In previous articles, I have frequently emphasized some different ways to take care of your gut.
I have often suggested consuming fermented foods and taking a good probiotic supplement.
It is a recommendation I stand by; however, without guidance, it can be a nebulous endorsement to follow.
After all, how is a person to choose between a good vs bad probiotic?
What do you look for on the label and how much do you need and when do you take them?
Let me dive into some specifics about probiotics and how to use them to your best advantage for your health.
What are probiotics? As defined by the International Scientific Association for Probiotics and Prebiotics, probiotics are “ live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”
Simply put, probiotics are “good bugs” that help you as opposed the “bad (pathogenic) bugs” that make you sick. Probiotics contribute of a person’s microbiota or microbiome – the sum total of all their bacteria.
Probiotics come in the form of food and supplements.
Fermented foods were more common and regularly consumed in the past before we had the shelf-stable food preservation techniques that we have today.
Those “old-fashioned” food forms include yogurt, kefir, buttermilk, some cheeses, brine from cured olives, traditional salami, real pickles, sauerkraut, kimchi, and kombucha. If you are looking for food sources of probiotics (specifically in yogurt), look for the terms “live and active cultures.”
So what do these small-but-mighty bugs do? Too many things to count, including: activating vitamins, boosting your immune system, displacing disease causing bacteria (think diarrhea and candida), regulating your hunger hormones and so much more!
It is an amazing truth that what the bacteria does in the gut, doesn’t stay in the gut – it affects your whole body.
Probiotics can be used as a treatment to help with more acute maladies. See below for a list the beneficial bacteria and what problem it may help resolve.
Because probiotics are microscopic living creatures that have a life cycle, they need to be consumed regularly in order to provide benefit. Also vital in developing your gut health and smart supplementation of probiotics is variety. You should rotate your probiotic supplement. Yes, you can supplement for a specific problem but in the long run you are going to want variety.
I recommend changing your probiotic every few months. Ideally your diet will see variety /diversity too!
There are two main types of probiotics produced commercially and added to food sources containing probiotics: the genus Lactobacillus and Bifidobacteria.
Naturally, humans have hundreds of different strains of bacteria in their guts and bodies; however, these two strains were the ones first studied and recognized as beneficial, so they are the most commonly manufactured.
There are a plethora of species (aka sub-types) of Lactobacillus and Bifidobacteria, so in an effort to abbreviate what could become a rather long name on a food label, you will often see L. (for Lactobacillus) and B. (for Bifidobacteria) in its place. For example you might see “L. rhamnosus” or “B. longum” on a label.
Aim for 1 to 25 billion colony-forming units (CFU) in each daily dose. (I personally go for 20 billion). There may be some more benefit when probiotics are taken during or following a meal, although there is no harm taking it on an empty stomach.
Note that a probiotic does not necessary have to be refrigerated in order to be high quality.
Some of the recent research suggests specific probiotic strains to support the recovery and symptom management for specific ailments. (Individual results vary, of course. This information is given as general guidance only and is not intended to diagnosis or replace the advice of a qualified healthcare professional):
- Upper respiratory tract infection (adults) – B. lacti (take 2 billion CFU for five months);
- Irritable Bowel Syndrome (IBS) – L. acidophilus, B. bifidum and B. lactus (take 25 billion CFU for eight weeks) and S. boulardii (20 billion CFU for four weeks);
- Acute diarrhea – S. boulardii ( 200-250mg 2x/ day);
- Eczema (women and children)– L. rhamnusus GG; and
- Women’s vaginal health – L. rhamnosus GR-1 and L. reuteri RC-14 ( 5Billion CFU).
Antibiotics and Probiotics
It is a commonly held myth that when a person is prescribed antibiotics they should stop taking probiotics.
On the contrary, if there is any time to take a probiotic, it is during and after antibiotic treatment! Antibiotic treatment kills a spectrum of bacteria, including both the good and bad. While high or repeated doses of antibiotics can actually put you at risk for serious, future gut and immune disturbances, supplementing with probiotics can be protective against such negative outcomes (all while still allowing the antibiotic fight the infection at hand).
The key is timing. Simply separate your antibiotics and probiotics (or probiotic-rich foods) by two to four hours. Continue taking the probiotic for two weeks after the antibiotic treatment is complete.
There is one special caution about probiotics that I will address.
Probiotics don’t seem to “work” for some people; in fact, they may actually feel worse on them. They may experience gas and bloating that lasts longer than the normal one week adjustment period. Certain foods may bother them or their bowel habits might change for the worse.
Drastic or subtle, probiotic intolerance can occur. If you find yourself in this camp, then it is worth paying attention to, as it could potentially indicate a condition called Small Intestinal Bacterial Overgrowth (SIBO).
There are many root causes of SIBO, but the outcome is similar: a disproportionate amount of bacteria in the small intestines rather than the large intestines.
In SIBO, the bacteria that is so good for your large intestines backs up into your small intestines and stomach, causing some uncomfortable and possibly chronic issues. Appropriate treatment for clearing out the bad bacteria and re-establishing good bacteria is essential to combat this.
Despite this caution, don’t panic at the first episode of bloating after you take a probiotic. Just know that if you are a person who just doesn’t feel “right” on them long term, then it might not be all in your head and you may need to get help from a holistic health care provider.
Resources: If you want to get mildly informed or even completely nerd out, check out the website for the Scientific Association for Probiotics and Prebiotics. They offer handouts and apps that can guide you through choosing a high-quality probiotic to fit your needs.
You can also visit the website usprobioticguide.com to find what strain of probiotics work best with different ailments.
– Cathryn Arndt is a Registered Dietitian Nutritionist. She lives in Lebanon with her husband and owns a nutrition counseling business called The Pantry Lab LLC. To learn more about Cathryn, visit her Facebook page or You Tube Channel by searching under “Dietitian Cathryn.” Find her blog at thepantrylab.com