The Life Inside All Of Us
Microbes & me is a new collaborative series between BBC Future and BBC Good Food.
In the series, well be looking at recent research into the microbiome of bacteria that lives in all of us.
Well be exploring how it affects our health, what could be having detrimental effects on it, and recommending recipes that might help it thrive.
Probiotics have been touted as a treatment for a huge range of conditions, from obesity to mental health problems. One of their popular uses is to replenish the gut microbiome after a course of antibiotics. The logic is antibiotics wipe out your gut bacteria along with the harmful bacteria that might be causing your infection, so a probiotic can help to restore order to your intestines.
But while it might sound like sense, there is scant solid evidence suggesting probiotics actually work if taken this way. Researchers have found that taking probiotics after antibiotics in fact delays gut health recovery.
Part of the problem when trying to figure out whether or not probiotics work is because different people can mean a variety of things with the term probiotic. To a scientist, it might be seen as a living culture of microorganisms that typically live in the healthy human gut. But the powdery substance blister packs on supermarket shelves can bear little resemblance to that definition.
Even when researchers use viable, living bacterial strains in their research, the cocktail varies from one lab to another making it tricky to compare.
What Type Of Probiotics Should I Take
Foods with naturally occurring probiotics such as yogurt and sauerkraut are recommended as part of your daily diet even when you arenât taking antibiotics. Continue consuming these âgoodâ bacteria powerhouses. There are a wide range of supplemental probiotics and they come in many forms, liquid, capsule, pill, even powders. They have different strains and varying levels of probiotic strains . Different strains of bacteria will interact differently with each antibiotic. Additionally, how the probiotic is designed to be broken down will affect the number of CFUs that you need. Discuss this with your healthcare provider and research the probiotic you are considering.
Take Probiotics At A Convenient Time
Some would recommend taking probiotics at least two hours before or after antibiotics to reduce the potential for the antibiotic to kill the probiotic you just took. You can do this if you want, but if that makes your medication schedule too complicated, just take them together. Youre better off taking them together than not at all.
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Probiotic Dosage After Antibiotics
The strain and dosage of probiotics you need to take while using antibiotics depends on the reason you’re using probiotics. Common side effects of antibiotic usage include diarrhea and yeast infections caused by an overgrowth of Candida albicans. Lactobacillus GG can help prevent or lessen diarrhea in both children and adults, while lactobacillus acidophilus can help treat a yeast infection 2.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Side Effects Of Probiotics
There have been very few scientific studies about the side effects of common probiotics. Most of what we know comes from consumer reports. In a large review study, researchers found that in about 10% of cases, people who used probiotics had mild digestive issues such as bloating, gas, and diarrhea . In another review, as many as 27% of people who used probiotics experienced gas and bloating .
In the case of Clostridium difficile infection, a serious side effect can be developing colon inflammation. However, it is not clear whether the C.difficile was already there prior to taking the probiotic or whether it was caused by the probiotic itself. More studies are needed to clarify this risk .
What we do know is that some bacteria may have antibiotic resistance and pass it on to other bacteria in the microbiome. Probiotics have been known to have multiple effects on the immune system as well, including causing allergies and worsening asthma.
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Challenges To Implementation: Lack Of Guidance On Dosing And Duration
Since probiotics are considered food supplements, health insurance will not cover the cost . No single probiotic strain has high-quality evidence however, most of the RCTs included in the meta-analysis used combinations of Lactobacillus species, which are usually found in over-the-counter antidiarrheal probiotic supplements. No standard dose exists, but dose ranges in RCTs are 107 to 1010 colony-forming units per capsule 1 however, product labels have variable accuracy.11 The duration of treatment ranges from one to 3 weeksor as long as the patient continues to take antibiotics.
What Foods To Not Eat While Taking Antibiotics
There are some foods you should avoid while on antibiotics, either because they interfere with absorption or because the combination can make you feel sick.
In most cases, these foods simply interact poorly and make the antibiotics less effective.
Foods to avoid include:
- Grapefruit You should avoid both the fruit and the juice of this sour citrus product. It contains compounds that can keep the body from properly absorbing your antibiotics as well as other medications, too!
- Excess Calcium Some studies show that excess calcium interferes with absorption. For best results, stick to fermented dairy products until you are finished with your antibiotics.
- Alcohol Mixing alcohol and antibiotics can lead to a host of unpleasant side effects. The most common of these are
- Increased nausea
- Abdominal pain
- Heart rate issues. You should avoid alcohol throughout the duration of treatment and for 48 to 72 hours after treatment ends.
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Dont Go Strain Shopping
You dont need to find the one right probiotic strain for your specific health condition.
Many different types of probiotics have been shown to be beneficial when used alongside antibiotics.
Thats because all probiotics have a similar effect of balancing the gut microbiota, modulating the immune system and reducing inflammation.
Lactobacillus/Bifidobacterium blends and Saccharomyces boulardii are the two categories of probiotics that are used most often in research. Soil-based probiotics are a third category of probiotics used in research, albeit less frequently.
One very large meta-analysis compared results for 63 different studies and found no difference in results across the three probiotic categories for antibiotic associated diarrhea . Most of the research trials used a blend of probiotic strains.
Take Probiotics At The Appropriate Time
Remember, probiotics are living organisms, and they must be taken in a way that maintains their integrity and nutritional value. If you purchase a powdered probiotic mix, don’t swirl it into a boiling liquid that will kill it on contact.
Keep probiotics that need refrigeration refrigerated and always use the product before its expiration date. There’s also the issue of when to take your probiotics with antibiotics.
One of the most common questions people ask is “How long after taking antibiotics can I take Probiotics?” Taking antibiotics at the same time as your probiotics can expose your probiotics to antibiotics that kill them. For that reason we recommend taking the probiotics as far apart from your antibiotic as possible to minimize the chances that they will come in contact with one another.
For example, if you need to take your antibiotic at 12:00 PM and 6:00 PM then we recommend taking your probiotics at 9:00 AM, 3:00 PM, and 9:00 PM. If you need to take your antibiotic every 4 hours then time your probiotic dose to be halfway between your doses of antibiotic. For specific advice please consult your doctor.
It is best to take your probiotics 30 minutes before breakfast. Moreover, you should continue your probiotic for four to six weeks after your course of antibiotics is done.
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Which Probiotics Should You Take With Antibiotics
Your pharmacy probably has shelves filled with different bottles of probiotics. How do you choose the right probiotics to take with your antibiotics? Dr. Bryan Tran, cofounder of DrFormulas, recommends looking for probiotics that have the three Ds:
Dose: The amount of active micro-organisms in a probiotic is measured in colony-forming units, or CFUs. You want a dose with 10 billion CFUs or higher, Dr. Tran says. This dose may appear on the product label as 1 x 1010. And while you may see probiotics with 100 billion or more CFUs, according to Dr. Hoberman, you generally stop reaping added benefits after about 20 billion.
Diversity: The label on a bottle of probiotics will also tell you which bacteria strains the capsules contain. Look for probiotics that have five to 10 unique strains. Studies that compare single-strain probiotics to multi-strain probiotics have found that a variety of strains is more effective at reducing diarrhea, Dr. Tran says.
Delayed-release mechanism: Finally, look for probiotics that use delayed-release capsules. When you take probiotics orally, you expose them to your stomach acid and that reduces the effective dosage that makes it to the gut, Dr. Tran says. Probiotics with delayed-release mechanisms wont release the microorganisms until they go past the stomach.
Keep Your Gut Healthy
In the meantime, the best thing you can do to ensure long-term optimal health is focus on tending to your microbial garden by protecting and nourishing your good flora.
And, dont forget to look out for antibiotics in your food! Farmers often use antimicrobial medications to fatten up their livestock, so if you eat meat, fish, or dairy, make sure its antibiotic-free.
Its hard to fathom where wed be without the life-saving power of antibiotics.
But, as we move forward responsibly using antibiotics only when absolutely necessary and making sure to support our wondrous gut microbiome along the way we can do so with confidence that were giving our entire body the fortification it needs to live a healthy and vibrant life.
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Which Strains Of Probiotics Should Be Taken While On Antibiotics
Antibiotics destroy all bacteria, the good and the bad, in our gut microbiome. Therefore, after a course of antibiotics, the main goal is to replenish the good bacteria and restore the diversity in your gut microbiome. You can do so by taking a multispecies and multistrain probiotic supplement.
Institut AllergoSan, the Competence Center in Microbiome Research, located in Austria has developed a probiotic that is specifically designed to restore a healthy gut microbiome after completing a course of medication.
OMNi-BiOTiC® AB 10 is a medically relevant probiotic that consists of ten specifically selected bacterial strains that have demonstrated to maintain the diversity of a healthy microbiome, support healthy bowel movements and boost the bodys immune response.
It has also shown in clinical studies to protect your body against aggressive pathogens, including Clostridium Difficile, which among other pathogens, has a stronger chance of flourishing in the body after the gut microbiome has been damaged because of an antibiotic treatment. Clostridium Difficile and other harmful pathogens are key drivers in antibiotic-associated diarrhea.
A study conducted by Goldenberg et al., published by the Cochrance Systematic Review in December 2017, found that OMNi-BiOTiC® probiotics reduced the risk of Clostridium Difficile-associated diarrhea by 60% in patients who have recently completed a course of antibiotics.
Double Check With Your Doctor On Mixing Probiotics And Antibiotics
There may be situations where your doctor doesnt want you to take probiotics with antibiotics. So please, for your own safety, check with your doctor to make sure taking antibiotics together with probiotics is the right call for you. The more health conditions and the more complicated your medications schedule is, the more important it is the check with your doctor.
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Probiotics Reduce Antibiotic Side Effects
When you have been on antibiotics before, did you have adverse effects such as diarrhea, yeast infections, or gastrointestinal pain?
Antibiotics work by killing harmful bacteria that cause infections. Most antibiotics are broad-spectrum, meaning they kill a lot of different types of bugs. This broad action makes them useful for a lot of different types of infections, and its also why they can end up killing good bacteria too.
Antibiotic side effects are often caused by the loss of beneficial bacteria and resulting dysbiosis [6
Antibiotic side effects can be long-lasting, especially with repeated antibiotic treatments. Probiotics can be very helpful in restoring the healthy balance of gut bacteria. A large number of studies back this up.
Lets look at a few examples:
Should You Take Probiotics Or Antibiotics
May 23, 2022
Is taking probiotics with antibiotics helpful or a waste of money? Antibiotics are prescribed to treat illnesses cause by harmful bacteria. Most of the harmful bacteria arenât normally present in our bodies, but there are a lot of âgoodâ bacteria normally present in our gut. Since the job of the antibiotic is to attack and kill bacteria, the âgoodâ bacteria are also attacked.
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Other Options To Strengthen The Gut Microbiome
Mayer added that this doesnt rule out that other life microbes occurring in fermented food products like sauerkraut and kimchi, for instance, may be beneficial for patients following a course of antibiotics.
Traditionally, antibiotics are one of the most prescribed medications out there, according to Megan Meyer, PhD, director of science communications at the International Food Information Council Foundation.
Because of this, antibiotic treatment may disrupt the composition and diversity of bacterial found in the gut, which can result in a variety of symptoms, including diarrhea. Probiotics may help improve the balance of bacteria found in the gut, counteracting potential alterations brought on by antibiotic treatment, she wrote in an email to Healthline.
Meyer added that this does have uses taking a probiotic like Bifidobacteria has been shown to reduce antibiotic-associated diarrhea. A 2008 review in the journal Nutrition cites that probiotics can have a beneficial effect on diarrheal conditions and related GI symptoms.
While the new study offers a counterpoint to the traditional emphasis on probiotics, it offers an alternate solution to returning to the gut microbiome to normal following antibiotic treatment.
Mayer, of UCLA, said that the only approved, recommended course of autologous fecal transplantation right now is for people who have C. difficile colitis, inflammation of the colon caused by the bacteria Clostridiumdifficile.
Yes You Should Take Probiotics And Antibiotics At The Same Time
Taking probiotics and antibiotics together is more effective than taking antibiotics alone.
Adding probiotics to an antibiotic protocol for SIBO can more than double the treatment success rate.
Probiotics reduce antibiotic side effects, including antibiotic-associated diarrhea.
Probiotics reduce the likelihood of C. difficile infections for patients on long-term antibiotic therapy.
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How To Replenish Good Bacteria After Antibiotics
Restoring gut flora after antibiotics is achievable if you eat the correct foods: plants. That’s because your gut microbes turn fibers and plant nutrients into important metabolites like short-chain fatty acids – acetate, butyrate, and propionate – which have important functions:
- fuelling the cells of your gut lining
- preventing damage to your cells
- anti-cancer properties
- nourishing other beneficial bacteria
- deterring opportunistic microbes
Probiotics May Help Prevent Diarrhea Due To Antibiotic Use
- By Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Eating yogurt or taking a so-called probiotic when you have to take antibiotics may help prevent the diarrhea that often accompanies antibiotic treatment.
Thats the conclusion of a study just published in the Journal of the American Medical Association. A team of California-based researchers combined the results of 63 randomized trials pitting probiotics versus placebo among almost 12,000 men and women taking antibiotics. Those who took antibiotics plus probiotics were 42% less likely to develop diarrhea as those who got the placebo.
About one in three people who take antibiotics develop diarrhea. The symptoms usually start on the last day or two of antibiotic therapy, or a day or so after it has ended. The diarrhea is usually mild, with two to four loose stools per a lasting for a couple days. In most cases, it gets better quickly without treatment. That said, antibiotic-associated diarrhea makes some people very sick. The most severe form, called C. difficile colitis, can be life threatening.
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What Are The Side Effects Of Probiotics
What are the risks of taking probiotics? Although probiotics are freely available to purchase without prescription or full regulation, there are risks associated with them. Hospitalised patients are increasingly are increasingly being treated with probiotics, but there are now reports of patients in intensive care becoming seriously ill with the same strain of bacteria found in the probiotics . While for most people who have a healthy immune system, this risk is low, it highlights the need for greater understanding about possible risks and benefits.
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The Benefits Of Taking Probiotics While On Antibiotics
Its important to take probiotics while on antibiotics in order to maintain the balance of good and bad bacteria in your gut. Antibiotics can kill both the bad and good bacteria, leaving you susceptible to infection. Probiotics help replenish the good bacteria, keeping you healthy.
- Taking probiotics while on antibiotics can help to reduce the side effects of antibiotics.
- Helps with intestinal problems caused by antibiotics.
- Can cure diarrhea caused by taking antibiotics.
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