, on the other hand, you are using probiotics in an effort to stabilize your blood glucose levels, that benefit might take several weeks to manifest. And if your aim is to strengthen your bones, you will need to take the long view.
Q: Can pregnant women take probiotics?
A: There does not seem to be any evidence that taking probiotics during pregnancy will in any way endanger the health of the mother or the baby (26). At the same time, there is no evidence that probiotics increase the chances the baby will be any healthier than it would if the mother did not take probiotics. Still, before taking any type of dietary supplement, pregnant women should discuss the matter with their doctor.
Q: Are digestive enzymes and probiotics the same thing?
A: Probiotics and digestive enzymes (27) work together to break down food into its essential parts so that nutrients can be absorbed into the bloodstream. Probiotics, however, have other duties besides just helping to extract nutrients. They also bolster the immune system, destroy disease carrying cells, force harmful bacteria out of your digestive tract and play a role in the production of vitamins. So while digestive enzymes and probiotics share some responsibilities, their roles also diverge in some important ways.
Q: Can I use probiotics after the expiration date?
A: Probiotics are living organisms. As such, they have a finite lifespan (28). Probiotics die when stored at room temperature, which is one reason some manufacturers put so many CFUs into their product (to ensure that at least some will live until you are ready to take them). If you want your probiotics to stay viable you must refrigerate them. The only exception is if your probiotics have been freeze-dried.
Q: What are the signs that I should take probiotics?
A: When a person has an acute need of probiotic supplements, their body will send them some pretty clear signals. Those signals typically include a loss of energy or stamina, chronic constipation or diarrhea, acid reflux, and frequent upset stomachs. But there is no reason things should ever get to that point. If you begin taking probiotics when you feel well, you have a greater chance of continuing to enjoy good health than if you don’t take them.
Q: Do probiotics need to be refrigerated?
A: We touched on this above but it bears repeating. Probiotics are living things. Living things that do not like to be stored at room temperature. Unless you have freeze-dried probiotics, storing probiotic supplements at room temperature for months at a time will result in many of them dying off and the supplement losing its effectiveness. So, yes. Keep all standard probiotics in the refrigerator.
Q: Is it dangerous to take probiotics?
A: There is no evidence that introducing probiotics to your system is a dangerous thing to do. Your body needs probiotics like it needs water, air, and food. The only potential issue worth mentioning is that if you take too much you might experience bloating (29). That’s about it. Keep in mind that if probiotics represented a clear and present danger to people’s health, the FDA would pull them from shelves faster than you could say “Colony forming units”.
Q: What are the side effects of taking probiotics?
A: One of the many great things about probiotic supplements is that they produce few, if any, side effects. Of course, there are exceptions to every rule, and probiotics are no different. For instance, people with sensitive stomachs may experience gas or stomach aches. But even if that should happen, switching to a different type of probiotic will usually solve the problem. That said, if you do experience side effects, you should stop using them and consult your doctor.
Q: Will I need to take probiotics for the rest of my life?
A: It’s probably a good idea, but at the end of the day it’s entirely up to you. The argument for long term probiotic use centers around the fact that probiotics are largely preventive in nature. That is, taking them long term will help prevent health problems like diabetes, IBS, GERD, high blood pressure, and more. Taking them for just a couple of weeks or months and then stopping is not likely to produce any significant long-term benefit.
Q: Should children take probiotics?
A: Because a child’s microbiome is still taking shape during childhood they are susceptible to numerous health conditions such as colic, constipation, IBS, and acid reflux. Now whether or not a parent should give their child probiotics to try and prevent such conditions is a topic that is still open for debate. Some researchers say ‘absolutely yes’ while others urge caution and suggest more study is needed (30).
Related Articles
Prebiotics
Probiotics for women
Probiotics for men
Recap
Probiotics are an indispensable component of the digestive system. Unfortunately, the amount and balance of probiotics in the gut can change over time due to age, illness, injury, surgery, or other reasons.
Probiotic supplements can re-establish a healthy gut microbiota and, in the process, restore regularity, alleviate acid reflux, stabilize blood glucose levels, improve mood, and much more.
The probiotics on our list satisfy all our selection criteria and are produced by trusted manufacturers in FDA-regulated facilities in the US.
For cpoe.org’s #1 recommended probiotics, click here.