The Science

Peer-reviewed studies on individual ingredients in Balance Complex, including a 2023 Cochrane review of cranberry products (about 8,857 participants). Balance Complex itself has not been studied in a clinical trial. Every study below is public, citable research - the same studies you’d find in PubMed.

We don’t hide our sources behind “clinically studied” marketing copy. The full bibliography is below with author, journal, year, sample size where applicable, PMID, and a one-line finding. Click any entry for the PubMed abstract. These are studies of individual ingredients, not of Balance Complex. Many used specific strain designations that Balance Complex does not list, a vaginal or topical route instead of an oral capsule, or laboratory and animal models; each entry says so.

1. [1]Hallen A, Jarstrand C, Pahlson C (1992). Treatment of bacterial vaginosis with lactobacilli. Sexually Transmitted Diseases. PMID1523530.

   Ingredient:L. acidophilus (vaginal suppository)

   57% of women treated with L. acidophilus had normal vaginal flora restored vs 0% placebo.

2. [2]Reznichenko H, et al. (2020). Oral Intake of Lactobacilli Can Be Helpful in Symptomatic Bacterial Vaginosis: A Randomized Clinical Study. Journal of Lower Genital Tract Disease. PMID32091443.

   Ingredient:L. acidophilus (oral 3-species blend; includes strains Balance Complex does not contain)

   BV recurrence 18.3% vs 32.1% placebo (p=.014) in 166-woman trial.

3. [3]Reid G, et al. (2003). Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora. FEMS Immunology & Medical Microbiology. PMID12628548.

   Ingredient:L. rhamnosus (oral; strains GR-1 and L. fermentum RC-14)

   37% on probiotics restored normal flora vs 13% placebo over 60 days.

4. [4]Cianci A, et al. (2008). Efficacy of L. rhamnosus GR-1 and L. reuteri RC-14 in the treatment and prevention of vaginoses and bacterial vaginitis relapses. Minerva Ginecologica. PMID18854803.

   Ingredient:L. rhamnosus + L. reuteri (oral; strains GR-1 and RC-14, after antibiotics)

   92% of patients achieved complete Lactobacilli recolonization.

5. [5]Ansari A, et al. (2023). Lactobacillus Probiotics Improve Vaginal Dysbiosis in Asymptomatic Women. Nutrients. PMID37111086.

   Ingredient:L. acidophilus + L. rhamnosus + L. reuteri (oral; strains CBT LA1, LR5 and LU4)

   60% of women with high Nugent scores improved to healthy after 6 weeks oral probiotic.

6. [6]Kohler GA, et al. (2012). Probiotic interference of L. rhamnosus GR-1 and L. reuteri RC-14 with the opportunistic fungal pathogen Candida albicans. Infectious Diseases in Obstetrics & Gynecology. PMID22811591.

   Ingredient:L. rhamnosus + L. reuteri vs Candida (strains GR-1 and RC-14; in vitro)

   Lactic acid suppressed C. albicans growth; reduced fluconazole-resistance gene expression (in vitro).

7. [7]De Seta F, et al. (2014). Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study. European Journal of Obstetrics, Gynecology and Reproductive Biology. PMID25305660.

   Ingredient:L. plantarum (strain P17630; vaginal capsule after clotrimazole)

   L. plantarum increased vaginal Lactobacillus levels in 89-woman 3-month study.

8. [8]Bertarello C, et al. (2024). Efficacy and safety of Lactobacillus plantarum P 17630 strain soft vaginal capsule in vaginal candidiasis: a randomized non-inferiority clinical trial. European Review for Medical and Pharmacological Sciences. PMID38235890.

   Ingredient:L. plantarum vs antifungal (strain P17630; vaginal capsule)

   L. plantarum P17630 vaginal capsules were non-inferior to miconazole vaginal capsules for vaginal candidiasis symptoms in a 200-woman randomized trial.

9. [9]Spaggiari L, et al. (2024). Bacillus coagulans LMG S-24828 Impairs Candida Virulence and Protects Vaginal Epithelial Cells against Candida Infection In Vitro. Microorganisms. PMID39203476.

   Ingredient:B. coagulans vs Candida (strain LMG S-24828; in vitro)

   B. coagulans impaired Candida virulence and protected vaginal epithelium (in vitro).

10. [10]Tsimaris P, et al. (2019). Alleviation of vulvovaginitis symptoms: can probiotics lead the treatment plan?. Beneficial Microbes. PMID31965832.

    Ingredient:B. coagulans (topical: vaginal douches and suppositories)

    Single-arm study in 70 women: vaginal pH fell and vulvovaginal discomfort symptoms eased (p<0.001). Antibiotics were added on day 4 and there was no control group.

11. [11]Williams G, et al. (2023). Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews. PMID37068952.

    Ingredient:Cranberry

    Cochrane Review of 50 studies (N=8,857) - cranberry products reduce UTI risk in women with recurrent UTIs.

12. [12]Fu Z, et al. (2017). Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women. Journal of Nutrition. PMID29046404.

    Ingredient:Cranberry

    Cranberry effective in preventing UTI recurrence in healthy women.

13. [13]Xiong Z, et al. (2024). Preventive effect of cranberries with high dose of proanthocyanidins on UTI: a meta-analysis. Frontiers in Nutrition. PMID39668896.

    Ingredient:Cranberry (benefit seen at 36 mg PACs a day or more)

    Meta-analysis of 10 trials: UTI risk was 18% lower when daily PAC intake was at least 36 mg, with no significant effect below 36 mg. Balance Complex does not state a daily PAC amount, so this result should not be read as applying to it.

14. [14]Kranjcec B, et al. (2014). D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World Journal of Urology. PMID23633128.

    Ingredient:D-Mannose

    Recurrence dropped from 60.8% (no prophylaxis) to 14.6% on D-mannose, comparable to nitrofurantoin (20.4%) - N=308.

15. [15]Lenger SM, et al. (2020). D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology. PMID32497610.

    Ingredient:D-Mannose

    D-mannose appears protective vs placebo; possibly similar effectiveness as antibiotics.

16. [16]Hayward G, et al. (2024). d-Mannose for Prevention of Recurrent Urinary Tract Infection Among Women: A Randomized Clinical Trial. JAMA Internal Medicine. PMID38587819.

    Ingredient:D-Mannose (2 g a day of powder on its own; placebo-controlled)

    No benefit. In 598 women with recurrent UTI in UK primary care, 51% on D-mannose and 56% on placebo had another suspected UTI within 6 months, a difference that was not significant. The authors concluded D-mannose should not be recommended for prevention in this group.

17. [17]Jadhav A, et al. (2017). The Dietary Food Components Capric Acid and Caprylic Acid Inhibit Virulence Factors in Candida albicans Through Multitargeting. Journal of Medicinal Food. PMID28922057.

    Ingredient:Caprylic acid vs Candida (in vitro)

    Caprylic acid inhibits morphogenesis, adhesion, biofilm formation, and arrests Candida cell cycle.

18. [18]Takahashi M, et al. (2012). Inhibition of Candida mycelia growth by a medium chain fatty acids, capric acid in vitro and its therapeutic efficacy in murine oral candidiasis. Medical Mycology Journal. PMID23257726.

    Ingredient:Capric and caprylic acid (laboratory and mouse study)

    In vitro, capric and caprylic acid inhibited Candida mycelial growth at low concentrations; the mouse study tested capric acid only.

19. [19]Bae YS, Rhee MS (2019). Short-Term Antifungal Treatments of Caprylic Acid with Carvacrol or Thymol Induce Synergistic 6-Log Reduction of Pathogenic Candida albicans by Cell Membrane Disruption and Efflux Pump Inhibition. Cellular Physiology and Biochemistry. PMID31334617.

    Ingredient:Caprylic acid and carvacrol (in vitro)

    Caprylic acid and carvacrol have been studied together in laboratory research; Balance Complex contains both.

20. [20]Chami F, et al. (2004). Evaluation of carvacrol and eugenol as prophylaxis and treatment of vaginal candidiasis in an immunosuppressed rat model. Journal of Antimicrobial Chemotherapy. PMID15456732.

    Ingredient:Carvacrol (oregano; vaginal route, rat model)

    In immunosuppressed rats, vaginal carvacrol cleared Candida in 7 of 9 animals after 7 days of treatment.

21. [21]Kelly GS (1999). Larch arabinogalactan: clinical relevance of a novel immune-enhancing polysaccharide. Alternative Medicine Review. PMID10231609.

    Ingredient:Arabinogalactan

    Review: larch arabinogalactan is a dietary fiber; human intake was linked to higher gut Lactobacillus and Bifidobacteria.

22. [22]Henao SLD, et al. (2018). Randomized Clinical Trial for the Evaluation of Immune Modulation by β-Glucans from Ganoderma lucidum. International Journal of Medicinal Mushrooms. PMID30317947.

    Ingredient:Reishi (Ganoderma lucidum; beta-glucans in yogurt, children aged 3 to 5)

    Significantly increased peripheral blood lymphocyte counts vs placebo (RCT).

More ingredient research

These 17 entries go deeper on individual ingredients: which lactobacilli are found in healthy vaginal flora, what the strains make in the lab, how B. coagulans spores hold up in lab models of stomach acid, and what has been studied for protease, aloe vera and arabinogalactan. Most are laboratory, animal or other-strain studies. None tested Balance Complex or its amounts, and each entry says what was studied.

23. [23]Zhang R, et al. (2012). Qualitative and semiquantitative analysis of Lactobacillus species in the vaginas of healthy fertile and postmenopausal Chinese women. Journal of Medical Microbiology. PMID22301614.

    Ingredient:L. acidophilus (survey of healthy women; no product tested)

    In 92 healthy women of reproductive age, L. acidophilus was detected in 39%, behind L. iners, L. crispatus and L. gasseri. It is one of several lactobacilli found in healthy vaginal flora, not the most common one.

24. [24]Sanders ME, Klaenhammer TR (2001). Invited review: the scientific basis of Lactobacillus acidophilus NCFM functionality as a probiotic. Journal of Dairy Science. PMID11233016.

    Ingredient:L. acidophilus (review of the NCFM strain; Balance Complex does not list strain designations)

    Review: the NCFM strain of L. acidophilus has been sold in US foods and supplements since the mid-1970s and has been studied in the lab, in animals and in people.

25. [25]Silva M, et al. (1987). Antimicrobial substance from a human Lactobacillus strain. Antimicrobial Agents and Chemotherapy. PMID3307619.

    Ingredient:L. rhamnosus (strain GG; in vitro)

    In the lab, strain GG produced a natural antimicrobial substance active at pH 3 to 5. The authors classed it as distinct from a bacteriocin.

26. [26]Dimitrijević R, et al. (2009). The identification of a low molecular mass bacteriocin, rhamnosin A, produced by Lactobacillus rhamnosus strain 68. Journal of Applied Microbiology. PMID19796123.

    Ingredient:L. rhamnosus (strain 68; in vitro)

    In the lab, L. rhamnosus strain 68 made a bacteriocin, rhamnosin A. Bacteriocin production belongs to particular strains and was not tested in people.

27. [27]Mu Q, et al. (2018). Role of Lactobacillus reuteri in Human Health and Diseases. Frontiers in Microbiology. PMID29725324.

    Ingredient:L. reuteri (narrative review)

    Review: L. reuteri lives naturally in the human gut, urinary tract, skin and breast milk, and produces organic acids and reuterin. Reported effects depend on the strain and come largely from lab and animal work.

28. [28]Talarico TL, et al. (1988). Production and isolation of reuterin, a growth inhibitor produced by Lactobacillus reuteri. Antimicrobial Agents and Chemotherapy. PMID3245697.

    Ingredient:L. reuteri (laboratory fermentation)

    In the lab, L. reuteri made reuterin, a natural antimicrobial compound, while fermenting glycerol. No effect in people was measured.

29. [29]Kabuki T, et al. (1997). Production, purification and characterization of reutericin 6, a bacteriocin with lytic activity produced by Lactobacillus reuteri LA6. International Journal of Food Microbiology. PMID9039561.

    Ingredient:L. reuteri (strain LA6, isolated from an infant; in vitro)

    In the lab, the LA6 strain made a bacteriocin, reutericin 6, active against another lactobacillus. Some L. reuteri strains make bacteriocins; that is not shown for every strain.

30. [30]Chatsirisakul O, et al. (2025). Strain-Specific Therapeutic Potential of Lactiplantibacillus plantarum: A Systematic Scoping Review. Nutrients. PMID40218922.

    Ingredient:L. plantarum (scoping review of 69 human studies of named strains)

    Effects of L. plantarum differ by strain, with different named strains studied for gut, immune, vaginal and oral health. Results do not carry over from strain to strain.

31. [31]Chong HX, et al. (2019). Lactobacillus plantarum DR7 improved upper respiratory tract infections via enhancing immune and inflammatory parameters: A randomized, double-blind, placebo-controlled study. Journal of Dairy Science. PMID30954261.

    Ingredient:L. plantarum (strain DR7; oral, 12 weeks, adults)

    In a placebo-controlled trial of 109 adults, the DR7 strain taken for 12 weeks changed several immune markers, including natural killer cells. A different strain and amount; it is not evidence about any other product.

32. [32]Keller D, et al. (2019). Spores of Bacillus coagulans GBI-30, 6086 show high germination, survival and enzyme activity in a dynamic, computer-controlled in vitro model of the gastrointestinal tract. Beneficial Microbes. PMID30694101.

    Ingredient:B. coagulans (strain GBI-30, 6086; lab model of digestion)

    In a computer-controlled lab model of human digestion, 97% of the spores survived the stomach stage and about 51% survived the whole upper-gut model. A lab model, not a study in people.

33. [33]Maathuis AJ, et al. (2010). Survival and metabolic activity of the GanedenBC30 strain of Bacillus coagulans in a dynamic in vitro model of the stomach and small intestine. Beneficial Microbes. PMID21831748.

    Ingredient:B. coagulans (strain GanedenBC30; lab model of digestion)

    About 70% of the spores survived passage through a lab model of the stomach and small intestine. A lab model, not a study in people.

34. [34]Majeed M, et al. (2021). Comparative evaluation for thermostability and gastrointestinal survival of probiotic Bacillus coagulans MTCC 5856. Bioscience, Biotechnology, and Biochemistry. PMID33580694.

    Ingredient:B. coagulans (strain MTCC 5856; in vitro; authors from the strain maker)

    In simulated stomach acid (pH 1.3 to 2.0), B. coagulans strains held up significantly better than Lactobacillus strains. A lab test, not a study in people.

35. [35]Paulussen KJM, et al. (2024). Acute Microbial Protease Supplementation Increases Net Postprandial Plasma Amino Acid Concentrations After Pea Protein Ingestion in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Nutrition. PMID38467279.

    Ingredient:Protease (a different microbial protease blend, one dose with 25 g of pea protein)

    In a placebo-controlled crossover trial of 24 healthy adults, the protease blend raised blood amino acid levels after the meal. A different enzyme blend and amount, tested with a single meal.

36. [36]Sawalha H, et al. (2025). Phytochemical Analysis and Antifungal Activity of Aloe vera Extract Against Candida albicans. Scientifica. PMID41523607.

    Ingredient:Aloe vera (whole-leaf extract and gel; in vitro)

    In a lab study, aloe vera whole-leaf extract showed modest activity against Candida albicans, only at high concentrations. Not tested in people.

37. [37]Le Phan TH, et al. (2021). The Role of Processed Aloe vera Gel in Intestinal Tight Junction: An In Vivo and In Vitro Study. International Journal of Molecular Sciences. PMID34204534.

    Ingredient:Aloe vera (processed gel polysaccharide; aged mice and lab-grown gut cells)

    Processed aloe gel polysaccharides improved markers of the gut barrier in aged mice and in lab-grown gut cells. Early animal and lab research on a different aloe preparation.

38. [38]Haasbroek A, et al. (2019). Intestinal Drug Absorption Enhancement by Aloe vera Gel and Whole Leaf Extract: In Vitro Investigations into the Mechanisms of Action. Pharmaceutics. PMID30669246.

    Ingredient:Aloe vera (gel and whole-leaf extract; lab-grown gut cells)

    Aloe gel and whole-leaf extract loosened the tight junctions between cultured gut cells, the opposite direction to the mouse study above, so the lab evidence on aloe and the gut lining is early and mixed.

39. [39]Robinson RR, et al. (2001). Effects of dietary arabinogalactan on gastrointestinal and blood parameters in healthy human subjects. Journal of the American College of Nutrition. PMID11506055.

    Ingredient:Arabinogalactan (15 or 30 g a day of larch arabinogalactan; 20 healthy adults)

    Over 6 weeks, gut Lactobacillus counts rose. Balance Complex contains 50 mg, a much smaller amount than this study used.

Anise seed, wormwood, black walnut hulls and cellulase are included for their traditional use. We do not cite studies for them and make no claim about what they do in the body.