Product Reviews
Probiotic Supplements Review (Including Pet Probiotics)
 

Reviewed and edited by Tod Cooperman, M.D. Tod Cooperman, M.D.
Initial Posting: 4/5/2020 Last update: 6/5/2020
Probiotic Supplements Reviewed by ConsumerLab.com
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Summary: What You Need to Know About Probiotics

There is such a variety of probiotic products available for purchase that choosing one can be difficult. On top of that, our tests showed that some products are lacking in quality and were "Not Approved". To help, we suggest that you first check our Results table to find identify products "Approved" for quality in our testing. Then consider the following:
  • Choose a product that contains the type(s) and amounts of probiotic organism(s) shown to work for your condition. See the "What They Do" and then check the Results table for products that contain that/those organism(s).
    • COVID-19 UPDATE: Probiotics have been promoted on some websites to help prevent or treat COVID-19, the infection caused by the SARS-CoV-2 virus. There is no direct evidence of such a benefit. There is preliminary evidence that certain probiotic strains have anti-viral effects (based on studies with other viruses) and some physicians in China have reported imbalances in intestinal bacteria in patients with COVID-19. See the COVID-19 section for details.
  • See our see our Top Picks for some of the most common uses of probiotics.
  • Be aware that there can be huge variation in the number of viable cells (CFUs) from product to product. Among products tested, this ranged from just 100 million to hundreds of billion! Typically, an adult probiotic should provide at least 1 billion cells daily — although, as discussed in the "What They Do" section, some probiotics have been shown to work at a lower dose.
  • Cautions If you have a milk allergy, be aware that trace amounts of milk proteins may occur in some probiotics (see Concerns and Cautions).
UPDATE (4/23/20):
CL was contacted this month by the company that makes one of the probiotics that was Not Approved in this Review due to two independent laboratories finding it to be contaminated. The company disputed CL's results, and we've offered the company an opportunity to retest the product at a third-party laboratory of mutual acceptance.

What They Are:
Probiotic products consist of viable (live) bacteria and/or yeasts that confer a health benefit. Probiotics are available in varied forms such as yogurt and other cultured milk foods, capsules, tablets, beverages, and powders. Probiotics should not be confused with prebiotics, which are complex sugars (such as inulin and other fructo-oligosaccharides) that are ingested as fuel for bacteria already present in the gastrointestinal tract. Prebiotics and probiotics are sometimes combined in the same product and termed synbiotics.

Although not included in this current Review, in past years, ConsumerLab has also tested probiotic-containing fermented drinks: kefir and kombucha.

Kefir
In 2015, ConsumerLab tested three popular kefir (cultured milk) products (Evolve, Lifeway, and Latta) and found huge amounts of live cells per cup (respectively, 950 billion, 250 billion, and 150 billion cells). Interestingly, although people with lactose intolerance are often advised to consumer kefir instead of milk, all the kefirs contained lactose, ranging from 8.2 to 12.7 grams per cup, nearly as much as in milk. However, enzymes from the bacteria in kefir may help breakdown lactose in the digestive tract.

Kombucha
Kombucha is a probiotic beverage produced by fermenting sweetened black or green tea with bacteria and yeast. Depending on the type of tea, sugar, and starter bacteria and yeast used, the resulting liquid contains varying amounts and types of bacteria and yeast, tea catechins (such as epigallocatechin gallate i.e. EGCG), organic acids (including acetic, lactic and gluconic acid), caffeine, sugars (sucrose, lactose, glucose, and fructose) and small amounts of ethanol (alcohol), amino acids, vitamins and minerals (Greenwalt J Food Proct 2000).

As a result of fermentation, kombucha is naturally lightly carbonated with a slightly vinegary taste. Fruit juices and/or spices and other ingredients may be added for flavor or to provide the sugar that is fermented. (See What to Consider When Buying and Using).

The starter culture of yeast and bacteria used to ferment the tea is called a SCOBY (symbiotic culture of bacteria and yeast), Medusomyces gisevi, or "mother" (a term also used to describe the culture in apple cider vinegar). Due to the mushroom-like shape and brown color of the SCOBY, pieces of which may remain in the liquid after processing, kombucha is also referred to as "mushroom tea."

(For the clinical evidence regarding kombucha see the end of the next section).

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