Can You Take Prebiotics and Probiotics Together? A Comprehensive Overview
Probiotics are a vital component of your immune system, and prebiotics provides the fuel probiotics need to keep you healthy. But why do we need them, and should you take prebiotics and probiotics at the same time?
What Are Probiotics?
Probiotics are the ‘good’ bacteria that live in your digestive system. They help your body break down and digest the nutrients in your food, and assist in regulating your immune system, and reducing the development and spread of harmful bacteria. Probiotic foods and supplements contain various types of these good bacteria. They are often used to maintain a healthy balance of gut bacteria or restore probiotics after an illness or course of antibiotics.
Different strains of bacteria have different health benefits, and bacteria must have scientifically proven health benefits to be classified as probiotics.1 many foods contain live bacteria associated with health benefits, such as sauerkraut and kimchi. However, unless those bacteria are shown to have health benefits and are present in a large enough quantity to have that beneficial effect, they cannot be called a probiotic. As a result, although many probiotic bacteria are found in food, they are not in sufficient quantities to offer the same health benefit as a probiotic supplement.
Although many bacteria and foods are claimed to be probiotic, research into the gut microbiome is ongoing, and in many cases, the positive effects have yet to be conclusively proven.
Probiotic supplements contain live bacteria and have a limited shelf life due to bacteria dying over time. Because of this, probiotic supplements provide the number of bacteria they contain at the date of manufacture and the amount they will contain by their expiry date. The expiry date indicates the point at which there are no longer enough living bacteria to gain any health benefit from consuming the probiotic. Live bacteria cultures in probiotics are usually referred to on the label as colony-forming units (CFUs).
What Are Prebiotics?
There are some types of fiber that our bodies can’t digest, but they act as food for the probiotics in your digestive system. Prebiotics are types of fiber that selectively promote the growth and activity of specific types of beneficial bacteria in your gut. Taking prebiotics can help those bacteria grow and thrive, boosting your immune system.
Each prebiotic aids the growth and efficacy of some beneficial bacteria, but not all, making prebiotic selection a crucial step in getting the intended health benefit.
What Are The Health Benefits Of Taking Probiotics?
Taking probiotics has several major health benefits. Research suggests that taking probiotics can be effective for treating health issues including:
- Irritable or Inflammatory Bowel Syndrome
- Diarrhea
- Some allergic disorders
- Colds
They have these effects because they boost the number and activity of bacteria in your gut that help breaks down food compounds, releasing more of their nutrients for your body to absorb. A lack of these bacteria can lead to nutritional deficiencies, as your body will be unable to take many vital nutrients from your food without them.
The presence of probiotics can also help limit the growth of harmful bacteria that can damage the cells lining your gut. These damaged cells are less able to absorb nutrients from food and less able to prevent toxins from passing through the gut lining and into your bloodstream, causing potential illness and inflammation.
Additionally, gut bacteria play an important role in your immune system’s ability to send signals back to the brain. These signals are needed to regulate hormone and neurotransmitter production. Disruption to these signals can make your immune system slower to respond to problems such as damaged cells and toxins. As a result, these problems have more time to take root and spread before your immune system can respond effectively, leading to more widespread damage, infection, and inflammation.
Treating Health Conditions With Probiotics
Specific probiotic bacteria can help with certain health conditions.
If you have a health condition that could be treated with probiotics, consult your doctor about the right probiotics for your situation. For example, Lactobacillus rhamnosus GG and Saccharomyces boulardii can reduce the risk of diarrhea caused by taking antibiotics. E. coli Nissle 1917 may help treat ulcerative colitis, and probiotics that contain Lactobacillus, Bifidobacterium, and Saccharomyces boulardii have been observed to improve symptoms in some people with constipation, irritable bowel syndrome, and some causes of diarrhea. 2
Do Prebiotics Have Health Benefits Too?
The main benefit of taking prebiotics is the fuel they provide to promote the growth of healthy bacteria.
However, prebiotics themselves also provide some benefits to your health:
Short-Chain Fatty Acids (SCFAs)
Most SCFAs only act as food for helpful bacteria, not the harmful kinds. In fact, they actually inhibit the growth of pathogens such as viruses and bad bacteria. This is because they lower the pH levels (increase the acidity) of your gut. Acidity is harmful to bad bacteria, but it is a beneficial environment for probiotics.3
Digestive Health
Prebiotics are insoluble fibers that are not broken down as they move through your digestive system until they reach the bacteria in your lower intestine. As a result, they help to carry waste products through your digestive system, supporting healthy bowel movements and helping your body remove waste from your body more efficiently.
Weight Loss
Increasing the fiber in your diet can help you maintain a healthy weight by contributing to the feeling of being full, reducing your appetite. Foods that are high in fiber take longer to chew, causing your body to produce more saliva and gastric acid. These distend the stomach resulting in a feeling of fullness.
Does Taking Prebiotics and Probiotics Have Side Effects?
According to the Centers for Disease Control and Prevention (CDC), it is safe for most people to take prebiotics and probiotics.4 However, probiotic supplements are not regulated as drugs, which means they are not subject to strict safety evaluations. They also contain live bacteria. Cheap probiotics produced in unsafe conditions may be contaminated with bacteria other than the intended strain or may even contain entirely different bacteria to the one on the label.
There are usually only mild side effects for safely produced probiotics, and these often clear up after a week or two of adopting a new probiotic regimen. These commonly include:
- Gas
- Constipation
- Loose stool
- Bloating
- Acid reflux
- Loss of appetite
The only potentially dangerous side effect is an allergic reaction. If you are allergic to the bacteria being ingested, you could experience painful stomach cramps or break out in hives.
Additionally, suppose you are experiencing bacterial overgrowth for safely produced probiotics here, such as Small Intestinal Bacterial Overgrowth. In that case, you should consult your doctor on whether you should take prebiotics and which to take.
Prebiotic and Probiotic Foods
Although most foods containing these live bacteria or fibers do not contain enough to confer a significant health benefit, if you are trying to restore a healthy gut balance or recover from an illness, eating these foods will help maintain a healthy immune system’s function in the gut microbiome.
Foods that contain helpful live bacteria include:
- Yogurt
- Cheese
- Sauerkraut
- Kimchi
- Tempeh
- Kefir
- Miso
- Kombucha
- Pickles
- Traditional buttermilk
- Natto
Foods that contain prebiotic fibers include:
- Apples
- Artichokes
- Asparagus
- Bananas
- Barley
- Beans
- Berries
- Chicory
- Cocoa
- Dandelion greens
- Flaxseed
- Garlic
- Green vegetables
- Konjac root
- Leeks
- Oats
- Onions
- Peas
- Tomatoes
- Soybeans
- Wheat
- Yacon root
Some foods, commonly including bread, cereal, yogurt, and baby food, have prebiotics added to them artificially during the manufacturing process. These may not be labeled as prebiotic, but you can spot them by looking for common prebiotic additives. Look for foods that are labeled as being fortified with:
- Galactooligosaccharides
- Fructooligosaccharides
- Oligofructose
- Chicory fiber
- Inulin
Microbiome Therapy
Taking prebiotics and probiotics at the same time is called microbiome therapy. Microbiome therapy can increase the effectiveness of taking probiotics by accelerating the growth of helpful bacteria.
Synbiotics
Supplements that contain both probiotics and prebiotics are called synbiotics. While you can take separate prebiotic and probiotic supplements, taking one synbiotic instead may be more beneficial.5
There are many different types of fiber that act as prebiotics, and they are not all as easy to break down for every type of probiotic. When you buy a synbiotic, the prebiotic it contains has been selected according to the included probiotic. Additionally, taking separate prebiotic and probiotic supplements might make the negative side effects more likely. Taking the supplements incorrectly could cause over-fermentation in your gut resulting in gas or stomach cramps.
Synbiotics can be formulated to reduce this by having more control over the rate at which the bacteria break down prebiotics. They also contain the exact proportion of prebiotic that the bacteria need to thrive.
Besides ensuring that helpful bacteria arrive in the gut with a supply of an optimal fuel source, including a prebiotic in the supplement means that more probiotic bacteria will survive the journey through your digestive tract. The highly acidic environment in your stomach can kill many bacteria cells before reaching their destination, but a prebiotic to help them repair and multiply can ensure a significant population makes it through.
Whether you take synbiotics or a separate prebiotic supplement, it is normal for prebiotics to contribute to digestive discomfort such as bloating and gas. As the probiotic bacteria multiply in your gut, they produce by-products, and with a prebiotic accelerating the process, this can cause a build-up of gas.
Taking Enzymes With Probiotics and Synbiotics
Like some beneficial bacteria, digestive enzymes help your body break down compounds in food so that their nutrients can be absorbed in the digestive tract. For example, the first digestive enzyme food encounters after we eat it is amylase, which is contained in saliva.
For a range of reasons, your body’s production of digestive enzymes can be compromised. This can be caused by:
- Pancreatic insufficiency
- Diabetes
- Weakened immune system
- Auto-immune disorders
- Excessive exercise
- Aging
- A genetic predisposition to insufficient enzyme production
- Damage to the gut lining
Some key digestive enzymes are secreted through the lining of your intestines. Damage to these cells can reduce this function, causing a lack of digestive enzymes in the affected area. As a result, gut bacteria imbalances can have the secondary effect of low enzyme production due to harmful bacteria damaging the cells lining the gut.
Because of this, taking digestive enzyme supplements along with a probiotic or synbiotic can help restore your gut and immune system to healthy working order following an illness or as part of improving your overall health. Research also suggests that some digestive enzyme supplements can help manage the symptoms of gastrointestinal problems such as Irritable Bowel Syndrome.6
Most people don't need to take digestive enzyme supplements on a long-term basis. A healthy body should be able to produce them itself.
Some people need to take digestive enzymes on a long-term basis because their bodies cannot produce certain enzymes naturally. This may be needed for people who have conditions including:
- Coeliac disease
- Pancreatitis
- Cystic fibrosis
- Pancreatic cancer
- Removed gallbladder
Unlike probiotics and synbiotics, it may be harmful to take digestive enzyme supplements over an extended period if you do not need to. This is because your system will stop producing enzymes that are already in abundance in your body. As a result, your body could stop trying to make enough of the digestive enzyme on its own, and it can take longer to return to normal enzyme production.
When Should I Take Probiotic and Prebiotic Supplements?
The best time to take your supplements depends on the type of bacteria you are dealing with, which is why supplements will usually instruct you on the right time to take them. This usually determines whether you should take them before or after meals. Some probiotic supplements recommend that you take them on an empty stomach, while others recommend taking them shortly before or after eating.
According to recent research, what you eat might matter more than whether you eat before or after taking supplements. Probiotics have to survive their journey through the digestive tract before they can colonize your gut, and some foods can help them do that.
For example, various probiotic bacteria depend on glucose to survive in an acidic environment like your stomach. Glucose is produced when your body breaks down sugar and carbs, so eating these before taking a probiotic might help more of the bacteria make it to your gut.
What Kind Of Probiotics Are Most Effective?
Probiotic supplements can be found in a wide range of forms, including:
- Capsules
- Lozenges
- Beads
- Powders
- Drops
- Tablets
Probiotics in capsules and tablets tend to survive the journey through the digestive tract more easily, as they are not immediately exposed to the acidic content of your stomach in the same way that liquids and powders are. Some probiotic bacteria, such as Lactobacillus, are more resistant to stomach acid because they originate from the human intestinal tract, making the form of probiotic delivery less important.
Conclusion
For the majority of people, taking prebiotics along with probiotics, ideally as a synbiotic, is the most effective way to support the healthy bacteria in your gut and maintain a strong immune system. Not All probiotics and prebiotics do the same things, however, and using probiotics to address deficiencies in your gut bacteria is much more effective than simply adding more of a probiotic that you already have in plentiful supply.
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References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045285/
- https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
- https://pubmed.ncbi.nlm.nih.gov/26925050/
- https://wwwnc.cdc.gov/eid/article/16/11/10-0574_article
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648921/
- https://fg.bmj.com/content/2/1/48