There are many reasons you may opt to take a probiotic supplement: Although more research is needed, studies show promising results where probiotics help manage irritable bowel syndrome (IBS), ease antibiotic-related diarrhea, and boost immunity, among other health benefits, according to the National Center for Complementary and Integrative Health (NCCIH).
Probiotics are also popular. One medical journal noted that 3.9 million people in the United States regularly take probiotic supplements, and that the worldwide probiotic market is estimated to be $37 billion.
Who Should — and Shouldn’t — Take Probiotics?
For most healthy people, probiotics are safe to consume, says Niki Strealy, RDN, LD, a registered dietitian in private practice in Portland, Oregon, who specializes in digestive health. But also note that some research suggests that probiotics have little benefit for healthy people, and taking them as supplements may actually disrupt the beneficial probiotics that people get from food.
So before you increase your intake, there are a few things to know about the most effective ways to take probiotics.
People commonly turn to probiotics to manage digestive symptoms such as gas, bloating, diarrhea, and abdominal pain. But remember, a healthy gut starts with your diet, so it’s important to focus on eating plenty of fruits, vegetables, healthy fats, proteins, and minimally processed whole grains, says Strealy.
If you have history of allergy or intolerance to gluten, soy, eggs, or dairy, be sure to check probiotic ingredient labels carefully for allergens before taking them.
“In addition, those who have a compromised immune system, those undergoing cancer treatment, pregnant women, the elderly, and children should talk to a healthcare provider before taking probiotics,” says Strealy.
Finally, people who have been diagnosed with small intestinal bacterial overgrowth (SIBO), which is common in IBS, should be cautious with probiotics. According to a study, probiotics might make symptoms like brain fogginess, gas, and bloating worse in people with SIBO — but taking an antibiotic and stopping probiotics can help, in these cases.
Common Mistakes When Taking Probiotic Supplements
There are some common missteps that can prevent you from getting the most out of your probiotics, according to Strealy. These can include:
- Leaving probiotics on the shelf when they require refrigeration.
- Not taking a probiotic for long enough. “I recommend taking it for at least a month,” Strealy says.
- Not taking a high enough dose. This might occur because there aren’t enough live cultures in your probiotic, or if you don’t follow the dosing directions, such as taking two supplements in the morning instead of one in the morning and another at night.
- Choosing a probiotic strain that hasn’t been studied for the symptoms you want to manage.
- Using a probiotic that also contains prebiotics if you have IBS. Some prebiotics are FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which are fermentable starches and fibers that can cause gas, bloating, diarrhea, and constipation for those with IBS. “Initially, to manage IBS, I recommend selecting a probiotic that does not contain prebiotics,” says Strealy.
How to Make the Most of Probiotic Supplements
Probiotics are generally simple to take, but like all supplements, they do require following directions for best results. These tips for taking probiotics can help you avoid typical pitfalls to get the most out of them:
- Choose the right kind of probiotic for your condition. Consult a dietitian or gastroenterologist, or visit the Alliance for Education on Probiotics (AEProbio), suggests Strealy.
- Check labels carefully. The strength of a probiotic is measured in colony forming units (CFUs), which refers to colonies of bacteria in the product. “More CFUs aren’t always better,” Strealy says. The optimal number of CFUs depends on the condition you want to treat. Your doctor or dietitian can help you figure out which number of CFUs is best for you.
- Make sure the product does what it says. Choose a brand that has been independently verified for ingredients and CFU accuracy. Strealy suggests consulting a resource such as Consumer Lab or Labdoor to verify a product’s claims before purchasing.
- Follow the dosing directions on the label. Different supplements can vary greatly in their dosing recommendations, so be sure to follow the instructions for the particular probiotic supplement you’re taking.
- Pay attention to when you’re supposed to take the supplement. According to Strealy, probiotics with lactobacillus or bifidobacterial strains are best taken 30 minutes or just prior to a meal, while saccharomyces boulardii can be taken at any time. Talk to your doctor about when to take your probiotic supplement in order to reap maximum benefit.
- Store the supplement appropriately. Pay attention to whether the probiotic is shelf-stable or requires refrigeration, and store it as directed.
- Give your probiotic supplement time to take effect. Stick with probiotics for a full month before you decide if you want to continue taking them, suggests Strealy.
- When probiotics have expired, throw them out. Although taking expired probiotics won’t hurt you, they may not have enough living organisms left to offer you any noticeable benefit.
What to Do If Your Symptoms Worsen With Probiotics
If you begin taking probiotics and your symptoms seem to be getting worse, you have several options:
- Push through a little longer. Sometimes symptoms get a little worse at first, then get significantly better a few days later, explains Strealy.
- Take half a dose. For example, take one capsule per day rather than one capsule twice a day.
- Switch the timing. For example, try taking the supplement at night before bedtime instead of during the day.
- Switch brands. Change to a different strain of bacteria, or switch to a yeast-based probiotic.
- Take a break and try again later. “Some people just don’t tolerate probiotics,” Strealy says. You might consider trying again in a few months and see how it goes then.
If you have questions as you continue to take a probiotic supplement, your doctor or dietitian can give you further guidance to help you get the most benefit from probiotic supplements.
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