Probiotic FAQ

Maintaining a healthy, balanced intestinal microbiom is important to both short and long term health. When our diets contain processed and sterilized foods we become deficient in essential microorganisms. As we age this balance can also become altered. These beneficial bacteria must be consumed to maintain their needed presence in our digestive system.

Immune modulation is supported by probiotics. This is important during seasonal stress from colds and flu. Both constipation and diahhrea can be improved with probiotics, and effectiveness in alleviating food allergies has also been shown. Probiotics offer benefit for those with more significant concerns such a irritable bowel syndrome, Crohn’s and ulcerative colitis.

Should I take probiotics with meals?

It seems reasonable to take probiotics with some food, but nothing hot. The idea here is that food can buffer the stomach acid and reduce damage to the bacteria. Another option is to drink lots of water to dilute the stomach acid and move the probiotics quickly into the intestines, reducing exposure to acid and bile. Though there is nothing definitive about these approaches and the industry remains divided on the topic.

Can I take probiotics when on an antibiotic?

Given that antibiotics are designed to kill bacteria, it seems reasonable to eliminate probiotics while on a course of antibiotics. The problem with this approach is that it leaves pathogenic microorganisms with the opportunity to grow quickly without opposition from beneficial bacteria. This can lead to diahhrea associated with antibiotics, yeast overgrowth and other problems. Taking probiotics while on antibiotics can reduce such symptoms.

Taking probiotics while on an antibiotic is a better idea. You can reduce the damage to probiotics by taking them an hour before, or two hours after, the antibiotic. Including Saccharomyces Boulardii in your probiotic is effective at fending off interic pathogens like E. coli and exerts several beneficial effects on the gastrointestinal tract.

Why are some probiotics refrigerated?

In general keeping your probiotics in the fridge will keep them more potent. Most probiotics that are freeze-dried deteriorate over time, though at room temperature this process is slow at the beginning and then accelerates over time. How fast this happens depends upon the individual strain of bacteria. Some spore based probiotics are 95% stable even after two years.

What this all means is that you can leave your probiotics out for days and weeks without much loss. But because survival is greater at low temperatures, you should refrigerate and avoid high temperatures that can cause die-off.

Do probiotics survive stomach acid?

This depends upon the strain of probiotic as each one has it’s own level of sensitivity to stomach acid and bile. Lactic acid producing bacteria do not survive well in acidic or alkaline medium. You either have to take more or find a way to protect them during transit. Some companies offer protection through coated capsules or by surrounding the microorganisms with plant extracts or fatty acids.

Scott Porter is a Functional Medicine Pharmacist at Sandpoint Super Drug, specializing in professional supplements and clinical nutrition.