Flora Maintenance (25 Billion CFU)

Flora Maintenance (25 Billion CFU)
  • Gluten Free
  • Vegetarian
  • Non-GMO
  • Vegetable Caps

Supports intestinal microflora balance, immune system performance and healthy inflammatory response

  • 25 Billion CFU
  • 10 compatible probiotic strains
  • Prebiotic included for enhanced effectiveness
  • Shelf stable
  • Dairy free and soy free
  • Delayed release capsule to support viability through the intestinal tract
  • Helps balance intestinal microflora
  • Promotes digestive health
  • Enhances immune function
  • Provides support for lactose intolerance

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Product Information Sheet (PDF)

Unique Properties 

Patient One Flora Maintenance is a multi-strain, identity-confirmed probiotic with a potency of 25 billion bacteria per serving at encapsulation. Ten compatible, well-researched bacteria (seven found in the small intestine and three found in the large intestine) are combined with a fructo-oligosaccharide (FOS, a prebiotic). The combination of a prebiotic and a probiotic has been clinically proven to promote enhanced effectiveness. 
Flora Maintenance supplies HardiStrainTM standardized bacteria cultures, produced with a proprietary system that promotes increased viability over an extended shelf life. Our freeze-dried probiotic cultures are provided in an acid-resistant, delayed release capsule to survive harsh stomach acids for effective delivery to the intestinal tract where the organisms can colonize and replicate.
Flora Maintenance helps to inhibit the growth of harmful bacteria, supporting enhanced immune defense while aiding digestion. The "good" probiotic bacteria have the ability to adhere to the intestinal epithelial cells and to implant in the intestines and positively modulate the immune system. Patient One’s proprietary blend contains significant concentrations of L. acidophilus, L. casei, and L. rhamnosus, three of the most well documented strains on the market today.
As strain identity is essential to link a strain to a specific health effect, the probiotic strains in our formula are genetically identified using a sophisticated RiboPrinter® microbial characterization system.  

Key Ingredients

Lactobacillus acidophilus (ATCC 4356)  

L. acidophilusa strain of lactic acid-producing microbes, offers numerous benefits for digestive health. L. acidophilus produces vitamin K, lactase and anti-microbial substances. Multiple human trials report benefits of L. acidophilus for bacterial vaginosis. Scientists have discovered that administering L. acidophilus orally helps reduce the colonization of undesirable bacteria, such as E. coli within the digestive tract. L. acidophilus has been shown to improve digestive functions and boost the immune system. By creating a lactase enzyme that assists in the breakdown of lactose into simple sugars, L. acidophilus can be beneficial for people who experience lactose intolerance.

Lactobacillus casei (ATCC 393) 

L. casei is a species of Lactobacillus found in milk, cheese and dairy. A lactic-acid producer that has been found to assist in the colonization of beneficial bacteria, it supports the growth of L. acidophilus, which can help guard against conditions such as constipation and irritable bowels. L.casei is active in a broad temperature and pH range and can be found naturally in the mouth and intestine of humans. As a lactase producer, it aids in the optimal digestion of lactose, promoting optimal digestive health. 

Lactobacillus rhamnosus (ATCC 53103) 

L. rhamnosus, one of the most widely studied probiotic strains, works to balance the GI microflora. Perhaps most notable about L. rhamnosus is its ability to tolerate and even thrive in the typically acidic conditions found in the stomach. L. rhamnosus is believed to greatly assist with immune function in healthy adults, particularly in combating pathogens involved with the urinary tract system (acidic condition). Research has shown that L. rhamnosus can prevent apoptosis in gastric epithelial cells, improving the integrity of the stomach lining. A review article in the American Journal of Clinical Nutrition reported that L. rhamnosus can reduce the duration of diarrhea caused by rotavirus and other causes.

Bifidobacterium longum (DUP-16555) 

B. longum is among the first to colonize the sterile digestive tract of newborn infants. There is evidence that B. longum competes for attachment sites on the intestinal mucosal membrane, preventing the colonization of undesirable coliform bacteria. It has a high resistance to gastric acid and shares similar functions as B. bifidum, such as boosting the immune system and providing barrier protection from pathogens.

Bifidobacterium breve (ATCC 15700) 

In medical studies, antibiotic-associated diarrhea, allergies, gas and irritable bowels have been linked to a patient's shortage of the B. breve bacteria. The presence of B. breve appears to inhibit E coli. B. breve is also present in the vagina, where it helps to inhibit overgrowth of Candida albicans, the primary cause of yeast concerns in women. The job of B. breve in the digestive tract is to ferment sugars and produce lactic acid as well as acetic acid. B. breve is like a champion among probiotic bacteria due to its superior ability to metabolize many types of food.

Lactobacillus plantarum (NCIMB 12422) 

L. plantarum has been used in the process of fermenting foods for hundreds of years. It promotes a normal digestive tract and is able to destroy harmful agents while preserving vital nutrients, antioxidants and vitamins. One of the most remarkable attributes of L. plantarum is its ability to synthesize L-lysine, an essential amino acid. L. plantarum is able to ward off unhealthy bacteria in the intestine by preventing it from attaching to the mucosal lining and also by competing for nutrients that the pathogenic bacteria live on. By doing so, undesirable bacteria pass harmlessly through the body.

Lactobacillus salivarius (ATCC 11741) 

L. salvarius, which resides in the mouth and small intestine, has been shown effective in fighting off at least five harmful bacteria that are involved in producing plaque, thus assisting in dental health. L. salivarius has the unique ability to fight off the H. pylori bacteria that are responsible for most peptic ulcers. Researchers studied animal response after induced colitis and septic shock and treatment with L. salivarius and discovered the role of L. salivarius in striving to reestablish homeostasis within the intestines. They concluded that L. salivarius may be related to the immune response.

Streptococcus thermophiles (DUP-14581) 

S. thermophiles appears to be resistant to gastric acidity when consumed with meals and is supportive for lactose intolerant people, as the lactase it produces aids with digesting lactose in the intestine. Moreover, primary in vitro results have shown that S. thermophiles could be highly effective in modulating the immune response. The role of S. thermophiles is to rapidly acidify the intestinal environment and to create one that is favorable to lactic acid bacteria.

Peddiococcus acidilactici (DUP-5600)

A hearty lactic acid bacterium, P. acidilactici can grow in a wide range of pH and temperatures, thereby able to survive harsh gastric conditions and colonize the entire digestive tract. This probiotic strain has been shown to function as an immune modulator, to resist pathogens such as Salmonella and E. Coli, provide digestive support, promote a healthy inflammatory response in the intestines, and help balance intestinal microflora.

Lactobacillus bulgaricus (Lb-87) 

L. bulgaricus effectively metabolizes sugars (including starches and fibers) to produce lactic acid. The generation of lactic acid in the intestine decreases the pH of the intestinal tract which makes it less suitable for the growth of acid-tolerant microbes including those that can act as pathogens. L. bulgaricus is also effective at reducing the lactose load in individuals who are lactose intolerant, thereby allowing them to ingest higher quantities of dairy products.

Fructo-oligosaccharide (FOS)

To complete our multi-strain formula, Flora Maintenance supplies FOS, a prebiotic from Jerusalem artichoke, to act as the nutrient source for the probiotics. FOS feeds the microflora in the intestines and prevents the overgrowth of yeast. FOS promotes calcium absorption due to an increase of lactic acid levels in the gut. Studies have found that probiotics are more effective when taken with a fructo-oligosaccharide. 


  • In 2005 Sherman et al demonstrated that probiotics prevent epithelial injury induced by attaching-effacing bacteria. One of the most important criteria to balance effectively the intestinal flora is the ability of a probiotic to inhibit the growth of pathogens. In vitro tests have shown that L. rhamnosus is able to inhibit the adhesion to intestinal epithelial cells of both enteropathogenic E. coli O127:H6 and enterohaemorrhagic E. coli O157:H7, that cause protracted diarrhea in infants and hemorrhagic colitis, respectively. (2)
  • L. rhamnosus down regulates the production of cytokines and chemokines associated with cell mediated immunity (TGF-?, TNF-?), and also IL-8, when it is produced by intestinal and gastric epithelial cells stimulated, by pathogen presence or inflammation. In addition, it prevents over expression of RANTES, which is apparent in inflammatory states. (4,5)
  • Several clinical trials have demonstrated the efficacy of L. rhamnosus association with L. acidiphilus in reducing or preventing diarrhea of various origins. Tláskal et al (1995) evaluated two groups of children suffering from pathologies of the gastrointestinal tract. The first group (33 children) received the association of L. acidophilus and L. rhamnosus. The second group (42 children) received a conventional treatment (smectite and concentrated metabolic products of common symbiotic bacteria of the intestine). A comparison of the results of the two groups revealed a better efficacy of Lactobacilli acidophilus and rhamnosus treatment than the conventional treatment. The duration of diarrhea was reduced among the children who received the probiotics compared to the group who received the conventional treatment. (6)


  1. Altieri C., Bevilacqua A., Sinigaglia M. Prolonging the Viability of Lactobacilus plantarum through the Addition of Prebiotics into the Medium. Journal of Food Science, 2011; 76, Nr.6, M336-M345.
  2. Sherman PM., Johnson-Kenry KC. Yeung HP. Ngo SC., Goulet J., Tompkins TA. Probiotics reduce enterohemorrhagic Escherichia coli )157:H7- and enteropathogenic E. coli O127:H6-induced changes in polarized T84 epithelial cell monolayers by reducing bacterial adhesion and cytoskeletal rearrangements. Infect. Immun., 2005; 73: 5183—8.
  3. Waldemar G., Kordowska-Wiater M., Koziol J. The influence of selected prebiotics on the growth of lactic acid bacteria for bio-yoghurt production. Acta Sci. Pol. Technol. Aliment. 2011; 10(4) 455-466.
  4. Wallace TD. Bradley S., Buckley ND. Green-Johnson JM. Interactions of lactic acid bacteria with human intestinal epithelial cells: Effects on Cytokine production. Journal of Food Protection, 2003; 66, 3; 446-472.
  5. Wood C., Keeling S., Bradley S., Johnson-Green P., Green-Johnson JM. Interactions in the mucosal microenvironment: Vasoactive intestinal peptide modulates the down regulatory action of Lactobacillus rhamnosus on LPS indusced interlukin-8 production by intestinal epithelial cells. Microbial Ecology in Health and Disease, 2007; 1-10.
  6. Tiáskal P, Lactobacillus acidophilus in the treatment of children with gastrointestinal tract illness. 1995, Cesko-Slovenska Pediatrie, 51 :615-619.

Supplement Facts

Serving Size: 1 Capsule
Servings Per Container: 60
Amount Per Serving % Daily Value**
Bacterial Culture Blend:25 Billion Live Organisms*
L. acidophilus (ATCC 4356)
L. casei (ATCC 393)
L. rhamnosus (ATCC 53103)
B. longum (DUP-16555)
B. breve (ATCC 15700)
L. plantarum (NCIMB 12422)
L. salivarius (ATCC 11741)
S. thermophilus (DUP-14581)
P. acidilactici (DUP-5600)
L. bulgaricus (Lb-87)
Fructo-oligosaccarides (FOS) 250 mg
† Daily Value not established.

Suggested Use

Take 1 capsule daily as a dietary supplement, with or between meals, or as directed by your health practitioner. Store in a cool, dry place.


If you are pregnant, nursing, or taking any medications, consult your health practitioner before use. Discontinue use and consult health practitioner if any adverse reactions occur. Keep out of reach of children. Use only if safety seal is intact.

Flora Maintenance (25 Billion CFU) Label