Picking a Probiotic

You’ve heard all the benefits of being a probiotic. They help with digestive symptoms, decrease allergies, improve brain function, the list goes on. So you go to the store hoping to find a probiotic and instead you find like 30 to choose from. Some are expensive, some are cheap, some have 2 strains of bacteria, some have like 10-20, why are there so many options and which is the best? The main things you need to pay attention to while choosing a probiotic is the stability, CFU count, and strain identification numbers.

Stability means that the product won’t degrade over time. Now it turns out when you put a whole bunch of bacteria together in a capsule, they start eating each other. So if you actually want any bacteria to be left by the time you take the capsule, the manufacturer needs to have something in place to keep the bacteria from eating each other. 

One common way is to put the probiotic in the refrigerator, because cold slows the bacteria down. This is NOT a good method, because all the moisture in the refrigerator does more to degrade the product than the cold does to stop degradation. So look for a probiotic that is shelf stable and does not need to be refrigerated. A better method is using single serving packets or nitrogen blister packs to keep each serving isolated from moisture.

Next, check the bottle for a guaranteed by date (not an expiration date). The guaranteed by date shows that the manufacturer has checked to make sure that the bacteria count on the label is consistent with how many bacteria will be in the capsule or packet by that date. Most manufacturers only count the bacteria at time of manufacture and label based on that number, which means you are getting way less bacteria than the label says by the time you actually use the product.

Dose matters. There are probiotics that are as low as 1 billion, which, compared to how many bacteria you have in your body, is trivial. If you are looking to just maintain health, this may be an ok option for you. This can also be a good choice if you are looking for a particular strain of bacteria and can be used in combination with another, higher dose probiotic. For instance, lactobacillus reuteri is an important strain for vaginal health, and 5 billion cfu of lactobacillus reuteri would be a nice add-on to a 50 billion cfu probiotic for someone who wants to work on GI as well as vaginal health.

However, if you need a complete overhaul of your GI tract, you’ll need at least 50 billion CFU. If you are also using any sort of antibiotic or antifungal product, I recommend at least 100 billion. In the case of overt gastrointestinal disease such as inflammatory bowel disease, I use a 350 billion CFU probiotic. 

Of course, if you take 350 billion cfu of lactobacillus acidophilus, this will be a fairly expensive supplement, and you may as well just be eating yogurt, because it’s the same bacteria. If you want a probiotic that will actually impact your health, you need to look at the strains of bacteria on the label. They should have a first and last name followed by a number like this: Lactobacillus (family name) rhamnosus (strain name) GR-1 (strain identification number). When you see that number it indicates that this identical bacteria strain has been used in research. Without that number, it could be any bacteria within the lactobacillus rhamnosus family, and yes, there is a lot of variation because bacteria mutate very quickly. If you’re going to spend the money on a probiotic, don’t you want to know that the bacteria you bought is the one that has been researched for its benefits?

Bottom line is that shopping for a probiotic is tough! A probiotic doesn’t have to meet all of these criteria to be able to bring benefit, but it is one of those situations where more is better. I always keep my favorite probiotics in stock at my clinic, but it case you do find yourself in a grocery store looking for a probiotic, hopefully this guide aids you in your choice.