Quality Probiotic Supplements –
How to Find a Brand You Can Trust

The Right Product Can Improve Your Microbiome

Interest in probiotic supplements and probiotics in general has mushroomed into the latest craze in modern health--microflora of “good bacteria” that’s found naturally in the human body. Some research shows these supplemental populations of “friendly bacteria” in the gut help to improve diverse health issues from diarrhea to gout.  But six studies found 95 of 106 products failed to provide viable bacterial counts when compared to labels.

These discrepancies illustrate the importance in finding a manufacturer whose bacterial contents validate label statements, and whose testing and production processes guarantees live delivery past stomach acids into the large intestine, .

The probiotic market has grown rapidly, both for foods and supplements intended to enhance wellness in healthy individuals, and for preparations for the dietary management of disease.

Navigating the world of probiotics can be extremely daunting.  Each company claims theirs is the best, even backing up claims with scientific evidence.  To add to the confusion, there are different strains, species, genuses, dosages and sources.

I did the research for you.  Please see the paragraph below "How to find a probiotics supplement company you can trust."

Is lack of regulation the cause of a 90 per cent "failure" rate of label claims? 

Can Probiotic Supplements Be Trusted?

"The problem is that because the probiotic marketplace is largely unregulated, it's impossible to know what, if anything, you're getting when you buy a probiotic product," wrote Michael Pollan in "Some of My Best Friends Are Germs".  The article appeared in The New York Times Magazine, May 15, 2015.  Pollan is a nationally-recognized food author, activist and journalism professor at Harvard University.

"Current regulation of probiotics is inadequate to protect consumers and doctors, especially when probiotics are aimed ath the dietary management of serious conditions," the author concluded in a clinical review entitled The Unregulated Probiotic Market.  It was published online in the journal Clinical Gastroenterology and Hepatology, March 14, 2018.  The author, Professor Claudio De Simone, is recognized internationally as a pioneer in the field of intestinal microflora

In researching this problem, I identified six separate studies that found 95 of a total of 106 probiotic samples did not have viable bacterial counts as mentioned on the labels. This is a 90 per cent "failure" rate.  Three of the studies involved foreign-made products that may also be marketed in the United States.  This serves to indicate a potential international quality problem for probiotic supplements. 

One study (Pankaj  Y, 2018) found all three samples tested did not have uniform counts. These results were in agreement with some of the previously done studies.(1)  In a study by Elliot, et al (2) only three out of nine tested probiotic supplements from South Africa were found to be containing the same bacteria as mentioned on the label, while studies by Berman, et all (3 and Temmerman, et al 4) found only one in twenty and six of fifty five of the different probiotic supplements tested to be consistent with the product label, respectively. 

In the fifth study, Patrone, et al (5) analyzed five probiotics and found all five had bacterial species and counts that varied from brand labels.  And in the sixth study, Marcobal, et al tested 14 commercial probiotics and found that only one contained the exact species stated on the label.6)

Probiotic supplements are regulated as foods, not drugs

It should be noted that probiotic products taken by mouth as dietary supplements are manufactured and regulated as foods, not drugs. Foods are not regulated as rigidly as drugs

Lack of rigidity in testing and processing is at the root of the problem in producing quality probiotic supplements.

The Food and Drug Administration (FDA) is the enforcement arm of the current Good Manufacturing Practices (cGMP) rules for dietary supplement makers.  These guidelines are often characterized by health officials and industry watchdogs as "too weak" and "lacking teeth" to ensure safety, quality and efficacy. 

Of particular concern is a lack of standardized testing protocols for an  industry where performing "a single test" satisfies the requirements. Some companies don't test at all.

Unlike the pharmaceutical industry, there is no requirement that a dietary supplement maker prove product efficacy or conduct clinical studies of any kind.  The FDA does not approve or even examine the product before it's marketed.

The result: The quality of probiotic supplements or gout supplements, for example, can vary widely from one manufacturer to another.(7)  

What are probiotics?

Probiotics are dietary supplements of live bacteria or yeasts thought to be healthy for the digestive tract. By definition, probiotics are live microorganisms (microflora) which when administered in adequate amounts confer a health benefit on the host.

Most probiotics are good bacteria similar to those naturally found in people's guts, especially in those of breastfed infants (who have natural protection against many diseases). Most often, the bacteria come from two groups, Lactobacillus or Bifidobacterium. Within each group, there are different species (for example, Lactobacillus acidophilus and Bifidobacterium bifidus), and within each species, different strains (or varieties).

Probiotics help to maintain healthy intestinal microbial balance. The term literally means “healthful for life,” and today, probiotics has a broader definition: a live microbial supplement which beneficially affects the host by improving its microbial balance.

Good probiotic supplements benefit a wide range of health issues

The bacterial colony of good and bad bacteria in the gut is collectively known as the human microbiome. However, content analysis of commercially available probiotics reveals a high percentage of such products . 

According to the U.S. government’s National Center for Complementary and Alternative Medicine (NCCAM), some uses of probiotics for which there is encouraging evidence from scientific study of specific probiotic formulations are as follows:

  • To treat diarrhea (this is the strongest area of evidence, especially for diarrhea from rotavirus, a viral infection of the digestive tract. It is the most common cause of severe diarrhea in infants and young children in the United States)
  • To enhance the immune function
  • Reduce the development of allergy in children
  • Decrease Helicobacter pylori (H-pylori) colonization of the stomach
  • Help patients cope with side effects of antibiotic therapy (most notable: diarrhea)
  • To prevent and treat infections of the urinary tract or female genital tract
  • To assist lactose intolerant people with lactose digestion
  • To treat irritable bowel syndrome (IBS)
  • To reduce recurrence of bladder cancer and decrease the risk of certain other cancers (colon, stomach)
  • To shorten how long an intestinal infection lasts that is caused by a bacterium called Clostridium difficile
  • To prevent and treat pouchitis (a condition that can follow surgery to remove the colon)
  • To prevent and manage atopic dermatitis (eczema) in children
  • Keeping healthy people healthy

In studies of probiotics as cures, any beneficial effect was usually low; a strong placebo effect often occurs; and more research (especially in the form of large, carefully designed clinical trials) is needed in order to draw firmer conclusions. Nonetheless, it is unmistakable that probiotic supplements are helpful with a myriad of health conditions.

If you have the following symptoms, you may need probiotic supplements

Here are the most common warning signs of a bacterial imbalance (if you suffer one or more of these problems it is quite likely that taking probiotic supplements could help balance your intestinal microflora):

  • Allergies and food sensitivities
  • Difficulty losing weight, sugar/carbohydrate craving
  • Frequent fatigue, poor concentration
  • Frequent constipation or diarrhea
  • Faulty digestion, acid reflux and other gut disorders
  • Sleeping poorly, night sweats
  • Painful joint inflammation, stiffness
  • Bad breath, gum disease and dental problems
  • Frequent colds, flu or infections
  • Chronic yeast problems
  • Acne, eczema skin and foot fungus
  • Extreme menstrual or menopausal symptoms

Long-term imbalance of bacteria in the colon can manifest serious health problems, including stomach and colon cancers. Under any circumstances, long-term imbalance underlines your body's need for probiotic supplements.

Other common factors that challenge good bacteria in the gut

We never really kill off all of our probiotics, but we can quickly and easily disrupt their fragile balance. Here are other common factors that challenge our good bacteria and put our ratio of good bacteria/bad bacteria out of balance::

  • Birth control pills
  • Steroidal and hormonal drugs
  • Non steroidal Anti-inflammatory drugs (NSAIDs) and pain killers (both prescription and OTC)
  • Flouride (naturally found in tea, but also added to toothpaste and sometimes even to drinking water)
  • Chlorine (a chemical added to water to kill bacteria; also kills friendly bacteria)
  • Excessive alcohol consumption Coffee/Tea
  • Carbonated drinks, colas
  • Colitis, Crohn’s Disease, and gastroenteritis.
  • Relieve inflammation
  • Synthetic vitamins (a problem with many manufactured vitamin supplements)
  • Radiation (may come from many sources around the home, including TV’s and mobile phones)
  • Stress and tension (can also affect the composition of the flora, including a significant decrease in beneficial bacteria)
  • Preservatives(added to most processed foods), excess sugar and carbohydrates
  • Additives (colorings, flavorings, and many other chemicals that are commonly incorporated in processed foods)
  • Pesticides (residues in most vegetables and fruit; a reason to go organic)
  • Fertilizers (toxic chemicals all add up and tax the body’s microflora)
  • Traveling outside the country two, three or more times a year.
  • Other toxins such as excess uric acid from gout (one-third of uric acid is eliminated from the body via the colon)

What else causes an imbalance in good bacteria in the gut?

As living organisms, the beneficial bacteria in your gastrointestinal tract are susceptible to many of the same challenges as you are. Some of the challenges to beneficial bacteria include:

  • Antibiotic Use. The most common cause of imbalance in normal microflora populations is the use of antibiotics. Not terribly specific, antibiotics simultaneously kill both harmful and helpful bacteria throughout our system, including the mouth, urogenital tract, gastrointestinal tract, and skin, leaving these territories more vulnerable to organisms that are resistant to the antibiotic used.

    The overuse of broad-spectrum antibiotics is a growing public health concern. Experts are concerned that the routine use of antibiotics as domestic animal feed additives, as well as the unwarranted use of prescription antibiotics, may be contributing to an increasing ability of undesirable microorganisms to resist antibiotic control.

    There is also increasingly widespread use of low-dose topical anti-bacterial products, including household cleaners, hand soaps, and hand lotions. There is currently no way to know whether this addition to the antibiotic “load” in the environment may also contribute over the long term to the prevalence of drug-resistant “super-bugs.”

  • Antibiotic use in children is of particular concern. It is estimated that the use of pediatric antibiotics has been increasing by as much as 15 percent per year since 1990, due largely to the treatment of middle ear infections. According to the Centers for Disease Control and Prevention (CDC), antibiotics may be overused in children, as well as misused, particularly when prescribed for non-bacterial infections which cannot be cured with antibiotics. To help inform parents about the proper use of antibiotics, the CDC developed a webpage entitled "Get Smart- Know When Antibiotics Work".

  • Age. Research shows that the populations of beneficial microflora steadily decline with increasing age in both men and women. In addition, research has shown an increase in undesirable microorganisms in postmenopausal women. Studies suggest that age and related modifications in hormone patterns may induce changes in the normal microflora populations of women.

  • Diet. The typical “Western” diet—high in meat, high in total fat, and high in animal fat and protein—is associated with reduced populations of beneficial microflora. Studies have shown that when migrants from countries that do not follow Western eating habits settle in Western countries, their health patterns change to match the typical health profile of their adopted country.

  • Fiber Intake. Beneficial microflora “feed” on the otherwise undigested dietary fiber that is found in the colon. Diets low in dietary fiber are associated with lower populations of lactobacilli and bifidobacteria in the gastrointestinal tract.

  • Transitional Microflora Populations. The balance of intestinal microflora is constantly ebbing and flowing. Research has shown that regular dietary intake of beneficial microflora must be maintained to maintain their higher levels.

Each of the above challenges to the balance of good bacteria in your gut may be indicative of the need for probiotic supplements.

Uniquely designed probiotic supplements are able to pass through the stomach to deliver live ‘good bacteria’ into the intestine

A quality probiotic supplement delivers guaranteed live probiotics through the stomach into the intestine where they promote colon health by supporting the growth of healthy microflora naturally found in the colon.

To supply live probiotics to their intended target, the supplement must be uniquely designed in a capsule that is guaranteed to withstand the acidic environment of the stomach.

Advanced supplement designs often use patented or exclusive technology, such as triple encapsulation using only natural ingredients to protect microflora against stomach acid in a seamless outer shell. Middle layer protects against oxygen and moisture and inner layer or core hold and protects microflora until released in the intestine.

What Are Prebiotics?

Prebiotics are nutrients which selectively feed the friendly bacteria. Research has shown that supplementing with both prebiotics and probiotics can significantly increase populations of beneficial microflora.  In simple terms, prebiotics are a food source for probiotics. As prebiotics travel through the digestive system, they nourish the good bacteria along the way and help them grow and multiply. The result? More good bacteria in the gut, which means better digestive health and a stronger natural defense system.

A quality prebiotic supplement should be a pleasant-tasting drink mix that contains at least three grams of dietary fiber and features additional nutrients that selectively feed the friendly bacteria. These include fructooligosaccharides (FOS), a family of short-chain carbohydrates that deliver an immediate food source to nourish friendly bacteria; and inulin, long-chain carbohydrates that also provide nutrients for beneficial microflora.

Other nutrients in a good quality prebiotic include Jerusalem artichoke, a vegetable containing a natural source of inulin and FOS, as well as gamma tocopherol (related to alpha-tocopherol, the most well-known member of the vitamin E family), found in relatively high levels in colon cells. Studies have shown that dietary intake of vitamin E, and particularly gamma-tocopherol, may reduce levels of potentially toxic oxidation products in the colon.

What are synbiotics?

As probiotics are mainly active in the small intestine and prebiotics are only effective in the large intestine, the combination of the two may give a synergistic effect. Appropriate combinations of prebiotic supplements and probiotic supplements are called synbiotics.

Synbiotic components work together with probiotics to help beneficial bacteria flourish in the intestinal tract to support whole-body health. To optimize “friendly flora” a synbiotic (two product supplement) is recommended.

Research confirms safety of probiotic supplements

Research shows that regular dietary intake of beneficial microflora must be sustained to maintain their high levels. Probiotic supplements offer a safe and natural way to supplement the diet with beneficial microorganisms naturally found in the gastrointestinal tract.

Research studies indicate that normal, healthy colonies of lactobacilli and bifidobacteria can help maintain a healthy balance between beneficial and undesirable bacteria. Bifidobacteria constitute up to 25% of the total bacterial population of healthy adults, and up to 95% in newborn babies. Lactobacilli are common inhabitants of the intestinal microflora, usually found higher in the gastrointestinal tract than bifidus.

According to the National Institutes of Health (NIH) these live microorganisms have a long history of use in probiotics without causing illness in people. Side effects, if they occur, tend to be mild and digestive (such as gas or bloating).

Statistically speaking for the need of probiotic supplements

A great many people in the United States may be affected by factors which compromise the healthy balance of their intestinal microflora:

  • 270 million antibiotic prescriptions in 2015, amounting to 838 antibiotic prescriptions for every 1,000 people per CDC .
  • 37.5 million women are experiencing menopause per CDC.
  • Five out of six children will have at least one ear infection by their third birthday. Up to 50 percent of children in the United States take antibiotics for ear infections three or more times before they reach the age of five per NIH.
  • 20%-50% of international travelers, an estimated 10 million persons, develop diarrheaIt is estimated that 40 to 50 percent of people traveling in developing countries run the risk of experiencing gastrointestinal distress due to microflora imbalances per rightdiagnosis.com.
  • In addition, anyone eating a typical “Western” diet which is high in fat, high in animal protein, and low in fiber, may be at increased risk for disturbing the optimal balance of their intestinal microflora.

As you can see, there are a myriad of situational causes for using probiotic supplements on a regular, daily basis.

How to find a probiotics supplement company you can trust

Some find it puzzling that the FDA legislates each industry so differently. After all, natural supplements are used by consumers to treat identical health conditions doctors prescribe pharmaceutical drugs for (arthritis pain relief, by example).

It is of utmost importance to choose a manufacturer of probiotic supplements carefully. Find a company that has a large staff of scientists and voluntarily does clinical studies and pre-market testing on its products to ensure their efficacy. It's not easy to find such a company in an industry whose regulations do not require such diligence.  Natural supplements are often tried for many conditions based on tradition, anecdotes, or marketing, but not all of these uses are supported by reliable or credible scientific research.

That's why we developed this site. Arthritis-Relief-Naturally explores plant-based clinically-proven alternatives for pain relief and other symptoms that safely shut the door on harmful side effects from pharmaceutical drugs.The arthritis relief information on this site is based on science—concrete scientific evidence gleaned from hundreds of clinical studies—and not just personal opinion.

And that's especially true for fragile probiotic supplements, which require sophisticated testing and manufacturing processes to insure uniformity, purity, and quality.

Years ago, to help with the process of how to find the best dietary supplement company, I prepared a list of questions, the answers to which led me to the #1 natural nutrition company in the U.S.

Featured pre-biotic and probiotic supplements

This website was created to help people with osteoarthritis, rheumatoid arthritis and related disorders, such as gout, to learn about natural treatments to ease symptoms and improve overall health.

A healthy colon supported by the growth of healthy microflora naturally found in the colon is an important gout consideration. After extensively researching probiotic supplements as a treatment option for many types of arthritis we have discovered two probiotic and one prebiotic supplements that delivers live optimum flora that we’ve had tremendous success with.

The featured company has a 'beyond organic' manufacturing philosophy for ingredient verification and purity by screening for over 350 contaminants, pesticides, and impurities on every new botanical. This is three times more than U.S. Pharmacopeia standards. They also conduct over 100,000 quality tests per year to ensure their products are pure.

The featured probiotic supplement delivers unique benefits via a proprietary formula with 10 billion CFUs with four bacterial strains, including the powerhouse Bifidobacterium lactis™  Other features:

  • Clinically proven to support both digestive and immune health*:
  • Helps support intestinal flora balance/good bacteria*
  • Helps maintain regularity*
  • Helps reduce occasional gas, bloating and constipation*
  • Laboratory tested to survive stomach acid through the GI tract into the large intestine
  • Gentle cold processing to protect delicate strains
  • Gluten free, soy free, dairy free, no refrigeration required

It's scientists believe the digestive and immune enhanced blend of 10 billion CFUs is a special perfect level studied by clinical research, and includes these strains:

  • Bifidobacterium lactis 
  • Lactobacillus acidophilus 
  • Lactobacillus plantarum 
  • Lactobacillus rhamnosus 

Our recommendation for probiotic supplements is this advanced probiotic supplement

Prebiotic supplements are important to:

  • Maintain a healthy digestive balance*
  • Provide nutrients to feed friendly bacteria*
  • Promote long term intestinal health*

Our recommendation is for this prebiotic supplement 

The featured manufacturer also makes a two-product system consisting of the above prebiotic combined with a 500 million pearl-sized probiotic (tiny size, great starter for kids or as a minimum base probiotic for healthy adults).  Twenty years ago the featured manufacturer's scientists led the way in developing a triple coating for the pearl probiotic to survive stomach acid.

Each probiotics supplement is available with the prebiotic, or can be purchased as an individual probiotic. 

Try one or more of the above probiotic supplements and see if these natural, safe treatments work for you.

Probiotic Supplements Disclaimer: Health statements on this probiotic supplements page have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.


1. Pankaj Y, et al,  Content Analysis of Commerically Available Probiotics, Ind Pediatr, vol 55; April 15, 2018, P344-345

2. Elliot E, Teversham K. An evaluation of nine probiotics available in South Africa. S Afr Med J. August 2004;94:121-4.

3. Berman S, Spicer D. Safety and reliability of lactobacillus supplements in seattle, Washington (a pilot study). International J Alternative Med. 2003;1:2.

4. Temmerman R, Pot B, Huys G, Swings J. Identification and antibiotic susceptibility of bacterial isolates from probiotic products. Int J Food Microbiol. 2003;81:1-10.

5. Patrone V, Molinari P, Morelli L. Microbiological and molecular characterization of commercially available probiotics containing Bacillus clausii from India and Pakistan. Int J Food Microbiol. 2016;237:92-7.

6. Marcobal A, Underwood MA, Mills DA; Rapid determination of the bacterial composition of commercial probiotic products by terminal restriction fragment length polymorphism analysis; Pediatr Gastroenterol Nutr, 2008, May; 46(5):608-11. doi: 10.1097/MPG.0b013e3181660694

7 https://www.newsday.com/news/health/fda-official-70-of-supplement-companies-violate-agency-rules-1.5920525 Ricks, D, Newsday, NewsHealth, FDA Official: 70% of supplement companies violate agency rules. 2013, Aug 23

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