Why You Should Take Probiotics With Antibiotics
Antibiotics play a critical role in killing bad bacteria. But as they destroy infections, they can also cause collateral damage to the good bacteria in your gut, which could result in diarrhea for a couple of daysor even weeksafter you stop taking the medicine.
So how can you get the benefits of antibiotics without the nasty stomach side effects? The answer might be found in probioticspills or even powders with live microorganisms that offer health benefits.
Your intestines contain around 1,000 different species of bacteria, with 100 trillion bacteria in total, says Dr. Lawrence Hoberman, president and chief executive of Medical Care Innovations Inc. If 80% of that bacteria is the good, healthy kind, the harmful bacteria stay at bay. But antibiotics change the balance in the microbiome, which may result in an increase in the harmful bacteria, he explained.
The immune system recognizes the bad guys and will try to destroy them. But in the process, it breaks down the intestinal lining and causes inflammation, and thats how we get antibiotic-associated diarrhea, Dr. Hoberman explains.
One study found that antibiotic-associated diarrhea affects between 5% and 39% of patients, depending on which antibiotic they take. But research shows that probiotics can curb digestion problems. A meta-analysis of 34 other studies found that probiotics reduce instances of antibiotic-associated diarrhea by 52%.
Choose A Quality Probiotic Formula
Quality assurance practices do matter. Probiotic manufacturing is not highly regulated and some label claims do not stand up to scrutiny. Consider the results of these investigations into probiotic quality:
- One study assessed 26 commercial probiotics and found that none fully supported label claims. Some probiotic supplements contained unacceptable microorganisms .
- The same study found two common problems in probiotic supplements: low concentration of viable cells and the presence of undesired organisms .
- Another study found only half of the probiotics examined had the specific strain listed on the label .
- 43% of the probiotics in another study contained less than half the amount of probiotics listed on their labels .
If a company follows quality assurance practices, a probiotic supplement will meet its label claims and not contain potentially harmful organisms.
Take Probiotics To Restore Gut Flora
Probiotics are your good gut bacteriathe ones that support healthy digestion, produce nutrients and get rid of toxins and pathogens, among other key roles. A diet rich in probiotics can help good microbes colonize in your gut and keep the unfriendly ones at bay. Heads up:
The histamines in fermented foods mean that some choices, like miso and conventional yogurt, dont work for everyone. Probiotic supplements are super effective ways to get these beneficial bacteria in your diet.
Heres an easy win: Bulletproof Unflavored Gut Health Collagen Protein covers all your bases. It contains probiotics, plus prebiotic acacia , glycine and zinc carnosine to a healthy gut lining.
What to know about probiotics and antibiotics
Every dose of antibiotics wipes out a large portion of bacteria throughout your entire body, including the good guys. After that, the good microbes and the unfriendly ones slowly rebuild, and if all goes well, they come back into balance. But, it takes time, and they dont always colonize in harmony.
To keep one strain of gut flora from taking over, take a probiotic supplement while youre taking antibiotics. The friendly probiotic bacteria may not colonize in the gut, but they can still help you through a course of antibiotics.
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How Long Does It Take To Restore Gut Flora After Antibiotics
It can take several weeks to months to restore gut health after antibiotics. Research shows that most healthy gut bacteria return to normal levels roughly 2 months after antibiotic treatment. However, studies have also found that some healthy bacteria are missing even 6 months after taking antibiotics.
The gut microbiota is a delicate ecosystem and even a few missing beneficial gut bacteria can throw it out of balance. There is no fixed timeline for a return to gut health after a course of antibiotics. Its possible that the gut flora may never return to normal. But this doesnt mean you cannot take steps to maximize gut health by increasing the microbial diversity in your digestive tract.
A More Effective Alternative
The Israeli study also explored an alternative approach to microbiome restoration.
One group of participants had their own stool collected and frozen prior to antibiotic treatment. It was then re-instilled into their gut at the end of the antibiotic therapy.
This treatment, known as autologous fecal transplantation, was able to restore the microbiome to original levels after just eight days. The other group took 21 days to recover.
This approach has also been shown to effectively restore the gut microbiome following combined antibiotic and chemotherapy treatment. These patients are predictably at risk of serious complications, such as bloodstream infection, as a result of microbiome disruption.
Research currently underway will help us understand whether microbiome restoration with autologous fecal transplantation will translate into tangible benefits for these patients.
But such an approach would not be a realistic option for most people.
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The Surprising Finding Was That The Group Who Received The Probiotic Had The Poorest Response In Terms Of Their Microbiome
As expected, a lot of major changes occurred in the function of the microbes many of which died because of the antibiotics, says Elinav.
The volunteers were divided into three groups. The first was a wait-and-see group, with no intervention after the antibiotics. The second group was given a common probiotic for a month. The third was given perhaps the least savoury option: a faecal transplant. This group had a small sample of their own stool taken before the antibiotic treatment returned to their colon once the treatment was over.
The surprising finding was that the group who received the probiotic had the poorest response in terms of their microbiome. They were the slowest group to return to a healthy gut. Even at the end of the study after five months of monitoring this group had not yet reached their pre-antibiotic gut health.
Probiotics won’t work exactly the same for everyone because gut biomes are different
We have found a potentially alarming adverse effect of probiotics, says Elinav.
The good news, incidentally, is that the group who received a faecal transplant did very well indeed. Within days, this group completely reconstituted their original microbiome.
So many people are taking antibiotics all over the world, says Elinav. We can aim to better understand this potentially very important adverse effect that we didnt realise existed.
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.
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Do Opposites Attract Or Cancel Each Other Out We Asked The Experts For The Bottom Line
by Health Writer
In short: Yes, you can take a probiotic while youre taking an antibioticits perfectly safe to do so. In fact, experts generally agree that probiotics may help ward off the gut reaction that comes from taking antibiotics , but the data is limited. On the other hand, to reap the maximum gut flora-restoring benefits that probiotics offer, it may be better to wait until the tail-end of your course of antibiotics before starting to take them, says Eric Goldberg, M.D., an internist and medical director of NYU Langone Internal Medicine Associates in New York City.
To understand how probiotics and antibiotics work together, lets first talk about the gut microbiome. The microbiome is where trillions of bacteria, fungi, and viruses live. We all have a balance of good and bad bacteria in our gut microbiome. When levels of the harmful bacteria get too high, you get sickin the form of stomach bugs, fungal infections, and a hit to your immune system, making you more vulnerable to future infection.
Taking Probiotics With Antibiotics Is Beneficial
Taking probiotics is a simple and highly effective way to improve your health outcomes when you need to take antibiotics.
Probiotics can not only help antibiotics be more effective at clearing an infection, but they can significantly reduce the incidence of undesirable side effects of antibiotics, most commonly diarrhea and gut dysbiosis.
In order to have the most beneficial effects with your antibiotic treatment, follow these simple steps to adding a probiotic:
- Start a high-quality probiotic as soon as you start antibiotics.
- Take the probiotics for about three to four weeks, and once your gut is doing well and you are not having gastrointestinal symptoms, keep on the probiotics for another month to allow your gut to get used to its new microbiome. Weve found this timeframe to be the most effective with our patients.
- After a month, you can decrease the dose to find your minimal effective dose for your optimal health outcomes.
We hope that this article helps you maintain a good gut balance and feel well during your course of antibiotic treatment and after.
If you have been struggling with the effects of taking antibiotics, especially if you have had repeated or long-term antibiotic treatment and would like individualized help, please contact our clinic.
References
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Why Probiotics Are Essential After Antibiotics
Find out why probiotics are important after antibiotics
What are probiotics?
The word probiotic literally means for life but the term usually refers to supplements that contain living, beneficial bacteria. Billions of these friendly bacteria from more than 400 different species occur naturally in a healthy digestive system, with most living in the intestines, where they are sometimes called intestinal flora.
These bacteria support general well-being in several ways, such as assisting digestion and helping to maintain immunity. However, they can be very sensitive to changes in their environment and taking a course of antibiotics can significantly reduce their numbers.
Why is it important to take a probiotic supplement after a course of antibiotics?
Antibiotics eliminate both bad and good bacteria. It is important to quickly replenish intestinal bacteria after antibiotic use. Taking a probiotic can help as they contain special live bacteria that can repopulate the intestinal tract and may also reduce the risk of developing candida .
Antibiotics eliminate both bad and good bacteria. It is important to quickly replenish intestinal bacteria after antibiotic use. Taking a probiotic can help as they contain special live bacteria that can repopulate the intestinal tract and may also reduce the risk of developing candida .
When should I start taking my probiotic?
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What Are Probiotics Anyway
Theres a lot of buzz around probiotics. However, many people dont exactly know what probiotics are. Probiotics are part of what is known as our collective microbiome, which is the community of bacteria in our gastrointestinal system, says Kevin Gebke, MD, a family and sports medicine physician at Indiana University Health. Often deemed the good bacteria, probiotics include live bacteria and yeasts that keep your gut healthy.
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Probiotics And Antibiotics: Whats The Difference
Probiotics are live, good yeasts and bacteria in your gut and digestive system that help regulate your body. On the other hand, antibiotics are drugs created to treat bacterial infections by killing the responsible bacteria.
Often, antibiotics also kill the beneficial bacteria in the digestive flora. As a result, your immune system efficiency decreases, and you are ironically more likely to become sick.
Should You Take Probiotics After Your Course Of Antibiotics To Replace Your Friendly Gut Micro
If antibiotics impact your microbiota, should take probiotics of antibiotics to replace them? Previous evidence from analysis of studies combined has suggested that probiotics can help with infections and antibiotic-associated diarrhoea. Taking probiotics after antibiotic treatment has become increasingly common.
However, two recently reported studies in Cell has called this evidence into question. One study investigated the recovery of gut microbiota after antibiotic treatment and found that probiotics might actually interfere rather than help . The probiotics rapidly colonised the gut but prevented the normal microbiota from repopulating for up to 5 months. But these effects seemed very individualised, with some people becoming colonised by the probiotics, while others guts rejecting them altogether .
Although rather unappealing, the group who received their own-pre antibiotic treated faeces transplanted back into their gut after the antibiotic therapy, recovered their microbiota the quickest . Faecal transplant is not a new phenomenon, with reports of people using it to treat food poisoning in China, as early as the 4th Century!
While the logic behind probiotics might seem sound, there is still much research to be done before we understand the complexity of the microbiota and effects of probiotics.
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When To Take Antibiotics Before Or After Food
When you are given them, it usually clearly states whether you need to take antibiotics with food. Taking them correctly is key to their effectiveness. You should take them with water because this doesnt interfere with their effectiveness as some fruit juices do.
Some types will need to be taken with food to reduce the risk of side effects like nausea and vomiting. After all, antibiotics are potent medicines, so its not really surprising that they can irritate your digestive system too.
If youre going to take probiotics with antibiotics, it is best to take them a few hours apart so this medication doesnt affect the probiotic bacteria too.
Probiotics And Antibiotic Associated Diarrhoea
When antibiotics reduce the microbiota, this provides an opportunity for less beneficial and pathogenic bacteria to establish themselves instead. Sometimes this can lead to antibiotic associated diarrhoea. A specific type of diarrhoea caused by a particularly nasty bacteria accounts for 25% of diarrhoea after a course of antibiotics. It can be particularly severe, so studies have investigated if this can be prevented by probiotics. A Cochrane Review of the data looked at 31 trials, totalling 8672 participants and found that probiotics reduced the risk of Clostridiumdifficile associated diarrhoea . Although this effect was greatest where the risk was higher, safety in immunocompromised patients isnt well documented .
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What Can I Do After Antibiotics To Help Build Gut Health Again
Im not going to reinvent that wheel here, but I would like to say that because antibiotics harm the guts flora, not the gut lining necessarily , taking probiotics and eating fermented foods are the most important steps to repair any damage from the medicine. Just beware the dangers of soil based probiotics. They are not the same thing!
The antibiotics are going to wipe out both good and bad bacteria in your gut, so you need to replenish it with the good guys, lest the bad guys take hold.
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
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Not So Long Ago In Pharmacies Nationwide
Hundreds of times a day in communities all across the country, people are diagnosed with bacterial infections and prescribed antibiotics. These antibiotics are heroes, but they are also imperfect. Their lightsaber wielding may cause damage on their own. With antibiotics, this is extra true, as not only do they cause side effects, but if those arent managed correctly, they can lead to more serious complications. We look towards probiotics to be the Rebel Alliance and help us topple the evil Empire.
To clear up the confusion on why a probiotic is needed and how and when to use it, we present to you Gut Wars.*
*NOTE: We will not be discussing the prequels because they are just horrible.
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