Probiotic Guide

When selecting a probiotic to combat psoriasis, PsA, RA, AS, or related autoimmune diseases, we have several key goals:

  1. Supporting the population of anti-inflammatory microbes already present
  2. Suppressing potentially harmful species of bacteria and yeasts (such as Klebsiella, E.coli, Candida, Streptococcus, Proteus Mirabilis etc.)
  3. Restoring the gut barrier
  4. Calming the immune system.

The best all-around probiotic species for these goals are found in the level 1 probiotics listed below.  For slightly more potent activity against pathogens, you can turn to a level 2 probiotic. The probiotics I categorize as level 3 are typically used short term for even more aggressive treatment of resistant pathogens such as Candida, E.coli, and Klebsiella.

Level 1 Probiotics:

At the introductory level, it is best to choose a probiotic combination that includes at least one of the preferred Bifidobacteria species, namely:

    • B. infantis
    • B. longum
    • B. breve

These species excel at supporting our resident anti-inflammatory microbes, restoring the gut barrier, and directly calming inflammation. Recommended products with these species and no inflammatory species include:

  • Jarrow-dophilus AF (Allergen Free) US,  UKCA
  • Klaire Labs Ther-Biotic Metabolic Formula US
  • Probiotic Pearls Digestion and Immunity US
  • Nature’s Way Primadophilus Bifidus US UK CA AU DE

Culturelle Health & Wellness and BioGaia Protectis are also good entry-level probiotics. These single-strain lactobacillus probiotics have been studied extensively and are typically well tolerated by even the most sensitive individuals, including newborn infants. They are also widely available in many countries.

  • Where to buy Culturelle:  US, UK, CAAU
  • Where to buy BioGaia:  US, UK, CA, AU

Level 2 Probiotics

For stronger activity against the undesirable bacteria that can drive inflammation, we can select a probiotic with a higher potency and broader range of Bifidobacteria species.  Good options include:

  • Gut Pro and Gut Pro Infant US
  • Jarrow Bifidus Balance US, UK, CA
  • Renew Life Adult 50 Plus Go Pack US
  • Kirkman Bifido Complex US, UK, CA

Because these probiotics contain B. bifidum, they may be slightly more effective than the level 1 probiotics at combating pathogens. Yet once pathogen overgrowth is brought under control, this potent species is likely no longer required. Because B. bifidum may theoretically spur immune activity, it may be preferable to return to a milder level 1 probiotic for ongoing maintenance. (You can of course continue taking a level 2 probiotic long-term, if you find that you respond well).

Level 3: Advanced Pathogen- Fighting Probiotics

For those with particularly severe inflammation, an overgrowth of persistent species such as E.coli, Candida, or Klebsiella, or a diagnosis of SIBO, you may see the greatest improvement by starting with 30 to 60 days of treatment with one of the advanced pathogen-fighting probiotics:

Note that the refrigerated beverage forms of BioK+ have shown slightly better results in clinical trials than the capsules.  These drinks can be purchased at WholeFoods market and other health food stores.

[For more detail on the rationale behind these probiotics, see the book excerpt below. ] 

Other Factors Influencing Probiotic Choice

In addition to focusing on the particular species present in probiotics, many other factors may come into play in determining which probiotic is right for you. These factors may include your budget, location, and ability to tolerate trace amounts of starch, dairy, or other ingredients.

Probiotics without fillers containing starch, prebiotics, or maltodextrin:

Dairy free probiotics:

Links to probiotics available outside the United States

  • Culturelle Health and Wellness: UK, CA.
  • Blackmores Probiotics + Eczema Relief (same L. rhamnosus GG strain as Culturelle) AU*
  • BioGaia Protectis: US. UK. CA AU*
  • Probiotic Pearls Digestion and Immunity: UK.
  • Jarro-Dophilus Allergy Free: UK.
  • Mutaflor: AU, UK, CA (also ships to US)
  • Florastor: AUCA , UK