What Probiotics Can and Cannot Do (2023)

Probiotics are live bacteria and yeast in foods, supplements, and other products that are meant to increase the healthy "flora" in or on the body. These naturally occurring microorganisms are considered "good" in that they keep "bad" bacteria and fungus in check.

Probiotics have been studied for their possible benefits in treating and preventing gastrointestinal conditions like irritable bowel syndrome (IBS) and gastroenteritis. They may even promote vaginal health by preventing the overgrowth of microbes that cause yeast infections and bacterial vaginosis.

Probiotics are found in yogurt and fermented foods but can also be purchased as dietary supplements, skin care products, and vaginal suppositories.

The most common types of probiotics sold in the United States are Lactobacillus and Bifidobacterium. The increasing popularity of these products has led to misconceptions about what they can and cannot do and whether they can deliver the promised results.

This article discusses probiotic benefits for digestive and reproductive health. It also details the side effects of probiotics.

What Probiotics Can and Cannot Do (1)

Health Benefits of Probiotics

A lot of research has been devoted to evaluating the benefits of probiotics, most especially in the area of digestive health. While some of the results have been positive, other long-held health claims have been unsupported by research.

The American Gastroenterology Association (AGA) released clinical practice guidelines specifically addressing the use of probiotics in managing digestive health disorders. The guidelines were developed based on a review of available research and are intended to provide healthcare providers with evidence-based guidance about the appropriate use of specific probiotics.

Here are some of the key findings from the research on probiotics and the AGA's guidelines:

Irritable Bowel Syndrome

The role of gut microflora in the development of irritable bowel syndrome is well established. As such, the body of research into the potential for probiotics in helping alleviate symptoms ofIBS continues to grow. Several studies have found that probiotics can have a positive effect on the severity of common IBS symptoms—including abdominal pain and diarrhea.

Although clinical research has been encouraging, it hasn't been enough to garner an official endorsement from most gastroenterologists. The AGA guidelines do not recommend the use of probiotics in children and adults with IBS except in the context of a clinical trial.

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Antibiotic-Associated Diarrhea

Other studies have focused on whether probiotics can play a role inpreventing diarrheacaused by antibiotic use. Since antibiotics can kill both "good" and "bad" bacteria, the hope has been that probiotic supplements could help restore the digestive flora back to its normal state.

A 2018 review of studies from China concluded that probiotics can reduce the risk of diarrhea by 50% to 60% if taken with antibiotics, particularly the probioticsSaccharomyces boulardiiandLactobacillus rhamnosus GG.

The AGA guidelines recommend certain probiotic strains for adults and children on antibiotic treatment and other probiotics for the prevention ofC. difficileinfection. Of note, the AGA tempers this recommendation by saying people who are concerned about the potential harms or costs of probiotics, or who have a low risk for C. difficiledevelopment, can reasonably choose to not take probiotics at all.

The specific strains the AGA recommends for adults and children taking antibiotics include S boulardii; or the 2-strain combination ofL acidophilusCL1285 andL caseiLBC80R; or the 3-strain combination ofL acidophilus,L delbrueckiisubspbulgaricus, andB bifidum; or the 4-strain combination ofL acidophilus,L delbrueckiisubspbulgaricus,B bifidum, andS salivariussubspthermophilus.

Vaginal Infections

The use of probiotics in treating common vaginal infections, like bacterial vaginosis and vaginal candidiasis (yeast infection), remains controversial with some studies showing benefits and others not.

A 2014 review in the Journal of Lower Genitourinary Tract Disease would only go so far as to say that oral probiotics taken daily may prevent the recurrence of bacterial vaginosis but would unlikely offer much in the way of treatment.

Of the oral supplements reviewed, Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1, and Lactobacillus fermentum RC-14 were considered the most beneficial.

By contrast, the oral or vaginal use of probiotics has not yielded positive results in treating yeast infections, according to a 2006 review in the Journal of Antimicrobial Chemotherapy.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), which consists of ulcerative colitis and Crohn's disease, is characterized by persistent gastrointestinal symptoms, including abdominal pain, bloating, blood in stool, flatulence, diarrhea, nausea, and vomiting.

Interestingly, while much of the current evidence suggests that probiotics may prevent the recurrence of ulcerative colitis, the same was not seen with Crohn's disease. Moreover, the benefits were attributed to specific probiotic strains or combinations of strains.

In 2011, VSL#3 (a high-potency combination probiotic) and the probiotic Escherichia coli Nissle 1017 were both given an A rating at the 3rd Yale Workshop on Probiotics based on strong evidence that they sustained remission of ulcerative colitis.

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By contrast, a 2009 Cochrane review, which evaluated 23 different randomized controlled studies, found that probiotics were no more effective in preventing or treating Crohn's disease than a placebo.

Possible Side Effects of Probiotics

Probiotic supplements are considered safe and well tolerated if taken as directed. Side effects of probiotics may include bloating and gas. Taking a yeast-based probiotic can sometimes cause constipation or increased thirst. Most of these side effects are mild and tend to improve once your body adapts to treatment.

Probiotics may contain allergens that can affect people with an egg or soy allergy. People with a yeast allergy would need to avoid yeast-based probiotics.

There are no documented drug interactions associated with probiotic supplements. With that said, speak with your healthcare provider before taking a probiotic if you are on antibiotics or antifungal medications. Taking these together can negatively alter your digestive or vaginal flora.

Probiotic Dosage and Preparation

Because there are many different probiotic strains and formulations, there is no set dosage. The recommended dosage will depend on the specific product. Factors like age, weight, and general health may also influence how much or little you need.

As a general rule, aprobioticshould provide at least 1 billion colony forming units (CFU) per day, withdosages rangingfrom 1 billion to 10 billion for adults. If used in children, less than 1 billion CFU would be prescribed. Probiotic supplements are generally taken on a daily basis, ideally before a meal.

Probiotic suppositories tend to have higher CFUs as they are meant for short-term use only. Generally speaking, suppositories should be used for no more than seven consecutive days.

What to Look For

In the United States, probiotics are classified as dietary supplements. Under this classification, the products are not strictly regulated and they can be sold without support from clinical research. With that being said, the Food and Drug Administration (FDA) forbids manufacturers from making any claims that the products can cure, treat, or prevent any disease or health condition.

To ensure quality and safety, only buy supplements that have been tested and certified by an independent certifying body like the U.S. Pharmacopeia, ConsumerLab, or NSF International. This helps ensure that products contain the ingredients and dosages they claim.

When used as a food ingredient, probiotics fall under the FDA umbrella category "GRAS," meaning they are "generally regarded as safe."

Frequently Asked Questions

  • Can you take probiotics every day?

    It's probably safe for most people, but there isn't clear evidence that it's helpful. Long-term, daily probiotic use has been studied for certain gastrointestinal conditions, such as pouchitis, for which it was found to be safe and potentially helpful. However, data on long-term safety and effectiveness is lacking for most conditions and for general health maintenance.

    Chronic probiotic use may not be safe for certain groups, such as those with weakened immune systems, so talk to a healthcare provider before starting a daily regimen. On the other hand, eating probiotic-containing foods daily is considered safe.

  • Generally speaking, it is always best to get your daily nutrients from food. Even though probiotic supplements are unlikely to cause you any harm, you should consider trying the following if you've been advised to increase your probiotic intake:

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    • Kefir: 27.7 billion CFU per 1-cup serving
    • Kimchi: 2.6 billion CFU per 1/2-cup serving
    • Yogurt: 3.6 billion CFU per 1-cup serving
    • Miso: 54,100 CFU per tablespoon
    • Sauerkraut: 195.2 million CFU per 1/2-cup serving
    • Kombucha: 23.1 million CFU per 1-cup serving
  • How long does it take for probiotics to work?

    It depends on why you are using them. When used as a treatment for infectious gastritis, research shows probiotics can take affect in as few as two days. For chronic conditions, it can take two to four weeks of daily probiotic treatment to notice a reduction or resolution of symptoms.

  • What time of day should I take probiotics?

    To get the most benefit from probiotic supplements, they should be taken first thing in the morning, on an empty stomach. This allows the beneficial probiotic bacteria to get straight to the digestive tract. If you can't take them first thing in the morning, you can take probiotic supplements before bed, provided it is two hours or more after eating.

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FAQs

What conditions should you not use probiotics with? ›

What medical conditions may be contraindicated with probiotics?
  • For those who are severely immunosuppressed. ...
  • For those who have pancreatitis. ...
  • For patients who are in the ICU. ...
  • For those that have melaena (dark blood in their faeces)
  • For those with a central venous catheter. ...
  • For infants with short bowel syndrome.

Which probiotics actually work? ›

Although there are many claims made by probiotic products, there's now reliable, evidence-based support that certain probiotics — like Lactobacillus, Bifidobacterium (bacteria), and Saccharomyces boulardii (yeast) — are generally safe and helpful in specific conditions.

Can you take probiotics if you have high blood pressure? ›

The results of this meta-analysis suggest that probiotic consumption with daily doses from 109 to 1012 CFU for a duration of 3 to 9 weeks may improve BP. The magnitude of improvement is greater among those with elevated BP, when daily dose of probiotic consumption is ≥1011 CFU and when intervention lasts ≥8 weeks.

What happens if your probiotics are too strong? ›

Even though the bacteria may be familiar to your body, it is possible to experience side effects from taking large amounts of probiotics. You may experience bloating, gas, nausea, or diarrhea when taking high amounts of probiotics.

Can probiotics have negative effects? ›

Digestive symptoms

Changes in the gut microbiota can result in bacteria producing more gas than usual, which can lead to bloating. However, these side effects usually clear up within a few days or weeks of taking the probiotics. If the symptoms persist, speak with a doctor, who can explore the possible causes.

How long after taking a probiotic can you drink coffee? ›

“Don't take a probiotic supplement with hot food and drinks such as tea or coffee as this can lessen the chance of the bacteria getting to your gut unharmed. Give it 30 minutes after taking them before you reach for the teapot.”

What probiotic Do most doctors recommend? ›

A general recommendation is to choose probiotic products with at least 1 billion colony-forming units and containing the genus Lactobacillus, Bifidobacterium, Bacillus or Saccharomyces boulardii, some of the most researched probiotics.

What is the #1 probiotic? ›

The probiotic strain in Culturelle® - Lactobacillus rhamnosus GG (LGG®) – is the #1 most clinically studied strain of probiotic. Considered the premier probiotic in the world, over 1,000 scientific studies and over 30 years of research have demonstrated the safety and efficacy of Lactobacillus rhamnosus GG (LGG®).

Can probiotics affect your heart? ›

Your gut bacteria can also affect your blood sugar, brain health and heart health by reducing cholesterol levels, blood pressure and inflammation ( 4 , 5 , 6 ). Probiotics can help restore healthy gut bacteria, which may improve your heart health.

What vitamins should you avoid with high blood pressure? ›

You may need to avoid supplements that raise your blood pressure or interfere with your blood pressure medications.
...
Herbal supplements
  • Arnica (Arnica montana)
  • Ephedra (ma-huang)
  • Ginseng (Panax quinquefolius and Panax ginseng)
  • Guarana (Paullinia cupana)
  • Licorice (Glycyrrhiza glabra)

Can probiotics raise your heart rate? ›

Data were statistically analyzed using mixed factorial ANOVA and results revealed that there is no significant difference between the probiotic and placebo groups for heart rate (61.90 bpm ± 5.84 vs.

Why do I feel worse when I take probiotics? ›

Reason #1 People Feel Worse When Taking Probiotics-

The specific strain within your probiotic formula, is the wrong kind or you already have too much of that strain in your gut. Remember that the bacteria and the bacterial diversity found in your microbiome is highly unique to you. There is no one size fits all.

Can probiotics cause more harm than good? ›

“When the gut barrier is healthy, probiotics are beneficial. When it is compromised, however, they can cause more harm than good.

How long do probiotics stay in your system? ›

The bacteria from a supplement likely take up residence in your gut, but scientists have found that the effects wear off within 1-3 weeks after you stop taking them.

Can too much probiotics cause problems? ›

Overdosing – can you take too many probiotics? There is absolutely no harm in taking probiotics in the long term, and there is generally no harm in increasing one's dose of a probiotic supplement if you feel the need.

What happens when you take probiotics everyday? ›

In addition, even though taking too many probiotics in one day doesn't pose an extreme risk like overdose, it can cause digestive discomfort and side effects such as diarrhea, constipation, bloating, and gas.

Is it harmful to take probiotics every day? ›

A common question about probiotics is whether it is ok to take probiotic supplements every day. Whilst there may be a few exceptions to this rule, the general answer is yes, it's safe, and usually recommended, to take them daily. It's important to understand that probiotics are a natural supplement and not a medicine.

How do I know if a probiotic is working? ›

6 Signs Probiotics are Working
  1. What Do Probiotics Do For Your Body?
  2. #1 You Can Concentrate Better.
  3. #2 You're Experiencing an Elevated Mood.
  4. #3 You Feel Calmer and Less Anxious.
  5. #4 Your Digestive System Is Working More Efficiently.
  6. #5 You're Body Is Staying Healthy.
  7. #6 You're Sleeping Better.
23 Mar 2022

Can you eat right after a probiotic? ›

The goal is to get the probiotics through your stomach acid as fast as possible. To do this, it's recommended to take probiotics ideally on an empty stomach (i.e., 2-3 hours after your last meal and 30 minutes before the next meal), so the probiotics bacteria can move through the stomach as fast as possible.

Does coffee destroy gut bacteria? ›

Coffee (Caffeine) promotes an imbalance of gut bacteria, called dysbiosis, by destroying your good bacteria (probiotics). The war within your gut determines your health, as declining levels of “good” bacteria allow overgrowth of harmful bacteria (C.

What is the most probiotics you can take in a day? ›

While dosage can vary, American Family Physician recommends children take 5 to 10 billion colony-forming units (CFU) of probiotics per day, and suggests adults consume 10 to 20 billion. Additionally, some research shows there's potential value in consuming multiple strands of probiotics daily rather than just one.

What drinks have probiotics? ›

8 Best Probiotic Drinks, From Worst To Best
  • Tepache. ...
  • Kombucha. ...
  • Kefir (cultured milk) ...
  • Water Kefir (ie. ...
  • Dairy free yogurt drinks. ...
  • Apple Cider Vinegar (live, “with the mother”) ...
  • Juice From Fermented Vegetables (eg. ...
  • Kvass.
29 Mar 2021

What food has the most probiotics? ›

Here are seven foods high in probiotics:
  1. Yogurt. Yogurt is made by culturing milk with bacteria that produce lactic acid, such as Lactobacillus bulgaricus and Streptococcus thermophilus, although more strains can also be added. ...
  2. Buttermilk. ...
  3. Sourdough Bread. ...
  4. Cottage Cheese. ...
  5. Tempeh. ...
  6. Sauerkraut. ...
  7. Miso Soup.
28 Mar 2022

What happens when you first start a probiotic? ›

Because microbes used as probiotics already exist naturally in your body, probiotic foods and supplements are generally considered safe. They may trigger allergic reactions, and may also cause mild stomach upset, diarrhea, or flatulence (passing gas) and bloating for the first few days after starting to take them.

Which probiotic is best for bloating and gas? ›

Recommended probiotic strains that have been well researched for bloating include:
  • Lactobacillus acidophilus NCFM. ...
  • Bifidobacterium lactis HN019. ...
  • Bifidobacterium lactis Bi-07. ...
  • Lactobacillus plantarum LP299v. ...
  • Bifidobacterium infantis 35624. ...
  • Bacillus Coagulans. ...
  • Saccharomyces cerevisiae CNCM I-3856.

Is probiotic good for cholesterol? ›

Probiotics are a natural, safe option to add into your daily regime to maintain healthy cholesterol levels and contribute to heart health. Probiotics can influence our cholesterol levels by: Reducing the absorption of cholesterol from our food. Increasing cholesterol levels used in the body to make bile.

What is the best probiotic for high cholesterol? ›

L acidophilus and B lactis are the most commonly used probiotics. Some studies reported the use of these probiotics. For instance, Shimizu et al reported that the L acidophilus strain has greater ability to lower TC. Furthermore, in vitro studies showed that L acidophilus and B lactis can reduce cholesterol absorption.

Do probiotics affect the brain? ›

Probiotics can do more than improve your gut health. They also may indirectly enhance your brain, too. Research shows that the gut and brain are connected, a partnership called the gut-brain axis.

What Vitamin brings your blood pressure down? ›

Research shows that some supplements may help lower blood pressure. These include magnesium, potassium, vitamin D, CoQ10, garlic, and fish oil.

What is the best vitamin for blood pressure? ›

Some vitamins, such as vitamin C, and B vitamins like B2, B6, and B9, may be beneficial for lowering blood pressure. Research has shown that vitamin C supplements may have some effects in reducing blood pressure. B vitamins like folate and folic acid may also have some effect on reducing blood pressure.

What Vitamin gives high blood pressure? ›

Vitamin D deficiency may be linked to heart disease and an increased risk of high blood pressure (hypertension).

Do probiotics increase circulation? ›

Demographic and clinical variables were similar between the groups. Conclusion: Probiotics administration significantly increases postprandial intestinal blood flow in extremely low birth weight preterm neonates when compared with the placebo group.

Can vitamin D cause heart palpitations? ›

Taking too much vitamin D is not good either, as it can lead to hypercalcemia, or high calcium levels, which can also cause irregular heartbeat.

Can probiotics make acid reflux worse? ›

Taking a probiotic can cause acid reflux in some people (whether you take it with food or not). Sometimes this is a temporary effect of rebalancing your gut. Or it may not be the right probiotic for you.

How long does it take for your gut to adjust to probiotics? ›

The short answer: It takes most people 2 to 3 weeks to feel significant benefits when they start taking probiotics. That's because probiotics need time to accomplish their three key goals: increase your good bacteria count, decrease your bad bacteria count, and reduce inflammation.

Does your poop change when you take probiotics? ›

Because of this, the short answer is yes. Probiotics will make you poop, and the size and frequency of your bowel movements have much to say regarding your overall health. Their mission is to improve your gut microbiome, and this is typically done in an effort to get you more regular in your pooping.

Can probiotics make anxiety worse? ›

Then she found an article in Mental Health Daily about the side effects and adverse reactions to probiotics that people have reported. And there she found her answer. That if you take more than 20 billion CFUs (she was taking 400 billion CFUs) per day, you can get side effects. And anxiety is listed as one of them.

Can probiotics affect your liver? ›

On the other hand, probiotics can strengthen the intestinal wall, reducing its permeability, bacterial translocation, and endotoxemia according to animal and human studies. They can also reduce oxidative and inflammatory liver damage, while improving the histological state in certain situations.

What medications should not be taken with probiotics? ›

Some medications that may interact with certain probiotics include: antibiotics, antifungals (such as clotrimazole, ketoconazole, griseofulvin, nystatin).

Can probiotic cause inflammation? ›

Probiotic Lactobacillus Strains Stimulate the Inflammatory Response and Activate Human Macrophages.

What happens if you take probiotics and then stop? ›

When probiotics administration is suspended, the probiotic cells are rapidly released, resulting in dysbiosis of the gut microbiome and disruption of the intestinal metabolites and physical function.

What happens when you quit probiotics? ›

If you stop taking them, your gut bacteria are likely return to their pre-supplementation condition within one to three weeks. You may be able to get longer-lasting changes by “feeding the healthy bacteria”.

How do you know when to stop taking probiotics? ›

If the gas, bloating or any other side effects continue for more than a few weeks, stop taking the probiotic and consult a medical professional. Some people experience an increase in gas, bloating, constipation or thirst when they start taking probiotics. These side effects should go away within a few weeks.

Are probiotics safe to take with other medications? ›

Probiotics are generally safe and not known to interact with many medications -- but they are regulated as a food rather than a medication, so study has not been as stringent as it would be for a drug.

Is it safe to take probiotics with other medications? ›

Keep in mind that it's safe to take probiotics and antibiotics at the same time ( 1 ). If you take other medications or supplements, it's best to discuss potential interactions with your healthcare provider. That's because probiotics may increase their effectiveness ( 12 ).

Can some people not tolerate probiotics? ›

The inability to tolerate probiotics is a common sign of gut pathogens like parasite and bacterial infections, as well as bacterial and yeast overgrowths like SIBO and Candida.

Is it safe for anyone to take probiotics? ›

A common question about probiotics is whether it is ok to take probiotic supplements every day. Whilst there may be a few exceptions to this rule, the general answer is yes, it's safe, and usually recommended, to take them daily. It's important to understand that probiotics are a natural supplement and not a medicine.

Can you take vitamin D with probiotics? ›

In addition, probiotics might have synergistic effects with vitamin D, through improving the expression of vitamin D receptors [9]. Therefore, modulating the microbiota-gut-brain axis by probiotics plus improving vitamin D levels might provide a novel target to treat mental and metabolic disorders.

Do probiotics affect the kidneys? ›

The natural intestinal microbiota is altered in CKD patients as an increase in aerobic bacteria such as E. coli and a decrease in anaerobic bacteria such as Bifidobacterium.
...
The Effect of Probiotics on Chronic Kidney Disease.
Condition or diseaseIntervention/treatmentPhase
Chronic Kidney Disease Probiotics Renal FunctionOther: ProbioicsNot Applicable

Is it better to take probiotics in the morning or at night? ›

Research shows the best time to take a probiotic is first thing in the morning before eating breakfast or before going to sleep at night. Probiotics are most effective when taken on an empty stomach.

Can you take vitamins and probiotics at the same time? ›

At recommended doses, most people can likely take probiotics and vitamins together safely. Micronutrients are more bioavailable when consumed from whole foods, so supplementing may not be necessary for healthy people who eat a varied, nutrient-rich diet.

Can long term use of probiotics be harmful? ›

Some may wonder about possible safety concerns associated with long-term use of a supplement. The good news is probiotics are not likely to cause harm over the long term. While there haven't been any long-term studies yet, numerous studies and reviews have found probiotics to be safe for adults, children, and infants.

How long does it take probiotics to start working? ›

The short answer: It takes most people 2 to 3 weeks to feel significant benefits when they start taking probiotics. That's because probiotics need time to accomplish their three key goals: increase your good bacteria count, decrease your bad bacteria count, and reduce inflammation.

Why do I feel worse with probiotics? ›

Reason #1 People Feel Worse When Taking Probiotics-

The specific strain within your probiotic formula, is the wrong kind or you already have too much of that strain in your gut. Remember that the bacteria and the bacterial diversity found in your microbiome is highly unique to you. There is no one size fits all.

Why do I feel sick after probiotics? ›

Because microbes used as probiotics already exist naturally in your body, probiotic foods and supplements are generally considered safe. They may trigger allergic reactions, and may also cause mild stomach upset, diarrhea, or flatulence (passing gas) and bloating for the first few days after starting to take them.

Why do I react badly to probiotics? ›

Probiotic supplements can contain allergens, lactose or prebiotic fibers that may cause adverse reactions in some people. These ingredients can be avoided by reading labels.

How long should you take a probiotic? ›

Bottom Line: For most conditions, take probiotics for at least 3-4 weeks to see if they work for you. Acute diarrhea and food intolerances are exceptions to these guidelines.

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