If you’re looking for a way to improve your digestive health, you may be exploring supplements, including prebiotics and probiotics. Prebiotics and probiotics are two types of dietary supplements used to help resolve digestive problems like IBS (irritable bowel syndrome), SIBO (small intestine bacterial overgrowth) or inflammatory bowel disease. But can you take prebiotics and probiotics together?
Surprisingly, it depends.
As clinical nutritionists, we have a lot of experience with helping our clients improve their digestive health. As much as we wish there were clear and simple answers about taking probiotics, this is a topic with a lot of nuances.
In this blog post, we’ll explain what each type of supplement does, discuss which ones might be right for you, and explore some potential side effects or risks that could arise from using them together. We’ll also explain a few of the possible interactions between these types of supplements.
So if you’re curious about taking these two helpful supplements together but want more information before making any decisions – read on!
What are probiotics?
Probiotics are live bacteria and yeasts that can help maintain a healthy balance of gut flora in your digestive system (1). Certain species of probiotics, in the right dose, may be useful for a variety of conditions, including diarrhea caused by antibiotics, constipation, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD).
There are many different kinds of probiotics that are divided into seven different categories (2):
- Lactobacillus
- Bifidobacterium
- Saccharomyces
- Streptococcus
- Enterococcus
- Escherichia
- Bacillus
Lactobacillus and Bifidobacterium are the most common probiotics in supplements.
Most probiotics are bacteria, some are yeast. Some probiotics are in the “spore” form, which means that they might just be better able to survive the acidic environment in your stomach and populate your digestive tract (3). As a bonus, these probiotics don’t need to be in the fridge.
All of the living organisms in your digestive tract and beyond form an ecosystem that is called your microbiome (4). The “good” living organisms offer health benefits to you, and they benefit from living in your digestive tract. This relationship is a two-way street.
How does a healthy microbiome benefit you? Let me count the ways! An optimal microbiome:
- Improves digestion by creating enzymes that help digest food
- Maintains the lining of the intestines that protect against toxins, allergens, and other inflammatory compounds
- Helps keep the immune system strong
- Create neurotransmitters
An optimal microbiome is kind of like having a well-organized city; you need to have the garbage collectors, farmers, teachers, bankers and grocery store baggers. Everyone has an important role to fill, just like having different species of probiotics in your gut.
So where do probiotics come from? Many places!
Food sources of probiotics
There are some foods that have these beneficial bugs living in them. Examples of these fermented foods include (5):
- Sauerkraut and kimchi
- Kombucha tea
- Yogurt (dairy and non-dairy)
- Keifer
- Fermented pickles
- Miso and tempeh
You can also take probiotics as a supplement. There is a wide range of doses of probiotics per serving and they can include a single strand of probiotics or a mixture of several.
What are the benefits of probiotics?
There are many potential benefits of taking probiotic supplements and eating fermented foods. The research about our gut health, specifically about the microbiome is still unfolding.
It is important to remember that this research is young, and the recommendations are not one-size-fits-all.
Having a healthy microbiome means that you have a community of different organisms. Having enough of the different kinds of “good guys” means that you get the boost of their gut-nourishing activity as well as helping to crowd out the “bad”, or disease-causing bacteria.
Probiotics may help promote a balanced and healthy microbiome. They also help support your digestive system by breaking down food, absorbing essential nutrients, and helping with digestion. Additionally, probiotics can have immune-boosting effects and reduce inflammation in the gut (6).
In order to have a specific benefit, we have to match the specific probiotics to the concern we’re trying to address. We use specific strains or blends that have been studied for specific indications or conditions.
For example:
- S. boulardii is used to help eradicate H. pylori, in the prevention of traveler’s diarrhea and in the prevention of diarrhea following antibiotics (7).
- Visbiome is helpful if you have a form of IBD known as colitis (8).
- Bifidobacterium animalis subsp. lactis HN019 can help treat constipation and can minimize leaky gut (9).
There are many potential benefits of taking probiotic supplements and eating fermented foods. The research about our gut health, specifically about the microbiome is still unfolding.
It is important to remember that this research is young, and the recommendations are not one-size-fits-all.
Having a healthy microbiome means that you have a community of different organisms. Having enough of the different kinds of “good guys” means that you get the boost of their gut-nourishing activity as well as helping to crowd out the “bad”, or disease-causing bacteria.
Probiotics may help promote a balanced and healthy microbiome. They also help support your digestive system by breaking down food, absorbing essential nutrients, and helping with digestion. Additionally, probiotics can have immune-boosting effects and reduce inflammation in the gut (6).
In order to have a specific benefit, we have to match the specific probiotics to the concern we’re trying to address. We use specific strains or blends that have been studied for specific indications or conditions.
For example:
- S. boulardii is used to help eradicate H. pylori, in the prevention of traveler’s diarrhea and in the prevention of diarrhea following antibiotics (7).
- Visbiome is helpful if you have a form of IBD known as colitis (8).
- Bifidobacterium animalis subsp. lactis HN019 can help treat constipation and can minimize leaky gut (9).
What are prebiotics?
Prebiotics are a type of fiber that nourishes the friendly bacteria in your digestive system. We can’t actually digest (take apart) these fibers.
Prebiotics can be found naturally in fiber-rich foods, such as (11):
- Bananas
- Onions
- Garlic
- Asparagus
- Artichokes
- Oats
Just like with probiotics, prebiotics also come in supplement form. They can be purchased as a stand-alone product, or you can find supplements that contain both prebiotics and probiotics together. These include:
- Inulin
- Chicory root fiber
- FOS
- GOS
Here’s the catch; prebiotics tend to be FODMAPs, that category of carbohydrates that can be especially irritating for people with digestive issues. If you don’t tolerate FODMAPs or fiber well and end up consuming some, you might have uncomfortable gas, bloating, and diarrhea.
Nourishing the good gut bacteria is a huge priority! Many of our clients come to us having a history of taking frequent doses of antibiotics or have been on a super-restricted diet for a long time. This means that their microbiome is likely depleted of the beneficial gut bacteria. We often work with our clients to broaden their diet; more diversity in what our clients eats helps to cultivate more diversity in their microbiome. In addition, we may supplement with prebiotics alone to help encourage the growth of the good guys.
Do no harm
In our work, we want to make sure that any recommendation that we offer you gives you relief from your symptoms that lasts.
If you were to just try and take a random supplement of probiotics and prebiotics, you might feel worse. In fact, we recommend that our clients eliminate probiotic and prebiotic supplements from their usual routine for a short period while we work on healing the gut.
Remember those FODMAPs we were talking about earlier? If you were to try to boost your fiber to improve your digestive health, things might backfire. Many of our clients can’t tolerate supplemental fibers like inulin or chicory root while they’re symptomatic. These fibers can be found in “health” foods, supplements, protein bars, protein shakes, or high-fiber cereal.
As our clients heal their gut, we often recommend slowly increasing prebiotic foods as part of our food-first approach. These supplements may have a benefit to your microbiome, but we need to make sure that you are able to incorporate them into your routine without worsening your symptoms (12).
Start with digestive health
Whether you should take prebiotics and probiotics together will depend on your need for the specific strain AND your tolerance of prebiotic fiber.
Fermented foods and prebiotic foods are a big part of a gut-healthy diet. Many of our clients need to slowly work their way up to increasing the amount of these foods in their diet.
Whether you should take prebiotics and probiotics together will depend on your unique needs.
Your digestive health represents far more than just your food choices. How your digestion runs depends on so many things beyond the fork, including:
See? It’s complicated.
That’s why you might be feeling so frustrated by your symptoms not going away, despite feeling like you’ve already tried it all. We’re able to help you take an unbiased look at your whole health history and make a comprehensive plan to finally feel better. Let’s banish those digestive health issues once and for all, shall we?
That’s a wrap
So is it beneficial to take prebiotics and probiotics together? It depends.
Before trying a new supplement, you need to ensure that it is the right kind of supplement for the health goals you’re aiming for, that you’re getting the right dose, and that the supplement will not cause you to have more symptoms. Oof! It’s complicated.
If you’re looking for help with your digestive issues, including supplements, we can help! At Belly Bliss Nutrition, we will provide you with personalized recommendations and give you guidance and accountability so that you can take action and keep making progress.
Ready for relief? Check out our booking page for more details and to take the next steps.
Sara Kahn, MS, CNS, CDN is a board-certified nutritionist specializing in digestive health conditions like SIBO, IBS, acid reflux and more. She’s the founder of Belly Bliss Nutrition and the Solving SIBO Program.
