Lactobacillus reuteri.
The testosterone probiotic. Also great for gut and skin. Helps balance your gut bacteria, which can support your immune system and calm down digestive issues like diarrhea or bloating.
Reviewed March 2026
- Category
- Probiotic
- Also filed under
- Gut healthSkinTestosterone
What Lactobacillus reuteri is, and what it does.
- Does it work
- Maybe. It's one of the more studied single-strain probiotics. If you're struggling with specific gut issues, it's a reasonable thing to try. But it's not a magic pill.
- How much to take
- Aim for at least 1 billion CFUs per day. Some studies go higher. Check the label carefully; CFU count at time of manufacture matters.
- Time to feel it
- Digestive changes tend to land within one to two weeks of daily use. Gum and mouth measures in lozenge studies read out over two to four weeks.
- The first dose
- Nothing. Probiotics need time to colonize and make a difference. Give it at least two weeks.
- With regular use
- After a month, you might notice more regular digestion and less bloating. Some people report fewer minor colds, but that's harder to pin down.
- How well tolerated
- Well tolerated for most people. If you have a severely compromised immune system, check with a doctor first.
- How it feels
- Subtle. It's not a drug. You'll notice a gradual improvement in digestion and gut comfort, not a sudden change.
- The overlooked benefit
- Its signature compound, reuterin, only gets made when glycerol is around. So what the organism can produce depends partly on what reaches it in the gut.
100 CFU a day is where Lactobacillus reuteri works.
Source: ISAPP consensus statement 2019 + Ford 2014 meta-analysis
The proof, claim by claim.
These words describe the research, not the molecule's worth. Research strength is how much work stands behind one claim, and it is never a product score.
Based on 30 human trials with 65% consistency.
- Digestive comfort and stool regularityMeta-analysis
- Crying time and settling in breastfed infantsMeta-analysis
- Gum comfort and plaque bacteria in the mouthRandomised trial
- Blood lipids already in the normal rangeRandomised trial
- Vitamin B12 and folate production by certain strainsIn vitro study
- Antimicrobial activity through reuterinIn vitro study
- Reproductive hormone measures in rodentsAnimal study
Questions people ask about Lactobacillus reuteri.
- Should I take it with food?
- Doesn't really matter. Some say food helps buffer it from stomach acid. The most important thing is just taking it consistently.
- Do I need to keep it in the fridge?
- Depends on the product. Many are shelf-stable now. Check the label. If it says refrigerate, do it.
- Is this the same as eating yogurt?
- No. Yogurt has probiotics, but usually different strains and in lower, less consistent amounts. This is a targeted dose of a specific strain.
- Can I take it with other probiotics?
- Yes. It plays well with others. Most probiotic blends include multiple strains.
- How do I know if it's working?
- You'll feel it in your gut. Less gas, less bloating, more regularity. It's a slow and steady change.
Why these belong in the same formula. Each row says what the basis is, from settled biochemistry through to a trial that measured the pair.
Inulin is a fructan that human enzymes cannot break down but lactobacilli ferment to lactate and short-chain fatty acids, lowering colonic pH. Pairing a strain with its substrate is the original synbiotic design.
Partially hydrolysed guar gum ferments steadily along the colon and supports lactic acid bacteria without the viscosity of intact guar. It is a common carrier fibre in strain formulations.
Pectin is fermented by resident lactic acid bacteria into short-chain fatty acids, and its gel also slows transit so organisms spend longer in contact with substrate.
Oat beta-glucan reaches the colon intact and is fermented by lactic acid bacteria, adding substrate for lactate production. The fibre also raises viscosity in the upper gut, which affects transit speed.
Lactobacilli produce lactate, which butyrate-forming bacteria take up and convert onward, so lactate output and butyrate supply are linked in one cross-feeding chain. Supplying butyrate covers the downstream end of that chain.
Glutamine is the main respiratory substrate for small intestinal cells and supports normal tight-junction protein expression, working on the host side of the barrier while the strain works on the luminal side.
Colostrum carries secretory immunoglobulins and milk oligosaccharides, and those oligosaccharides are substrate that lactobacilli ferment. It is a long-standing pairing in gut formulations.
Lactic acid bacteria carry their own beta-galactosidase, so they break down some lactose in the gut alongside a supplemental lactase enzyme. The two act on the same substrate by different routes.
Lactobacillus reuteri is one of the few lactic acid bacteria carrying cobalamin biosynthesis genes and making corrinoid compounds. That places the strain and the vitamin on the same cobamide pathway, though microbial output is not a substitute for dietary intake.
Carvacrol and thymol disrupt bacterial membranes without distinguishing lactic acid bacteria from other organisms, so taking them at the same time lowers delivered viable counts. Formulators separate the doses rather than blend them.
Berberine has direct antibacterial activity in the gut lumen and shifts community composition, which works against a live-organism dose given at the same time. Staggering the two is the standard handling.
Activated charcoal adsorbs organic molecules broadly in the gut lumen, including the nutrients and substrates a delivered strain needs. Anything taken with charcoal should be spaced by a couple of hours.
Galactooligosaccharides pass to the colon undigested and are fermented by lactobacilli and bifidobacteria. Supplying a substrate alongside the organism is the standard synbiotic construction. Whether it increases what the delivered strain actually does in a given person is not settled.
Short-chain fructans are fermented by resident lactobacilli to lactate and acetate, lowering local pH. Pairing them with a delivered strain adds substrate at the site the strain has to compete in. The commonest practical issue is gas during the first week.
Resistant starch reaches the colon intact and is fermented largely to butyrate by cross-feeding communities. L. reuteri is a lactate and acetate producer, and those acids are substrate for the butyrate producers downstream. The pairing works through cross-feeding rather than through a direct effect on the strain.
Chicory-derived inulin is a longer-chain fructan fermented more slowly and further along the colon than short-chain fructans. That spreads fermentation over a larger stretch of bowel. It is a substrate contribution, not a change in what the strain itself does.
Pectin is fermented by a broad set of colonic organisms and contributes to short-chain fatty acid production. It is a gentler substrate than fructans for people who react to those. No combination trial with this species is available.
S. boulardii is a yeast and is unaffected by antibacterial pressure that would reduce a delivered bacterial strain. The two occupy different niches and are commonly combined for that reason. The pairing is formulation logic supported by each organism's own literature, not by a head-to-head combination trial.
L. plantarum is facultatively heterofermentative and L. reuteri is obligately heterofermentative, so they handle sugars differently and produce different acid mixes. Multi-strain products combine them for that breadth. Multi-strain formulas are also harder to attribute an effect to, since strain-specific results do not transfer across a blend.
Bifidobacteria dominate the infant colon and lactobacilli the small intestine, so the two genera address different sites. Products pair them to cover both. Evidence for the combination is weaker than for either genus studied alone.
B. lactis tolerates oxygen and processing better than most bifidobacteria, which is why it appears in shelf-stable blends alongside L. reuteri. The pairing is a stability and coverage decision. It is not evidence that the two act together.
Lactoferrin sequesters free iron, which restrains iron-requiring organisms, and lactobacilli have low iron requirements compared with many gut bacteria. That difference is the stated basis for pairing the two. It is mechanistic reasoning drawn from each ingredient's own literature.
Zinc supports the expression of tight junction proteins that hold the intestinal barrier together, and probiotic organisms are studied for effects on the same barrier. The two reach the endpoint by different routes. Combination products exist, but the pairing itself has not been isolated in a trial here.
Vitamin D receptor signalling in the gut epithelium influences barrier proteins and antimicrobial peptide expression. That is a separate route to the same tissue a delivered strain interacts with. Any combined benefit is inference from two separate literatures, not a measured combination.
Gastric acid is the main barrier to delivering viable organisms to the intestine. Raising gastric pH, whether by a buffering agent or by taking the dose with food, increases the fraction that survives transit. This is a delivery effect, not a change in what the organism does once it arrives.
Catechins inhibit a range of bacteria in culture, and some lactobacilli in turn metabolise them into smaller phenolic acids. The relationship runs both ways and has been characterised mostly in test systems. Nothing here supports a claim in either direction for a person.
Nothing specific on file for Lactobacillus reuteri. Match the label to the daily amount above, and tell your doctor what you take.
Not medical advice. Show the label to your pharmacist.What Lactobacillus reuteri actually does.
This species turns glycerol into a compound called reuterin, using an enzyme that needs vitamin B12 to work. Reuterin acts against a broad range of microbes, and making it depends on glycerol being available.
It's an obligate heterofermenter, meaning it ferments sugars into a mix of lactate, acetate, ethanol and carbon dioxide rather than lactate alone. Those organic acids lower the pH right around it.
Results are specific to the strain. DSM 17938 and ATCC PTA 6475 are genetically different strains with different metabolic abilities, and a finding for one doesn't carry over to the other or to an unnamed strain.
Freeze-dried cells pull in moisture and lose viability with damp, heat and oxygen, which is why you see oil suspensions, blisters or desiccant-protected bottles, and why a colony-forming-unit count only means something with a date attached.
Where Lactobacillus reuteri comes from.
The bacteria are grown in a large sterile tank, separated out from the liquid they grew in, then freeze-dried so they go dormant instead of dying. The dried powder gets counted, then packed into capsules, drops or sachets.
Built by fermentation, the same way vitamin B12 and many amino acids are made at scale. Controlled conditions, consistent output.
Production starts from a master cell bank of a specific deposited strain, for example DSM 17938 or ATCC PTA 6475. The deposit number is the identity, since strains within the species differ in what they can do.
The culture is grown in a sterile nutrient medium under controlled pH, temperature and oxygen, with acid neutralised as it accumulates so the cells keep multiplying.
Cells are separated from the spent medium by centrifugation or filtration and concentrated into a wet biomass.
The biomass is mixed with cryoprotectants such as sugars or skimmed milk solids, frozen, then dried under vacuum so water sublimates without heat. The cells end up dormant rather than dead.
The dried powder is plated and counted, then blended with a carrier to hit a declared count per dose, with an overage set so the label figure still holds at the end of shelf life.
The standardised powder is encapsulated, suspended in oil, filled into stick packs, or compressed into tablets, then packaged with moisture protection.
Getting Lactobacillus reuteri from food.
The whole-food sources on file. A supplement closes the gap, it does not replace dinner.
A gram-for-gram figure (how much of each you would eat to match a dose) will appear here once it is sourced and reviewed. This page will not print a number it cannot cite.
The forms it comes in.
The essence, in one line each.
- Pools randomised controlled trials of Lactobacillus supplementation and reports pooled effects on the outcomes those trials measured; the pooled trials span mixed species, strains and settings, so it is not strain-specific evidence for any one product or for L. reuteri in particular.Meta-analysis. Azam et al., 2025 (MicrobiologyOpen). PMID 41327607 ↗
- Systematic review and meta-analysis of trials of the DSM 17938 strain in preterm newborns and in infants with excessive crying, pooling the crying and tolerance outcomes those trials reported.Meta-analysis. Bianchi et al., 2026 (Nutrition). PMID 42485904 ↗
- Randomised trial of Lactobacillus acidophilus in infants, reporting crying behaviour alongside microbiota composition; the microbiota result is a marker and the tested organism is a different species from L. reuteri.Randomised trial. Vaz et al., 2026 (BMC Pediatrics). PMID 41998618 ↗
- Randomised controlled trial of Lactobacillus casei on low mood after childbirth; it tests a different Lactobacillus species, so it speaks to the genus and the format rather than to L. reuteri specifically.Randomised trial. Abdollahpour et al., 2025 (BMC Psychiatry). PMID 41318456 ↗
- A pig-derived L. reuteri strain fed to pigs was followed for growth performance and lipid metabolism markers; these are markers in an animal model, not outcomes in people.Animal study. Xie et al., 2025 (Porcine Health Management). PMID 41291940 ↗
- Maternal L. reuteri supplementation shifted the intestinal microbiome of the offspring in mice; a compositional shift is a marker, and the model is murine.Animal study. Krishna et al., 2022 (FASEB BioAdvances). PMID 35141475 ↗
These are the studies our verdict leans on, chosen from the 6 we read for Lactobacillus reuteri. The full linked list is below.
The studies, linked.
11 sources behind our Lactobacillus reuteri verdict: peer-reviewed studies and registered clinical trials. Every one links straight to PubMed, the journal, or ClinicalTrials.gov. Read them yourself.
- Clinical trialZekai Tahir Burak Maternity Teaching Hospital, Ankara/TurkeyClinicalTrials.gov ↗PHASE4 · 300 participants · Completed
- Clinical trialRandomised Controlled Trial With Two Parallel Arms Testing the Effect of L. Reuteri on Bowel Movements in Children Aged 6 Months to 4 YearsClinicalTrials.gov ↗NA · 52 participants · Completed
- Clinical trialPrevention of Glucocorticoid Induced Impairment of Bone Metabolism - A Randomized, Placebo-Controlled, Single Centre Clinical TrialClinicalTrials.gov ↗NA · 50 participants · Completed
- Clinical trialOral Microbiota Shift After 12-week Supplementation With Lactobacillus Reuteri DSM 17938 and PTA 5289ClinicalTrials.gov ↗PHASE2 · 44 participants · Completed
- Clinical trialThe Effect of Lactobacillus Reuteri Supplementation to Adult With Functional Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled TrialClinicalTrials.gov ↗PHASE3 · 40 participants · Completed
- Clinical trialLocal Delivery of Lactobacillus Reuteri Probiotic as An Adjunct to Non-surgical Periodontal Therapy in Patients With Stage II, III, and IV Periodontitis and Type 2 Diabetes Mellitus: A Prospective Split-Mouth Clinical TrialClinicalTrials.gov ↗NA · 14 participants · Completed
- Clinical trialEffects on Crying Time in Colicky Infants With the Supplementation of Lactobacillus Reuteri DSM 17938: A Randomized, Double Blind, Placebo-controlled StudyClinicalTrials.gov ↗NA · 116 participants · Unknown
- Clinical trialCirculAting Bile Acids as Biomarkers of Metabolic Health - Linking microbiotA, Diet and HealthClinicalTrials.gov ↗NA · 64 participants · Unknown
- Clinical trialEffects of Probiotics Intake on Oral Microbiome and Mucosa Inflammation in Patients With Cytotoxic Therapy Induced Oral Mucositis: A Pilot StudyClinicalTrials.gov ↗PHASE2 · 50 participants · Unknown
- Clinical trialThe Effect of Lactobacillus Reuteri ATCC PTA 4659 in Patients With Ulcerative ColitisClinicalTrials.gov ↗PHASE2 · 40 participants · Unknown
- Clinical trialTreatment of Chronic Constipation in Children With Lactobacillus Reuteri (Biogaia): A Prospective Placebo-controlled TrialClinicalTrials.gov ↗NA · 40 participants · Unknown
Evidence surfaced via Semantic Scholar (Allen Institute for AI) and ClinicalTrials.gov. Ranked by study type and citation weight, not cherry-picked.
Problems people have reported.
Read this carefully. These are 778 voluntary, unverified reactions reported to the FDA (openFDA). The number mostly reflects how popular Lactobacillus reuteri is, not how risky it is. A report is not proof Lactobacillus reuteri caused anything. It is a signal of what to watch for, nothing more.
Source: openFDA adverse-event reports. Voluntary reporting, not an incidence rate.
FDA Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This information is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider before starting any supplement regimen.



