Do you have questions about probiotics? We got in touch with James B. LaValle, RPh, CCN, for answers!

Frequently Asked Questions on Probiotics

• Types of Probiotics and Your Needs

  • How do you know if you need to take probiotics?

    • For Digestive and Immune Issues

      Other than people with SIBO (small intestine bacterial overgrowth), anyone with digestive issues such as gas, bloating, indigestion, constipation, or loose stools or immune issues such as allergies or being prone to colds will benefit from probiotics.

    • After Taking Antibiotics

      Anyone who has taken antibiotics for an illness or surgery or acne in the past should take a probiotic to restore beneficial flora to adequate levels.

    • When Taking Certain Medicines

      People on acid-blocking medications or nonsteroidal anti-inflammatory drugs (NSAIDS) should also consider probiotics.

  • Which strains work well for specific symptoms/conditions?

    The science of probiotics for condition-specific uses is still evolving. For example, L. rhamnosus has a couple of studies showing it might help weight loss, especially in women.

    I recommend “the friendly trio,” which are three of the most stable, well-documented, clinically studied species:

    • Lactobacillus gasseri KS-13
    • Bifidobacterium longum MM-2
    • Bifidobacterium G9-1

    These have been reported to:

    • improve digestion
    • reduce cold and allergy symptoms
    • restore a healthy microbiome in aging adults

• Proper Dosages for Probiotics

  • What are the recommended levels of colony forming units (CFUs)?

    You want counts in the billions.

    • Some conditions like antibiotic-induced diarrhea will resolve more quickly with higher CFUs.
    • For issues like colitis or autoimmune disorders, healthcare providers may recommend higher CFUs initially but then back down to lower doses as maintenance.

    It is not just about CFU count. Verifying that a brand tests to guarantee that the bacteria remain viable through the shelf life and CFU counts are accurate to the date of expiration is an important part of picking a probiotic.

  • If you eat fermented food, do you need to take probiotics?

    Depending on the products, you often do still need to take a probiotic supplement, mostly because the bacteria starters used to make those food products can be limited in bacteria types.

    Kefir tests out pretty well for the amount of beneficial bacteria it contains, but you have to tolerate milk.

  • How do you know if you should take probiotics daily or weekly?

    Take probiotics daily until symptoms improve. After that, cut down to a couple of times a week.

    If you are on medications that disrupt the microbiome, try taking a probiotic at least five days per week.

• For Those with Medical and Health Concerns

  • If you’re taking antibiotics, when and how do you take probiotics to restore healthy flora?

    Take a probiotic at least two hours away from antibiotic dosing, typically twice a day.

  • Can people of any age take probiotics?

    Probiotics are safe and effective for every stage of life.

    I often recommend probiotics for children due to their role in supporting the immune system, in addition to helping to address skin issues, and easing digestive woes associated with antibiotic usage.

A fermented dairy product, kefir is rich in antioxidants as well as lactobacilli and bifidus bacteria. The word "kefir" comes from the Turkish word keif, which means "feeling good." While many Americans pronounce the word as "KEE-fer," the correct way to pronounce it is "kuh-FEAR."

Kefir outperforms yogurt in both CFU (colony forming units) and the number of strains of probiotics it offers. Each cup of kefir may contain up to 12 different strains of live, active cultures. These strains of good bacteria can help cure recurring Clostridium difficile infections (the diarrhea-causing bacteria that plagues hospital patients), reduce the duration of respiratory infections in the elderly, protect the body from toxins, relieve cold and flu symptoms in children, and fight yeast infections.

This tangy, thick beverage also contains active yeast and bacteria to aid digestion, encourage gut health, and help keep weight int check. Probiotics are recommended for anyone taking antibiotics, which destroy beneficial as well as harmful bacteria.

According to Andrew Weil, MD, kefir may be a better choice than yogurt for some lactose-intolerant individuals.

Cleopatra knew it. Confucius too. Caesar no doubt hailed it.

We have been eating fermented foods for some 5,000 years or so.

Why? Because they taste good and, as our ancestors knew, they’re good for us.

Beer, wine, coffee, yogurt, soy sauce, sourdough breads, and countless pickled vegetables, all rely on fermentation to give them that little extra zing, that pungency that tickles your taste buds. But perhaps best of all, fermented foods pack a powerful punch that helps promote and maintain good health.

There are so many things you can ferment (sometimes called “pickling”), you’re certain to find foods you and your family will enjoy.

10 Health Benefits of Fermented Foods

• Better Digestion

  Fermented foods are partially digested foods. That means the fermentation has done some of the heavy lifting for your digestive system and digesting these foods is easier. The fermentation in yogurts and kefir, for example, help lactose-intolerant people digest dairy foods.

• Nutrient Absorption

  Try a dill pickle or sauerkraut. These two fermented veggies (cukes and cabbage) are made with lactic acid bacteria. Eating these enzyme-rich foods helps the body absorb nutrients more easily while keeping naturally occurring plant toxins at bay.

• Boost the Immune System

  Because fermented foods are bacteria-based, they support the beneficial bacteria already in our digestive tract. These good bugs strengthen the immune system and help us ward off disease and illness.

• Increased Vitamin Content

  Fermented dairy products, such as kefir or yogurt, release more of the vitamins in foods that our bodies rely on to stay healthy, such as folic acid, B vitamins, riboflavin, and biotin.

• Longer Shelf Life

  Leave a cucumber or quart of milk in your refrigerator and it will go bad in a week to 10 days. Fermented foods, however, last much longer. Refrigerated pickles, salsa, and sauerkraut, for example, will keep for months.

• Save Money

  Whether you can or pickle it yourself (a great hobby most anyone can do, especially with the kids on a summer day, rain or shine), fermented vegetables can lower food costs and stretch your budget while keeping healthy veggies on the plate—in season or out.

• Tastes Great

  It may seem counterintuitive given our propensity for sweet, but that pungent pop you get from fermented foods tastes great.

• Relieves Constipation

  The bacteria in fermented foods stimulates peristalsis (fecal elimination) and thus wards off constipation.

• Improve Neonatal Health

  When a mother has a healthy amount of good bacteria in her own system, those benefits transfer to her fetus and can help prevent neonatal infections.

• Weight Loss

  Some fermented foods, such as sauerkraut, are high in choline, which can help lower blood pressure and metabolize fats more quickly.

Add Fermented Foods to Your Diet

• Use miso to season soups.
• Drink kefir a few times a week.
• Use fermented chutneys as a relish.
• Drink kombucha tea.
• Eat kimchi.

What Is Kombucha Tea?

One of the latest biocultures to join the SCOBY category (a symbiotic colony of bacteria and yeast), kombucha is a fermented tea (less than 0.5% alcohol) whose earliest entry into the lexicon is 1995 but some references to the drink itself date as far back as China’s Qin Dynasty (221-206 BC).

Lab studies published by the U.S. National Institutes of Health (NIH) indicate that the antioxidants present in kombucha may help with healing gastric ulcers.

Other studies conducted in Tunisia and at the University of Washington conclude that kombucha may also help with controlling hypoglycemia in diabetics. The research also showed that kombucha delayed absorption of LDL (lousy) cholesterol while increasing HDL (healthy) cholesterol significantly.

What is Kimchi?

Kimchi is a spicy pickled sauerkraut popular in Asia. It's one of the best food sources of probiotics, which are healthy microflora that supports overall health.

Kimchi is also a great source of beta carotene, calcium, iron, and vitamins.

Read More About Fermentation

Learn more about the benefits of eating fermented foods in The Art of Fermentation by Sandor Katz.