This product specifically states on the label that it must be climate controlled to maintain potency. The item arrived in a cardboard box with no insulation or ice packs. Just a bare cardboard box.

These are the best probiotics I have ever used. I started using Metagenics in 2006 and I continued until 2010 when I moved and could no longer find them locally. I switched to a GNC product, which was ok, but nothing has ever come close to how good my stomach acts and feels when I take this. It is shipped and stored in refrigerated conditions, and I believe that this is the difference between Metagenics probiotics and store bought. These are live cultures, so it makes sense that there are kept cool to preserve. Also these have ten times the live culture level than other probiotics. Once again, probably because of the refrigeration. I am so glad to have found these on Amazon. Now if Amazon would just do the auto-shipment...hint, hint :)

How very disappointing to pay so much for a product that MUST be climate controlled to stay cool, so that the potency is at it's highest. Otherwise why else would someone purchase this at this price? Will be returning!

This is a very high quality product and my trusted Natural Path sells it as well. Three years ago my father had esophageal cancer and underwent an extreme surgery to remove a large portion of his esophagus and partial stomach. He had to be tube fed and was slowly introduced back into his normally healthy diet. But, he experienced diarrhea and abnormal bowel functions for two years… his doctors said it was a normal part of his healing and that he may have those symptoms possibly forever. He had little energy and was eating more, but loosing weight. I purchased these probiotics for him to take up to three times a day depending on how his gut responded. Within a week he was having normal bowel function and now takes only one a day. I’m happy to say he’s healthy now and gaining weight. I was surprised that his extremely talented and respected surgeon medical staff didn’t recommend a quality probiotic. I have since contacted the surgeon office to let them know of our success. I hope this helps someone in need, because it’s changed my father’s life.

Disappointing product: overpriced and limited in its effectiveness. I have researched and tried may similar products. This one has only 15 Billion and two (2) strains. This results in non-broad spectrum of probiotic coverage, as well as a fewer and weaker number of probiotics, as compared with other well-know and respected brands. For example "Renew Life Ultimate Flora 30 Billion" band (also sold on Amazon) is half the price, has double the number of probiotics (30 Billion), and has many more strains---thus a broader spectrum of of effectiveness. This item is normally sold and marketed through doctors' offices, where the doctor gets to keep 100% mark up, thus the high price of this product on line. Metrogenic, which sells UtraFlora Balance, wants to "protect" its doctor marketers by "keeping the price high" and not "under cutting" their doctors.

This probiotic is supposed to be refrigerated yet it was sitting in my mailbox all day roasting. And it gave me diarrhea everytime I took it, even though I have been on it from somewhere else for months with no problems. Very upsetting as it is expensive!