The Power Of Probiotics
It may seem strange: Youre taking antibiotics, so wouldnt probiotics undo the good your treatment is doing?
However, probiotics add helpful bacteria to your digestive system not the bacteria that cause infections. They dont have any effect on the antibiotic treatment. They only treat the side effects.
The thing that has really been shown to help the most with preventing diarrhea is taking probiotics when taking antibiotics, Dr. Rabovsky says. He notes that reviews of studies suggest probiotics are effective both for regular antibiotic-associated diarrhea and for diarrhea related to C. diff. They also seem to help with side effects such as cramping and gas.
Probiotics come in several varieties. The most commonly studied for antibiotic-associated diarrhea are Lactobacillus rhamnosus-based and Saccharomyces boulardii-based probiotics. Probiotics come in capsules, tablets, powders and even liquid form.
With so many options, be sure to ask your doctor for advice before taking any probiotics, as you should for any type of supplement. Probiotics could possibly be harmful for people with immune deficiencies or those who are severely debilitated.
Probiotics And Gi Health
Found in yogurts with live bacterial cultures, as well as in other foods and dietary supplements , âprobioticâ products continue to multiply on the shelves of grocery stores and vitamin and supplement retailers.
Global sales of probiotic foods and supplements reached $21 billion in 2010 and were projected to reach $31 billion by 2015, according to one market analysis.
But which probiotics are best and in what quantities?
Sydne J. Newberry, PhD, of RANDâs Southern California Evidence-based Practice Center, says this is not yet clear.
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Mistake #: You Store Probiotics In Your Medicine Cabinet
The bathroom medicine cabinet can have fluctuating temperature changes, which will affect moisture in the air, and can compromise the quality of your probiotics.
Its important to note that there are a few ways to take probiotics. While one is in food , you can also take probiotic supplements. They are available in refrigerated or dry formulas. The latter can be kept at room temperatures. Foods and refrigerated supplements must be kept in a cool fridge to keep the bacteria alive. For dry probiotic supplements, check the packaging on how to store them, but generally they must be kept in a dry, dark place thats free of moisture. However, some probiotic capsules are better kept in the fridge, says BioK scientific director Mathieu Millette, PhD, Mcb. A., RMCCM. Check the instructions on the package to ensure youre storing them properly.
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Warnings Of Benefiber And Metamucil
It is important to take Benefiber and Metamucil products with adequate amounts of fluid. Taking fiber therapy without adequate fluid intake can lead to esophageal blockage and choking. Do not take these products if you have difficulty swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing, seek medical attention immediately.
If you experience constipation for more than seven days or if you experience rectal bleeding while taking Benefiber or Metamucil, contact your healthcare provider immediately.
Benefiber and Metamucil powders are gluten-free, though some other products made by these brands may not be. Patients with celiac disease should read the label and consult a healthcare professional to ensure the fiber product they have chosen is safe.
Study Summary: Probiotics Significantly Reduce Aad
Hempel et al reviewed 82 studies and pooled data from 63 RCTs to identify the relative risk of AAD among patients who received probiotics during antibiotic treatment compared with those who received no probiotics or were given a placebo. The studies encompassed a variety of antibiotics, taken alone or in combination, and several probiotics, including Lactobacillus, Bifidobacterium, Saccharomyces, and some combinations.
The outcome: The pooled RR for AAD in the probiotics groups was 0.58 , with a number needed to treat of 13. Although the authors reported that the overall quality of the included trials was poor, a sensitivity analysis of the higher quality studies yielded similar results.
Subgroup analyses by type of probiotic and duration of antibiotic treatment were also consistent with the overall pooled RR. In subgroup analysis by age, a similar decrease in AAD was found among the youngest patients and those between the ages of 17 and 65 years. Among patients older than 65 yearsfor whom there were just 3 studiesa non-significant decrease in risk was found. Twenty-three of the studies assessed adverse outcomes, and none was found.
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Mistake #: Youre Not Taking The Right Dose
Like mentioned previously, the dose must be proven effective to make a claim on package in Canada. A dose is measured in colony-forming units . Look for a product with at least 10 billion CFU, because that appears to be a minimum dosage across the scientific literature, and take as directed, says Nielsen.
The best way to ensure youre getting the most out of your probiotics, experts say, is to follow a balanced high-fibre food plan, understand the type of probiotic youre taking, review its clinical research, take the appropriate dose and store them according to the package directions. And if you have any concerns talk to your health care provider. Then youll have no worries that your probiotics are failing you.
What We Do And Dont Know About Concurrent Probiotic And Antibiotic Use
To begin, probiotics will not deactivate the antibiotic or make them not work. It is actually much closer to the opposite, where antibiotics will deactivate/kill probiotics when dosed too close together. The need and relevancy of taking probiotics when on an antibiotic is justifiably increased however, as antibiotics are typically not a very discriminatory killer.
That means that while antibiotics may kill off a lot of the bad bugs causing illness, they will also typically cause a lot of your beneficial bacteria to die and instigate a variety of potential side effects, including diarrhea. Probiotic supplementation can help to offset these potential issues.*
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Mistake #: You Take More Than One Type Of Probiotic Supplement
If you are considering layering your probiotic supplements for different health concerns, know that different bacteria can interact. Think of it this way: part of the reason we take probiotics is to fight off other bacteria, says Nielsen. It is possible, in a multi-strain product and if you take two different probiotic products at the same time, that they can out-compete each other. Research supports this: you can include 10 strains in a single product but without proper study, you cant be sure that one strain isnt out-competing the other nine. Nielsen says to check out the manufacturers website for clinical studies that the strains were tested together.
What Is Intestinal Flora: Why Your Gut Bacteria Matters After Antibiotics
There is a complex connection between your gut and your brain, which doctors refer to as the gut-brain axis:
A strong gut microbiome may improve cognition, including memory and learning
Taking antibiotics may wipe out an infection youre struggling with. But unless you take immediate care of your gut after finishing your round of medication, your brain health and mental health may struggle for months afterwards while your gut tries to get back to a place of balance.
Thankfully, there are several ways to improve gut microbiota and speed up your guts recovery after antibiotics.
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Probioticsantibiotics: The Bottom Line
Antibiotics are important against bacterial infections, but they can cause side effects, including long-term negative changes in the composition of your gut microbiome because they do not distinguish between health-promoting microbes and the ones causing illness.
Taking a probiotic supplement or eating probiotic foods may help mitigate immediate side effects, like diarrhoea, and they can help to get your gut microbiome back on track afterwards too.
Incorporating foods that are rich in fibre, as well as fermented foods containing live bacterial cultures, can enrich your microbiome with health-promoting bacteria that help restore this ecosystem to its former glory.
Its also good to know which foods and beverages to avoid when taking a course of antibiotics. Stay away from alcohol, grapefruit, and calcium-fortified foods to avoid any unnecessary harm from this medication.
You can check in on your gut microbes three months after taking antibiotics with the Atlas Microbiome Test. Youll also receive personalised food recommendations to restore microbiome balance with your diet.
Caveats: Limited Data On The Safety Of Probiotics Exist
There was some heterogeneity among the studies in the meta-analysis by Hempel et al, and some of the studies were of poor quality. Because of this, the authors used subgroup and sensitivity analysis, which supported their initial conclusion.
Probiotics have generally been considered safe however, there have been rare reports of sepsis and fungemia associated with probiotic use, especially in immunosuppressed patients. Fifty-nine of the included studies did not assess adverse events, which limited the ability of this meta-analysis to assess safety. Patients taking probiotics should be monitored for adverse effects.
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Probiotics Instead Of Antibiotics
As the field of microbial research continues to expand, we expect the future of medicine will include targeted probiotic prescriptions in lieu of antibiotics, and that antibiotics will be reserved for specific or emergency scenarios.
In fact, probiotics are already proving to be more effective than antibiotics at treating and preventing certain diseases and infections, such as mastitis.
In one study, researchers analyzed 352 women suffering from mastitis, a painful breast infection often associated with breastfeeding. After 21 days, women who took probiotics saw more improvement and fewer recurrences than those taking antibiotics .
Mistake #: You Put Your Probiotics Into A Personalized Pill Box
Sure, organizing your daily pills and supplements in a handy pill box will help you to remember to take them, but it could compromise how effective your probiotics are. Like crackers, probiotic capsules will expire more quickly when exposed , says Millette. And Nielsen agrees. She says to keep your probiotics in sealed individual doses away from bright light and heat.
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The Best Probiotics After Antibiotics
Learn how to reverse the effects of antibiotics and use probiotics to counter the long term side effects of antibiotics.
Antibiotics are a double-edged sword. While they can help us to recover from some illnesses, theyre also heavily over-prescribed .
Antibiotics also dont only kill the bad bacteria in your body, but even wipe out the important, beneficial bacteria in your gut. If you want to learn how to reverse the effects of antibiotics and improve your gut microbiome, keep reading. Well also break down the best probiotics after antibiotics.
There are six primary forms of antibiotics used in the UK:
Penicillins for general infections like skin infections or urinary tract infections
Macrolides for those who have a penicillin allergy or who have an infection from a penicillin-resistant bacteria strain
Cephalosporins for more severe infections, such as meningitis
Aminoglycosides, which are typically used in hospitals due to their severe side effects
Tetracyclines for many skin conditions
Fluoroquinolones, which are slowly being phased out of general usage
While each drug is different, they have one thing in common: while they can effectively target the bacteria that makes you sick, they also have widespread collateral damage on all bacteria in your body.
This is especially alarming in light of the increasing usage of antibiotics in the UK, and also due to the important connection between good bacteria and your general health and wellness.
Mistake #: Youre Not Prepping Your System Prebiotics
Prebiotics are food for good bacteria. But Nielsen warns that most of the research on prebiotics is done with high doses , which can be hard on the stomach, especially for those with gastrointestinal issues like irritable bowel syndrome.
So, how do you get the benefits of prebiotics to get the benefits of probiotics? I recommend eating a diet high in plant foods, such as fresh fruit, vegetables, legumes and whole grains, says Nielsen. A high-fibre, plant-centred diet has been shown to have an overall beneficial effect on the flora, and will naturally include prebiotic foods such as wheat, legumes and onions.
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What Studies Do Not Recommend Giving Probiotics With Antibiotics
Researchers from the Weizmann Institute of Science in Israel and other institutions reported that the gut microbiome took longer to return to normal in those people given an 11-strain probiotic treatment for four weeks following a course of antibiotics. This was despite the probiotics effectively colonizing the gut with healthy bacteria. The trouble was the presence of the new bacteria and yeasts strains prevented the gut microbiome from returning to normal for the full six month study period.
Conversely, the gut microbiome in those given no probiotics returned to normal within three weeks of going off the antibiotics. The authors did conclude that this study just examined one type of probiotic, and a different probiotic may be helpful in patients taking different antibiotics. However, they did point out the findings of the study imply that the traditional practice of taking a probiotic after antibiotic may not be beneficial.
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 82 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.
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Should You Take A Psyllium Fiber Supplement
The decision whether you should take a psyllium fiber supplement is highly individual and truly is one you must make for yourself, and I would caution you do that in all instances having to do with your personal health. Never just take someones word for it, no matter how authoritative they may appear to be.
That said, let me tell you what I do and why.
I do take a daily psyllium supplement and have for years. My original reasoning was for the many known and documented health benefits it confers, from heart health to weight control to cholesterol reduction to, yes, regularity.
To be honest, the notion that it provides additional benefits for my microbiome is basically frosting on the cake.
If you are specifically looking to benefit your microbiome, I do believe psyllium plays a role, but not the only one, and certainly not the primary one. It is becoming increasingly apparent that a wide variety of fibers, including both broadly and narrowly defined prebiotics, are your best bet.
The beneficial microorganisms that inhabit your gut can be particular about what they consume, so the greater variety of food you provide them, the greater variety of health-promoting microorganisms you will have.
And the healthier your gut is, the healthier you are.
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Mistake #: You Think All Probiotics Are Equal
Its not good to assume that all probiotics will provide the same benefits, says Millette. There are a variety of probiotic strains and not all strains have the same health benefits. The human body houses more than 500 different strains of bacteria. Some are for immune support. Some are for digestive issues. Some are for weight maintenance. And there are even strains for heart health.
Examples include: Lactobacillus Acidophilus has been shown to help blood pressure, cholesterol, allergies and digestion, while Lactobacillus Rhamnosus can help with blood glucose, immune function and cholesterol, and Lactobacillus helveticus reduces blood pressure, improves sleep quality and bone health.
Check the packaging, talk to your health care provider or even double-check with a pharmacist to make sure what youre buying is what you need. Thankfully in Canada, foods with probiotic claims must be truthful and not misleading , and supplements must meet requirements for its claims as well as science to support its efficacy, safety and quality.
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Should You Take Probiotic Supplements While Taking Antibiotics
Antibiotics are an important class of drugs that are prescribed by healthcare providers to treat harmful bacterial infections in the body. However, they have not been proven useful for treating illnesses like the common cold or flu, which are viral infections. Moreover, current research suggests that antibiotics may have been over-prescribed in recent years as a preventative medication to reduce the risk of secondary infections. Since antibiotics kill all kinds of bacteria, including helpful gut bacteria, side effects of antibiotic use often include stomach upset, diarrhea, or thrush.
Probiotics are often called âthe goodâ bacteria because, along with yeasts, they help keep your gut healthy. Probiotics help food pass through your digestive system by affecting the nerves that cause gut movement. Researchers are still actively trying to figure out how probiotics work but doctors often suggest taking probiotics to help with antibiotic-related diarrhea, such as clostridium difficile infection commonly associated with taking fluoroquinolones, such as ciprofloxacin or Cipro.
Tips for Taking Antibiotics
Anytime you are prescribed an antibiotic, you should take the meds exactly as prescribed. You are sick, so donât be too anxious to restore absolute balance to your system. Listed below are few helpful tips for taking antibiotic drugs:
New Research on Side Effects of Taking Probiotics
Should You Take Antibiotics And Probiotics At The Same Time
Raise your hand if you’ve ever had this experience: Your doctor prescribes a 10-day course of antibiotics for the cough you haven’t been able to shake for weeks. After a few days the cough is much better … but you suddenly have intestinal symptoms that are making your life pretty unpleasant. Long story short, the antibiotics have given you diarrhea, and at this point you’d almost rather have that annoying cough. Other than discontinuing the antibiotics , what can you do to banish the need to run to the bathroom?
This is the unfortunate downside of antibiotics — they’re almost too good at flushing out infections . As they barrel through your system, they can do a real number on your gut. They wipe out the bad stuff but can also eliminate the good bacteria that keep your digestive system healthy and in balance. And when the good bacteria are out of the picture, harmful bacteria can swoop in and take over, causing all sorts of problems. If you’re lucky, your gut will just be a little bit out of whack for a while after you take antibiotics. If you’re not so lucky, you could be one of the 20 percent or so who get antibiotic-associated diarrhea .
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