Probiotics – do you really need them?

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Humans have approximately 10 times more bacteria than human cells! Bacteria can be bad and also good with the World Health Organisation describing good bacteria (probiotics) as “living microorganisms which when administered in adequate amounts confer a health benefit on the host”. Good bacteria lives in stomachs and intestines and can be added to some natural yogurts, supplements (capsules, tablets, sachets which are sold in health food stores), and they can also be found naturally in fermented foods.

Antibiotics, alcohol, smoking, stress, and a mono-diet (limited variety of food) can reduce the quality and number of good bacteria in the digestive system. Probiotics have also been suggested to help achieve a healthy weight – slim people have different bacteria than obese people, but this may be due to a high bad fat and low fibre diet limiting the variety of bacteria.

Do you really need probiotics?

Probiotics help to stimulate the immune system to fight infections and digest fibre to help keep the digestive system healthy. Here’s some situations when including them in your diet might be helpful:

  • Antibiotics – antibiotics should be taken as suggested by the GP for the duration specified. They are great at killing bad bacteria, but they’re non-selective which means they kill the good bacteria too. Immediately following completion of a course of antibiotics it is suggested to take probiotics to put back some of the bacteria which has been lost. Some people may develop diarrhoea as a result of antibiotics and probiotics can help to reduce this. NHS guidelines suggest taking probiotics for at least one week following the completion of antibiotics, realistically Nutritionists would suggest at least two weeks. The supplements often come in packs of 30 so it would be quite normal to take them for a month.
  • Travellers tummy – if you’re travelling to a country where there is a risk of food poisoning it’s advised to take probiotics with you in case you may have an episode of diarrhoea. Choose one brand which contains at least these three strains; Lactobacillus acidophilus, Bifidobacterium bifidum, and Saccharomyces boulardii.
  • Constipation – Bifidobacterium lactis may be helpful to increase the frequency of bowel movements if bowel motions are not at least daily.
  • Irritable Bowel Syndrome (IBS) – if you have IBS symptoms check with your GP first for their diagnosis. Usually they will suggest a series of simple tests to rule out anything more sinister. A common IBS symptom is bloating. A probiotic with as many strains as possible my help to reduce bloating. Pick one which has a lower level of Fructo-oligo-saccharides (FOS) as sometimes FOS can be a bit too stimulating and lead to more bloating. Try a probiotic for two weeks to see if bloating symptoms improve.

How should probiotics be taken?

Take the probiotic as prescribed on the label. It is generally one per day, and most say with food. Most Nutritionists would suggest taking them away from food as stomach acidity may reduce the effectiveness of some strains. Once opened keep the bottle in the fridge to prolong the probiotic life.

Food sources

Supplement capsules/tablets/sachets are a quick way to increase the good bacteria in the digestive system, particularly following antibiotics or food poisoning. There are some probiotic drinks which are available from the supermarket which reduce the feeling of boating for some people however they are often expensive, high in sugar, and don’t contain the quantity and breadth of strains available from supplements. If you’d like to take probiotics for medium to longer term the best source would be food. Here’s a list of some good bacteria food sources;

  • Yogurt – choose a natural yogurt which has “live cultures” on the label. People who are lactose intolerant may also be able to tolerate this type of yogurt as the lactose has been turned into lactic acid
  • Kefir – fermented food kefir is added to cows or goats milk. It can taste a little more sour than yogurt but it contains more strains of good bacteria than yogurt so adding just a spoonful to natural yogurt will boost the probiotics in your natural yogurt and taste indifferent
  • Sauerkraut – shredded cabbage which has been fermented by lactic acid. Added in small amounts as a side to meals. This is not a suggested food if you have under active thyroid as uncooked cabbage can reduce thyroid function
  • Tempeh – a fermented soybean product which has a nutty/earthy flavour. Soybeans themselves are not suggested if you have an underactive thyroid or have low iron as they contain phytates, but if the soybean is fermented the phytic acid is reduced, and can also produce some vitamin B12 which is not usually found in plant products so there’s added benefit
  • Kimchi – cabbage is the usual ingredient which is flavoured with red chilli, garlic, ginger, and contains Lactobacillus kimchi
  • Miso – is a fermented soybean paste which is commonly added to soup. The flavour is slightly salty. It’s a good source of protein and fibre
  • Kombucha – is a fermented black or green tea drink
  • Pickles/gherkins – these are cucumbers which have been pickled in salty water to allow them to ferment. Pickles in vinegar are not the same though as they don’t contain the live bacteria

What are prebiotics?

Prebiotics help to feed the probiotics helping them to grow, and usually they are included in supplements. They are often labelled as Fructo-oligo-saccharides (FOS) which is a type of non-digestible carbohydrate and they are found in; onions, artichoke, garlic, leeks, asparagus, banana, and chicory. You can add some of these to a health smoothie recipe – here’s one of our favourite ones with banana.

Which probiotic is the right one?

Probiotic strains work in different ways so not all probiotics will help with all symptoms. Perhaps try a different strain or ask a Pharmacist / Dietitian / Nutritionist for their recommendation specific to your health.

Probiotics can vary in price depending on how many bacteria strains are included. Pick one which has the greatest number of strains within your budget. The most basic will include Lactobacillus acidophilus and Bifidobacterium bifidum.

Probiotics are not known to interact with medications and are considered safe to use for all age groups.

If you’d like to find out more about probiotics here’s a link to some information from the NHS.

A reminder:

  • The information in this article is for educational purposes and should not replace medical advice.
  • The information is not intended to diagnose or treat any medical condition.
  • If you have a diagnosed medical condition, you should consult a doctor before making any major changes to your diet, and;
  • Some supplements may interact with medications and you should check with your GP before commencing any supplement programme.
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