There’s been a wealth of data in the last decade about the role the microbiome plays in warding off sickness, losing weight and maintaining good mental health.
Since you’re here, my guess is that you too have hopped on board with the acceptance that adding to the trillions of bacteria in our gut might actual help, not hurt us in the long-run.
Of course, as one area of health enters the zeitgeist, so too must capitalism rise up to meet it!
In the last several years, the probiotic supplements market has sky-rocketed into a 30-billion-dollar global industry. These probiotic pills promise to deliver billions of organisms to the bed of your gut garden, along with any number of health benefits from weight loss to reduced risk of heart disease.
But the question among skeptics remains: do they actually work?
The answer comes down to what probiotic brands you’re buying, how you’re using specific strains to treat various deficiencies or improve a medical woe, and what else you’re doing with your diet to support these changes.
I’ll get to all those prongs in a minute.
But first, in an effort to clear up some probiotic myths, let’s first chat about what probiotics actually do.
WHAT ARE PROBIOTIC BENEFITS VS. PREBIOTIC BENEFITS?
One of the general misconceptions about probiotics is that these bottled bugs join your existing bacteria and take permanent residence in the gut.
Rather, probiotic bacteria are transient visitors. They serve as dummies that allow the immune system to fine-tune its response to more dangerous microbes.
Each of us has a different microbiota—more unique in its complexity than a fingerprint—so there’s no such thing as a one-size-fits-all solution. One combination could work in one individual, but not another. Some probiotic pills are best for women, others for men. Which is one reason why the science is still far behind the anecdotal evidence that certain probiotics work–it’s a hard thing to study.
Many companies now sell probiotics with the built-in bonus of “prebiotics” that claim to increase the effectiveness of the bacteria once it reaches your gut. In reality, prebiotics can be found in most vegetables. They are a type of undigestable plant fiber that serves to feed the existing population of bacteria. (As you probably know if you have SIBO, these carbs are your bacteria’s favorite food!)
For this reason, many gut scientists argue that the best way to get more good bacteria into your gut is by eating lacto-fermented foods—like, yogurt, kefir, sauerkraut, kimchi, and kombucha—as they contain the most bacterial diversity and give you a double whammy on the prebiotic / probiotic front.
To review: probiotics fine tune your immune system, which improves the overall population of beneficial bacteria by making your body better at warding off the bad guys. Prebiotics nourish and nurture your existing good bacteria. (While sugar and processed foods aid the species you don’t want).
Still, there are times when you may need the extra help or require a solution to a specific problem, and that’s where bottled bugs come in.
WHEN SHOULD I USE A PROBIOTIC?
Most of the gut scientists that I interviewed for The Wellness Project said the best way to improve your microbiome overtime is through diet. That’s not to knock taking a daily probiotic to keep moving things in the right direction. But if you’re subsisting only on burgers and fries, even the best probiotic pills at a dollar a pop might be a waste of money. What’s the point of dousing your garden with expensive fertilizer if no one is going to water the plants?
I prefer to think of my probiotic supplements as one of many in my arsenal when times are particularly tough. Here are some examples of scenarios when they can be the most beneficial:
1. While taking antibiotics. Taking a broad-spectrum antibiotic wipes out 1/3 of your gut bactera—good and bad guys alike. That’s a huge number and very difficult to recover from. But your best chance is to replenish what you’ve lost as you go. Throughout your course, take your probiotic as far away from the antibiotic as possible (e.g. mid-afternoon if you’re taking pills in the morning and at night).
2. When traveling to foreign countries. If you’re prone to food poisoning or already have troubled gut health, taking precautions in countries that might cause you the most problems (Mexico, India, etc.) is a wise move. As mentioned above, probiotics keep your immune system on its toes and will make you better equipped at fighting pathogens that can disrupt your inner ecosystem. (We talk about this a lot in this episode of the podcast).
3. To treat SIBO or other gut imbalance / dysbiosis. Dr. Jason Hawrelak has done a lot of research on which probiotic strains can help improve motility and encourage bacteria in the small intestine to move to the large intestine. We will cover this on a future episode of the SIBO Made Simple podcast! Make sure to subscribe.
4. When you feel yourself coming down with an illness. No offense to vitamin C, oregano oil, and other essentials in the anti-cold arsenal, but probiotics have a definite place there too.
5. During times of stress. Piggybacking on the last point, probiotics can also be preventative. Even if you’re not feeling a pain in your throat just yet, when you know you’re more rundown than usual or have a lot on your plate, they can be a good tactic to fortify your immune system before it breaks down.
6. When you have a yeast infection. Yeast infections often occur when there’s not enough of the lactic acid producing lactobacilli strains in the vaginal tract. Lots of things can reduce the number of these good girl strains; antibiotics, birth control, poor diet can all contribute to yeast overgrowth. If this is something you suffer from look for a high quality probiotic designed specifically for women with strains of lactobacilli (or choose the one I recommend below!).
7. During pregnancy. One of the most important times in life to take a probiotic is during pregnancy. When a baby is born through the birth canal, it is inoculated with mom’s bacteria, which becomes the basis of baby’s microbiome and immune system. You’re not just giving your baby your DNA, you’re giving it millions of bacteria that have their own DNA. This will have a huge impact on your child for the rest of their life, and it’s also one reason why children born via C-section have such a higher rate of autoimmune diseases. See below for the best probiotics for women.
WHAT SHOULD I LOOK WHEN BUYING A PROBIOTIC?
When I first did research on probiotic pills for my book, I turned to my friend Ashley Harris, the founder of Lovebug Probiotics. Ashley has an incredible story (you can read it here), is incredibly passionate and knowledgeable, and truly started her company for the right reasons—to help people like herself with chronic illness, and provide the best probiotics for women and families.
(This post isn’t sponsored, I just believe in her product and what she’s doing, which is why you’ll find I recommend so many of her probiotics below.)
Much like the vitamin industry as a whole, over-the-counter probiotics lack oversight and accountability with the FDA. Per Ashley’s advice, and some other research, here are the top things to keep in mind when buying a probiotic:
1. Look for a multi-strain formula. Products that list the specific strain usually have more data to support their claims, says Ashley. For example, lactobacillus (genus) rhamnosus (species) GG (strain) was isolated and patented in the 1980s and is the most clinically studied strain in the world. Look for 4-10 strains of lactobacilli and bifidobacterium to help replenish that diversity in your gut. If you go below 4, you’re not getting much diversity, and above 10 you’re getting such a small percentage of each strain that you won’t get the full benefit of what each can do.
2. Make sure it has a high CFU count. The number of colony-forming units will indicate how potent a pill is. Though it sounds like a crazy high number, you want to look for at least 10 billion CFU count.
3. Ensure survivability. Since your stomach acid is designed to kill incoming bugs, one of the issues with probiotics on the market is not whether they contain the CFU count they claim, but if it will even make it to the part of your gut where it will be useful. Most probiotic brands who use acid resistant delivery technology to ensure these critters make it to your intestines will talk about survivability on their packaging. Ashley advises if choosing a probiotic in capsule form, go for a really high CFU count to ensure that a percentage of that number make it to the intestines where they’re needed. Or look for a product with delivery technology that helps probiotics get through your stomach acid unharmed: pearl encapsulation, enteric coating, or a host of new technologies hitting the market as the demand for probiotics increases.
4. Make sure it’s sugar-free, gluten-free lactose free. If it isn’t clear that these certifications are from a third party independent lab, feel free to email the company and ask them. If a product is made in the USA or somewhere the company is proud of they will say it right there on the packaging. Sugar is especially important, as that feeds unwanted bacteria. These days a trend is to add sugar alcohols like xylitol, which are technically not metabolized like fructose, but can be very irritating to your intestines and hard to absorb. Especially if you are dealing with SIBO, this is a big no no. Be especially careful with probiotics that don’t come in pill form, like powders that are meant to dissolve under your tong.
5. Understand storage information and expiration. A lot of probiotics today are shelf stable, but it’s always best to keep probiotics in the refrigerator as that will maximize their potency. All probiotics lose their potency over time, so look for a probiotic that has an expiration date and a guarantee of potency at time of expiration.
THE BEST PROBIOTIC PILLS AND WHAT TO USE THEM FOR
Since I wrote The Wellness Project, more research has been done on specific probiotic strains, what their functions are in the microbiome, and what benefits they can give you. If you suffer from bloating after meals or struggle with constipation, there’s now a probiotic for that. Here are some of the best probiotics I turn to in my medicine cabinet/fridge and what I use them for. I’d love to know your favorites in the comments!
Colds Suck by Lovebug Probiotics – General Immunity – If you get sick often, there are strains that have been found specifically to boost your immune system, which is especially important this time of year. I notice a distinct difference with my digestion and energy levels when I’ve taken this probiotic.
MegaSpore by Microbiome Labs – Preventing Traveler’s Diarrhea – This probiotic was recommended by several MD’s I interviewed for the SIBO Made Simple podcast (Dr. Will Cole in episode 2 and Dr. Jolene Brighten in episode 3). They recommended it for both ongoing repair and specifically for when traveling to ward off pathogens. It’s made from spores, so another benefit for travel is that it can be kept unrefrigerated.
VSL #3 – Rebuilding a Highly Damaged Gut or During Antibiotic Use. This medical grade probiotic may require a doctor’s prescription, but it’s what I’ve always been given during intense periods of healing because of its insanely high CFU count. It comes in powder sachets that don’t taste the best, and aren’t the most convenient to travel with since they need to be refrigerated. But the stuff works.
Yeast is a Beast by Lovebug Probiotics – General Women’s Health and Yeast Infections – Lactobacillus (genus) reuteri (species) RC-14 (strain) is a patented strain that has been closely studied for its effect on vaginal health. Lactobacilli create lactic acid which lowers the pH level in the vaginal tract and makes the environment less hospitable to pathogens like yeast overgrowth. This probiotic also has some other great additions like cranberry extract and d-mannose.
Silver Fern Ultimate Probiotic – Travel and General Maintenance – I haven’t personally tried Silver Fern, but I’ve heard great things about their probiotics and they check all the boxes I outlined above: third party tested for survivability, shelf-stable, which makes them perfect for travel, and certified gluten-free.
Saccharomyces Boulardii by Biotics – Traveler’s Tummy and Biofilm Disruption – This is a specific strain of non-pathogenic yeast that has been shown in multiple clinical trials to reduce the need for antibiotics associated with traveler’s diarrhea. I take it while traveling, and I’ve also used it during my H.Pylori treatment as a biofilm disrupter, meaning it breaks the mucus barrier of pathogenic bacteria and makes it easier to kill through herbal antimicrobials. More on this here.
Labor of Love by LoveBug Probiotics – Prenatal – If you’re a pregnant woman or soon to be pregnant woman, it’s worth thinking about incorporating a probiotic into your daily routine. This is Lovebug’s latest that specifically addresses this need and supports digestive health for new moms growing babies.
In need of a digestive reset or a dietary detox in the name of your microbiome?
My month-long meal plan and lifestyle strategies might be the perfect way to snap your gut back into gear (no pills required). In the 4 Weeks to Wellness program, you’ll now receive a 20 recipe cookbook, shopping lists, elimination diet guidance and reintroduction worksheets, group coaching calls with me, DIY intestinal massage videos, in addition to the many other resources.