Frequently Asked Questions About Probiotics

Fish OilProbiotics are an important part of your supplement regimen and can support immunity, balance digestive health and more (learn more about which strains to look for based on your health concern.) Here, Tori Hudson, ND, member of Pharmaca’s Integrative Health Advisory Board, answers some of the most common questions our practitioners get about how and when to take probiotics.

I eat yogurt; aren’t I getting enough probiotics?

Not all yogurts contain active live cultures of probiotics, and not all contain the same species and strains of probiotics. In those that do contain active live cultures, there are differences in the number of these live and active cultures. Optimally, the yogurt would come with a label that reveals the species it contains as well as the number of colony forming units (CFUs) it contains. Beware though that the number of CFUs listed is based on the amount contained in the yogurt at time of manufacture. Some yogurt manufacturers will feature more information on their website about testing and quality assurance that will tell you about the stability of the probiotic strains in their yogurt.

Two other issues with yogurt as a source for your probiotics: the dose is lower per serving than you could easily get in a pill, and many yogurts contain sugar and are high in carbohydrates and calories. Using a dietary supplement as a source of probiotics rather than yogurt is more efficient, reduces calorie/sugar intake, offers more accuracy in labeling and can deliver higher amounts of probiotics in a shelf-stable form. Some supplemental probiotics even have more sophisticated delivery systems that allow the probiotics to bypass the stomach acid so that they’re even more prominent in the intestines.

How old do children have to be before taking probiotics?

The ideal time to introduce a child to probiotics is in utero! Probiotics are one of the most important dietary supplements a pregnant woman can take. I put it in the top three important supplements, along with fish oils and folic acid.

Later, infants can be introduced to probiotics through mom’s milk when breastfeeding, or as a powder—put on the nipple or on a finger that is then placed in the infant’s mouth. Pediatric studies confirm that when probiotics are introduced as early as week one, it can reduce the incidence of vomiting, reflux, constipation and diarrhea. Other research also confirms reduction of Colic, crying time, spitting up and constipation when introduced in the first three months. As they grow, you’ll find special formulations for children of all ages at Pharmaca.

Do seniors need different strains/strengths of probiotics?

As we age, the microflora of the gut changes, including a reduction in the numbers of good bacteria (lactobacilli and bifidobacteria) and an increase in the numbers of potentially pathogenic bacteria. These changes can result in gastrointestinal disorders and infections, including antibiotic-associated diarrhea, clostridium difficile, constipation and irritable bowel syndrome.

A growing body of research is showing that when the elderly supplement with some species and strains of probiotics, they’re seeing positive effects such as a reduction in fecal enzymes, improvements in vitamin synthesis, cholesterol reduction, lactose intolerance reduction, reduction of potential mutagens and predigestion of proteins. Some of the research that has been done includes Bifidobacterium longum 46 and B. longum 2C, and several Lactobacilli species.

What’s the best time of day to take a probiotic?

There are numerous opinions on this. Some say to take them on an empty stomach so that the stomach acid is relatively low, which may result in a higher chance of the probiotics adhering to the intestinal wall and colonizing the colon. Other researchers assert that probiotics should be taken with food for optimal colonization. I am of the belief that they should be taken with food because the increased gastric pH is more favorable for the probiotics. But I think the most important thing is to take them at a time that will work for you and not worry about the details.

Can I take them while I’m on antibiotics?

Not only can you, but it’s very smart to do so. By doing so, you can reduce the incidence of antibiotic-associated diarrhea, which can range from mild to severe. Probiotics, such as Lactobacillus spp., (consider L. rhamnosus, L. acidophilus, L. plantarum, Bifidobacterium spp. and Saccharomyces boulardii), can not only reduce the incidence of antibiotic-associated diarrhea by as much as 42 percent, but they can also improve antibiotic therapy as they keep the infection-causing microbe from adhering and multiplying.

As far as when to take the probiotics in relation to your antibiotics, S. boulardii does not appear to be inhibited by the antibiotics, but the lactobacilli species can be and should be taken at least 2-4 hours after the antibiotic dose. Consider taking the probiotics for 1–3 weeks longer than the duration of antibiotic treatment.

I’ve read that probiotics can help with mood elevation or depression, is that true?

There is a growing body of evidence linking gut health to brain health, and one study showed that even daily consumption of a probiotic-containing yogurt for three weeks significantly increased mood.

It appears that probiotics can also help to deliver neuroactive substances such as serotonin and GABA, which act on this brain-gut axis. Further research is needed to identify which species and strains are most beneficial to mood and the brain.