Probiotics are live microorganisms that, when taken in adequate amounts, can benefit your gut health, immune system, and more [1]. So it’s no wonder that probiotics have become a popular buzzword in the health and wellness world.
But with so many probiotic brands available, how do you know which one to choose?
Don’t just grab any bottle off the shelf—the truth is, not all probiotics are created equal. In this article, we’ll explore how to choose the best probiotic supplement to support your gut health and more.
Why take probiotics?
It's important to note that not everyone needs to take a probiotic. Following a healthy and varied diet (or just breastmilk for babies that haven’t started solids) could be enough to keep your gut in optimal conditions. But in certain situations, probiotics can be an effective means of supporting gut health.
These tiny microorganisms may support your gut by:
- Producing lactic acid and other molecules that hamper the growth of unfriendly bacteria
- Protecting and restoring the gut barrier, which in turn reduces symptoms of “leaky gut”
- Boosting host immune response and host defense to fight unfriendly bacteria
- Producing some essential vitamins
- Helping to digest food [2], [3]
When to take probiotics
We often hear the questions “should I take probiotics? and for how long?” The answer varies from person to person as it depends on your gut microbiome composition, symptoms, and specific conditions.
At Tiny health, we believe that probiotics aren’t always necessary. If you do need one, the duration of usage depends on various factors such as your goal—be it to alleviate symptoms, address a specific condition, or boost the levels of key missing microbes. So again, the answer varies from person to person.
For babies and toddlers, different situations such as cesarean birth, antibiotics, and the lack of key microbes such as Bifidobacterium are some of the things for which we may recommend supplementing with probiotics. You can read more about it in this blog post about probiotics for babies.
For adults and children, we recommend you consider taking probiotics for the following conditions:
1. When you’re prescribed antibiotics
Antibiotics kill not only the unfriendly bacteria, but can also kill beneficial gut bacteria, which may lead to gut dysbiosis.
These changes in your microbiome can last for months and even years [4], [5].
It’s highly recommended to take probiotics the first day you start on antibiotics and continue during the entire period of treatment [6]–[8]. We also recommend that you continue taking probiotics for at least one to two more weeks after you stop the antibiotics.
Because antibiotics can also kill the probiotic bacteria, make sure to separate antibiotic and probiotic treatment by as much time as possible given your prescribed antibiotic regimen.
2. When you have digestive symptoms and complaints
If you have certain gastrointestinal complaints, you can use probiotics along with specific dietary interventions to address symptoms. Probiotics may help with common gastrointestinal conditions or disorders such as diarrhea, constipation, irritable bowel syndrome, and inflammatory bowel disease.
3. When you have bacterial vaginosis
If you have bacterial vaginosis (BV), a condition that commonly pops up during pregnancy, you can consider taking probiotics. When it comes to BV, there’s evidence backing the use of Lactobacillus to restore the vaginal microbiome and prevent recurrence [9]–[14]. Studies support the use of Lactobacillus in the form of oral probiotics or vaginal suppositories.
4. When you or your child have low levels of essential bacteria for gut health, like Bifidobacterium
Along with dietary interventions, you can consider taking probiotics to increase low levels of beneficial gut bacteria, such as Bifidobacterium. A gut microbiome test can tell you whether these bacteria are in or out of the appropriate range. Having a healthy amount of Bifidobacterium is especially important for future moms, as these are key bacteria that are passed from mom to baby during birth or breastfeeding.
Many probiotic supplements contain well studied and clinically tested Bifidobacterium species. Taking a product like this may help to increase the levels of beneficial bacteria in your gut. Keep in mind that probiotic bacteria don’t need to colonize your gut in order to have a beneficial effect. Most of the time they are transient passengers that contribute to the gut environment, but do not remain for a long period of time.
5. If I have more than one condition, do I need to take two different probiotics? And if so, how should I take them?
Yes, you can take two probiotics for two different conditions. For example one for BV and one for digestive complaints.
It’s important to know that different products are designed to help with different types of conditions.
Consider starting with only one probiotic for a few days to assess your gut’s response. Then you can introduce a second one. You may also want to consider starting with a lower dose to give your gut time to adjust.
Although there is no evidence to suggest that taking two different probiotics together affects their effectiveness, it may be beneficial to separate their intake by a couple of hours or more.
How to select the best probiotic supplement
Ask the following questions when selecting a probiotic supplement [15], [16]:
Is it specific enough for the benefits you are looking for?
Depending on your needs, you may want to choose a Bifidobacterium, Lactobacillus, or Bacillus probiotic.
When we talk about specificity, we mean choosing probiotics that have been clinically demonstrated to have benefits for a specific condition. Some strains may be beneficial for infant gut function, some for adult symptoms, and others may help fight vaginal infections.
Select a product that has evidence for the symptom or condition you are looking for. See if the manufacturer website mentions any clinical study backing up the effectiveness of a probiotic for a specific condition.
Is it backed by research?
Look for a product that has been tested and shown to be effective in human randomized controlled trials. Manufacturers typically list clinical studies in their product web page if there are any, or they mention the main findings in these studies. Evidence in non-human studies is not as strong, because findings in mice may not translate to humans.
Is it an effective dose?
Probiotic concentration is typically measured as colony forming units (CFU), which indicate the number of viable bacteria present in a serving. The best probiotic dosage is one that has been tested in randomized clinical trials and proven effective. Most probiotic products have been tested at a concentration between 1-10 billion CFU/day.
Keep in mind that more is not always better. Many products are offered as superior only because they contain higher CFU, but this doesn’t always mean that the product is stronger or more effective than products with lower CFU. It’s also important to note that probiotics for babies often contain less CFU than those for children or adults.
What does the label say?
Look for a label that contains the complete names of the probiotic microorganisms since no two species are the same [17]. Quality products always include the genus, the species, and the strain name. For example, Lactobacillus rhamnosus GG: Lactobacillus is the genus name, rhamnosus is the species name, and GG is the strain name. Make sure that the product you buy mentions all of them.
If you’ve taken a Tiny Health test, you’ll notice that our top recommended probiotics almost always contain strain details. In some cases, we may recommend products without this information if other options aren’t available. Sometimes we also have our own internal data to back up a product’s effectiveness.
In addition to the names of the probiotics in the product, look for a label that also:
- Clearly states the exact CFU per dose till the expiration date
- Describes the recommended use and for which indication you can expect to see a beneficial effect
- Points towards the recommended dose
- Describes the storage conditions
- Has company contact information where you can get more information about the product
Here is an example of a label that includes most of this information:
And here is an example of a label that doesn’t include strain information:
Do I need to buy products with more than one strain? Are they more effective?
Not necessarily. Just like with probiotic concentration, more is not always better.
Many studies have shown the health benefits of both single-strain and multispecies probiotic formulations. The key factor is whether or not the product has been clinically studied and has been shown to have health benefits. Always remember that different strains can have different impacts, so look for products that contain the appropriate strain when possible.
Why should you look for probiotics with clinical results on the entire formulation?
Probiotics often contain a mixture of different strains. But for scientists it’s easier to study individual strains to determine their properties and benefits. Because of this, strains that were discovered a long time ago tend to have more research and clinical data supporting their effectiveness than newer strains or combinations of strains.
Today, consumer companies buy strains from probiotic providers and mix them together to create probiotic products. Ideally, these should be clinically tested as a whole to ensure their efficacy, but many products only contain well-studied strains without clinical data supporting the final product. It’s important to note that combining different strains can affect their impact, as some strains may prevent others from growing or having their intended effect.
If possible, select products with demonstrated efficacy of the entire formulation to ensure maximum health benefits.
My probiotic doesn’t seem to be working, what can I do?
Regardless of the origin of the probiotic strain, the number and combination of strains contained in a product, or the amount consumed, some individuals will respond to probiotic treatment, while others will not. This is similar to how many conventional medications work, where some individuals may experience benefits and others may not.
If the probiotic you're taking isn't yielding the desired results, we recommend trying an alternative brand or strain that has been shown to be effective for your specific condition or symptom. How much time to wait before switching depends on your goal. We suggest waiting for a minimum of a couple of weeks to assess the impact, but certain probiotics may require a longer duration to produce visible changes. Sometimes manufacturers provide a recommended time frame. It’s possible that you don’t notice any immediate changes in symptoms but the probiotic may still be having a positive impact on your gut microbiome.
For more information about probiotics, how to use them, and what to look for when buying a product, you can refer to the International Scientific Association for Probiotics and Prebiotics.
Probiotics and Tiny Health
Do you want to know exactly which probiotic would be the best pick to support your gut or vaginal microbiome? With your Tiny Health test report you get:
- Personalized probiotic recommendations based on your microbiome results.
- Additional probiotic recommendations based on symptoms or issues you’ve told us about.
- When possible, a list of recommended products with strains that are research-backed and meet our selection criteria.
