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Probiotics improve various functions of our GI tract, and can help with GI disorders, such as IBS and IBD. However, these “good bacteria” can also prevent cardiovascular disease and boost our immunity, preventing and ameliorating  viral and bacterial infections.

Probiotic Four Part Series

Health Benefits of Probiotics

22) Probiotics are Beneficial in Metabolic Syndrome

B. animalis ssp. lactis significantly reduced BMI, total cholesterol, low-density lipoprotein and inflammatory cytokines in patients with metabolic syndrome (R).

L. plantarum reduced total cholesterol, LDL-cholesterol, glucose and homocysteine levels in postmenopausal women with metabolic syndrome (R).

L. casei  improved insulin sensitivity in subjects with metabolic syndrome (R).

L. gasseri  decreased food and energy intake, and improved body weight, insulin resistance and cholesterol levels in rats with metabolic syndrome (MS) (R).

23) Probiotics Prevent Cardiovascular Disease


Probiotics and prebiotics have preventative and therapeutic effects on cardiovascular disease due to a reduction in total serum cholesterol, low-density lipoprotein (LDL-cholesterol), and inflammation (R).

Daily supplementation with S. boulardii  lowered remnant lipoprotein in hypercholesterolemic adults, a predictive biomarker and potential therapeutic target in the treatment and prevention of coronary artery disease (R).

L. casei  improves insulin sensitivity index in humans, an important risk factor for cardiovascular morbidity, especially stroke and coronary heart disease and mortality (R).

L. acidophilus consumption lead to 2.4% to 3.2% reduction in blood cholesterol in clinical studies. Since every 1% reduction in serum cholesterol concentration is associated with an estimated 2% to 3% reduction in risk for coronary heart disease, regular intake of L. acidophilus has the potential of reducing the risk for coronary heart disease by 6 to 10% (R).

L. acidophilus can protect against atherosclerosis through the inhibition of intestinal cholesterol absorption in mice fed a Western diet (R).

Lipoteichoic acid (LTA) from L. plantarum inhibits the production of proinflammatory cytokines and suppresses atherosclerotic plaque inflammation in mice (R).

L. acidophilus reduces cholesterol and inhibits the accumulation of lipoprotein in atherosclerotic plaques in mice (R).

L. acidophilus attenuates the development of atherosclerotic lesions in mice by reducing oxidative stress and inflammatory responses (R).

24) Probiotics Improve Our Gut Health


Probiotics can decrease the number of potentially pathogenic gastrointestinal microorganisms and pathogens, reduce gastrointestinal discomfort, flatulence and bloating, and improve bowel regularity (R).

B. animalis spp. lactis improved digestive comfort and GI symptoms in healthy adults (R,R).

Probiotic fermented milk containing B. animalis spp. lactis by healthy women may improve GI well- being and decrease the frequency of GI symptoms (R,R,R).

4 weeks’ supplementation with B. animalis ssp. lactis resulted in a clinically relevant benefit on defecation frequency in healthy adults with abdominal discomfort (R).

Ingestion of B. bifidum significantly decreased the prevalence of gastric and lower abdominal symptoms in adults taking no medication (R).

Administration of L. helveticus to healthy human subjects resulted in a significant increase in butyrate, beneficial for gut homeostasis (R).

Probiotics promote gastric mucus secretion (R). B. bifidum alleviates acute gastric injury by enhancing the production of gastric mucin in rats (R).

Probiotics Beneficially Modify Gut Microbiota

Probiotics in general tend to increase the levels of Lactobacilli and Bifidobacteria in the gut, while decreasing the levels of potentially pathogenic microorganisms (R,R,R,R,R,R,R,R,R,R,R,R,R).

Check individual probiotic posts for more information.

Probiotics Strengthen the Intestinal Barrier

The intestinal barrier separates the contents of the gut from the rest of the body. This barrier prevents the entry of harmful substances such as foreign antigens, toxins and microorganisms. Hyperpermeability of this barrier (“leaky gut”) contributes to the pathogenesis of several gastrointestinal disorders including IBD, Celiac disease and food allergy (R).

In humans, L. rhamnosus protects against disruption of the gastric mucosal barrier (R).

Fermented milk with L. paracasei  promotes intestinal epithelial cell growth and intestinal epithelial integrity and strengthens the intestinal barrier against chemical and inflammatory stimuli-induced damage (R).

L. paracasei  synbiotic therapy can prevent or repair colon damage in mice with acute colitis, where this bacterium completely restores epithelial barrier integrity (R,R).

In rats, B. bifidum or B. animalis protect the mucous membrane layer of the stomach (R).

S. cerevisiae strengthens epithelial barrier function (R). Oral treatment with viable or heat-killed S. cerevisiae strain prevents bacterial translocation, protects intestinal barrier integrity, and stimulates immunity in mice with intestinal obstruction (R).

Probiotics Prevent and Ameliorate Drug-Induced GI Damage

Probiotics maintain an individual’s intestinal microbiota in subjects receiving antibiotic treatment (R).

L. acidophilus administered with amoxicillin/clavulanate was associated with a significant decrease in patient complaints of GI side effects and yeast superinfection (R).

L. casei  is effective for the treatment of aspirin-associated small bowel injury in chronic low-dose aspirin users (R).

Long-term L. rhamnosus supplementation has an influence on the composition of the intestinal microbiota in children, and reduces the frequency of gastrointestinal complaints after antibiotic use, preventing certain bacterial infections for up to 3 years after the trial (R).

L. delbrueckii microcapsules relieve intestinal tissue damage in mice and ameliorate antibiotic-induced intestinal microbiota dysfunction (R).

L. paracasei therapy prevents antibiotic induced visceral hypersensitivity and restores normal gut permeability in rats (R).

L. fermentum  normalizes the composition of gut microbiota and alleviates ampicillin-induced inflammation in the colon in mice (R).

B. animalis ssp. lactis protects against NSAID-induced GI side effects in rats and may prevent more serious GI mucosal damage and/or enhance the recovery rate of the stomach mucosa (R).

S. boulardii  significantly reduced the numbers of gastric ulcers and the ulceration surface of the gastric mucosa in rats treated with ibuprofen (R).

S. thermophilus reduces inflammation and prevents chronic gastritis in aspirin-treated mice (R,R).

Probiotics Ameliorate Gastric Ulcers

Probiotics inhibit the development of acute gastric mucosal lesions and accelerate gastric ulcer healing (R).

Lactobacilli are particularly useful in promoting gastric ulcer healing in rats, when administered as an individual probiotic strain, such as L. rhamnosus, L. gasseri, or L. acidophilus or as a probiotic mixture (R,R,R,R,R,R).

B. breve and B. bifidum were able to repair and protect the mucosa of rats against gastric ulcers and erosions (R).

Pretreatment of mice with gastric ulcers with the probiotic C. butyricum alleviated the inflammation and gastric mucosal damage (R).

Certain yeasts, such as S. boulardii and S. cerevisiae have also shown beneficial effects in rats with gastric ulcers (R).

Probiotics Prevent and Treat Diarrhea

Use of probiotics in antibiotic-associated diarrhea decreased the risk of diarrhea by 52%, traveler’s diarrhea by 8%, and acute diarrhea from various causes by 34%. Probiotics were more effective in reducing the risk of acute diarrhea in children 57% versus 26% in adults (R).

Acute Infective Diarrhea:

L. casei reduces the incidence, duration, and severity of diarrhea in children (R,R).

L. paracasei effectively resolves acute diarrhea (R) and ameliorates non-rotavirus-induced diarrhea in children (R).

L. acidophilus reduced the duration of diarrhea in hospitalized, but not outpatient, children (R), and ameliorated both rotavirus-positive diarrhea (R), and nonrotavirus diarrhea in children (R).

L. acidophilus and B. bifidum shortened the duration of diarrhea in infants and children (R).

L. rhamnosus administration was associated with significantly lower rates of and symptomatic rotavirus gastroenteritis diarrhea in hospitalized children (R).

L. reuteri  decreases the incidence of diarrhea in children (R).

Formula supplemented with B. bifidum and S. thermophilus reduced the incidence of acute diarrhea and rotavirus shedding in infants admitted to hospital (R).

B. breve together with S. thermophilus reduces the severity of acute diarrhea and dehydration among healthy young infants (R).

B. animalis spp. lactis milk formula prevents diarrhea in infants, and decreases diarrhea frequency and duration (R,R,R).

S. boulardii  significantly reduces the frequency and duration of acute diarrhea in children (R,R,R,R,R,R,R,R). It also often reduces the length of ECU and hospital stay in acute infectious gastroenteritis in children (R,R).

S. boulardii  also decreases the duration and frequency of diarrhea, and ameliorates abdominal pain in adults (R), and shortens the hospital stay in patients with acute infectious diarrhea (R).

Antibiotic-Associated Diarrhea:

Treatment with L. rhamnosus reduced the risk of antibiotic-associated diarrhea (AAD) in patients treated with antibiotics from 22.4% to 12.3% (R).

L. casei intake was associated with a decreased risk of antibiotic-associated diarrhea (R,R).

L. helveticus and L. rhamnosus supplementation significantly reduced the duration of antibiotic-associated diarrhea in healthy adults receiving antibiotics (R).

B. animalis spp. lactis together with S. thermophilus reduced the frequency of antibiotic-associated diarrhea (AAD) in infants (R).

Concomitant administration of C. butyricum with antibiotics normalizes the intestinal microbiota, prevents the decrease of Bifidobacteria, and is effective for preventing and treating antibiotic-associated diarrhea in children (R).

Some studies report that S. boulardii  is not effective in preventing the development of antibiotic-associated diarrhea (R,R,R,R). However, many studies do, in fact, show that S. boulardii  is effective in reducing the risk of antibiotic-associated diarrhea in both children and adults (R,R,R,R,R,R,R).

B. subtilis significantly reduced the incidence of antibiotic-associated diarrhea and prevented nausea, bloating, vomiting and abdominal pain (R).

Traveler’s Diarrhea:

S. boulardii prevents traveler’s diarrhea, particularly in regions such as North Africa and in the Near-east (R).

Chemo- and Radiotherapy-induced Diarrhea:

Probiotics may have a beneficial effect in prevention of chemo- and radiotherapy-induced diarrhea, where they rarely cause adverse effects (R).

See individual probiotic posts for more information and animal studies.

Probiotics Relieve Constipation

L. paracasei relieves constipation (R).

Heat-killed L. brevis improved intestinal function in women with constipation (R,R).

L. reuteri helps constipation, increasing the number of bowel movements in adults (R) and infants (R).

B. breve is effective in diminishing abdominal pain and increasing stool frequency in children with functional constipation (R).

B. animalis spp. lactis showed beneficial effects on constipation in human studies (R,R,R).

B. coagulans improved constipation symptoms in children (R) and adults (R).

P. freudenreichii  relieves constipation in young healthy women (R).

Combined regimen of lactulose and live binary B. subtilis is an effective and safe therapeutic method for elderly with functional constipation (R).

See individual probiotic posts for more information and animal studies.

Probiotics Combat IBS


Irritable bowel syndrome is known to cause a reduction in intestinal Lactobacilli and Bifidobacteria (R). Probiotics improve global IBS symptoms, and decrease IBS-associated pain (R).

L. acidophilus reduced abdominal pain and discomfort in patients with irritable bowel syndrome (IBS) (R,R).

L. plantarum reduces gas problems and pain in people who suffer from irritable bowel syndrome (R).

Probiotics containing L. plantarum and B. breve in IBS decreased pain by 38% in the probiotic group compared with 18% in the placebo group, and after 28 days, pain was decreased 52% in the probiotic group compared with 11% in the placebo group (R).

L. rhamnosus can reduce pain frequency and intensity in children (R) and adults (R) with IBS.

L. rhamnosus has been proven to reduce symptoms in children with functional gastrointestinal disorders (R).

L. reuteri helps produce serotonin, and lessens susceptibility to gut problems and IBS (R).

L. rhamnosus, L. reuteri and VSL#3 significantly increased treatment success for functional gastrointestinal disorders (FGIDs) in children and adolescents (R).

A mixture of B. infantis, B. breve, and B. longum improve abdominal pain and the quality of life in children with irritable bowel syndrome (IBS) (R).

B. longum ssp. infantis reduces intestinal inflammation, improved abdominal pain/discomfort, bloating/distention, and bowel movement difficulty in patients with IBS (R,R,R).

B. bifidum significantly improved the pain/discomfort, distension/bloating, urgency and digestive disorder in patients with IBS (R).

Fermented milk containing B. bifidum improves symptoms in patients with functional gastrointestinal disorders (FGID). Abdominal pain, diarrhea, and constipation significantly improved, as did acid-related dyspepsia. Psychological symptoms such as anger and hostility also improved (R).

B. animalis has a beneficial effect on discomfort, bloating and constipation in constipation-predominant IBS patients (R).

B. animalis spp. lactis significantly improved objectively measured abdominal girth and gastrointestinal transit, as well as reduced symptomatology in IBS patients (R).

B. coagulans decreased bloating, vomiting, diarrhea, abdominal pain and stool frequency and increased the quality of life in patients with the diarrhea predominant irritable bowel syndrome (IBS) (R,R,R,R).

A combination of simethicone and B. coagulans reduced bloating and discomfort in patients with IBS (R).

L. brevis improves the quality of life, reduces diarrhea and abdominal pain and increases Bifidobacteria in patients with IBS (R).

S. boulardii  improved the cytokine profile, histology, and the quality of life in patients with diarrhea dominant irritable bowel syndrome (IBS-D) (R) or mixed-type IBS (R).

S. boulardii  alone or with mesalazine improved IBS-D symptoms (R). One study, however, found no improvement in IBS-D patients after S. boulardii treatment (R).

In one clinical trial, S. cerevisiae reduced abdominal pain and discomfort in subjects with IBS (R). In another trial, however, S. cerevisiae had no beneficial effect on IBS symptoms and wellbeing. However, it seemed to have some effect in the subgroup with constipation (R).

A combination product designated VSL#3, which contains large quantities of 8 bacterial species, was shown to significantly improve IBS symptoms (R).

Probiotics Ameliorate IBD

B. longum ameliorated ulcerative colitis symptoms in Japanese patients (R).

S. boulardii added to baseline therapy improved intestinal permeability in Chron’s disease (CD) patients, even though complete normalization was not achieved (R). This probiotic also reduced the frequency of bowel movements in CD patients (R).

P. freudenreichii was effective in the treatment of mild to moderate ulcerative colitis in a human pilot study (R).

In Asian studies involving patients with ulcerative colitis, the addition of a B. subtilis probiotic significantly reduced the number of days with bloody stool, lead to complete remission without relapse, and significantly increased the efficacy of mesalazine or sulfasalazine therapy (R).

L. plantarum ameliorates ulcerative colitis in mice via both anti-inflammatory and immunomodulatory activities (R), and decreases the severity of intestinal inflammation in mice with inflammatory bowel disease (IBD) (R).

B. bifidum decreases symptoms of inflammatory bowel disease (IBD) in mice, such as thickened intestinal wall and inflammatory cell infiltration, and decreased inflammatory cytokine production (R).

Other probiotics that were effective in ameliorating colitis in animal models include L. casei  (R,R), L. paracasei  (R), L. salivarius (R), L. delbrueckii  ssp. bulgaricus (R), L. delbrueckii  ssp. lactis (R), L. helveticus (R), B. longum (R), B. animalis ssp. lactis (R,R,R), C. butyricum (R,R,R), B. coagulans (R,R), L. brevis (R,R,R), L. fermentum  (R,R,R,R), S. boulardii  (R), L. lactis (R,R,R,R), S. thermophilus (R), P. freudenreichii  (R,R,R), B. subtilisis (R,R,R,R) and S. cerevisiae (R,R).

B. longum ssp. infantis ameliorates colitis by decreasing Th1 and Th17 responses (R).

S. thermophilus also represses the Th17 response to ameliorate intestinal lesions (R).

S. boulardii  treatment limits the infiltration of Th1 cells into the inflamed colon and inhibits proinflammatory cytokine production in mice with IBD (R).

Note that L. crispatus can ameliorate colitis in mice (R), however, a specific strain, M206119, exacerbates intestinal inflammation (R).

Check individual probiotic posts for more information.

Probiotics Ameliorate Necrotizing Enterocolitis

Oral supplementation of L. paracasei  reduced the clinical progression of necrotizing enterocolitis in infants (R).

Prophylactic L. acidophilus and B. infantis reduced the incidence and mortality of necrotizing enterocolitis (NEC) in infants (R).

B. breve was associated with decreased risk of necrotizing enterocolitis in neonates (R).

Oral administration of B. breve reduces the production of butyric acid in infants, which may be helpful in protecting low birth weight infants from digestive diseases such as necrotizing enterocolitis (R).

However, one study found no benefit in B. breve administration for prevention of necrotising enterocolitis and late-onset sepsis in very preterm infants (R).

B. breve suppresses inflammation, reduces the pathology and increases survival in rats with necrotizing enterocolitis (R).

Probiotics Ameliorate Diverticular Disease

L. paracasei, in association with a high-fiber diet, is effective in reducing abdominal bloating and prolonged abdominal pain in patients with symptomatic uncomplicated diverticular disease (R).

25) Probiotics Boost Immunity


Gut microbiota cooperate with the host immune system through an extensive array of signaling pathways (R).

Studies with germ-free animals show that microbiota is necessary for the development and regulation of immunity in the gut, where it prevents the development of inappropriate inflammation (R).

Probiotics modify the immune system by stimulating anti-inflammatory cytokines, downregulating proinflammatory cytokines, and modulating white blood cell responses (R).

Probiotics activate both the innate and acquired immunity in humans (R,R,R,R,R,R,R,R,R,R,R).

L. paracasei, L. delbrueckii, L. fermentum, L. lactis, L. gasseri, B. longum, B. breve, B. animalis and other probiotics were shown to skew the Th1/Th2 balance toward Th1 (R,R,R,R,R,R,R,R,R,R) in infections and allergies.

Probiotics Combat Infections


L. paracasei prevents common infectious disease (CIDs) in children attending daycare (R).

L. helveticus supplementation significantly shortened the duration and decreased the number of symptoms of upper respiratory tract illness in athletes, and increased their sense of vigor (R).

Fermented milk containing L. johnsonii  suppressed infections in the elderly (R).

L. brevis reduces the incidence of influenza in elementary schoolchildren. The improvement is especially pronounced in unvaccinated individuals (R).

S. boulardii enhances the immune response in pediatric acute gastroenteritis (R).

Yogurt fermented with L. lactis lowers the risk of common cold in human subjects (R).

Fermented milk containing L. rhamnosus was efficient in reducing the risk on respiratory tract infections that lasted longer than three days in hospitalized children (R).

Preterm infants treated daily with L. rhamnosus in capsules starting within one week after birth, appear to have significantly lower incidence of respiratory tract infections (RTIs) and rhinovirus-induced episodes in the first 2 months (R).

Consumption of L. rhamnosus reduced the occurrence of respiratory illness in children attending day care centers (R).

Children receiving L. rhamnosus probiotics had fewer days with respiratory symptoms per month than the children in the control group (R).

Capsulated L. rhamnosus was shown to protect hospitalized patients against ventilator-associated pneumonia, mainly when caused by Gram-negative pathogens like Pseudomonas aeruginosa (R).

In cystic fibrosis patients with P. aeruginosa, long-term L. rhamnosus significantly decreased the incidence of pulmonary exacerbations and increased body weight (R).

L. casei  significantly lowered the incidence and duration of upper respiratory tract infections (URTIs) in healthy middle-aged office workers (R).

Similarly, in healthy shift workers, L. casei  decreased the incidence of gastrointestinal and respiratory common infectious disease (CIDs), increased the time to the first occurrence of CID, and reduced the total number of CIDs in the subgroup of smokers. In the course of CID, the total duration of fever was lower and an increase in leukocyte, neutrophil, and natural killer (NK) cell counts and activity was observed (R).

L. casei  also lowered the incidence of common infectious diseases (CIDs) in children (R), and decreased the duration of CID, and especially upper-respiratory-tract infections (URTI) such as rhinopharyngitis in the elderly (R).

In athletic men and women who engaged in endurance-based physical activities in winter, L. casei  lowered the proportion of subjects who experienced 1 or more weeks with upper-respiratory-tract infection (URTI) symptoms, and decreased the number of URTI episodes (R).

L. gasseri, B. longum and B. bifidum taken in winter by healthy subjects shortened common cold episodes by almost 2 days and reduced the severity of symptoms (R).

L. acidophilus, B. bifidum and B. animalis plus vitamin C reduced the incidence rate of upper respiratory tract infection, the number of days with symptoms and the absence from preschool in children (R).

A synbiotic containing L. acidophilus, B. infantis, and B. bifidum can provide effective control of respiratory infection and wheezing frequency in children under five years old (R).

The intake of yogurt fermented with L. delbrueckii  ssp. bulgaricus increases the activity of natural killer cells and reduces the risk of catching the common cold in elderly (R).

L. acidophilus suppressed all of the 74 gram-negative and 16 of gram-positive bacteria found in burn wounds, that can cause burn wound infections (R).

L. fermentum  reduced the duration and severity of respiratory illness in highly trained distance runners (R).

L. fermentum  reduced the severity of gastrointestinal and respiratory illness symptoms in male but not female cyclists (R).

L. fermentum  reduced gastrointestinal and upper respiratory tract infections in infants (R,R).

Oral administration of L. fermentum  potentates the immunologic response of an anti-influenza vaccine and may provide enhanced systemic protection by increasing the Th1 response and virus-neutralizing antibodies. The incidence of an influenza-like illness during 5 months after vaccination was decreased in the group that consumed this probiotic (R,R).

B. longum reduces the incidence of influenza and fever in subjects with influenza vaccination (R).

B. longum fed infants showed a trend toward fewer respiratory tract infections (R).

B. longum ssp. infantis triggers the anti-poliovirus response in infants (R).

B. breve significantly inhibited rotavirus multiplication and prevented rotavirus infection in infants (R).

B. animalis ssp. lactis reduces days with cold/flu in young healthy adults (R).

Infants and children receiving B. animalis ssp. lactis experienced fewer respiratory tract infections (R,R).

S. boulardii  reduces E. coli numbers in children (R).

S. boulardii  can treat B. hominis infection in children as efficiently as metronidazole (R).

S. boulardii  was effective in treating giardiasis when combined with metronidazole therapy in adult patients (R).

The addition of S. boulardii  to metronidazole in amebiasis significantly decreases the duration of (bloody) diarrhea and enhances clearance of cysts in children (R), and decreases the duration of symptoms and cyst passage in adults (R).

Prophylactic S. boulardii  supplementation is as effective as nystatin in reducing fungal colonization and invasive fungal infection, more effective in reducing the incidence of clinical sepsis and the number of sepsis attacks and has a favorable effect on feeding intolerance in very low birth weight infants(R).

B. subtilis decreased the frequency of respiratory infections in elderly subjects (R).

B. subtilis inhibits disease transmission in patients with acute non-typhoid Salmonella gastroenteritis (R).

Metabolites of B. subtilis decrease the resistance of urogenital pathogenic microflora to antibiotics in patients with urinary tract infections, resulting in accelerated elimination (R).

Probiotics were effective in treatment and prevention of urogenital infections in women as alternatives or co-treatments. They were effective for treatment and prevention of bacterial vaginosis, prevention of recurrences of candidiasis and urinary tract infections, and clearing human papillomavirus lesions. No study reported significant adverse events related to the probiotic intervention (R).

Probiotic supplementation with vaginal L. rhamnosus is useful in hindering bacteria growth especially after antibiotic therapy (R).

L. rhamnosus vaginal tablets have demonstrated to be a reliable topical effective and safe treatment to reduce the bacterial vaginosis recurrence rate (R).

Daily ingestion yogurt, enriched with L. acidophilus may reduce the episodes of bacterial vaginosis (R). Treatment of patients with bacterial vaginosis with L. acidophilus contributed to the restoration of a normal vaginal environment (R).

L. fermentum and L. plantarum significantly reduced bacterial vaginosis in women (R).

L. crispatus reduces recurrent urinary tract infections in premenopausal women (R).

L. crispatus inhibits Chlamydia trachomatis, the most common sexually transmitted bacterial pathogen, in human epithelial cells and macrophages (R,R).

Cervicovaginal mucus with high L. crispatus concentrations can trap the HIV virus (R).

B. coagulans reduced vaginosis symptoms in women when co-administered with antibiotics (R).

See individual probiotic posts for more information and animal studies.

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Further Reading

For technical information, check individual probiotic chapters:

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  • Allen Morrison

    I take probiotics for my GI health! My digestive system is extremely sensitive and reactive, and taking probiotics has truly helped regulate everything for me to live a normal functioning life without excessive bowel and digestive issues. I take Florajen Digestion and it works for me

  • A.

    Hi Joe!
    Great articles!
    One aspects that I cannot find in these articles is how to actually take probiotics? Some people say 30min before first meal in the day, others claim last thing in the evening, and yet others advise on taking it with food at any point? Think it would be useful to include in the article. Also, do you think VSL has any better effect than the other ones (since it’s supposed to contain live, freeze-fried bacteria and seems to be the most standardized dose)?
    Thanks for great job!

    1. Joseph M. Cohen

      First thing in morning, 1/2 hr before meals

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