The Best Probiotic


Someone asked me awhile back what I thought was the best probiotic, so here’s my answer.

Probiotics are supplements that contain bacteria that are deemed gut-friendly. People take them for a number of reasons, and they’ve been shown, in controlled trials, to have efficacy in treating antibiotic-associated diarrhea, infectious diarrhea, and inflammatory bowel disease.(1)

The scientific evidence from both humans and animals indicates, with less robust evidence, that they’re useful in treating many other illnesses, especially chronic, mysterious illnesses, such as chronic fatigue syndrome, depression, maybe even obesity.

I usually don’t take probiotics, as I don’t feel the need any longer. I took them when I had chronic fatigue, since that illness is associated with leaky gut.(2)

As I ultimately cured my chronic fatigue, probiotics were part of the solution, although I used many other interventions, so one can’t be sure of the extent of the role that probiotics played.

Leaky gut and how to get rid it

In leaky gut – something most doctors insist does not exist – lipopolysaccharides from gram negative bacteria in the intestines leak through the intestinal barrier. They then chronically activate the immune system, and produce inflammation and oxidative stress.

Lipopolysaccharides are very toxic and the body strives to keep them confined to the intestines and out of the circulation. In normal, healthy people, the intestinal barrier has so-called tight junctions, but in illness, these junctions can become loose, allowing bacteria and/or their cell walls into the body.

Probiotics can treat and alleviate leaky gut.(3)

Most probiotics consist of several different bacterial species in the genera Lactobacillus and Bifidobacterium. Lactobacillus species are the same bacteria that ferment yogurt. Bifidobacterium species are major constituents of the human intestinal tract.

By supplying probiotic bacteria, the intestinal contents can become more normalized and intestinal illnesses can be treated. The number and variety of bacteria in the intestines are important for health, although the science of how this all works is in its infancy.

Garden-variety probiotics, those that contain the above species of bacteria, can have limited effectiveness (it seems), because the human intestines contain many billions of bacteria of at least 400 species – and I suspect that 400 may be a serious under-counting.(4) It would seem to follow that adding a few million bacteria of limited species number might not have the desired effect of normalizing the gut.

On top of that, the bacterial contents of the gut can vary a lot between individuals.

Probiotics can prevent bad effects of antibiotics

In any case, over the past few years, a family member had to take antibiotics on a couple of occasions. When doctors prescribe antibiotics, they’re concerned lest their patient get a Clostridium difficile infection, a serious side effect of oral antibiotics which in old or debilitated people can even be fatal. Hence even the more hide-bound doctors these days often recommend a probiotic, or sometimes just live-culture yogurt, for their patients when they take oral antibiotics.

Even absent a C. difficile infection, oral antibiotics often cause diarrhea due to their effect in killing off normal gut flora. Antibiotic-associated diarrhea, when not caused by C. difficile, is less serious but still mighty annoying.

During the first instance of taking antibiotics, this family member took a standard Lactobacillus and Bifidobacteria based probiotic, and it didn’t work. No, this family member didn’t get a C. difficile infection, but was in pretty miserable shape.

During the second instance of taking antibiotics, the family member took a soil-based probiotic called Prescript-Assist. Totally worked. There were no unwanted side effects from the antibiotics.

Prescript-Assist, the best probiotic

Prescript-Assist contains 29 different species of bacteria that were originally isolated from the soil and are similar to gut bacteria. There have been some clinical trials of Prescript-Assist for irritable bowel syndrome, and it reduces symptoms.(5)

This story is of course n=1, anecdotal, but given how it worked on that one occasion, it seems well worth trying for anyone who has to take oral antibiotics. Prescript-Assist is somewhat more expensive than standard, Lactobacillus-based probiotics, but it’s money well spent if you need it. My family member told me that she wouldn’t ever take antibiotics without Prescript-Assist.

It may have also have greater efficacy than standard probiotics in treating leaky gut.

If you need to take a course of antibiotics, especially if for longer than two or three days, Prescript-Assist would be my choice of supplement to take along with it. There’s no way I want to risk a C. difficile infection, or even the lesser but miserable illness of antibiotic-associated diarrhea.

In chronic fatigue, depression, autoimmune disorders, and bowel disorders, this probiotic could prove very useful.


Leave a Comment:

Neguy says February 1, 2016

I have used PreScript Assist. I also took a AOR Probiotic 3, which has different strains. Both are shelf-stable.

I also eat fermented vegetables – raw kraut and kimchi – and eat as many farmers market vegetables (unwashed, often) to recruit more bacteria.

And I take 2 Tbsp/day of potato starch (resistant starch – bacteria food)

I made many other lifestyle changes, but have seen reductions in inflammatory illness, including my chronic allergies and mild psoriasis. I’ve also had a vast decline in colds.

Stephen Werner says February 1, 2016

In addition to addressing the issue of leaky gut, there are other potential benefits to supplementing with certain strains of proboitics. Given the the nearly ubiquitous nature of our modern exposure to xenoestrogens, particularly bis-phenol A (BPA), I personally prefer probiotic sources which include Bifidobacterium breve and/or Lactobacillus casei. Both strains seem to bind-up BPA and carry it out of the body. Here’s an overview which referes to the study which shows this particularly useful (IMHO) functionality:

Specific probiotics, Bifidobacterium breve and Lactobacillus casei are two beneicial bacterial strains that bind BPA and eliminate it from the intestines ( The referenced study here: – the link in the web page appears to be misdirected).

Lactobacillus casei appears to be in every Greek yogurt I’ve tried; and I also personally like Lifeway kefir, which contains both of the BPA binding strains.

JRM says February 1, 2016

A while ago, Free the Animal recommended three soil based probiotics: Prescript Assist, AOR Probiotic 3, and Garden of Life Primal Defense Ultra. I think I had noticed an effect in terms of firming up my stool, but I am not sure. The Primal Defense lists “290 mg of ionic plant based minerals” which I assume contains some calcium which would make my stool harder and account for the effect.

After trying these for six months, I am still not sure if they are helpful to me.

Also, bacillus subtilis (found in prescript assist and primal defense) is a species of bacteria which produces vitamin K2.

Tuba says February 2, 2016

I grew up on a farm, shoveled a lot of manure, weeded a garden, and in my area of expertise have consumed a lot of bacteria. The gut is not an issue of mine. That said I make my own kefir, yogurt and lacto-ferment all my own vegetables. But taking pro-biotics is only one half of the dynamic. Feeding the bacteria is the other half. My personal jury is out at the moment on resistant potato starch. And most plantain and cassava starches sold are not resistant so they don’t count. Chia and Psyllium are good and I am warming up to arabinogalactan. Don’t, however, ever take a soluble fiber mixed with coconut water. You’ll have enough gas to sing an aria..

Damon says February 2, 2016

We do three things to promote good gut bacteria health. My wife makes kombucha, which is a fermented tea (<1% ac) that uses healthy bacteria and yeast as a fermenting agent. Second, we have our own garden, and since we know where our food comes from, don't get too obsessive about washing vegetables, especially root vegetables. A little dirt never hurt nobody, and might actually help. Third, we drink a tablespoon of organic apple cider vinegar with 12 oz of water and a little honey every morning. This, along with IF, has greatly improved our digestive health. I used to suffer from reflux, resulting in two unsuccessful surgeries, and my wife had chronic constipation. We now have healthy guts, and seem to avoid getting sick from strep, flu, and other viruses. I have even included organic apple cider vinegar and probiotics for our cattle. Death loss has declined significantly because my calves are healthier and are able to fight off infection, and their rate of gain has improved.

    P. D. Mangan says February 2, 2016

    Damon, thanks for that comment. I’ve read that vinegar has some benefits in blood glucose control, apparently because of acetate, but don’t recall having read about a connection to gut health. You surgeries are perfect examples of one of my general themes here, namely how modern mainstream medicine so often fails us. I’ve made kombucha before but haven’t done so in awhile, I’ll have to do so again.

    I agree, a little dirt never hurt nobody.

      Damon says February 2, 2016

      I recommend Bragg organic apple cider vinegar. My understanding is that the “mother” in the ACV is what is most beneficial for gut health. I tried using regular ACV and it was not nearly as effective as Bragg. Most “organic” benefit claims are bunk, but organic ACV is the exception to the rule.

        Kelly says January 7, 2017

        It’s important to note that vinegar — any vinegar — is constipating, and honey is the opposite. So that may explain why your wife’s constipation and overall gut health improved, due to the combination of the two.

Tuba says February 2, 2016

I’ve made my own vinegar for more than 20 years… I collect the mother from the wild and when I find a good one I use it. But I also support the view that Bragg’s is a good untreated vinegar to use.

Roland says March 7, 2016

If possible, could you comment on the following negative review of Prescript-Assist?

Evidently, the probiotic market is unregulated and there’s some degree of danger associated with a subset of the bacteria strains in the supplement.

    P. D. Mangan says March 8, 2016

    The crux of his argument seem to be this: “All of these listed HSO’s are known to cause opportunistic infections in humans.” However, many bacteria normally found in the human intestines can cause opportunistic infections. E. coli, for instance, most common cause of urinary tract infections, also numerous in the gut. Lots of other gram negative bugs that do this in the gut. Plenty of skin flora, like Staph aureus, also cause opportunistic infections. So, my take is that unless something in Prescript Assist is shown to be a real problem, then I take his point with a large grain of salt.

Aaron says May 23, 2016

I like Prescript Assist, but we also tend to rotate our probiotics among some proven, trusted brands like Garden of Life and Bio-Kult. These things get pricey but make a difference.

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