Dozens of boxes, billions displayed in large print, promises for digestion, immunity or intimate flora: choosing a probiotic feels like a gamble. Studies help settle the question. In the Cochrane review on antibiotic-associated diarrhea in children, probiotics reduced the risk from 19% to 8%, and at 5 billion CFU per day or more, from 23% to 8%.
This guide brings together what trials and meta-analyses identified via PubMed show: why there is no single best probiotic but rather a strain for each objective, the criteria that matter (strain, dose, survival in the stomach, stability, prebiotic), then, need by need, the tested strains and doses, how to take a probiotic and the precautions to know.
There is no single best probiotic in general : a review of 228 trials shows that efficacy depends on the strain and the indication. Criteria to read: complete strain (genus, species, code), dose in CFU matched to that of the trials, survival in the stomach (spores, suitable capsule, taken with a meal), stability until expiration.
By objective : bloating and irritable bowel, Bacillus coagulans MTCC 5856 at 2 billion spores, Bacillus coagulans Unique IS2, Bifidobacterium infantis 35624 or Lactobacillus plantarum 299v ; antibiotics, Saccharomyces boulardii or Lactobacillus rhamnosus GG at least 5 billion CFU ; constipation, Bifidobacterium lactis ; intimate flora, Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 orally ; winter, 1 to 10 billion CFU for at least 3 months.
- Probiotic, prebiotic, postbiotic, synbiotic: the definitions
- Not a single best probiotic, but a strain for each objective
- Criterion 1: identified strain and CFU dose
- Criterion 2: survive the stomach and time
- Criterion 3: associated prebiotic, postbiotic and excipients
- Bloating and irritable bowel
- Constipation and slow transit
- Antibiotic-associated diarrhea and acute diarrhea
- Intimate flora: bacterial vaginosis, yeast infections and urinary tract infections
- Immunity, winter infections and skin
- Mood and weight: measurable effects, but small
- How to take a probiotic, and who should avoid it
- Frequently Asked Questions
Probiotic, prebiotic, postbiotic, synbiotic: the definitions
A probiotic is, according to the FAO/WHO definition adopted in 2014 by the consensus of the International Scientific Association for Probiotics and Prebiotics (ISAPP), a set of "live microorganisms that, when administered in adequate quantities, confer a health benefit to the host". Three conditions: alive, in sufficient dose, with demonstrated benefit. Experts called for more rigorous use of the term to distinguish products.
A prebiotic is "a substrate selectively utilized by the host's microorganisms and conferring a health benefit" (ISAPP consensus 2017): fibers that our bacteria ferment, such as inulin or acacia fiber. A postbiotic is "a preparation of inactivated microorganisms and/or their components that confers a health benefit" (ISAPP consensus 2021): bacteria inactivated, for example by heat. A synbiotic combines live microorganisms and substrate; the ISAPP 2020 consensus distinguishes complementary synbiotic, a simple addition of both, from synergistic synbiotic, where the substrate specifically nourishes the associated strain.
A true probiotic indicates a complete strain and a dose in CFU (colony-forming units) guaranteed until expiration. Our guide on the benefits of probiotics and our file on the gut-brain axis detail how the microbiota works.
Why there is no single best probiotic, but one strain per objective
The data contradict the idea of a product that works better than all others. A 2018 systematic review examined 228 randomized trials with identified strains: evidence of efficacy existed for 7 out of 10 strains or combinations (70%) in four preventive indications and for 11 out of 17 (65%) in five curative indications, with clear differences between strains of the same species (some Lactobacillus strains prevented antibiotic-associated diarrhea, others did not) and between indications for the same strain. Efficacy is specific to the strain and the disease ; grouping different strains in the same analysis leads to misleading conclusions.
Irritable bowel illustrates this. A meta-analysis of 53 trials (5,545 patients) published in 2018 found that certain strains appear to improve symptoms, without specifying which. A strain-by-strain meta-analysis from 2026 (32 articles, 10 strains tested alone) clarifies: five strains effective on key symptoms (detailed in section 6), improved quality of life for Bacillus coagulans MTCC 5856, contradictory results for Saccharomyces boulardii CNCM I-745, and no demonstrated efficacy for Escherichia coli Nissle 1917, Lactobacillus gasseri BNR17 or Lactobacillus casei Shirota.
The word "probiotic" alone tells you nothing about a product: read the strain, look for the tested indication and compare the dose to that used in trials.
Criterion 1: an identified strain and a CFU dose comparable to trials
A strain is named in three parts: the genus (Lactobacillus, Bifidobacterium, Bacillus), thespecies (rhamnosus, lactis, coagulans) and the strain code (GG, HN019, MTCC 5856). Only the third one allows finding the trials. Genus names have changed in recent years (Lactobacillus rhamnosus became Lacticaseibacillus rhamnosus in 2020; Bacillus coagulans, renamed Weizmannia then Heyndrickxia coagulans) and coexist on labels; the strain code does not change.
The dose is expressed in CFU, colony-forming units, that is, in microorganisms capable of multiplying; the right dose is that of the trial which demonstrated an effect. Two Cochrane reviews provide benchmarks. For diarrhea under antibiotics in children (33 trials, 6,352 participants), at 5 billion CFU per day or more, incidence dropped from 23% to 8% (relative risk 0.37); below that, from 13% to 8% without reaching significance. For prevention of upper respiratory infections (23 trials, 6,950 participants), most trials used one or two strains, for example Lactobacillus plantarum HEAL9 or Lactobacillus paracasei 8700:2, at 1 to 10 billion CFU per day for more than three months.
| Need | Strains and doses from trials | Level of evidence |
|---|---|---|
| Bloating, gas, irritable bowel | B. coagulans MTCC 5856, 2 billion spores, 4 weeks to 90 days; B. coagulans Unique IS2, 2 billion, 8 weeks; B. infantis 35624; L. plantarum 299v | Randomized trials and meta-analysis strain by strain 2026; MTCC 5856 trials funded by the manufacturer |
| Diarrhea under antibiotics | S. boulardii (21 trials); L. rhamnosus GG (12 trials); at least 5 billion per day | Meta-analyses and Cochrane review 2019, moderate certainty |
| Constipation, slow transit | B. lactis (including HN019 and DN-173 010), short courses | Meta-analyses 2013 and 2014, high heterogeneity |
| Intimate flora, bacterial vaginosis | L. rhamnosus GR-1 and L. reuteri RC-14 orally, 1 billion of each twice daily, 30 days; L. crispatus CTV-05 vaginally | Randomized trials of 125 and 228 women |
| Winter infections | L. plantarum HEAL9, L. paracasei 8700:2 and others, 1 to 10 billion, more than 3 months | Cochrane review 2022, weak to moderate certainty |
| Mood, weight | Various strains; for adiposity, decreases seen only at 10 billion or more for at least 8 weeks | Meta-analyses: small effects |
Criterion 2: surviving the stomach and time
The first obstacle is gastric acidity. Lactobacilli and bifidobacteria are fragile cells; bacteria of the Bacillus genus come in the form of spores, a dormant form protected by multiple envelopes, which germinates in the intestine. The study below, conducted with the manufacturer of a specific strain, illustrates this.
Introduced into the gastric compartment in the presence of a meal, spores of Bacillus coagulans GBI-30, 6086 survived 97% through gastric transit, with 76% still in spore form. After the small intestine, 51% of the oral dose was found in the form of viable cells, of which 93% were germinated cells, with measurable metabolic activity.
Keller D, Verbruggen S, Cash H, et al. Benef Microbes 2019;10(1):77-87. DOI: 10.3920/BM2018.0037
For non-sporulating strains, the timing of intake matters: in a model of stomach and duodenum, a mixture of four strains in capsule (Lactobacillus helveticus R0052, Lactobacillus rhamnosus R0011, Bifidobacterium longum R0175 and Saccharomyces boulardii) survived best when taken with a meal or 30 minutes before, and poorly when taken 30 minutes after; the yeast was unaffected. The authors, employees of a manufacturer, conclude that bacterial probiotics without enteric coating should be taken with or just before a meal containing some fat. Enteric-coated capsules delay their opening for the same purpose.
The second obstacle is time: the useful dose is that guaranteed "at the expiration date," not "at manufacture." Fragile strains are often stored in the refrigerator; spores tolerate room temperature. Our Probiomix also uses a sporulated form, Heyndrickxia coagulans MTCC 5856, whose gastric survival was not measured in this model: 2 billion spores per day, in HPMC vegetable capsules. In 30 healthy adults, the same strain at 2 billion CFU per capsule for 28 days caused no adverse effects and made little change to an already balanced microbiota; the amount of B. coagulans in stool varied considerably from person to person, both before and after the course.
| Format | Gastric survival | Stability and use |
|---|---|---|
| Bacillus spores (B. coagulans) | 97% gastric survival for strain GBI-30, 6086 in a digestive model (not measured for MTCC 5856) | Room temperature; with a meal in the model; on an empty stomach in practice |
| Standard capsule of lactobacilli or bifidobacteria | Better with or 30 minutes before a meal, weak 30 minutes after | Frequent refrigeration; check the dose at the expiration date |
| Gastro-resistant capsule | Coating that delays opening after the stomach | Less dependent on meals; stability according to strain |
| Yeast (Saccharomyces boulardii) | Unaffected by meal timing in the digestive model | Stable at room temperature; the most studied under antibiotics |
| Inactivated postbiotic | Not applicable: cells already inactivated | Very stable; dosed in milligrams, not CFU |
Criterion 3: associated prebiotic, postbiotic and excipients
Combining a prebiotic with a probiotic meets the definition of a synbiotic. The acacia fiber (gum arabic) is one of the best-documented prebiotics in humans. In a randomized double-blind trial by an ingredient manufacturer, healthy volunteers consumed 5, 10, 20, or 40 g of gum arabic per day for 4 weeks, versus water or 10 g of inulin: bifidobacteria and lactobacilli in stool were significantly more abundant than with water, with an optimum around 10 g per day, where gum arabic performed at least as well as inulin, without digestive discomfort. Our Probiomix provides 600 mg of Fibregum acacia fiber per day, much less than the 10 g in this trial: this dose contributes to fiber intake without reproducing, on its own, the measured effect; its benefit is its tolerance, with the formula remaining low in FODMAP.
The postbiotics open another pathway. In 200 healthy adults, 50 billion inactivated cells of Lacticaseibacillus paracasei MCC1849 per day for 24 weeks reduced the number of days of nasal congestion and cold-like symptoms, in a trial funded by the strain manufacturer. Our Probiomix contains 50 mg of Plenibiotic, a heat-inactivated Lacticaseibacillus paracasei 327 preparation, with no clinical human trial identified in PubMed: we attribute no results obtained with MCC1849 or other strains to it. Its role is that of a postbiotic in the sense of the 2021 consensus, stable and without survival constraints.
Check the capsule (animal gelatin or HPMC vegetable), the presence of lactose, gluten, sugars, sweeteners or colorants, and declared allergens. For a sensitive stomach, a formula without lactose, without gluten, without sugar and low in FODMAP avoids an irritant.
Bloating and irritable bowel
For Bacillus coagulans MTCC 5856, the LactoSpore strain, randomized trials against placebo come from its manufacturer. In the first, 36 patients with diarrhea-predominant irritable bowel disease received, with standard care, 2 billion CFU per day or placebo for 90 days: bloating, pain, diarrhea and stool frequency decreased significantly. The most recent in adults involved 70 bloated adults.
In 66 adults who completed the study, the indigestion score on the GSRS scale, which measures gas and bloating, decreased from 8.91 to 3.06 with Bacillus coagulans MTCC 5856 (2 billion spores per day for 4 weeks), compared to 9.42 to 8.43 under placebo. Overall patient assessment increased from a median of 3 to 9 out of 10, compared to 3 to 4 under placebo, with no adverse effects. Trial funded by the strain manufacturer.
Majeed M, Nagabhushanam K, Paulose S, et al. Medicine (Baltimore) 2023;102(9):e33109. DOI: 10.1097/MD.0000000000033109
Two independent meta-analyses incorporated MTCC 5856 trials conducted in irritable bowel. A network meta-analysis of 81 trials (9,253 participants) ranked each strain criterion by criterion: Bacillus coagulans MTCC 5856 ranked among the most effective for abdominal pain (SUCRA score 96.9%) and stool consistency in diarrhea-predominant irritable bowel (99.6%), with Lactobacillus acidophilus DDS-1 ranking first on overall severity score. The 2026 strain-by-strain meta-analysis, more stringent, confirms improved quality of life with MTCC 5856 but ranks efficacy on key symptoms favoring B. infantis 35624, L. rhamnosus GG, L. plantarum 299v, S. cerevisiae CNCM I-3856 and B. coagulans Unique IS2. For the latter, a manufacturer trial in 136 adults (2 billion CFU per day, 8 weeks) showed less pain and more complete spontaneous bowel movements compared to placebo.
In these trials, Bacillus coagulans MTCC 5856 was taken at 2 billion spores per day for 4 weeks to 90 days; our Probiomix provides exactly this dose, in a course of 1 to 3 months. The dietary causes of bloating are in our guides to reduce bloating and on bloated belly.
Constipation and slow transit
For functional constipation in adults, a meta-analysis of 14 randomized trials (1,182 patients) measures with probiotics a reduction in total transit time of 12.4 hours, 1.3 more bowel movements per week and better consistency (effect size 0.55, a moderate effect). The effect was significant for Bifidobacterium lactis (+1.5 bowel movements per week) but not for Lactobacillus casei Shirota (−0.2), with high heterogeneity and significant risk of bias.
Another meta-analysis, on transit time in 464 adults, measures an overall effect of 0.40, more pronounced in constipated individuals (0.59) than in others (0.17), and clearer with Bifidobacterium lactis HN019 (0.72) and DN-173 010 (0.54). The effect exists mainly in truly constipated individuals and remains modest; fiber remains in first place, as detailed in our article on konjac and fiber for transit.
Antibiotic-associated diarrhea and acute diarrhea
This is the area with the strongest evidence, detailed by two strain-by-strain meta-analyses. With Saccharomyces boulardii, 21 trials (4,780 participants) show a risk reduced from 18.7% to 8.5% (relative risk 0.47), meaning 10 people to treat, in adults (17.4% to 8.2%) as well as in children (20.9% to 8.8%). With Lactobacillus rhamnosus GG, 12 trials (1,499 participants) show a risk reduced from 22.4% to 12.3% (relative risk 0.49), significant in children only; in adults, only in the subgroup treated for Helicobacter pylori (relative risk 0.26), with weak to moderate quality of evidence.
In children receiving antibiotics, the incidence of diarrhea was 8% with a probiotic versus 19% without (relative risk 0.45, 9 children to treat to prevent one case, moderate certainty). At 5 billion CFU per day or more, it decreased from 23% to 8%, meaning 6 children to treat, and diarrhea lasted nearly one day less. No serious adverse effects were attributed to probiotics, but observational studies have described serious infections in severely weakened or immunocompromised children.
Guo Q, Goldenberg JZ, Humphrey C, et al. Cochrane Database Syst Rev 2019;4(4):CD004827. DOI: 10.1002/14651858.CD004827.pub5
For acute infectious diarrhea, the 2020 Cochrane review (82 trials, 12,127 participants, mostly children) is cautious: in trials with low risk of bias, probiotics did not change the number of diarrheal episodes lasting 48 hours or more. A manufacturer's trial tested Bacillus coagulans MTCC 5856 at 4 billion spores per day for 5 days, with oral rehydration and zinc, in 110 children aged 1 to 10 years: diarrhea lasted 51.3 hours versus 62.7 hours under placebo. Single trial in children, at a double dose of our Probiomix, which is not intended for children under 6 years.
In the trials, the probiotic is started with the antibiotic and continued throughout the course. Spacing the two doses a few hours apart is common practical advice; the yeast Saccharomyces boulardii is not sensitive to antibacterial antibiotics.
Intimate flora: bacterial vaginosis, yeast infection and cystitis
The search "best probiotic for intimate flora" almost always returns Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, taken orally and found in the vagina after oral intake in the reference trial, summarized below.
In 106 women reviewed at 30 days, 88% of those who received metronidazole (7 days) combined with Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 orally (1 billion each, twice daily, 30 days) were cured of their bacterial vaginosis, compared to 40% with metronidazole and placebo. Lactobacilli were found in large quantities in the vagina in 96% of supplemented women, versus 53%.
Anukam K, Osazuwa E, Ahonkhai I, et al. Microbes Infect 2006;8(6):1450-1454. DOI: 10.1016/j.micinf.2006.01.003
By vaginal route, a phase 2b trial funded by the National Institutes of Health tested Lactobacillus crispatus CTV-05 in 228 women after a metronidazole gel: recurrence of bacterial vaginosis at 12 weeks in 30% of women receiving probiotic versus 45% receiving placebo (relative risk 0.66). For vaginal yeast infection, the 2017 Cochrane review (10 trials, 1,656 women) concludes that as a supplement to an antifungal, probiotics slightly increase short-term healing (relative risk 1.14) and reduce relapses at one month (relative risk 0.34), with low-quality evidence and no demonstrated benefit at three months. For urinary tract infections, the 2015 Cochrane review (9 studies, 735 people) finds no significant reduction in recurrences versus placebo (relative risk 0.82 across 6 studies and 352 people), with studies too small to conclude. Cranberry has distinct data, detailed in our article on recurrent urinary tract infections ; our Organic Cranberry is its capsule form.
In all positive trials, lactobacilli were added to antibiotic or antifungal treatment, without replacing it. Unusual discharge, odors, burning or pain warrant diagnosis: bacterial vaginosis, yeast infection, sexually transmitted infection and urinary tract infection are not treated the same way. During pregnancy or breastfeeding, consult your doctor or midwife.
Immunity, winter infections and skin
The 2022 Cochrane review on upper respiratory infections (23 trials, 6,950 participants of all ages) concludes that probiotics could reduce the number of people experiencing at least one episode (relative risk 0.76, low certainty), probably reduce those experiencing three or more (relative risk 0.59, moderate certainty), shorten an episode by 1.22 days and probably reduce antibiotic use (relative risk 0.58), with no more adverse effects (relative risk 1.02). Most trials used one or two strains at 1 to 10 billion CFU per day for over three months.
Zinc complements this approach: the 2024 Cochrane review (34 studies, 8,526 participants) concludes it probably has little or no effect on cold occurrence (relative risk 0.93), but could reduce its duration by 2.37 days when taken at the first symptoms, with more non-serious adverse effects (relative risk 1.34). The forms studied were lozenges, mostly gluconate (45 to 276 mg per day), for 4.5 to 21 days, doses far exceeding nutritional intakes. A rapid review of 28 trials (5,446 adults) points in the same direction: 5 respiratory infections avoided per 100 person-months (moderate certainty) and symptoms resolved 2 days earlier (very low certainty). Our article on zinc and the common cold and our guide immunity: what really works place probiotics, zinc and vitamin D in the same framework. ★ OUR FORMULA
skin front, oral probiotics have been tested against acne in only three randomized trials (231 participants), pooled in a 2025 meta-analysis: modest reduction in inflammatory lesions (effect size −0.57), with substantial heterogeneity and a prediction interval that does not exclude absence of effect. For oral zinc, a 2020 meta-analysis observes lower blood levels in acne-prone individuals and a reduction in inflammatory papules with zinc, with no more adverse effects than comparators. Our articles onzinc against acne and on acne, gut and probiotics review the forms and durations. 11
Psychobiotics and weight-loss probiotics exist in studies, provided you read the effect sizes.
L'axe intestin-cerveau a fait naître le terme de psychobiotic. A systematic review of 54 randomized placebo-controlled trials, with 30 meta-analyzed, concludes that most probiotics did not change mood, stress, or anxiety; in pooled data, depression improved slightly (mean difference −0.37), as did psychological distress (−0.33). A pilot trial by the manufacturer in 40 patients with both major depression and irritable bowel syndrome tested Bacillus coagulans MTCC 5856 at 2 billion spores per day for 90 days: depression scores and quality of life improved compared to placebo, which does not make it a depression treatment, which requires medical follow-up. Our article on cortisol and stress details the mechanisms tested in trials.
For weight, a meta-analysis of 26 trials (1,720 overweight or obese adults) measures with probiotics a weight loss of 0.70 kg, a BMI reduction of 0.24 kg/m² and 1.13 cm less waist circumference; adiposity reductions appeared only in trials with at least 10 billion CFU for at least 8 weeks. Real but small effects: no probiotic causes weight loss on its own.
How to take a probiotic, and for whom it is not indicated
The timing of intake depends on gastric survival: standard capsule of lactobacilli or bifidobacteria with or just before a meal; yeast or spores at any time, in the morning on an empty stomach with a large glass of water being the simplest. The duration depends on the trials: 4 weeks to 90 days for bloating, the full course of antibiotics, a few weeks for transit, 30 days for intimate flora, at least three months for winter. The steps below are practical advice, not study results.
The safety is good in trials: 4% adverse effects versus 6% without probiotic in the pediatric Cochrane review, no serious attributable effects; relative risk of 1.02 in the Cochrane review on respiratory infections, mostly minor digestive disorders. A systematic review of safety identifies septicemia, fungemia and intestinal ischemia as serious reported effects, essentially in intensive care, in severely ill infants, recent post-operative patients and immunocompromised individuals.
Immunosuppression (chemotherapy, transplant, uncontrolled HIV, long-term corticosteroid therapy), Serious illness or hospitalization, central venous catheter, recent digestive surgery, acute pancreatitis, Prematurity : the serious cases reported concern these situations. Pregnancy, breastfeeding, children under 6 years old : Probiomix is not recommended, nor is Zinc during pregnancy and breastfeeding. If you are undergoing treatment or have a health condition, consult a healthcare professional.
2 billion spores of LactoSpore (Heyndrickxia coagulans MTCC 5856), 600 mg of Fibregum acacia fiber and 50 mg of Plenibiotic (inactivated Lacticaseibacillus paracasei 327) per day, in HPMC vegetable capsules. Two capsules in the morning on an empty stomach, in a treatment course of 1 to 3 months renewable. Gluten-free, lactose-free, vegan, low FODMAP. Not recommended for children under 6 years old or pregnant or breastfeeding women.
View ProbiomixFor winter, our Zinc provides 14.16 mg of elemental zinc and 2 mg of vitamin B6 per day.
Frequently asked questions
What is the best probiotic?
There isn't just one: a review of 228 trials shows that efficacy depends on the strain and the indication. The best one is the one whose strain has been tested for your objective, at the dose used in trials, in a format that survives the stomach and remains stable until expiration.
What is the best probiotic for intimate flora?
Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 taken orally: combined with metronidazole in 125 women with bacterial vaginosis, they brought the cure rate at 30 days to 88% compared to 40% with placebo. They complement a treatment, they do not replace it.
What are the best probiotics in pharmacies?
In pharmacies as well as online, the criteria are the same: complete strain with its code, CFU dose guaranteed until expiration and comparable to trials, format that survives the stomach. Where you buy a product does not determine its quality; the label does.
Which probiotic for bloating?
Bacillus coagulans MTCC 5856, tested at 2 billion spores per day for 4 weeks in 70 adults with bloating in a manufacturer trial: gas and bloating score decreased from 8.91 to 3.06 compared to 9.42 to 8.43 under placebo. Bacillus coagulans Unique IS2, Bifidobacterium infantis 35624 and Lactobacillus plantarum 299v also have positive trials.
Which probiotic to take with antibiotics?
Saccharomyces boulardii (21 trials, diarrhea risk reduced from 18.7% to 8.5%) and Lactobacillus rhamnosus GG (12 trials, especially in children), at 5 billion CFU per day or more according to the Cochrane review. Begin with the antibiotic and continue throughout the entire course.
How many billion CFU are needed?
It depends on the strain: 2 billion for Bacillus coagulans MTCC 5856 or Unique IS2, at least 5 billion with antibiotics, 1 to 10 billion for more than three months for winter, at least 10 billion for at least 8 weeks for effects on adiposity. The right dose is the one used in the trial.
Spores or enteric-coated capsules: which to choose?
Both aim for survival in the stomach. Bacillus coagulans GBI-30, 6086 spores survived 97% of gastric transit in a digestive model; this measurement does not exist for MTCC 5856, which is also a spore-forming strain. Spores keep at room temperature; enteric-coated capsules protect fragile strains, often requiring refrigeration.
Should you take a probiotic on an empty stomach or with meals?
Standard capsule of lactobacilli or bifidobacteria: with food or 30 minutes before a meal, as survival is much better than after a meal in a digestive model. Spores or yeast: the timing matters little; morning on an empty stomach with a large glass of water is simplest.
How long does a probiotic treatment course last?
Trials lasted 4 weeks to 90 days for bloating, the entire duration of antibiotic use, a few weeks for transit, 30 days for intimate flora and more than three months for winter. A treatment course of 1 to 3 months, renewable, covers most objectives.
Do probiotics help with weight loss?
Slightly. A meta-analysis of 26 trials in 1,720 overweight adults measured a weight loss of 0.70 kg and 1.13 cm waist circumference; reductions in adiposity only appeared in trials with at least 10 billion CFU for at least 8 weeks. Real but modest effects.
Do probiotics affect mood?
Slightly. In a meta-analysis of 30 trials, depression and psychological distress improved somewhat (mean differences of −0.37 and −0.33), with most strains not affecting mood. Depression requires medical supervision.
Who should not take probiotics?
Without medical advice: immunocompromised individuals, hospitalized or seriously ill persons, those with a central catheter, recently operated patients, and premature infants, in whom septicemia and fungemia have been reported. Our Probiomix is not recommended during pregnancy, breastfeeding and before age 6.
Sources
The studies cited below were identified via PubMed.
- Guo Q, Goldenberg JZ, Humphrey C, et al. Probiotics for the prevention of antibiotic-associated diarrhea in children. Cochrane Database of Systematic Reviews, 2019;4(4):CD004827. DOI
- Anukam K, Osazuwa E, Ahonkhai I, et al. Enhancement of metronidazole treatment for bacterial vaginosis by oral probiotics Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized double-blind placebo-controlled trial. Microbes and Infection, 2006;8(6):1450-1454. DOI
- Zhao Y, Dong BR, Hao Q. Probiotics for the prevention of acute upper respiratory tract infections. Cochrane Database of Systematic Reviews, 2022;8(8):CD006895. DOI
- Keller D, Verbruggen S, Cash H, et al. Bacillus coagulans GBI-30, 6086 spores demonstrate high germination, survival, and enzymatic activity in a dynamic computerized model of the gastrointestinal tract. Beneficial Microbes, 2019;10(1):77-87. DOI
- McFarland LV, Evans CT, Goldstein EJC. Strain specificity and disease specificity of probiotic efficacy: systematic review and meta-analysis. Frontiers in Medicine, 2018;5:124. DOI
- Hill C, Guarner F, Reid G, et al. Expert consensus document: consensus statement from the International Scientific Association for Probiotics and Prebiotics on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology, 2014;11(8):506-514. DOI
- Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: ISAPP consensus statement on the definition and scope of prebiotics. Nature Reviews Gastroenterology and Hepatology, 2017;14(8):491-502. DOI
- Salminen S, Collado MC, Endo A, et al. ISAPP consensus statement on the definition and scope of postbiotics. Nature Reviews Gastroenterology and Hepatology, 2021;18(9):649-667. DOI
- Swanson KS, Gibson GR, Hutkins R, et al. ISAPP consensus statement on the definition and scope of synbiotics. Nature Reviews Gastroenterology and Hepatology, 2020;17(11):687-701. DOI
- Ford AC, Harris LA, Lacy BE, et al. Systematic review with meta-analysis: efficacy of prebiotics, probiotics, synbiotics, and antibiotics in irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 2018;48(10):1044-1060. DOI
- Maslennikov R, Gosteeva E, Ananeva V, et al. Systematic strain-by-strain review with meta-analysis of probiotic efficacy in the treatment of irritable bowel syndrome. Journal of Clinical Medicine, 2026;15(3):1152. DOI
- Tompkins TA, Mainville I, Arcand Y. The impact of meals on a probiotic during transit in a model of the human upper digestive tract. Beneficial Microbes, 2011;2(4):295-303. DOI
- Majeed M, Nagabhushanam K, Mundkur L, et al. Probiotic modulation of the intestinal microbiota by Bacillus coagulans MTCC 5856 in healthy subjects: randomized double-blind placebo-controlled trial. Medicine, 2023;102(20):e33751. DOI
- Calame W, Weseler AR, Viebke C, et al. Gum arabic establishes prebiotic functionality in healthy volunteers in a dose-dependent manner. British Journal of Nutrition, 2008;100(6):1269-1275. DOI
- Sato S, Arai S, Iwabuchi N, et al. Effects of heat-inactivated Lacticaseibacillus paracasei MCC1849 on maintaining physical fitness in healthy adults: randomized double-blind placebo-controlled trial. Nutrients, 2023;15(15):3450. DOI
- Majeed M, Nagabhushanam K, Natarajan S, et al. Supplementation with Bacillus coagulans MTCC 5856 in the management of diarrhea-predominant irritable bowel syndrome: randomized double-blind placebo-controlled pilot trial. Nutrition Journal, 2016;15:21. DOI
- Majeed M, Nagabhushanam K, Paulose S, et al. Effects of Bacillus coagulans MTCC 5856 on functional gas and bloating in adults: randomized double-blind placebo-controlled trial. Medicine, 2023;102(9):e33109. DOI
- Xie P, Luo M, Deng X, et al. Efficacy by endpoint of different probiotic strains and combinations in irritable bowel syndrome: systematic review and network meta-analysis. Nutrients, 2023;15(17):3856. DOI
- Madempudi RS, Ahire JJ, Neelamraju J, et al. Randomized clinical trial: effect of the probiotic Bacillus coagulans Unique IS2 versus placebo on symptoms of irritable bowel syndrome in adults. Scientific Reports, 2019;9(1):12210. DOI
- Dimidi E, Christodoulides S, Fragkos KC, et al. Effect of probiotics on functional constipation in adults: systematic review and meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, 2014;100(4):1075-1084. DOI
- Miller LE, Ouwehand AC. Probiotic supplementation reduces intestinal transit time: meta-analysis of randomized controlled trials. World Journal of Gastroenterology, 2013;19(29):4718-4725. DOI
- Szajewska H, Kolodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea. Alimentary Pharmacology and Therapeutics, 2015;42(7):793-801. DOI
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