The health benefits of probiotic supplements have been well-established in a very large body of clinical research. We know from the research that probiotics are helpful for digestive issues like IBS, IBD , SIBO, leaky gut and more. In addition to that, probiotics have been shown to improve non-digestive issues like mood, sleep, risk for chronic disease, hormonal balance, autoimmune conditions and more.
Some probiotic manufacturers recommend taking probiotic supplements on an empty stomach, while others advise taking it with food. Let’s take a look at the research.
How should you take them?
Probiotics in capsules, tablets, and yogurt tend to survive your stomach acids better than powders, liquids, or other foods or beverages, regardless of when they’re taken.
Glucose and fructose enhanced survival of L. rhamnosus GG in simulated gastric juice at pH 2.0, while lactose and sucrose, which L. rhamnosus GG could not metabolize, did not enhance survival.
Some research suggests that saccharomyces boilardii microorganisms survive in equal number with or without a meal. I use saccharomyces probiotics for those with poor immune function, diarrhea, leaky gut, and other GI infections.
Some research shows that in order to increase survival of probiotics during gastric transit, components such as milk, milk proteins, cheese and yogurt, reconstituted skim milk with gum acacia, and cereal extracts should be taken. This supports the idea of consuming foods that naturally contain probiotics in them.
Situations where I will suggest a client should prioritize taking a probiotic with food include:
- When a client is consuming lactose. Probiotics with lactobacillus acidophilus and bulgaricus may help with digesting dairy
- When a client is consuming gluten and has a gluten sensitivity. Probiotics have been shown to help break down gluten.
When should you take them?
Research shows that probiotics must survive in the acidic gastric environment if they are to reach the small intestine and colonize the host, thereby imparting their benefits. Lactobacillus species are considered intrinsically resistant to acid. Although there are differences between species and strains, organisms generally exhibit increased sensitivity at pH values below 3.0.
Lactobacillus, Bifidobacterium, and Enterococci are more resistant to stomach acid than other types of bacteria. In fact, most strains of Lactobacillus come from the human intestinal tract, so they’re inherently resistant to stomach acid. However, there are certain type of lactobacillus such as L. rhamnosus strain E800, which was undetectable after 30 minutes of exposure to stomach acid.
If your probiotic is enteric-coated or uses delayed-release capsules, it is more likely to survive stomach acid and so the exact timing is less important
Taking probiotics at night might help the bacteria survive due to the lower levels of acid. This is something I have experimented with in my practice and have a lot of clients who notes benefits when taking their probiotics at night before bed.
If you’re taking a live strain probiotic supplement, ideally you want to take them 20 minutes after you eat, first thing in the morning or right before bedtime. This allows more of the probiotics to get into the large intestines where they will have the most benefits. If you are taking a soil-based probiotic, you can take them with food for the most impact
Research shows that taking probiotics and antibiotics together is a more effective treatment than taking antibiotics alone. This includes antibiotics that are used to treat SIBO, H.pylori, and other gut infections.
Based on several research studies, there are a lot of the recommendations regarding when and how you should be taking probiotics. A lot of this research takes place in test tubes, which can’t reproduce the dynamic complexity of your gastrointestinal tract. Some studies have attempted to correct this by using simulated models of the upper digestive tract. Research with these models show better survival rates of probiotic bacteria than in test tubes, however even a dynamic model can’t fully replicate what happens in our digestive system.
At the end of the day, consistency is more important than timing and administration. You can experiment with consistently taking your probiotic in different ways to see if you notice certain benefits. I personally notice that when I take my probiotic during the day, I feel more bloated. Therefore, I choose to take it right before bed.
In addition to supplementation, there are natural food sources of probiotics such as kefir, sauerkraut, yogurt, miso, kombucha, and kimchi, which have all been shown to provide health benefits to humans. However, I don’t typically have client just use food as supplements have been an amazing tool for gut healing in my practice.
In my 1:1 and group coaching I teach you how to choose the best probiotic and when it’s appropriate to use different kinds. If you want to join the waitlist for the fall group, you can apply here.
To learn more about the research of probiotic, where to find probiotics in food, and which brands have been lab tested and approved, check out my previous blog post.