Dr. Sadeghi supported her statement by noting that she does not go out of her way to eat fermented foods. Until there are more studies to prove the benefits of ingested probiotics, you won’t find her popping any pills or spooning “gut-friendly” yogurt—nor will she recommend these to her patients.

According to Dr. Bulsiewicz, even though probiotic use is widespread and relatively safe, he is uncertain that most supplements actually do what they claim.

"The bottom line is that you want and should expect results from your probiotic. Unfortunately, many do not get results, and are left confused and frustrated that they spent so much money. To increase the odds of success with a probiotic, you should opt for the strain and quantity that has been proven in study to work for whatever medical condition you are trying to address," Dr. Bulsiewicz says.

… let's pretend hypothetically that you're in my clinic. Jonathan, you're my patient. Okay. To me, I want to start with getting at the root cause of the problem, and that starts with diet and lifestyle.

So I want to have a conversation about what we can do from a dietary perspective or with your lifestyle to try to get things working the way that they're supposed to. You can't take a person who has a C plus microbiome as a result of their diet and lifestyle and turn it into an a minus with a probiotic.

You can't do that, right? You can take the C plus, and maybe if you're lucky, you turned it into a B minus. So you're only getting a little bit of wiggle with the probiotics. After pill, there's no magic pill. And so even though we want it, you know, even though we want it and it's so sexy, um, it doesn't work that way.

After dynam lifestyle, the first thing that I would consider would be actually pre biotic, uh, pre P R E biotic, which is essentially soluble fiber. Soluble fiber allows us to feed an energize the healthy microbes that live inside of you. We are selecting for the right antiinflammatory microbes. And then what happens is they reward us by taking that fiber and transforming it into short chain fatty acids that have healing effects throughout the entire body.

And I wrote an entire chapter about short chain fatty acids, my book, because I'm so obsessed with them. So that would be number two. And the reason why it's number two for me. Is because it doesn't matter who you are. It could be, you could be me, we could have radically different, radically different microbiome, but the, the effect that you're going to get from the prebiotic is going to be beneficial to both of us because we are selecting for healthy microbes.

I would make probiotics number three.

Dairy as a Probiotic Source

The best known examples of food with probiotics are yogurts containing lactic acid-producing bacteria, called Lactobacillus bulgaricus.  These organisms are non-toxic and survive passage through the intestine.  However, they cannot live and reproduce in the colon (they do not colonize the colon); therefore, they must be ingested regularly for any health promoting properties to persist.  I do not recommend yogurt as a source of friendly bacteria for two reasons. First, these bacteria’s beneficial effects have not been conclusively proven.¹⁵  More importantly, yogurt brings with it all the negative qualities of dairy products: high in fat and cholesterol, allergy producing dairy proteins, and infection with harmful viruses and bacteria. (See my May 2003 newsletter article Marketing Milk and Disease.)  Acidophilus milk is made by culturing milk with Lactobacillus acidophilus bacteria and has similar drawbacks.¹⁶   Any benefits provided by any species of Lactobacillus can be obtained much more safely and effectively in supplement forms (pills), avoiding the health risks of dairy products.