Are Probiotics Good for You? What to Know When Choosing a Probiotic Supplement

Everyone has probiotics––beneficial bacteria and yeasts––living in their gut. Without them, we wouldn’t have much of an immune system, not to mention good digestion and nutrient absorption. But are probiotics, as in probiotic supplements, good for you? Do probiotics work, and what kind should you take? 

In this article, we’ll discuss: 

• What are probiotics?
• Not all probiotics are the same
• Knowing your microbiome
• Who should (and shouldn’t) take probiotics
• How often should you take probiotics
• Probiotic alternatives
• Why prebiotics are more sustainable than probiotics
• Postbiotics.

What Are Probiotics?

Probiotics are strains of beneficial bacteria that reside in our gut and confer health benefits to us by protecting the gut environment and creating metabolites like short-chain fatty acids, vitamins, neurotransmitters, and acids that control the pH level in the gut [1, 2, 3]. Ideally, we carry a diverse range of probiotic bacteria in our microbiome that produce these different key metabolites as well as protect us from an imbalance of pathogenic bacteria.

We also naturally find probiotics in foods like yogurt, kefir, kimchi, sauerkraut, kombucha, and other fermented foods across many cultures and regions of the world. 

Lastly, we can get probiotics from supplements in different combinations and strengths, indicated by colony forming units or CFUs. Some packaged foods and beverages now have probiotics added to them, too. 

Not All Probiotics Are the Same

Here’s the thing: we have a diverse range of probiotics in our gut, mostly in the large intestine, because we need them for different reasons. Some probiotics support gut motility and healthy bowel movements. Some probiotics support an appropriate immune response and a healthy inflammatory response. Some support balanced blood sugar or healthy blood pressure. And that’s just the tip of the iceberg. 

You should always pay attention to what probiotic strains you’re taking because of their different effects. It’s a red flag when a probiotic supplement doesn’t list the strains and CFU counts included per serving. 

Fortunately, this also means that we can look for certain probiotic strains based on what health outcome we are trying to achieve. For example, research shows that supplementing Bifidobacterium lactis may support faster intestinal transit time [4]. Another study found that a combination of B. lactis, B. longum, and L. casei had the greatest efficacy in treating pediatric atopic dermatitis [5]. 

We can even trace different neurotransmitters to their probiotic producers. Members of the Bacillus family produce norepinephrine and dopamine, Bifidobacteria produce GABA, Enterococcus and Streptococcus produce serotonin, just to name a few [6]. This is great news for those who want to try probiotics to address different mental health conditions like anxiety and depression, since research has connected deficiencies in different neurotransmitters to these outcomes [7, 8]. 

By doing just a little research, you can figure out which probiotics will benefit you and your health goals.

Knowing Your Microbiome

Along with clinical evaluation, you can dig into the composition of your microbiome in more detail through testing like 16s rRNA or shotgun metagenomic sequencing [9, 10]. Unlike stool testing, which is very popular but only looks for a few species of bacteria, these gene sequencing tests can look at the broader ecosystem of the microbiome, and a trained practitioner can identify any abnormalities or imbalances. This lets you know exactly what imbalances need to be worked on.

From there, you can identify which probiotic strains will work best for you. It might be more work upfront, but it eliminates the guessing game of trying one probiotic after another and potentially not seeing any results from your efforts. 

Who Should (and Shouldn’t) Take Probiotics?

By and large, probiotics have been proven to be very safe for most people, even babies [11, 12]. However, there may be some situations where certain individuals shouldn’t take probiotics. Again, this underlines the importance of knowing what strains you are taking and what they do, instead of blindly taking any probiotic supplement.

In cases of severe illness, such as patients in intensive care units, critically sick infants, and hospitalized immunocompromised patients, probiotic use should be carefully evaluated. Theoretically, these patients may be more susceptible to immune dysfunction, infections, or extreme imbalances in the microbiome that could be initiated or worsened with probiotic use [13, 14]. But again, this is not to cause panic. Probiotics have been shown to be safe, effective, and helpful for most people. 

To evaluate whether probiotics are a good fit for you, we always recommend working with a trusted healthcare professional who can help you find a type of probiotics that matches your needs. 

How Often Should You Take Probiotics?

Not to sound like a broken record, but how often you should take probiotics depends on the individual. Some people feel the best when they take probiotics every day, but others may be able to take them every other day or even every few days and maintain their benefits. 

This may also depend on your diet, how many prebiotic foods you consume, and other probiotic foods in your diet as well. 

The good news is that we don’t have to treat probiotics like we would treat medication. Where medication should always be taken as directed, typically following a set schedule, you can adjust your probiotic use to find what works best for you. Maybe you find that taking your probiotics at night is more effective than taking them in the morning. Maybe you find that a half dose is just as effective as a full dose. And if you miss a dose of probiotics, that’s okay too. 

Once you find your most effective probiotic, you have control over when and how you take probiotics. 

Probiotic Alternatives

If you’re not interested in probiotics but you’re still looking for microbiome support, there are other options available to consider. Let’s take a look at a couple of these. 

Why Prebiotics Are More Sustainable Than Probiotics

Over the long term, adding prebiotic foods to your diet can make a huge difference to your gut microbiome, maybe more so than taking probiotics. This is because, for most people, probiotics are only effective while you’re taking them. The change they effect in the gut microbiome only lasts for a week to ten days after you stop taking them. Then, the microbiome will likely revert to the same condition as before taking the probiotics. 

Eating prebiotic foods, however, is like adding fresh compost to the garden of your microbiome––they allow certain bacteria to flourish and maintain the levels of those bacteria over time. 

If you want to target butyrate-producing bacteria in your gut, for example, you would focus on consuming prebiotics called resistant starches, including cooled potatoes, oats, and legumes. 

Increasing prebiotics can be a delicate process–-too much too quickly can cause digestive symptoms like bloating and slow transit to worsen, especially in those with SIBO or those with sensitive digestive systems. Sometimes these issues need to be worked on before prebiotics are a good idea. 

But then prebiotics can be increased over time, until digestive health reaches a balanced state. 

Postbiotics

Postbiotics are still a new frontier in gut health, but more and more research is showing that they can be highly effective in supporting a healthy inflammatory response, modulating the immune system, supporting the gut lining, and more [15, 16].*

The type of postbiotics with the most research on its therapeutic potential are the short-chain fatty acids (SCFAs), including butyrate. Butyrate is remarkable in its potential for healing––from supporting the tight junctions in the intestinal epithelial layer, to promoting cognition and memory, to supporting healthy metabolism and energy levels [17, 18, 19].*

You can increase your microbiome’s production of butyrate over time by consuming resistant starches along with endogenous sources of butyrate, like butter and other dairy products. But for acute gastrointestinal issues, taking a high-quality supplement like BodyBio Butyrate may be helpful.*

Our butyrate is made without any fillers or additives, just premium quality butyric acid joined with an alkali to get the buffered compound butyrate in its most absorbable form. 

Read more about butyrate and its role in the gut.

Probiotics Are One Piece of the Microbiome Puzzle

Probiotics can be everything they are cracked up to be–-when they are used in a targeted way that matches specific strains to their best uses. It’s not necessarily a good idea to randomly take any probiotic, especially a cheap formula that over-promises and under-delivers. 

Probiotics are also not completely without risk, even though they have been shown to be largely safe in humans. The microbiome is a delicate ecosystem with many microbial players, and it's worth taking the time to understand how we can best support it in the context of our overall health. This can be accomplished by working with a provider who understands your desired health outcome and can evaluate testing that shows how your specific microbiome is made up. 

Finally, probiotics can be a valuable tool in your health toolbox, but prebiotics and postbiotics like butyrate can be helpful too. It’s up to you to choose what makes the most sense for you in your health situation.