Are you supposed to take probiotics on an empty stomach

Take probiotics with Food

Rather than sunrise or sunset, it’s more important to take probiotics with food, not on an empty stomach.

The reason is the pH balance. Stomach acidity is described in terms of pH—the lower the pH, the higher the acidity, whereas higher pH is more neutral.

On an empty stomach, the low pH (more acidic) is too harsh for bacterial survival.

During a fasting state, the stomach is more acidic with a pH around 2. After a meal, the pH of the stomach contents rises to a more basic value of around 7, which is less acidic. That means there is less chance of the probiotics dying.

In a study found in Beneficial Microbes, researchers found that probiotics taken within 30 minutes of a meal, or with the meal, survived in much higher numbers than if taken 30 minutes after a meal. In fact, they found probiotics taken with food containing healthful fats had the greatest survival.

To make more sense of this, here is an explanation.

After working their way out of the stomach, the bacteria also have to survive the fluctuating pH of the small intestine.

After leaving the stomach, bacteria with food are subjected to a lower pH, similar to the contents of the stomach.

Slightly lower down in the upper small intestine, the contents (food and probiotics) are subjected to bile and pancreatic juices that increase the pH making the environment more alkaline and more favorable for survival.

The small intestine is the crucial site of nutrient digestion and absorption.

After leaving the stomach, food and bacteria move through this area fairly quickly, and so there are no huge colonies of flora (bacteria) in the small intestine. However, it is in the small intestine where we want a healthy recolonizing of healthful bacteria, including lactobacillus and bifidobacterium species.

The large intestine is where we see the greatest number of bacterial colonies. Where the small intestine meets the large intestine is the location where we absorb fat-soluble vitamins, and recycle digestive enzymes.

The goal of probiotic therapy

The goal of taking a probitoic is not only to properly populate the small intestine, but to repopulate the junction of the small and large intestine with healthful bacteria.

Taking a probiotic with an evening meal can also make the side effects (gas, bloating) more tolerable because you are asleep. As the bacteria make their way through the digestive tract assisting in the digestion of your food, often times hydrogen and methane gases are produced, creating bloating and stomach pain.

When you are asleep, you hopefully won’t feel those symptoms.

When making a decision to take probiotics, I suggest evaluating and understanding your gut health to determine what type of probiotic to take.

Comprehensive stool testing is the diagnostic test of choice. Based on what is found in the gut, specific probiotics are recommended to restore normal function and combat disease.

For example, Saccharomyces Boulardii is the bug of choice to help eliminate candida, parasites, and other unwanted pathogenic micro-organisms found in the gastrointestinal tract (GI) tract.

Lactobacillus acidophilus NCFM® and Bifidobacterium lactis Bi-07 are powerful anti-inflammatories.

General strains of Lactobacillus and Bifidobacterium are good to repopulate the GI tract if there is small intestinal bacterial overgrowth (SIBO).

While gut health is more complicated than just the population of bacteria that reside there, understanding when to take probiotics will help you quickly rebuild from your chronic gut problems.

References
Tompkins TA, Mainville I, Arcand Y. The impact of meals on a probiotic during transit through a model of the human upper gastrointestinal tract. Beneficial Microbes. 2011 Dec 1;2(4):295-303.

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Are you supposed to take probiotics on an empty stomach

The Best And Worst Time Of Day To Take Your Probiotics

You’ve probably heard 100 times by now how important your gut health is for your overall well-being—and that the healthy bacteria (a.k.a. probiotics) that live in your digestive system play a huge role in keeping that gut health in tip-top shape.

After all, these probiotics help us digest food, destroy microorganisms that might trigger disease, and even produce vitamins. Our bodies naturally house both good and bad bacteria, but as long as the two are in balance, our immune system stays strong, which is crucial for our general health, explains Sarina Pasricha, M.D., M.S.C.R., a Harvard-trained, double-board certified gastroenterologist with the Delaware Center for Digestive Care in Newark, Delaware. In fact, probiotics have been shown to help us fight off everyday bugs, overcome irregularity in the bathroom, and manage digestive conditions.

Given their many benefits, it’s no wonder many of us have added probiotic supplements to our daily routines. Thing is, benefiting from a supplement isn’t quite as simple as just remembering to take it at some point every day. Turns out, when we take our probiotic supplements actually has a pretty big impact on just how much they’re able to do for our digestive system.

Here’s what top gut experts—and the latest science—have to say about when (and when not!) to take your probies.

When NOT To Take Your Probiotics

Most experts and studies assert that if there’s one time of day not to pop your probiotic supplement, it’s first thing in the morning.

“Probiotics are living organisms, [so] they need food, water, and warmth to survive and multiply,” explains David Friedman, N.D., C.C.N., author of Food Sanity: How to Eat in a World of Fads and Fiction. “In the morning, conditions are not optimal for probiotics simply because there is not enough food or water for the bacterial strains to flourish.”

Another reason the early A.M. isn’t ideal probiotic-taking time: Your stomach is super-acidic. “In a fasted state, or when you have an empty stomach, your stomach is more acidic and has a pH around two,” explains Robert Zembroski, D.C., D.A.C.N.B., M.S., functional medicine specialist, clinical nutritionist, and author of REBUILD. It’s hard for probiotics to survive this harsh, acidic environment, so fewer make it through the stomach to the intestines, where they work their magic. “The biggest danger for probiotics is the powerful acids in the digestive system, which are meant to break down and disintegrate materials that travel through it,” says Friedman. “If enough acid overcomes the coating of a probiotic capsule, it could kill the delicate strains.”

When TO Take Your Probiotics

After you eat, your stomach’s pH rises to about a four, which is much less acidic and easier for probiotics to survive, so it’s best to take your probiotics alongside a meal, says Friedman. “By consuming your probiotic with food, you provide a buffering system for the supplement and ensure its safe passage through the digestive tract,” he says. “Plus, aside from protection, food also provides your probiotic with the proper nourishment it needs to survive, grow, and multiply once in your gut.”

A study published in the journal Beneficial Microbes found that probiotics taken with a meal—or even within 30 minutes of eating something—survived in much higher numbers than those taken 30 minutes after a meal. You see, about a half hour after you eat, the pH of your stomach once again becomes more acidic (and hostile towards probiotics).

The study also noted that probiotics taken with food containing healthy fats had the greatest survival rates, so the authors recommend the meal you take your probiotics with contain some fat.

Related: 6 Possible Reasons Why You’re So Gassy

If you’re new to probiotics and notice that you’re gassier than usual after taking them, pair your supplement with dinner so you sleep through any of the unpleasant side effects. This effect usually occurs when someone who has an overgrowth of bad bacteria takes a probiotic supplement that also contains prebiotics, non-digestible fibers that feed gut bacteria (which many probiotic supplements do). That bad bacteria can feed on the prebiotics and produce a whole lot of gas, explains Lauren Deville, N.M.D., author of The Holistic Gut Prescription. Don’t worry, though, if you stick to your supplement regimen, your gut bacteria should balance out in a few weeks and any gas issues should dissipate.

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Do I need to take probiotics with food?

Take your probiotics in the morning, 15-30 minutes before food. You want to take them before food so they don't get stuck in the stomach behind the food as they make their way down to your intestines where they do their best work.

What time of day should probiotics be taken?

While the time of day is ultimately up to you, this expert suggests that probiotics may be most effective if you plan to take them about 30 minutes before a meal — and most effective if you take your supplement before breakfast.