With roughly 50 million of us suffering with GI disorders like irritable bowel syndrome, digestive issues are on the rise. We are learning that diverse levels of gut flora–the ecosystem of bacteria and microbes in our gut– are critical for immune health, weight maintenance, and even mood regulation. Probiotic supplements offer an easy way to supplement your own gut bacteria levels. But do they work? And should YOU take probiotics?
Let me break it down for you: There’s no one size fits all probiotic for everyone, and you shouldn’t continue taking the same one indefinitely.
One of the most common questions I get is, “which supplements should I be taking?” The answer is, unless you have a deficiency, imbalance, or you’re under stress, you shouldn’t need to take handfuls of supplements. Sure, a multi helps fill in the nutritional gaps, and fish oil is an excellent way to reduce inflammation. But when it comes to probiotics, it’s not as easy as grabbing something off the shelf.
Your Gut Flora: The Microbes in Your Digestive Tract
Your gut is home to an unfathomable trillions of microbes (bacteria, viruses, fungi), mostly bacteria, both “good” and “bad.” This is your gut microbiome. Some microbes are commensal, meaning they start out good but can go rogue and turn against you, becoming pathogenic.
Our gut bacteria outnumber our body cells by about 2 to 1, which is pretty remarkable. That means that in order to positively affect the health of your body, start with your gut! (there’s a reason for the popular saying “all disease begins in the gut.“) The majority of our immune system resides in the gastrointestinal tract (GI tract), and the health of our gut also directly impacts our brain health and mood. So, we gotta keep those bacteria happy and plentiful.
The Friendly Neighborhood in Your Gut
We all have the good guys, beneficial probiotic bacteria (flora), and the bad guys, pathogenic bacteria. That’s good– the bad guys challenge the good guys to work harder. Then there are some easily swayed guys–the commensal bacteria–that can be either good or bad, depending on the environment in the gut. They’re call opportunistic because if given the opportunity (overuse of antibiotics, poor diet, birth control pills), they’ll overtake the good guys.
Think of your gut as a neighborhood. There are nicely maintained houses and cops that keep the bad guys and vandals out (good bacteria). But if the cops get lazy or disappear due to poor conditions, the bad guys move in and trash the neighborhood, making it undesirable (bad bacteria). Along the way, the bad guys peer pressure others (the commensal bacteria) into trashing the hood, and you have a good neighborhood gone bad in the gut. The technical term is dysbiosis.
When the bad bacteria overtake the good bacteria, you notice symptoms such as belching, heartburn, gas, bloating, difficulty maintaining weight, constipation or/and diarrhea, candida infections, skin rashes, nail fungus, and diagnoses like IBS, SIBO, and Crohn’s.
Should I Take Probiotics?
Yes and no. If all is going well in your gut, about 85 percent of the bacteria should be the good guys. This is pretty rare these days, however. These folks do just fine including fermented foods and beverages like raw kraut and kefir (dairy or non-dairy, like water kefir) regularly to nourish their gut flora. And the carbohydrates you eat nourish your gut microbes too. But I’d say this is hardly the norm these days or even common, unfortunately. When I work with clients to heal ongoing GI issues, I’ll typically recommend that they rotate between different probiotics so they get a variety of important strains such as L. acidophilus, Bifidobacterium animalis, L.casei, Lactobacillus salivarus, bacillus coagulans, Bifidobacterium longum, Lactobacillus plantarum and Saccharomyces boulardii.
Here are the folks that should be taking probiotic supplements:
- struggle with persistent GI issues like constipation, gas, bloating, indigestion
- working on healing leaky gut
- been diagnosed with inflammatory GI issues like gastritis or ulcers
- have multiple allergies and/or asthma
- have taken many rounds of antibiotics
- frequent yeast infections or UTIs
- recurrent diarrhea
- working on reversing autoimmune conditions
- on a weight loss program
- you have a skin condition like eczema, psoriasis, acne
- struggle with anxiety
- babies with colic or eczema
Probiotic supplements may not be right for you if
- you’ve been diagnosed with SIBO
- they cause your digestive symptoms to worsen*
Conditions That Can Benefit from Probiotic Use
Here’s the thing: Each one of us has a gut microbiome as unique as our fingerprint. We all have different levels of the bacterial strains that live there. Certain stool tests can measure the beneficial, pathogenic, and commensal bacteria and tell us which strains are low. That’s ideal for knowing which strains to supplement with. For the rest of us who haven’t measured our gut bacteria, my go-to all around favorites are Elixia and Renew Life. Garden of Life’s Primal Defense is a good one too.
If you’re healing leaky gut and want to recolonize your gut bacteria after doing a parasite cleanse or a candida cleanse, Renew Life is a high potency, all-around excellent probiotic that’s high in the strains you want to repopulate your GI tract. This is the equivalent of the flowers and the nice new houses you want to plant and build once you’ve kicked all the bad guys out of the hood and are rebuilding.
If you’re prone to diarrhea and yeast infections, Saccharomyces boulardii is your guy. I also recommend this strain during antibiotic treatment to preserve gut health. Sac B is a yeast-eating strain of bacteria. Take this one also if you have to take antibiotics to protect your gut, but take it 6 hours away from the antibiotic. Sac b is also great if you’re doing a candida cleanse or traveling abroad and want to prevent traveler’s diarrhea. If you’re prone to candida overgrowth or yeast infections, this is an excellent probiotic for women.
If you have IBS or other inflammatory GI conditions, Elixia will intensively recolonize the gut. This high potency powder is a longer term good choice. This one is excellent for ulcerative colitis.
If you’re working on healing leaky gut, want to recolonize the gut, or just finished a round of antibiotics, I recommend starting with Elixia, then transitioning to Renew Life and then Primal Defense, which contains some soil-based organisms, for a few months. I also rotate this one in from time to time. It’s so inexpensive and works great!
A word on soil-based probiotics (or SBOs)
These guys are all the rage lately because they contain microbes from soil, which used to be a huge part of our ancestral diets. But sadly we don’t get inoculated with these beneficial strains these days. Proponents of soil based probiotics say they increase probiotic diversity in the gut and may boost immune health and even aid in reversing SIBO and IBS. But there is also a concern that because the spores in these probiotics are so hearty that they may crowd out other less hearty but crucial lactobacillus strains and potentially even turn pathogenic, worsening your gut health. There is not much research on this, so proceed with caution here. (some info here) The main strains you’ll see are bacillus species. The most popular is MegaSpore, or this Terra Flora is excellent for constipation and is typically well tolerated by SIBO folks.
This wonderful article matches specific probiotic strains (including brands) to conditions for best outcome.
So here’s the thing: Taking probiotics is excellent for healing your gut and boosting your immune system, but they’re not a band-aid and will not have a lasting effect alone. It’s not really like filling up your deficient gut with a probiotic supplement and continuing on your way will be effective longterm. You MUST combine probiotic supplementation with fermented foods and a microbiome-building diet. Probiotic supplements help tremendously while you are taking them, but they don’t tend to stick around and make a home in the gut. You can achieve that by eating prebiotic foods that feed your probiotics + eating fermented foods.
I also don’t recommend taking probiotics (ESPECIALLY the same brand!) longterm. It’s possible that if you continually take the same strains you can experience overgrowth in beneficial strains, which is no bueno. Once you’ve achieved your GI health goals and your digestion has improved, you can maintain your benefits by getting a good spectrum of probiotic foods. My top choices are raw kraut and fermented foods like kim chi or beverages such as water kefir. This CocoBiotic coconut water kefir is a rich source made with mineral-rich coconut water. All you need is an ounce daily or a 1/4 cup of kraut. Combine these probiotic-rich foods with prebiotic-rich foods to work on nourishing your microbiome.
Prebiotic starches feed your probiotics. Starchy root vegetables, pumpkin, honey, green tea, artichoke, onion and garlic are excellent prebiotics. Resistant starch such as green tipped bananas, potatoes, or this banana flour added to smoothies is a great choice too.
*If You Experience Uncomfortable Symptoms from Probiotics
It typically means you have very low probiotic levels to begin with, you could have SIBO, you’re taking a strain that isn’t right for you (you may have too much of it already), or you need to work up very, very slowly. There is often dysbiosis present which needs to be fixed. I typically start these folks with probiotic foods and recommend stool testing to see if there are pathogens or parasites present.
You may need to start with 1/4 tsp of kraut juice or 1/4 a capsule of probiotic and work up from there.
If you’re clearing up a GI infection, you want to boost your immune health, you’re working to lose weight, or you’re healing leaky gut and dysbiosis issues, probiotics are your friend. I recommend transitioning between different probiotic brands to get a better variety of strains. Once you’ve reached your goals you can rely solely on probiotic and prebiotic foods and drinks, but even then it doesn’t hurt to take a good one like Primal Defense for a month or so if you’re under stress, traveling, or feeling run down. Just remember: do not take probiotic supplements indefinitely!
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.
I always love all the wealth of information you share, Mary!
thank you for your appreciation, kelly! 🙂
Really you know the subject! a brilliant information
I’ve tried Prescript Assist but even 1/3 of the capsule bloated me ..and fermented foods increase my histamine levels … * sigh *
Just wanted to say, I’m currently doing a candida cleanse and your website and articles have been immensely helpful. Thank you so much for sharing your knowledge!
Glad you found what you needed to help, Beth!
Hi, I have gas morning, noon and night. So embarrassing and so tired of it, please help me.
Hi Linda, I know how frustrating that is. There are a number to things that cause that, from SIBO to food intolerances. Feel free to drop me a line through the ‘get in touch’ tab and I can let you know some options to help you.
Part of the secret to a healthy body is to eat probiotic foods and let the food fight it out inside.
Many people wonder if probiotic pills or powders provide the same benefit as probiotic foods since they seem to be marketed in the same way—healthy bacteria for our guts. However, probiotic foods work significantly better because of their construction.
To get into the small intestine and colon, where they do the work of breaking down and processing food and powering up the immune system, the bacteria first have to move through the stomach, but the stomach is filled with acid designed to kill bacteria. When you eat a probiotic food, the food itself provides a protective armor that helps shield the friendly bacteria. It also speeds the transport out of the stomach, thus keeping the good bacteria intact. Probiotic pills are often trapped in the acids of the stomach, and the probiotics are killed before the body ever gets a chance to use them. So consuming probiotic foods, such as kefir, kombucha, and cultured vegetables, is 100 TIMES more effective than taking pills.
Fermented vegetables stronger than supplements
Dr. Mercola, from Mercola dot com, stated, “Fermented foods not only give you a wider variety of beneficial bacteria, they also give you far more of them, so it’s a much more cost-effective alternative. Here’s a case in point: It’s unusual to find a probiotic supplement containing more than 10 billion colony-forming units. But when my team actually tested fermented vegetables produced by probiotic starter cultures, they had 10 trillion colony-forming units of bacteria.
Literally, one serving of vegetables was equal to an entire bottle of a high potency probiotic! So clearly, you’re far better off using fermented foods.””
Cultured foods are inexpensive, and the logical way the body wants to receive these beneficial bugs. Supplemental probiotcis do not colonize the digestive flora anyhow, you must take them for life and when you stop all benefit stops. Food sourced probiotics still cannot colonize the guts either.
Some clean up protein waste, others carbohydrate waste, others dairy, others raise or lower ph levels so others can survive, some kill yeast, and others help us digest our food so we can get the nutritional benefits from it, etc. Some bacteria’s only job is to help other bacteria perform their job whatever that may be. They are a colony, they live together much like people live together in a city, each performing a separate task or job so that community can survive and flourish.
We cannot possibly duplicate this in a pill or a powder.
There are some 500-1000 different microbials which inhabit and reproduce in the gut. THEY THINK>>>we know so little yet
Some are only there transiently and therefore, to have a “healthy” gut (based upon our historical traditional cultures), we need to consume beneficial microbials regularly. Whole food probiotics more effectively remain viable until they reach the large intestine.
*Homemade milk kefir has 56+ different beneficial microbials strains.
*Water kefir has about 30 different beneficial microbial strains.
*Commercial store-bought kefir has about 10 different beneficial microbial strains, more than most bottle probiotics.
*Kefir “starters” have about 7 microbial strains.
*Commercial yogurt has about 7 different beneficial microbial strains. (They add strains intentionally for benefit. Bifidum is one to look for, if you purchase commercial whole food probiotics.)
*Homemade yogurt strains vary, but each starter has somewhat limited different strains, usually about 5-7 different strains. Having different sources of microbials in our food is optimal.
Basically, most probiotics are not viable all the way to the gut, due to heat destruction during transportation and storage, acidity in the stomach, and low viability of powders and capsules. Commercial yogurts must have “Active Live Cultures”.
I prefer whole foods which are naturally cultured or fermented: kefir or yogurt from cow, goat, coconut, almond, hemp seed milk, etc. And fermented foods. Bubbies brand sauerkraut and dill pickles are easy to add to the diet.
“Homemade yogurt that is fermented for 24 hours, will have an average concentration of 3 billion cfu/mL of yogurt. If you were to eat a small bowl (500 ml) of 24 hour fermented homemade yogurt, you would receive 1.5 trillion beneficial bacteria –
100 times more bacteria than a 15 billion capsules. 15,000,000,000..amazing isnt it?
And homemade kefir has 5x that; homemade kimchi 10x that!
Dairy-free kefir, or any type of dairy could be made into kefir. And the kefir grains reproduce
Tom, you are absolutely correct. Fermented foods are the best option, and it’s impossible to replicate all the diverse strains in a supplement. To add to that, probiotics don’t have a long lasting effect of recolonizing the gut, but they DO offer excellent short term benefit. That’s why I recommend probiotic therapy (and rotating through different brands for the best diversity) along with fermented foods to anyone who is healing from a gut issue. Some people cannot tolerate fermented foods and have to work up slowly using probiotic capsules. So my point is probiotics benefit the immune system and the gut and are used as part of a protocol (and to keep the gut healthy), but they are not a sub for ferments (or prebiotic foods).
I tried Saccharomyces while on a Candida diet and anti-fungal rotation. It immediately made me feel light headed and dizzy. I took it for 3 days and I felt dizzy all day long. Any thoughts??
Rebekah, it’s possible to have some kind of adverse reaction, but I’ve never heard of that with Sac B, and it probably wasn’t die-off if it happened right away.
Thank you for your competent, professional, straightforward and helpful website, articles and advice!
Do xylitol, lucuma and stevia have anti-fungal and anti-candidal effect or it would be easier to get rid of candida if they are not used?
Hi Kate, no, those do not have any anti-fungal properties to speak of. They don’t feed candida either bc they’re not sugars. Stevia and xylitol or monk fruit are good sugar subs on a candida diet.