Probiotics have become very popular – and with a good reason. They are thought to improve the balance of our own normal flora, the healthy bacteria in our gut. These live microorganisms help us to stay healthy by improving our digestion and enhancing immunity. They are beneficial for treating certain illnesses – including diarrhea caused by antibiotics, acute infectious diarrhea, irritable bowel syndrome, vaginal yeast infections, eczema, and the list goes on.
Lifestyle, diet, age, stress level, exercise and antibiotic use all have an impact on the balance of intestinal microflora. A diet high in sugars, fried and processed foods can have a negative impact. So can high levels of stress and not enough exercise. Antibiotics can negatively impact the microflora balance by killing the good bacteria along with the bad. Sometimes antibiotics are crucial, but they shouldn’t be used unnecessarily or excessively since they can wreak havoc on the digestive system.
Foods containing probiotics are usually fermented and may have added live active cultures. This includes yogurt, kefir, cottage cheese, kimchi, kombucha, pickled vegetables, sauerkraut, tempeh and miso. Dietary sources are an important part of a healthy diet, but I often recommend a high quality encapsulated probiotic in addition to dietary changes.
Grocery and health food stores are flooded with probiotic supplements in the form of capsules and powders. Not all probiotics are created equal, and with so many to choose from, it can be tricky and confusing.
Here are five things to look for when choosing a probiotic:
1. Know the dose – Look for products that list the amount of Colony Forming Units (CFUs) present. Ideally this is guaranteed as a “best by” date. If it is listed “at the time of manufacture” then expect the actual amount present to be decreased by at least half (50-90%). Make sure to buy well within the expiration date. In general, avoid products that list probiotics only by weight.
2. Take a sufficient amount – Probiotics need to be taken in high enough amounts in order to be effective. A general rule of thumb is that 2-10 billion CFUs are protective and preventive, while 25-100 billion CFU daily are indicated when recovering from or treating an illness or disease. In general, children should take about half that dose.
3. Buy a brand that is gluten-free and dairy-free – Always read the labels and look for something that is hypoallergenic. High quality supplements are usually free of dyes, artificial flavors, gluten and dairy.
4. Choose clinically tested strains – Properly labeled probiotic supplements will list the types of bacteria and/or yeast that are present. There are a handful of probiotic cultures that have been tested to be beneficial. Look for bifidobacterium, lactobacillus and/or saccharomyces species.
5. Buy from a reputable source – Most probiotics require refrigeration to maintain freshness. I always recommend buying dietary supplements from a reputable source with good quality control. You can read more about that here.
These are some of the brands I routinely recommend. Unless otherwise noted, they should be stored in your refrigerator.
Klaire Labs Ther-Biotic Complete – 25+ billion cfu/capsule – Blend of 12 probiotic species offers the most complete spectrum of microorganisms in the Klaire line. I have personally found this one to be the most helpful for me, but we are all very unique, so it will likely take some experimentation on your part.
Klaire Ther-Biotic Children’s Chewable – 25+ billion cfu/ chewable capsule – My daughter loves these! Made for children two and older with 4 Lactobacillus and 4 Bifidobacterium species. Formulated with xylitol, a natural sugar alcohol, that is usually a better option to prevent tooth decay.
Klaire Ther-Biotic Infant Formula – 10+ billion cfu per ¼ tsp – Blend of 5 Lactobacillus species and 5 Bifidobacterium species. Designed to safely meet the needs of infants up to the age of 2 years. Often helpful after cesarean section delivery, or for formula feedings, antibiotics, toxin exposures, and a maternal diet lacking in fresh fruits and vegetables. For very small infants, powder can be brushed on the nipples before breastfeeding. 1/4 tsp can eventually be mixed with expressed breast milk, formula, or solid food at room temperature. Never attempt to feed powder directly to infants or children, and remember that it can be deactivated by heat. Talk to your child’s physician before using this or any other medication.
VSL#3 – 112.5 billion cfu/ capsule – Contains 8 strains of live bacteria. This is the brand most supported by scientific literature. In pharmacies, VSL#3 is stored behind the counter in the pharmacist’s refrigerator, but it does not require a prescription. Capsules may also be opened and added to cold water or food.
Xymogen ProbioMax DF – 100+ billion cfu/ capsule – Contains 4 strains of Lactobacillus and Bifidobacterium species. This conveniently comes in a foil sealed blister pack and doesn’t require refrigeration, which makes it great for travel or work.
Finally, if you’re taking probiotics on a daily basis, it’s a good idea to periodically rotate through a few different brands. Functional medicine stool testing can help identify your levels of healthy or pathogenic bacteria. This is often useful to help guide more specific recommendations.
I can’t wait to share more about what I’m learning in the field of holistic nutrition and functional medicine on my blog. Stay tuned for my series “A Holistic Approach to Childhood Nutrition.”