by Anne Salazar RH (AHG)
There can be quite a bit of confusion around the proper dosing of probiotics- when to take them, how to take them, etc. This blog post will address these parameters. This is important information to know, as it can make the difference between making traction in a health challenge...or not.
Probiotic doses are typically standardized in terms of the amount of living bacteria per unit of volume (dose). Each living bacterium is referred to as a colony-forming unit (CFU). A quality probiotic is not about high numbers of CFUs, but more importantly about the proper clinically studied strains (see former blog on strains) in the proper ratios. I often hear patients say they get their probiotics from yogurt (or Kombucha). Unfortunately those mostly do not contain enough live bacteria to be truly therapeutic. And they often do not contain the bifidum strain that is so important. Only yogurt brands that are guaranteed to contain this level of viable bacteria, those that have done so in independent market-basket surveys, or those that have clinical trials demonstrating efficacy should be relied upon for therapeutic purposes (1).
Another important factor in taking supplemental probiotics is the timing of it; both the actual time of day, and whether to take with or without food. These both can make a difference in the efficacy of the therapeutic purpose of the probiotic.
First, it is important to remember that probiotics need prebiotics. In simple terms, prebiotics are a type of non-digestible fiber that act as a food source for the beneficial bacteria in the gut and throughout the body. So, as they travel through the digestive system, they nourish all those good bacteria along the way and help them grow and multiply. Secondly, supplements in general are best consumed with/after meals in order to take advantage of the increased alkalinity of the stomach environment – which equates to greater bacterial survival. Therefore, taking probiotics with meals is advantageous.
The time of day can also positively affect the outcome of the health benefits of probiotic intake. For the most part, probiotics can be taken with the first meal of the day. The only exception to this would be if the patient is taking probiotics to mitigate/correct constipation. In that case, taking a Bifidus focused probiotic at night with dinner would be more beneficial.
Yet another important timing factor involves concurrent taking of antibiotics with probiotics. It is very important that patients take probiotics along with their antibiotic therapy (2), in order to keep healthy bacteria intact in the gut. However, it is vitally important that the probiotics are taken at a different time of day. If taken at the same time, the antibiotics will kill off all the beneficial bacteria, leaving the probiotic useless. Therefore, taking the probiotics away from the antibiotics by at least 2-3 hours is vitally important.
This is an area most are not familiar with. And it's not something that comes up so frequently that it would be widely known. However, in cases of Bacterial Vaginosis or vaginal yeast infections, some specific probiotics can be used as a vaginal suppository (along with oral supplementation of appropriate probiotics concurrently (3). This allows for a healthy internal/vaginal environment to be encouraged; crowding out the unwanted bacteria from the specific area (4). This assists in more efficiently and quickly moving out of vaginal dysbiosis. This is something that should come through the specific advice of a practitioner who understands this mechanism. Not every probiotic product is appropriate for this. There are specifications that a versed practitioner will know.
With all this being said, we are here and prepared to assist you in finding what will work best for you. If you have a situation that needs more than a consult on the floor, we are also available for private consultations. We are here to help!!
- Rybka, S. and G.H. Fleet, Populations of Lactobacillus delbrueckii ssp. bulgaricus, Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacterium species in Australian yoghurts. Food Australia, 1997. 49(10): p. 471-475.
- Rodgers B, Kirley K, Mounsey A. PURLs: prescribing an antibiotic? Pair it with probiotics. J Fam Pract. 2013;62(3):148-150.
- 2Jones K, Ewigman B. PURLs: Help for recurrent bacterial vaginosis. J Fam Pract. 2011;60(2):91-93.Jones K, Ewigman B. PURLs: Help for recurrent bacterial vaginosis. J Fam Pract. 2011;60(2):91-93.
- Ehrstrom S, Daroczy K, Rylander E, et al. Microb Infect. 2010;12:691-6991. Ehrstrom S, Daroczy K, Rylander E, et al. Microb Infect. 2010;12:691-699.