When Should You Really Take Probiotics?

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Supplements. Photo: Milenko Savovic/Getty Images/iStockphoto

Most of us have heard that we should take some sort of probiotic when we’re on antibiotics — particularly to prevent the inevitable yeast infections accompanying the five-day Z-pack you take for a sinus infection. But while the term “probiotic” might be familiar — it basically means the opposite of antibiotic, right? — there’s still plenty of confusion about how they work and when to take them. The Cut spoke with two experts to get the lowdown on these supplements. Next time you’re on antibiotics — or having an IBS flare up — you’ll know where to turn.

What are probiotics? Weirdly, there’s no formal medical definition for probiotics in the U.S., according to Dr. Sarah Yi, a scientist with the Centers for Disease Control. Instead, Dr. Yi told the Cut, scientists consider a probiotic to be “a live microorganism that, when administered in appropriate amounts, confers a health benefit on the host.” Nutritionist Nikki Ostrower of NAO Nutrition has the layman’s definition: Basically, probiotics are beneficial strains of bacteria.

How do they work? We all have microorganisms living on us, inside us, and in our gut. Collectively, they’re called a microbiome. But when we take antibiotics, certain bacteria or organisms in our microbiome end up dying, and sometimes those include the ones with health benefits. That’s where probiotics come in.

Probiotics — which include a bunch of different strains, from bacteria to yeast — help create a level of homeostasis in the body, specifically in the gut. So, if your antibiotics take a scorched-earth approach to killing all of your gut bacteria, these supplements will help replenish the good stuff. On top of that, vaginal microorganisms also need to be well balanced, and taking antibiotics can cause a buildup of yeast in the vaginal tract. That’s why taking probiotics can also help fight off yeast infections.

When should you take them? The nutritionist and the scientist disagree on this front. Ostrower says you should take them all the time: “You always want to make sure you’re getting probiotics into your system because it really helps to keep the small intestine and the colon in a state of homeostasis.” But Dr. Yi says that while it’s important to keep your microbiome healthy when you’re on antibiotics, scientists don’t know yet if taking probiotics will definitely do the trick. She noted that studies believe probiotics may be able to help treat or prevent antibiotic-associated diarrhea. Given these varying expert opinions, we’d suggest only taking them when you are on antibiotics or dealing with digestive health issues.

What else do they do that I should know about? In addition to helping out your gut, probiotics are believed to boost your immune system and help with digestion. Furthermore, Ostrower points out, they can also help prevent pathogens from getting into your system and help with vitamin production and reducing cholesterol.

So, which ones should I buy? Some fermented foods — like sauerkraut, apple-cider vinegar, and kombucha — contain probiotics. But you can also get them in supplemental form. Dr. Yi suggests buying them from a reputable brand. Ostrower, meanwhile, went a step further and suggested some of her favorite brands: GutPro, Garden of Life Primal Defense, Udo’s Choice, and Biokult.

Who shouldn’t take them? As with many other herbal supplements, probiotics generally aren’t recommended for pregnant women. The American Pregnancy Association noted that they’re usually safe, but given the variety of probiotics and lack of research, pregnant women should steer clear of them as a precaution.

This post has been updated.

When Should You Really Take Probiotics?