Did you know that the gut microbiome contains more microorganisms than there are stars in the Milky Way? External factors such as stress, an unhealthy diet, and use of certain medications (such as antibiotics) can disturb this finely tuned microbial community. Additionally, individuals who are prone to intestinal infections, parasites, or who suffer from gut inflammation or immune-suppressed conditions tend to have the microbial imbalance known as dysbiosis. Probiotics play a key role in restoring microbial balance and maintaining a healthy bacterial population, but what are probiotics, exactly? In this guide, we'll explore everything you need to know.

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A body of clinical research has demonstrated that probiotic intake provides promise for easing symptoms in a number of different conditions. Scientists are also studying whether probiotics may play a further role in reducing disease risks in healthy individuals. While more research is needed to pinpoint which types and quantities of probiotics affect different populations, emerging work does suggest that probiotics can support intestinal health and overall well-being for many individuals. 

What is the role of bacteria in the gut?

Good bacteria are integral for a healthy digestive system, assimilation of nutrients and certain drugs, gut integrity, motility, and efficient removal of toxins and wastes. Altering the normal flora can result in colonization of pathogenic bacteria leading to gastrointestinal (GI) distress and a wide variety of other disorders. 

What are probiotics, and how do probiotics work?

Probiotics are naturally-occurring, friendly bacteria that produce metabolites (such as short chain fatty acids, or SCFAs) that promote regularity, ease gas and bloating, generate energy, and boost a healthy immune system. Beneficial bacteria work by crowding out the bad bacteria so that they can’t produce endotoxins that result in chronic inflammation and disruptions to barrier integrity. The World Health Organization (WHO) has officially defined probiotics as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.”  

Do probiotics help with immune health?

Good digestion is considered by many healthcare providers as the foundation of health, a concept attributed to the fact that over 70% of all immune cells reside in the GI tract. The greatest concentration of bacteria in the human microbiome occurs in the tissues of the gut and, as mentioned previously, the chemicals produced there provide “barrier immunity” to prevent pathogens from entering and taking hold. It is well established in the literature that composition of the gut microflora is a factor in immune health and in the development of many illnesses.

The intake of probiotics is associated with the restoration of a balance between “good and bad gut microflora,” following a disturbance that affects barrier immunity. This rather complicated balancing act is what scientists believe leads to the beneficial health impacts of probiotics, as discussed in the next section.

What are the health benefits of probiotics?

A growing body of scientific evidence links intake of probiotic-rich foods and supplements to therapeutic support for:

• Infectious or antibiotic associated diarrhea
• Irritable bowel syndrome and ulcerative colitis
• Constipation
• Upper respiratory, vaginal and urinary tract infections
• Insulin resistance
• Stress management
• Blood lipid management
• Inflammatory skin conditions like eczema and allergies
• Oral health

As mentioned previously, the beneficial effects of probiotics relate to their ability to restore the balance of microflora in your gut, which in turn lets your gut produce more of the beneficial byproducts that may help fight disease. However, while evidence has associated probiotic intake with benefits to individuals suffering from symptoms of specific gastrointestinal disorders, allergies, and various infections, the potential for probiotics to provide benefits to healthy people and help prevent disease and disorders is still an ongoing area of research. 

What are the best probiotic foods for digestive health?

Fermentation is one of the oldest known techniques for food preservation; it results when bacteria feed on sugar and starch in foods to create lactic acid, transforming foods like cabbage into sauerkraut and milk into yogurt. Historically, cultures throughout the world have incorporated fermented foods into their traditional diets, helping to re-establish and maintain a healthy probiotic profile. Typically, baking, canning, or pasteurization inactivates naturally occurring probiotics in food.

Types of probiotic foods

Some foods that naturally contain probiotics or are enriched with them include:

• Yogurt
• Kefir
• Miso
• Kimchi (fermented Korean vegetables)
• Sauerkraut
• Pickles
• Natto (a fermented soybean dish)
• Olives
• Kombucha
• Apple cider vinegar
• Tempeh
• Unpasteurized Cheese 
• Cottage cheese (look for labels that say ‘fermented with live active cultures’)
• Kvass (a fermented beet drink)

Probiotics and prebiotics

It should also be mentioned that probiotics within the gut thrive when an individual consumes a diverse diet that includes prebiotics, the non-digestible fermentable fibers that are known as “food” for probiotics. In a study to determine the influence of dietary intervention on the microbiome and immune system, a fermented food diet increased microbiome diversity and decreased inflammatory markers. It was also found that a high-fiber diet was linked to microbiome function and immune response. 

Take home point: Knowledge of how specific dietary interventions impact microbes could be used to develop effective dietary strategies to improve human health; however, until research elicits details to allow specific recommendations, it is wise to consume both prebiotic fibers and a variety of fermented (probiotic) foods — which is known medically as a synbiotic approach — for optimal microbiome support.

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What are the best probiotic supplements?

Probiotic supplements are taken for the purpose of restoring or maintaining a healthy microbial balance. However, to be effective as supplements, probiotics must have the ability to persist and colonize in the intestinal mucosa. There are many types of bacteria classified as probiotics and available as supplements. Mainstream formulations commonly contain Lactobacillus or Bifidobacterium species, both of which have well-documented safety and beneficial effects.

Other common probiotics include Enterococcus, Escherichia, Saccharomyces, Streptococcus, and Bacillus. On labels, the type of bacteria is denoted by a genus and species; for example, Lactobacillus rhamnosus (abbreviated L rhamnosus), and sometimes a subspecies and the strain will be indicated by letters or numbers after the species name. The functional benefits differ amongst probiotic species, and further research is necessary to determine which strains and at what dose will provide specific benefits to most individuals.  

With the plethora of different formulations and dosages available, how does one know which product to choose? Consider Eden’s synbiotic blend, which — together with select prebiotics and polyphenols — contains the following four carefully selected and scientifically-vetted probiotic ingredients:

• Bacillus coagulans SC208: The B coagulans species has a unique protective spore microencapsulation system rendering it more resistant to gastric acid and antibiotics than other strains and allowing extensive proliferation in intestinal mucosa. Because of its spore barrier, B coagulans do not need to be refrigerated and are not susceptible to “die-off” as many probiotic species are. All these factors contribute to making this highly stable preparation of lactic acid-producing bacteria the probiotic of choice in many formulations. 

Therapeutically, B coagulans has demonstrated effects on a range of intestinal ailments, attributed to its effect on modulation of microbiota composition, host immunity, and metabolism. Results from a study in individuals with irritable bowel syndrome (IBS), who were supplemented with B coagulans, suggests it is efficacious in alleviating overall pathophysiological symptoms. In combination with a prebiotic fiber blend, an in vitro study found that B coagulans consistently supports enhanced metabolic activity through modulation of the gut microbiome. Additionally, in a controlled clinical trial with 80 adults, spore forming bacilli probiotics were linked to a notable reduction in triglyceride levels in individuals with mild to moderately elevated levels. 

• Saccharomyces boulardii: An evidence-based probiotic derived from yeast, S boulardii has been clinically shown to ease both acute and chronic gastrointestinal distress and restore healthy gastrointestinal flora.
• Lactobacillus rhamnosus GG: Often referred to as LGG, L rhamnosus GG is one of the most common naturally-occurring beneficial gut bacteria. This strain is resistant to bile and acid, which allows it to proliferate in the gut microbiome. Both in vitro and human trials have elucidated strong evidence to support LGG’s effect in alleviating GI upset and stimulating the immune response.

• Lactobacillus paracasei LPC-37: Another well-researched strain of robust good bacteria, L paracasei helps to strengthen the intestinal mucosal barrier, support immune health, and improve nutrient absorption. In clinical trials, this strain has been researched for its ability to alleviate stress, improve sleep quality, reduce fasting glucose, positively impact lipid levels, and boost overall gut health.
  
  

How to know how much of a probiotic to use

The dose of a probiotic is indicated on supplement labels by colony-forming unit (CFU), which is a measurement of the activity of live microorganisms per serving. Dosage ranges for probiotic supplements are anywhere between 1 billion to 100 billion CFUs, sometimes more. More is not necessarily better when it comes to probiotics; the effective dose is dependent on the species  of probiotic, the expected benefit, and the health of an individual’s gut microbiome — all factors that should be discussed with your healthcare provider before using a probiotic supplement. 

Can consuming probiotics cause discomfort or side effects?

Probiotics are generally well-tolerated; however, some individuals may initially experience mild side effects, such as gas and bloating, due to alterations in the gut microbiota. Typically, any discomfort clears up within a few days, but persistent symptoms would need to be discussed with a healthcare provider.

Eden’s synbiotic supplement, which blends prebiotics, probiotics, and polyphenols, has been found to be well-tolerated by most users. 

Key takeaways

What are probiotics, and should you take them? Probiotics occur in fermented foods and are widely available as dietary supplements. Consumption of probiotics has been linked to a healthy balance of gut microflora, a key factor in digestive, metabolic, and immune health. There is no “one-size-fits-all” supplemental probiotic species or dose that delivers the documented effects of probiotics. The most heralded health benefits of probiotics are their ability to relieve gastrointestinal distress and symptoms of various other disorders. Scientists also are continuing to investigate their efficacy for reducing risks for or treating a broader variety of health conditions, and for determining the extent to which they can help maintain a healthy gut in otherwise healthy individuals. The ongoing work is promising, as nutritional interventions (including adoption of a diet that regularly incorporates high-fiber and a wide variety of probiotic-rich foods) hold great potential to improve human health through their effect on the gut microbiota and, by consequence, the functioning of so many physiological processes that are impacted by the gut microbiome.