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The Best Probiotics for Anxiety and How to Use Them

Understanding How to Choose Probiotics for Anxiety and Stress Improvement

Key Takeaways
  • A multi-strain Lactobacillus/Bifidobacterium probiotic blend has been the most researched for its ability to decrease symptoms of anxiety.
  • Studies on the effectiveness of probiotics for anxiety show a moderate reduction in symptoms of anxiety.
  • Probiotics support the gut-brain connection, decreasing brain inflammation and supporting the creation of neurotransmitters.
  • Probiotics can be a great addition to a comprehensive mental health plan, but aren’t a replacement for treatment.
Best probiotic for anxiety: happy woman holding a white pill and a glass of water

Probiotics have been shown to help with anxiety, as well as stress, depression, and mood imbalances. But is there one best probiotic for anxiety? The answer is: probably not — so rather than trying to zero in on which strain is best, focus instead on finding a high-quality probiotic in general. Multi-species Lactobacillus/Bifidobacterium blends have been the most studied when it comes to anxiety and mental health, making them a good first choice. But any high quality probiotic supplement may be able to help with anxiety. 

This article will look at choosing probiotics for anxiety, the current research studies in probiotics for anxiety, and how to incorporate probiotics into your life.

Choosing the Best Probiotic for Anxiety

Best probiotic for anxiety: stressed man sitting at the corner of his bed, holding his head

In the world of psychobiotics (prebiotics and probiotics that can affect mental health), sometimes there are claims that one type of probiotic strain is the best for anxiety and another type is best for depression [1]. However, evidence hasn’t found one strain or species of probiotic to be more effective than another. This is good news, because it means you don’t have to search for a super-specific type of bacteria. 

Generally speaking, there are three categories, or types, of probiotics: Lactobacillus/Bifidobacterium blends, Saccharomyces boulardii, and soil-based probiotics [2]. Most of the studies of probiotics for anxiety and improved mood have used probiotics from the Lactobacillus/Bifidobacterium category. This doesn’t mean one of the other categories won’t work, they just haven’t been studied yet. 

Within the Lactobacillus/Bifidobacterium category, the most commonly researched species for mental health have been Bifidobacterium longum (B. longum), Lactobacillus acidophilus, Lactobacillus helveticus, Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium infantis

No one strain has proven to be more effective at improving anxiety than any other strain. Based on current research, the best probiotics for anxiety are a high-quality, multi-species Lactobacillus/Bifidobacterium blend [1, 3, 4].

Probiotics can also be found in foods such as sauerkraut and kimchi. While these are worth eating, if you’re using probiotics as a wellness intervention, probiotic foods alone might not be the most effective choice. We don’t know all of the strains in many fermented foods, especially ones that are homemade, and the levels of probiotics found in foods aren’t high enough to match the levels used in research on probiotics for mental illness. 

Basically, you wouldn’t be able to eat enough sauerkraut to improve symptoms of anxiety. 

Now that we know which probiotics are best for anxiety, let’s take a look at the research behind the effectiveness of probiotics for anxiety.

Benefits of Probiotics for Anxiety

Probiotics have been shown to decrease levels of anxiety and stress, but more research needs to be done. Some studies show strong improvements and others show just a moderate improvement.

  • A large systematic review and meta-analysis (rigorous summary of the findings of multiple randomized controlled trials) found that probiotics mildly reduced stress in healthy people [5].
  • In a study of students facing exam stress, researchers found that students who took a multi-strain probiotic had lower cortisol (stress hormone) levels, as well as improved scores on anxiety and depression scales than those in the placebo group [3].

Probiotics for anxiety is an exciting area of research, and as we get more information we’ll know more about exactly how and why probiotics can improve anxiety symptoms. What the preliminary research shows is that generally an improvement in the gut microbiome, which can be from probiotics or from other interventions, can lead to an improvement in anxiety [6].

Why might this improvement in the gut microbiome help with anxiety? The gut and brain are connected and what happens in the gut can affect how our brain works. Let’s take a closer look at the brain-gut connection. 

The Gut-Brain Connection and Anxiety

Best probiotic for anxiety: The Gut-Brain Connection infographic

Probiotics can help improve symptoms of anxiety by helping the gut microbiota and thus resolving underlying issues of inflammation and leaky gut that may be disrupting the communication between the brain and gut. 

The brain and gut send signals to each other through the vagus nerve, which is part of our central nervous system. This communication not only regulates stress response and anxiousness, but the gut even makes and then sends neurotransmitters such as serotonin and dopamine along the vagus nerve to the brain [7, 8].

If the gut microbiome is unhealthy then this communication system may not work well and you may have increased levels of anxiety. 

Many people don’t realize that they have any issue with their gastrointestinal system because they don’t have symptoms such as stomach pain or bloating, but our gut microbiome can be disrupted without experiencing gut symptoms. Instead, someone may only experience mood symptoms such as anxiety [9].

If you do have a digestive condition, such as irritable bowel syndrome or SIBO (small intestinal bacterial overgrowth), you may also have mood disturbances, which are common in digestive illness [10, 11, 12].

Inflammation, Leaky Gut, and Anxiety

Woman with a headache holding her forehead

When the gut microbiome (the mix of bacteria and other microbes that help our gut function well) is unbalanced, the gut and brain may not be able to communicate, leading to anxiety symptoms.

The gut microbiome can get out of balance from leaky gut, which is when the tight junctions of the gut that normally keep toxins and undigested food out of the bloodstream and brain start to weaken and allow these foreign bodies into the bloodstream [13]. The immune system then attacks these foreign bodies, leading to an immune reaction and inflammation in the gut and brain [14].

Inflammation in the gut can harm the gut microbiome, which can affect the brain, but also brain inflammation from leaky gut can affect the brain and lead to anxiety symptoms [15].

Leaky gut can occur for a few different reasons, but the most common is inflammatory foods that weaken and inflame the gut lining, and/or an imbalance of gut bacteria that leads to intestinal permeability.

One way to improve leaky gut is to remove inflammatory foods, often starting with a Paleo or low-FODMAP diet. However, if you have leaky gut, your gut microbiome is imbalanced and needs support not only from low-inflammatory foods, but also from probiotics. Probiotics help balance the microbiome, heal leaky gut, and support the gut-brain axis and communication between the brain and gut [1].

Using Probiotic Supplements for Mental Health

Blue pill with a smiley face on it

If you want to add probiotics to your mental health plan to see if they may reduce anxiety for you, here are a few guiding principles:

  • Continue to work with your current healthcare team. Probiotics aren’t meant to replace other forms of treatment for anxiety disorder. 
  • Try a multi-strain Lactobacillus/Bifidobacterium blend, as those have been found to have the most positive effects on anxiety and stress.
  • For the best health benefits, also support gut healing and beneficial bacteria with an anti-inflammatory diet. Dietary interventions, especially a low-FODMAP diet, have been shown to improve anxiety and also depressive symptoms [6, 16, 17, 18].

We hope that this article helps you understand how and why probiotics can help with anxiety and the best way to get the positive effects from probiotics as part of a full mental health plan. 

If you’d like more information about improving your gut health, my book, Healthy Gut, Healthy You, goes into detail on how to support good bacteria in the gut and resolve leaky gut and inflammation through diet, probiotics, and lifestyle changes.

➕ References

  1. Zagórska A, Marcinkowska M, Jamrozik M, Wiśniowska B, Paśko P. From probiotics to psychobiotics – the gut-brain axis in psychiatric disorders. Benef Microbes. 2020 Dec 2;11(8):717–32. DOI: 10.3920/BM2020.0063. PMID: 33191776.
  2. Fleishman MS RDN C. IPA guidelines to qualify a microorganism as probiotic. International Probiotics Association. Available from:
  3. Venkataraman R, Madempudi RS, Neelamraju J, Ahire JJ, Vinay HR, Lal A, et al. Effect of Multi-strain Probiotic Formulation on Students Facing Examination Stress: a Double-Blind, Placebo-Controlled Study. Probiotics Antimicrob Proteins. 2021 Feb;13(1):12–8. DOI: 10.1007/s12602-020-09681-4. PMID: 32601955.
  4. Messaoudi M, Violle N, Bisson J-F, Desor D, Javelot H, Rougeot C. Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in healthy human volunteers. Gut Microbes. 2011 Aug;2(4):256–61. DOI: 10.4161/gmic.2.4.16108. PMID: 21983070.
  5. Zhang N, Zhang Y, Li M, Wang W, Liu Z, Xi C, et al. Efficacy of probiotics on stress in healthy volunteers: A systematic review and meta-analysis based on randomized controlled trials. Brain Behav. 2020 Sep;10(9):e01699. DOI: 10.1002/brb3.1699. PMID: 32662591. PMCID: PMC7507034.
  6. Yang B, Wei J, Ju P, Chen J. Effects of regulating intestinal microbiota on anxiety symptoms: A systematic review. Gen Psych. 2019 May 17;32(2):e100056. DOI: 10.1136/gpsych-2019-100056. PMID: 31179435. PMCID: PMC6551444.
  7. Arneth BM. Gut-brain axis biochemical signalling from the gastrointestinal tract to the central nervous system: gut dysbiosis and altered brain function. Postgrad Med J. 2018 Aug;94(1114):446–52. DOI: 10.1136/postgradmedj-2017-135424. PMID: 30026389.
  8. Tran N, Zhebrak M, Yacoub C, Pelletier J, Hawley D. The gut-brain relationship: Investigating the effect of multispecies probiotics on anxiety in a randomized placebo-controlled trial of healthy young adults. J Affect Disord. 2019 Jun 1;252:271–7. DOI: 10.1016/j.jad.2019.04.043. PMID: 30991255.
  9. Isasi C, Tejerina E, Morán LM. Non-celiac gluten sensitivity and rheumatic diseases. Reumatol Clin. 2016 Feb;12(1):4–10. DOI: 10.1016/j.reuma.2015.03.001. PMID: 25956352.
  10. Frändemark Å, Jakobsson Ung E, Törnblom H, Simrén M, Jakobsson S. Fatigue: a distressing symptom for patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017 Jan;29(1). DOI: 10.1111/nmo.12898. PMID: 27401139.
  11. Han CJ, Yang GS. Fatigue in Irritable Bowel Syndrome: A Systematic Review and Meta-analysis of Pooled Frequency and Severity of Fatigue. Asian Nurs Res (Korean Soc Nurs Sci). 2016 Mar;10(1):1–10. DOI: 10.1016/j.anr.2016.01.003. PMID: 27021828.
  12. Nocerino A, Nguyen A, Agrawal M, Mone A, Lakhani K, Swaminath A. Fatigue in inflammatory bowel diseases: etiologies and management. Adv Ther. 2020 Jan;37(1):97–112. DOI: 10.1007/s12325-019-01151-w. PMID: 31760611. PMCID: PMC6979464.
  13. Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019 Aug;68(8):1516–26. DOI: 10.1136/gutjnl-2019-318427. PMID: 31076401. PMCID: PMC6790068.
  14. Maes M, Kubera M, Leunis J-C, Berk M. Increased IgA and IgM responses against gut commensals in chronic depression: further evidence for increased bacterial translocation or leaky gut. J Affect Disord. 2012 Dec 1;141(1):55–62. DOI: 10.1016/j.jad.2012.02.023. PMID: 22410503.
  15. Maes M, Kubera M, Leunis J-C. The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuro Endocrinol Lett. 2008 Feb;29(1):117–24. PMID: 18283240.
  16. Kortlever TL, Ten Bokkel Huinink S, Offereins M, Hebblethwaite C, O’Brien L, Leeper J, et al. Low-FODMAP Diet Is Associated With Improved Quality of Life in IBS Patients-A Prospective Observational Study. Nutr Clin Pract. 2019 Aug;34(4):623–30. DOI: 10.1002/ncp.10233. PMID: 30644587.
  17. Firth J, Marx W, Dash S, Carney R, Teasdale SB, Solmi M, et al. The Effects of Dietary Improvement on Symptoms of Depression and Anxiety: A Meta-Analysis of Randomized Controlled Trials. Psychosom Med. 2019 Apr;81(3):265–80. DOI: 10.1097/PSY.0000000000000673. PMID: 30720698. PMCID: PMC6455094.
  18. Opie RS, O’Neil A, Itsiopoulos C, Jacka FN. The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials. Public Health Nutr. 2015 Aug;18(11):2074–93. DOI: 10.1017/S1368980014002614. PMID: 25465596.

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