Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

What Are Probiotics?

 

Am Fam Physician. 2017 Aug 1;96(3):online.

  See related article on probiotics for gastrointestinal complications.

What are probiotics?

Probiotics are organisms (bacteria and yeasts) that are taken to improve health.

Why should I use them?

Our bodies are home to trillions of organisms. The right variety of these organisms can keep us healthy. Different types of organisms have different jobs. Some keep us healthy by fighting other disease-causing organisms. Others interact with immune cells to reduce inflammation or prevent allergic reactions.

Good, health-protecting organisms are fed by certain foods. When we eat, organisms in our gastrointestinal (GI) tract eat too. Sometimes, the numbers of good organisms can get low (for example, if you have diarrhea or if you take antibiotics). When this happens, taking probiotics may help increase the number of good organisms in your GI tract.

Which GI conditions can be improved with probiotics?

Probiotics can help if you have diarrhea after using antibiotics, Clostridium difficile–associated diarrhea, ulcerative colitis, or irritable bowel syndrome (IBS). They can also help with colic in infants. See the table for a list of products to use for specific GI conditions.

Which GI conditions are not improved with probiotics?

Probiotics are probably not helpful if you have pancreatitis or Crohn disease.

Which species of probiotics are helpful?

Some of the probiotic species that have shown benefit include Bifidobacterium, Lactobacillus, Leuconostoc, Saccharomyces boulardii, and Streptococcus.

What are the risks of taking probiotics?

Probiotics are considered safe for most people (infants, children, adults, and older persons). However, they may cause problems in people with cancer or people who do not have a normal immune system. Rarely, probiotics have caused a serious blood infection in people with cancer.

What should I know when buying probiotics?

It is important to read the label. Think of three “Ds”: diversity, dose, and delivery.

  • Diversity means that there are a lot of different species included, not just one.

  • Dose is measured in colony-forming units (CFUs). You should aim for at least 10 billion CFUs per species.

  • Delivery is the way that you take the probiotic. Enteric-coated capsules make it more likely that more probiotic cells will reach your intestine. Probiotics can also be taken as powders, gel caps, gummies, liquids, and foods such as yogurt. Delivery affects the dose that makes it to your intestine. Choose a delivery method that is easy and comfortable so you will be more likely to take probiotics regularly.

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Table

Gastrointestinal Conditions and Recommended Probiotics

GI conditionStudied productsThird-party tested productsComments

Colic

Jarrow Formulas Baby's Jarro-Dophilus plus FOS Nature's Way Primadophilus Reuteri


Diarrhea after taking antibiotics

Align

Garden of Life Raw Probiotics Ultimate Care

Broad-spectrum (containing many different kinds) combination products likely to have the most benefit

Bio-K+

Now Foods Probiotic-10

Culturelle

Renew Life Ultimate Flora

DanActive

Sedona Labs iFlora Multi-Probiotics

Florastor

Consider a minimum of 10 billion colony-forming units per day of each organism

HOWARU Restore

MIYAIRI 588

VSL#3


Diarrhea from Clostridium difficile

Align

Garden of Life Raw Probiotics Ultimate Care

Culturelle

Now Foods Probiotic-10

DanActive

Renew Life Ultimate Flora

Florastor

Sedona Labs iFlora Multi-Probiotics

MIYAIRI 588

VSL#3


Helicobacter pylori infection

Bacid

Garden of Life Raw Probiotics Ultimate Care

Used with antibiotics

Culturelle

Now Foods Probiotic-10

Lactinex

Renew Life Ultimate Flora

Sedona Labs iFlora Multi-Probiotics


Hepatic encephalopathy

Align

Garden of Life Raw Probiotics Ultimate Care

Mutaflor

Now Foods Probiotic-10

VSL#3

Renew Life Ultimate Flora

Sedona Labs iFlora Multi-Probiotics


Irritable bowel syndrome

Activia

Garden of Life Raw Probiotics Ultimate Care

Align

Now Foods Probiotic-10

Bacid

Renew Life Ultimate Flora

Culturelle

Sedona Labs iFlora Multi-Probiotics

USANA

VSL#3

YoPlus


Necrotizing enterocolitis

Bacid

Florastor Kids

Products containing a variety of bifidobacteria species are most beneficial

Culturelle

Nature's Answer Probiotics for Kids

Florajen

Florastor


Ulcerative colitis

Activia

Garden of Life Raw Probiotics Ultimate Care

VSL#3 and similar high-dose multispecies products with several bifidobacteria species are preferred

Align

Now Foods Probiotic-10

Bacid

Renew Life Ultimate Flora

Culturelle

Sedona Labs iFlora Multi-Probiotics

Mutaflor

VSL#3

Table

Gastrointestinal Conditions and Recommended Probiotics

GI conditionStudied productsThird-party tested productsComments

Colic

Jarrow Formulas Baby's Jarro-Dophilus plus FOS Nature's Way Primadophilus Reuteri


Diarrhea after taking antibiotics

Align

Garden of Life Raw Probiotics Ultimate Care

Broad-spectrum (containing many different kinds) combination products likely to have the most benefit

Bio-K+

Now Foods Probiotic-10

Culturelle

Renew Life Ultimate Flora

DanActive

Sedona Labs iFlora Multi-Probiotics

Florastor

Consider a minimum of 10 billion colony-forming units per day of each organism

HOWARU Restore

MIYAIRI 588

VSL#3


Diarrhea from Clostridium difficile

Align

Garden of Life Raw Probiotics Ultimate Care

Culturelle

Now Foods Probiotic-10

DanActive

Renew Life Ultimate Flora

Florastor

Sedona Labs iFlora Multi-Probiotics

MIYAIRI 588

VSL#3


Helicobacter pylori infection

Bacid

Garden of Life Raw Probiotics Ultimate Care

Used with antibiotics

Culturelle

Now Foods Probiotic-10

Lactinex

Renew Life Ultimate Flora

Sedona Labs iFlora Multi-Probiotics


Hepatic encephalopathy

Align

Garden of Life Raw Probiotics Ultimate Care

Mutaflor

Now Foods Probiotic-10

VSL#3

Renew Life Ultimate Flora

Sedona Labs iFlora Multi-Probiotics


Irritable bowel syndrome

Activia

Garden of Life Raw Probiotics Ultimate Care

Align

Now Foods Probiotic-10

Bacid

Renew Life Ultimate Flora

Culturelle

Sedona Labs iFlora Multi-Probiotics

USANA

VSL#3

YoPlus


Necrotizing enterocolitis

Bacid

Florastor Kids

Products containing a variety of bifidobacteria species are most beneficial

Culturelle

Nature's Answer Probiotics for Kids

Florajen

Florastor


Ulcerative colitis

Activia

Garden of Life Raw Probiotics Ultimate Care

VSL#3 and similar high-dose multispecies products with several bifidobacteria species are preferred

Align

Now Foods Probiotic-10

Bacid

Renew Life Ultimate Flora

Culturelle

Sedona Labs iFlora Multi-Probiotics

Mutaflor

VSL#3

Where can I get more information?

Your doctor

AAFP's Patient Information Resource

https://familydoctor.org/probiotics/

Labdoor (probiotic product rankings)

https://labdoor.com/rankings/probiotics

National Institutes of Health: Dietary Supplement Label Database

https://dsld.nlm.nih.gov/dsld/index.jsp

National Institutes of Health: National Center for Complementary and Integrative Health

https://nccih.nih.gov/health/probiotics

August 2017


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

 

Copyright © 2017 by the American Academy of Family Physicians.
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