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How Should I Take Probiotics?

Foods appear to be better carriers for probiotics than supplements, but if one does choose to go with the supplement route, should they be taken before, during or after meals?

The package labeling on probiotic supplements is often confusing. Sometimes the consumer is instructed to take the probiotics with meals, sometimes before or after meals, and occasionally on an empty stomach. I was surprised to find so few actual data in the scientific literature concerning this topic, but that is par for the course for most dietary supplement advice. See, for example, my video series about how little pharmacists and natural food store employees know:

The lack of information on how to take probiotics has led to serious confusion, both for the industry and the consumer. Surprisingly it doesn’t appear as if any studies had ever examined this question–until now.

Researchers hoped to be able to measure probiotic concentrations throughout the entire process after taking a probiotic supplement minute-by-minute.  To do this, they had to build a fake digestive track with a fake stomach and intestines, but complete with real saliva and digestive enzymes, acid, bile, and other digestive fluids. What did they find? If you click the above video, you can see the survival of three different types of probiotics before, during, and after meals. You can also see how the probiotics fared when taken in oatmeal and milk, milk alone, apple juice, or water.

What did they find? Like vitamin D supplements, which should also probably be taken with meals for maximum efficacy (Take Vitamin D Supplements With Meals), probiotic bacterial survival was best when provided within 30 minutes before or simultaneously with a meal or beverage that contained some fat content.

This study didn’t shed light on what dose we should take and under what circumstances, however. To see what the best available science says, see the first video in this series, Preventing and Treating Diarrhea with Probiotics. Then I compared probiotics to prebiotics in Preventing the Common Cold with Probiotics? and moved to the effect of your gut flora on your mood in Gut Feelings: Probiotics and Mental Health.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

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Related:
Vitamin D from Mushrooms, Sun, or Supplements?
How To Counter Dietary Pollutants & Pesticides
Boosting Gut Flora Without Probiotics

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Dr. Michael Greger

A founding member of the American College of Lifestyle Medicine, Michael Greger, M.D., is a physician, author, and internationally recognized speaker on nutrition, food safety, and public health issues. Currently Dr. Greger serves as the Director of Public Health and Animal Agriculture at The Humane Society of the United States. Hundreds of his nutrition videos are freely available at NutritionFacts.org.

56 comments

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9:54PM PDT on Sep 6, 2013

Thnk you Mihael for the great article, I am always interested in probiotics, and thanks to the 55 care 2 members that commented on the article. I enjoyed readin them. I usually have a yogurt and couple of probiotics during the day with meals. pill in the morning , yogurt in the aftrernoon, and pill at night. It has been working for me for years.

8:57AM PDT on Aug 24, 2013

Thank you.

8:35AM PDT on Aug 21, 2013

So I've been looking into probiotics a bunch recently and read this post on the bulletproof exec about why you want to avoid certain strains of probiotic: http://www.bulletproofexec.com/why-yogurt-and-probiotics-make-you-fat-and-foggy/
After reading it I found these probiotics which have 2 of the histamine degrading strains (Bifidobacterium longum, Lactobacillus plantarum) and none of the histamine producing strains. They come in 30bn and 100bn versions for $35 and $63, respectively:
Xymogen ProbioMax DF - 100 Billion CFU Probiotic - 30 vcaps
XYMOGEN ProbioMax Daily DF 30 billion CFU probiotic 30 vege caps
If that's a concern of yours, these should work well!

1:27AM PDT on Aug 19, 2013

I don't take the supplements, but do eat yogurt or kimchee. Thanks, Dr Greger!

7:07AM PDT on Aug 18, 2013

ty

12:23PM PDT on Aug 12, 2013

Ty

6:43PM PDT on Aug 10, 2013

Bookmarked! Thanks

5:42PM PDT on Aug 10, 2013

I'll be starting on probiotics tomorrow! Thanks.

11:50PM PDT on Aug 9, 2013

good info

12:28AM PDT on Aug 9, 2013

Thank you for your usual informative articles

I don't want to take any more supplements.. will have to survive on my organic yoghurt

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