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Taking Probiotics With Antibiotics: What You Should Know

Taking Probiotics With Antibiotics: What You Should Know

Co-authored by Dr. Ilene Ruhoy, MD, PhD and Dr. Gillian Ehrlich, ARNP, DNP

Oftentimes, people turn to doctor-prescribed antibiotics for ear, throat or viral infections such as flu to kill the bad bacteria causing discomfort. However, it’s not just the bad bacteria that antibiotics come for – strong antibiotics will kill good bacteria as well which negatively impacts your immune health.

Taking probiotic supplements if you have a history of multiple courses of antibiotics can often help you keep on top of the microbiome destruction from antibiotics.

Below are some frequently asked questions when it comes to taking probiotics with antibiotics.

When Should You Take Probiotics With Antibiotics?

Taking antibiotics gradually decreases the natural friendly bacteria gut which can result in less-than-ideal digestive issues, like not fully breaking down waste. 

This can cause you to have diarrhea, indigestion, abdominal pain and cause a rapid decline in energy levels. The goal is to maintain a healthy gut microbiome, where many trillions of bacteria live peacefully with each other.

Studies have shown that taking probiotics at the same time while you’re taking antibiotics can act as a counterbalance in the gut microbiome. Probiotics increase the beneficial bacteria and lessen the side effects of taking antibiotics.

Many pharmacists are already recommending people to take it together or eat more foods that replenish the good bacteria if they have been prescribed antibiotics.

Taking probiotics won’t ruin the efficacy of your antibiotics, however you might want to make sure that your probiotics are suited to do the job.

Best Probiotic Supplements To Take After Antibiotics

The probiotics that you take with your antibiotics may vary, as each body type may react differently to a course of probiotics & antibiotics. That's why it's important to find the best probiotic to take after antibiotics for you.

However to get the most out of a probiotic supplement, the strains should be diverse, clinically validated, and alive. Otherwise, you’re not going to reap any of the benefits. 

More specifically, Lactobacillus rhamnosus can reduce inflammation (which causes common inflammatory conditions like lowering symptoms of atopic dermatitis).

If you suffer from chronic inflammatory illnesses, taking an antibiotic could exacerbate your condition as fewer good gut bacteria are present.

If you have an irritable bowel syndrome, Bifidobacterium strains have the ability to restore the microbes that are beneficial to your health. This particular probiotic will help you keep a balance of your stomach and bowels, aiding in the passing of waste and digestion.

What Are Benefits of Taking Probiotics While On Antibiotics?

Probiotics will prevent cramps in the abdominal region, break down food which hasn’t been properly digested due to the lack of good gut bacteria, and generally lessen the side effects of antibiotics.

Are There Any Potential Side Effects Of Taking Both Together?

There are some side effects to probiotics, as there are with any supplement. If you are taking a yeast-based probiotic, you may feel bowel discomfort and digestive issues.

Those who take probiotics that have amines in them may feel headaches because of it. The most common kinds of amines found in probiotic-rich foods include histamines, which can upset the neurotransmitters in your brain. These cause headaches because of the H3 receptors in the brain (not found elsewhere in the body) and the vasodilatory effect of histamine. Some (many) are particularly sensitive.

The lactobacilli strain is also linked to increases in infection. This is due to some harmful bacteria that have a tendency to cause infections.

Although it’s recommended that you take probiotics while taking antibiotics, you should seek medical advice before taking anything. Remember that not all probiotics were created equal.

Probiotic-rich foods (such as yogurt) should be eaten in moderation. Yes, they’re generally good for you, but most of these foods are processed and contain additives and sugar (so… much… sugar…) Fermented foods will have a yeast-based probiotic nature, so eating sauerkraut and drinking wine (in moderation) are good for you. Sign us up.

How Long Should You Keeping Taking Probiotics After A Course of Antibiotics?

There are over 100 trillion bacteria in our gut. And replenishing your good bacteria is all a matter of knowing how strong your antibiotic is. If you are taking a broad-spectrum antibiotic, it will battle the infection with great strength, but leave many friendly casualties as well. 

During one study, lab mice were given a cephalosporin antibiotic – which is a trio of bismuth, metronidazole and amoxicillin. The mice had very noticeable changes in their gut microbial ecosystem, and were able to recover their normal microbial diversity. The mice which were given more narrow antibiotics mostly went straight back to normal levels again. 

Antibiotics are very potent and they don’t often discriminate against which bacteria they kill. That’s why doctors are so careful not to prescribe antibiotics so freely. It takes a long time for the body to return to its normal bacteria diversity after a trial of antibiotics.

The collateral damage done by antibiotics takes the gut, approximately 18 months to recover from, and even then it's never back to 100%. Therefore it's highly recommended that you take a couple of probiotics and antibiotics together. 

Dr. Gillian Ehrlich, MD, PhD shares why overall gut health shouldn't get pushed to the wayside during a course of antibiotics, "while the acute infection that can and should be treated by an antibiotic is the short term goal, the long term goal is whole body health.

We know that an imbalanced microbiota can increase risk for later-onset of chronic disease like Alzheimer’s Disease or Parkinson’s. You don’t want your acute-necessary treatment to worsen your long term health, and probiotic supplements can play a role in rebalancing back to baseline.

You need that beneficial bacteria in your gut, especially your colon, to break down nutrients that haven't been digested in the small intestine. Probiotics supports the balance of good bacteria and can improve your digestive system and overall health.  

The bottom line is, if you are ever given antibiotics, make sure you have probiotics handy. You might also want to check out our post on taking probiotics with specific antibiotics like Doxycycline and Amoxicillin.