How Should Probiotics Be Taken For Best Results
In order to ensure the best results from probiotics, it is important to take them in a timely manner. Most doctors recommend taking probiotics at least 1 hour before a meal. This will provide optimal protection against stomach acid and also minimize the amount of food that needs to be digested after taking your probiotic supplement.
Taking probiotics with food may allow for better absorption by the intestines but it may also increase symptoms such as bloating or gas. Probiotics should not be taken on an empty stomach because this can cause indigestion or nausea which can lead to other symptoms such as diarrhea, constipation, cramps, and pain in your abdomen area.
Additionally, you should never drink alcohol while taking probiotics since alcohol will kill off many of your good bacteria. Therefore, you should never take a probiotic supplement on an empty stomach or with alcohol.
Given The Very Heavy Involvement Of The Industry Clear Conclusions As To Whether Probiotics Are Truly Helpful To Humans Remain To Be Proven Erin Elinav
The rate of continued moderate to severe gastroenteritis within two weeks was slightly higher in the probiotic group than in the placebo group . And there was no difference between the two groups in terms of the duration of diarrhoea or vomiting.
Despite evidence such as this, the demand for probiotics is large and growing. In 2017, the market for probiotics was more than $1.8bn, and it is predicted to reach $66bn by 2024.
Given the very heavy involvement of the industry, clear conclusions as to whether probiotics are truly helpful to humans remain to be proven, says Elinav. This is the reason why regulatory authorities such as the USs Food and Drug Administration and European regulators have yet to approve a probiotic for clinical use.
Taking probiotics when your gut health is weak may not be a good idea
But that is not to write off probiotics completely. The problem with them may not be with the probiotics themselves, but the way we are using them. Often probiotics are bought off the shelf consumers may not know exactly what they are getting, or even whether the culture they are buying is still alive.
Elinav and his colleagues have also carried out research on who will benefit from probiotics and who wont. By measuring the expression of certain immune-related genes, the team was able to predict who would be receptive to probiotic bacteria colonising their gut, and for whom they would simply pass through without taking hold.
Taking Probiotics With Antbiotics: Revisited
Should you take probiotics with antibiotics? Read on as I review the evidence, break down some important methodology, and discuss the best practices for supporting antibiotic recovery.
Last year, I published an article and recorded a podcast with Chris Kresser on a study published in Cell that suggested the need for caution about taking probiotics after antibiotics. In both humans and animal models, probiotics were shown to delay the return of the normal, native microbiota.
Ive gotten a lot of questions this week about a recent blog post by popular gut health blogger and functional medicine practitioner Dr. Michael Ruscio. His article dismissed the latest study in favor of a 2014 systematic review and contended that you should take probiotics with antibiotics. Hes certainly not the only one that has dismissed this study.
To dispel any confusion, Im sharing my take here and thought Id walk you through my analysis of the article and its claims.
TLDR:I still believe that the evidence warrants caution about taking probiotics during or after antibiotics and stand by what I said in my original article. If you feel like you have to take a probiotic with antibiotics, Saccharomyces boulardii CNCM I-745 is probably the least harmful, but more research is needed. Better yet, supplement with butyrate to support gut hypoxia or consider an autologous fecal transplant!
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Potential Benefits Of Probiotics
Arjun Avila, a product development consultant specialized in vitamins and probiotic supplements, says probiotics are essentially very tiny living microorganisms and there are thousands of probiotic strains that offer different health benefits.
Probiotic strains are diverse, Avila says. If you think of dog breeds, it can range from chihuahua to pit bulls, and probiotic strains are very much like that as well.
Researchers are still studying these various probiotic strains to understand exactly how they work. But some studies have shown that probiotics may help improve heart health and support digestive systems, especially when the levels of healthy gut bacteria are off balance.
Probiotics are able to help you balance your gut so that you dont have as many unwanted side effects from the use of antibiotics, Avila says.
Probiotics can be found in yogurt, as well as a wide range of fermented foods like kimchi, miso, kombucha, and kefir. Its generally best to obtain probiotics from food sources since they also offer other nutrients. But probiotic supplements are convenient and easy to travel with, Merenstein adds, and they can last longer than many probiotic foods that need to be refrigerated.
Merenstein also stresses the importance of taking the probiotics as early as possible, before any antibiotic symptoms emerge. In the study, participants started the probiotics regimen the same day they started taking the antibiotics.
Take Probiotics During And After Treatment
Taking antibiotics can alter the gut microbiota, which can lead to antibiotic-associated diarrhea, especially in children.
Fortunately, a number of studies have shown that taking probiotics, or live healthy bacteria, can reduce the risk of antibiotic-associated diarrhea .
One review of 23 studies including nearly 400 children found that taking probiotics at the same time as antibiotics could reduce the risk of diarrhea by more than 50% .
A larger review of 82 studies including over 11,000 people found similar results in adults, as well as children .
These studies showed that Lactobacilli and Saccharomyces probiotics were particularly effective.
However, given that probiotics are usually bacteria themselves, they can also be killed by antibiotics if taken together. Thus, it is important to take antibiotics and probiotics a few hours apart.
Probiotics should also be taken after a course of antibiotics in order to restore some of the healthy bacteria in the intestines that may have been killed.
One study showed that probiotics can restore the microbiota to its original state after a disruptive event, such as taking antibiotics .
If taking probiotics after antibiotics, it may be better to take one that contains a mixture of different species of probiotics, rather than just one.
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Taking Probiotics With Antibiotics Can Help
Although it may sound counterintuitive to take probiotic supplements while also taking probiotic-killing antibiotics, research shows that its beneficial to your gut health to fortify your system with the protective good guys.
In one recent review, patients taking probiotics during a course of antibiotics saw a whopping 60 percent reduction in the risk of contracting a C. difficile infection .
In another study, adults and children who took the probiotic Lactobacillus rhamnosus during antibiotic treatment had a 10 percent less risk of contracting antibiotic-associated diarrhea .
Even in people who do experience diarrhea when taking broad-spectrum antibiotics, probiotic supplementation reduces the duration of symptoms by an entire day .
Probiotics may also help prevent widespread antibiotic resistance by ensuring that people take their full course of prescribed antibiotics.
Stopping a course of antibiotics early usually because of intolerable side effects increases the chances that some of the bad bacteria may survive and become resistant. By reducing or eliminating side effects, probiotics can make it much easier to stay the course .
Not too shabby for a bunch of microscopic friendly flora!
The Lack Of Consistency In The Findings On Probiotics Comes In Part Because They Are Being Treated Like Conventional Drugs
This opens the door to developing personalised probiotic treatments based on someones genetic profile. Such a system is realistic and could be developed relatively soon, says Elinav, but at this stage it remains a proof of concept. To become a reality, it will need more research on probiotic tailoring and testing more bacterial strains in larger groups of people.
This kind of personalisation may release the full potential of probiotic treatments for gut health. At the moment, the lack of consistency in the findings on probiotics comes in part because they are being treated like conventional drugs. When you take a paracetamol tablet, you can be more or less sure that the active component will do its job and work on receptors in your brain, dulling your sensation of pain. This is because most peoples pain receptors are similar enough to react in the same way to the drug.
But the microbiome is not just a receptor it is closer to an ecosystem, and sometimes likened to a rainforest in its complexity.
As a result, finding and tailoring a probiotic treatment that will work on something as intricate and individual as your own internal ecosystem is no easy task. And with that in mind, its not so surprising that a dried-out pack of bacteria from a supermarket shelf may well not do the trick.
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When Is The Best Time To Take Probiotics After Amoxicillin
To some extent, this depends on the dosage recommendations for the antibiotic itself. Often it will be recommended that you take an antibiotic three times a day, at six-hour intervals . In this case, the wisest move will be to take probiotics after amoxicillin at a three-hour interval This ensures that there is time for the probiotic to work unhindered as far away as possible from each dose of the antibiotic.
Allowing a window when taking probiotics with antibiotics is beneficial not just because it gives maximum functionality to the former, but because the latter will also be able to work on the bacteria it really needs to be killing, without its task being further complicated. If the gap between doses is shorter than six hours, then it is important to also narrow the window for doses of the probiotic. The optimum time to take lactobacillus is half-way between antibiotic doses.
Summary Of The Article’s Main Point
Treatment with a probiotic mixture associating lactobacilli, bifidobacteria and Saccharomyces during an in-hospital antibiotic treatment is associated with a decrease in colonization of the gut microbiota with Pseudomonas and with a transient colonization with AmpC producing enterobacteria after the antibiotic treatment which was not retrieved at the end of the study treatment.
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How To Take Probiotics
How long after you stop an antibiotic should you continue to take your probiotic? Experts say one to four weeks, but the research is unclear. A study published in the journal Cell found that participants who took a probiotic for four weeks after an antibiotic were able to restore their gut microbiome to normal after six months the placebo group, however, colonized new, healthy gut bacteria in just three weeks.
The upshot here? The benefits of taking a probiotic with or after an antibiotic isnt 100% confirmed, but there is little downside to trying it. Stick to the more studied strains such as Lactobacillus, Bifidobacterium, and Saccharomyces. Look for supplements with USP seal, a dietary supplement certification that ensures the bottle contains what it says it does. The FDA does not regulate probiotics, so its essential to do some legwork. You can also eat your probiotics in active culture-containing and fermented foods and drinks such as yogurt, sauerkraut, miso, and kefir.
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General Info: National Central for Complementary and Integrated Health. Probiotics: What You Need to Know.
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Probiotic and AAD:The Journal of Family Practice. Prescribing an Antibiotic? Pair it with Probiotics.
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 doesn’t affect the probiotic bacteria too.
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Is There A Case Against Taking Probiotics With Antibiotics
Ive seen some internet articles that warn people against taking probiotics to help with recovery from antibiotic therapy. Where is this advice coming from?
It may come from single small studies, such as one that questioned the value of taking probiotics and antibiotics together . In this study of 21 patients, eight patients received probiotic therapy, seven patients received no treatment, and six patients received a fecal transplant. Researchers found that probiotics were less effective for antibiotic recovery than no treatment at all. The fecal transplant brought near-complete recovery in a matter of days.
However, when you are looking for health insights from research, its important to follow the overall trends rather than focus narrowly on one study. For example, lets compare the evidence from that small, non-randomized study to a broad meta-analysis of many randomized controlled trials , the gold standard type of research.
The large-scale meta-analysis of 63 RCTs showed that subjects had 48% less antibiotic-associated diarrhea after taking probiotics [11
Trusted SourcePubMedGo to source].
Its clear that one small, non-randomized study doesnt stand up against a much larger meta-analysis of 63 gold standard RCTs. This is the reason the meta-analysis of RCTs is the highest quality type of research.
Bottom line: Be careful about science-based claims you read on the internet. Marketers often cherry-pick studies to support their position.
Pros And Cons Of Probiotics
The assumption that there is little downside to taking probiotics was challenged in a recent Israeli study.
The participants were given antibiotics and split into two groups: the first group was given an 11-strain probiotic preparation for four weeks the second was given a placebo, or dummy pill.
The researchers found the antibiotic damage to the gut bacteria of those in the first group allowed the probiotic strains to effectively colonise the gut. But this colonisation delayed the normal recovery of the microbiota, which remained perturbed for the entire six month study period.
In contrast, the microbiota of the second group returned to normal within three weeks of finishing antibiotics.
This research exposes a perhaps unexpected truth: we still don’t know what types of bacteria are truly beneficial or even what constitutes a healthy microbiome.
The answer is unlikely to be that individual bacterial strains are particularly helpful.
It’s more likely a diverse community of thousands of different types of microbes working together can provide health benefits. This microbial community is as individual as each one of us, meaning there is not just one configuration that will result in health or illness.
So, it’s unlikely that the addition of one or even 11 strains of bacteria in a probiotic could somehow balance this complex system.
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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
Side Effects Of Antibiotics
Unfortunately, antibiotics are associated with a few side effects. These include:
- Digestive problems
The most common side effects of antibiotics are digestive problems. These include:
- Nausea or vomiting
- Abdominal pain or cramping
Luckily, many of the digestive problems that are caused by antibiotics can be helped by probiotic supplementation. Well go over that in just a minute, but hold tight there are a few other common side effects of antibiotics that well cover first.
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What Kind Of Yogurt Do You Eat When On Antibiotics
The probiotics, or live microorganisms in fermented foods such as yogurt, are also found in our very own gut.
These are good types of bacteria that are essential to regulating the immune system and keep us healthy. However, medicating with antibiotics can disrupt the population of good bacteria in the gut and cause other side effects such as diarrhea, yeast infections, nausea, or vomiting.
Yogurt is an effective remedy for that, but all yogurt is not made equally. Heres what you should look out for:
Probiotics Work With Antifungals To Control Yeast
Researchers have found that combining probiotics and antifungals is a powerful way to restore beneficial bacteria and reduce harmful fungi in the gut.
In a study published in Digestive and Liver Disease, antifungals were shown to control the overgrowth of yeast and fungi by breaking down biofilms. At the same time, probiotics helped to restore and maintain the balance of gut flora in those with inflammatory bowel diseases like Crohns.
Interestingly, the researchers also found that members of the same family who have IBD also tend to have both yeast overgrowth and bacterial imbalances in their gut microbiome. These organisms appeared to join forces to make robust biofilms that made intestinal inflammation even worse.
Another benefit of taking probiotics alongside antifungals is that they will help support your normal digestive processes. When on the Candida Diet, you may suffer some ill effects of yeast die-off, which can include bloating, gas, indigestion and other issues. This is due to the Candida yeast releasing unpleasant toxins as it is broken down by the antifungals.
A quality probiotic supplement can prevent these digestive symptoms, reducing bloating and diarrhea. These beneficial bacteria help to break down the food as it moves through your intestines, allowing your body to absorb nutrients more efficiently, while also easing discomfort.
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