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Overview

We know that probiotics are good for your gut health, but it’s still unclear exactly how they are helping you. Science shows that probiotics only have clear, guaranteed benefits if you have a condition -- such a medically diagnosed problem -- that requires help. Otherwise, many of the benefits of probiotics for gut health are speculation. However, there is strong research to suggest that probiotics can help improve your immunity and fight disease.

What if the key to your health -- both mental and physical -- all lived within your stomach? That’s the current theory about the gut microbiome and microbes -- microorganisms that live throughout your body and are the home to millions of good bacteria.

Breakthroughs in the microbiome have led to millions of dollars of research -- with many findings still in progress. These are good things. The bad part: scientists know that much is still unknown about the microbiome -- how it works, what it does, and how to make it function in ways the benefit your health.

But that hasn’t stopped marketers for taking an inch of information and a promising a mile of benefits. It’s commonplace in the supplement industry where the “magic pill” mentality is why so many people are frustrated by the products they buy (because they set false expectations). And -- as you’ll soon see -- while probiotics are good for you, the expectations for what they will do for your body are extremely misleading.  

Yes -- the microbiome (your gut environment) is one of the biggest breakthroughs in health, and its role in many health conditions is both exciting and unknown. Before you buy another probiotic, you might be surprised by just how much we don’t know about these helpful bacteria.

The Probiotic Paradox

If you search the web, many articles blatantly state some version of, “everyone knows that probiotics are good for you…” That would be fine, if the experts that worked with probiotics shared the same mentality. Unfortunately, that’s not the case.

“There are many products labeled with the word ‘probiotic’ in the U.S., but not all are responsibly formatted or studied for health benefits,” says Mary Ellen Sanders, Ph.D., executive science officer of the International Scientific Association for Probiotics and Prebiotics.

In fact, the claims about probiotics are grossly overstated: “There is no evidence that it is essential to take probiotics to be healthy...you don’t need probiotics if you are healthy.”

And that’s only the start of an industry that might turn out to be incredibly helpful. The question -- as you’ll soon find out -- is not if the microbiome is important. We know it is. The real question is what types of products, supplements, or food will trigger the changes that we desire most.

We assume that probiotics -- because they are “gut friendly -- will help promote better health. And, in time, we might find that they do. But even after several years of research, we:

  1. Still really don’t know exactly how to improve gut health
  2. Know some probiotics -- which you might be buying right now -- are a complete fraud.

“The benefits of probiotics in foods -- especially foods that aren’t fermented dairy products -- is questionable, at best,” says Shira Doron, M.D., professor of medicine and attending physician in infectious diseases at Tufts University School of Medicine.

So should you take probiotics? Deciding if it’s worth your money requires a little background, a quick self-diagnosis (see below), and tempered expectations.

The Truth About Probiotics

Probiotics are live microorganisms that feed the healthy bacteria in your gut. If you have a healthy gut -- meaning no dysfunction or diseases -- then taking probiotics is a good habit that might not have any additional benefits.

So what do probiotics do? If you have a gut condition like irritable bowel syndrome, the probiotics can help restore a better environment for your gut, improve symptoms, and make you feel better. Or, if you take antibiotics for an illness, those drugs can be a disaster for your microbiome. Following that disruption, probiotics might help restore a healthy environment. In that way, it’s best to think of probiotics -- as we understand them now -- like medication. When you’re healthy, you don’t just take medication; it’s only needed to help solve or fix a problem. Probiotics work in a similar fashion.

Which might leave you wondering: “Great -- probiotics have a benefits, but why are people taking these things every day and popping up in everything from granola to popcorn?”

As we mentioned before, we know that many secrets of your body are currently hiding in the microbiome. So supplement manufacturers are jumping the shark and putting them in everything. If you’re taking probiotics, you don’t need to worry, but you should be mindful of:

  1. What they will actually do for your body.
  2. If the form you’re using will actually do anything for your body. (Many probiotic sources -- like popcorn-infused probiotics -- are about as effective as the Shakeweight. Remember that?)

Researchers are currently trying to figure out exactly how probiotics (and other gut friendly foods and supplements) can benefit your body. Here’s what we know right now and how you can put probiotics to good use (if you so choose).

Your Guide to Probiotics

If you are generally healthy then there aren't too many downsides. If you take a supplement, give it a month, trust yourself, and see how your body responds. It’s possible that you’ll feel better -- but know that studies indicate the positive outcomes you experience could be a placebo effect.

As we mentioned before, probiotics are great if you already have a known problem. So, if you are suffering from any of the following, taking probiotics (after consulting with your physician) is a no-brainer:

Additionally, some research suggests taking specific probiotics may support immune health and potentially reduce the risk or duration of the common cold. That’s why you might see them added to certain products like greens powders or proteins.

But, before you start investing in infused products, there are a few very important exceptions. Any benefit is specific to the strain of probiotic, and even the transport of the good strains is still a work in progress. That’s because we still don’t know if good strains that we can create in a supplement -- or a food like yogurt -- can survive the environment in your stomach and then have a positive impact in your gut.

First off, skip the fortified foods. That means popcorns, cereals, granola, and breakfast bars are all great ideas that will simply charge you more money for probiotics that won’t do anything for your body.

“The benefits of probiotics in foods — especially foods that aren’t fermented dairy products — is questionable, at best,” says Shira Doron, M.D., professor of medicine and attending physician in infectious diseases at Tufts University School of Medicine.

Also, for now, you might want to use caution with microbiome tests that will allegedly help you understand what probiotics you need to eat.

“At this point, an individual cannot look at their microbiota and come to conclusions about their health, Doron says. “There are still more questions than answers.”

Your best bet is to consult a doctor who understands your condition and is also well-versed in probiotics. Doron suggests researching academic medical centers and looking at the profiles of physicians in the field you need.

“Check [for doctors whose] interests include subjects like ‘probiotics’ and ‘microbiome,’” Doron says. “The field is still young, and even for the world’s experts, there are way more questions than answers when it comes to manipulating the human microbiome for health purposes. But there are certainly doctors in a variety of fields who take an interest in this area of research or do the research themselves and use the knowledge they have gained in their medical practice.”

Follow your doctor’s recommendation down to the strain and dose. The strain will be a long name and often include a number, such as L. acidophilus NCFB 1748.

The “dose” is the big number on the label, most likely in the billions, which indicates the colony-forming units, or CFU. Higher isn't necessarily better, so follow your doctor’s advice.

Avoid any products that list the CFU “at time of manufacture.”

“That's a red flag,” Sanders says. Counts of the live microbes decrease over time, so you want to know the CFU through the end of shelf life.

And if the product is refrigerated at the store, keep it in the fridge at home to ensure you don't kill off more CFU.

The last thing to look for is any seal from a third-party verification program to be sure that what the probiotic contains what the label says it does. NSF International guarantees that label claims are accurate and that no contaminants or impurities exist within the product. But note that statements like “quality guaranteed” do not mean they have been verified by third parties.

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