Probiotics seem to be everywhere — from foods to supplements to skin care and seltzer water. Thinking of getting on the bad wagon? Then you may be wondering the best time to take probiotics.
The health-boosting microorganisms are marketed for everything from promoting gut health to balancing pH and helping with a number of other conditions. The most common ways to take probiotics are via supplements or by eating fermented foods.
What are the benefits of probiotics, and should you be taking a supplement? Experts discuss what we know about probiotics, how they work in the body, and what to consider before trying them out.
What are probiotics?
Probiotics are live bacteria and yeast that are beneficial for the body. They supplement the microbiome, or create more diversity and improve the health of the bugs that live in the gut, Dr. Rabia De Latour, gastroenterologist at NYU Langone Health, tells TODAY.com.
Probiotics are involved in immune health, digestion and other bodily functions. Along with many other species of bacteria and germs, they live in the digestive tract, mouth, nose, lungs, urinary tract, genitals and on the skin, per the Cleveland Clinic.
Some microorganisms in the body can cause disease, but others can help fight or control the bad ones, Julia Zumpano, a registered dietitian with the Cleveland Clinic Digestive Disease Institute, tells TODAY.com.
"You need a proper balance of good versus bad bacteria to promote health," Zumpano explains. Probiotics help maintain this balance by increasing the good bacteria in the gut.
Not all probiotics are equal — there are different strains which function differently in the body, says Zumpano. The most commonly recommended and well-studied species of probiotics, per the Cleveland Clinic, include:
- Lactobacillus (L. acidophilus, L. rhamnosus, L. casei and L. plantarum), which live in the gut and female genital system
- Bifidobacterium (B. longum and B. breve), which live in the gastrointestinal tract
What about prebiotics? Although the names are similar, they are different. Prebiotics are a type of non-digestible fiber, which are food for the probiotics in the gut, says De Latour. These are found fruits, vegetables, whole grains and other plant-based foods.
Probiotics benefits
In addition to helping the body maintain a healthy community of microorganisms, probiotics may also:
- Aid digestion
- Improve absorption of nutrients
- Boost immunity
- Strengthen the mucosal barrier in the gut
“There has been a huge focus on the immune-supporting aspect of probiotics since 70-80% of immune cells are in the gut,” registered dietitian nutritionist Frances Largeman-Roth tells TODAY.com.
Probiotics may also help the body recover from bacterial or yeast infections, including diarrhea, vaginal and urinary tract infections, and gum disease, per the Cleveland Clinic.
In the body, probiotics release important byproducts such as short chain fatty acids, "which can have long-term benefits on immunity, inflammation and lowering cholesterol,” says Zumpano.
Research has shown that probiotics may help with certain health conditions. These include inflammatory bowel diseases such as ulcerative colitis, allergies, eczema and acne, according to the Cleveland Clinic. However, the results among people taking probiotics to treat or prevent these conditions vary.
The benefits of probiotics is still an active area of research, and how they work in the body is not yet fully understood, the experts note.
Probiotic sources
Probiotics are found naturally in foods and sold over-the-counter as dietary supplements, either in pill or powder form, as well as some topical products.
The following fermented foods and drinks are sources of probiotics, according to the experts:
- Yogurt and kefir
- Kombucha
- Sauerkraut
- Kimchi
- Tempeh and tofu
- Miso and natto
- Some cheeses (cheddar, gruyere, gouda)
Probiotics may also be added to food products and drinks, says Largeman-Roth. Supplement forms include oral probiotics, which are ingested into the digestive tract, and probiotic creams, which can be applied to the skin or mucosal surfaces in the body, according to Cleveland Clinic.
There is no recommended daily intake for probiotics or set dosage because there are many different strains, the experts note.
Who should take probiotic supplements?
Most healthy adults can get enough probiotics to add to the existing supply of healthy bacteria in the body by eating a balanced diet containing fermented foods, the experts say. However, the strains and dosage of probiotics in supplements may be helpful in certain cases.
Some people can have an imbalance or deficit of healthy microbes in their body, which can become dangerous, says De Latour.
This may occur if a person does not eat a balanced diet with enough probiotic-containing foods, says Largeman-Roth, but it's also caused by certain health conditions, lifestyle factors and medications.
The most common is antibiotics, which can kill the bad bacteria causing an infection but also some good bacteria, says De Latour. When there aren't enough good bacteria to keep the gut balanced, the bad bacteria can flourish and cause diarrhea and other issues.
A severe microbiome imbalance can lead to life-threatening infections such as Clostridium difficile, says De Latour. People with this imbalance, also called dysbiosis, may benefit from probiotic supplements, per the Cleveland Clinic.
However, different probiotics are used to help with different conditions, says Zumpano. Additionally, supplements may contain specific strains or multiple combined.
Always talk to your doctor before starting probiotics to determine which type and dosage is right for you, the experts emphasize.
When should you not take probiotics?
There's no time of day when it's not recommended to take probiotics, but there are some situations in which it can be risky to take them.
The main concern is when probiotics introduce harmful microbes along with the good ones, the experts note, which could cause serious infections in some people.
For example, the risk of harmful effects is greater among people with weakened immune systems, including individuals with severe illnesses, chemotherapy patients and premature infants, per the NCCIH. Cases of severe and fatal infections have been reported in preterm infants given probiotics, TODAY.com previously reported.
In rare cases, some people may have an allergic reaction to probiotics, says Zumpano.
That said, probiotic supplements are generally considered safe for healthy individuals, says Zumpano.
But keep in mind that there is little in-depth research on the safety of probiotics, so there’s a lack of evidence about risks and side effects, according to the National Center for Complementary and Integrative Health. Also know that probiotic dietary supplements are not regulated by the U.S. Food and Drug Administration, says De Latour. This means the ingredients, dosages and claims on the label aren’t FDA-approved before the probiotic goes to shelves.
When is the best time to take probiotics?
Probiotics, like many other supplements, can be taken at any time of day, says Largeman-Roth. So, the best time to take probiotics is the time you’ll remember to take them and stick to it.
Most research on the probiotics does not compare timing, the experts note.
"I don't think it matters, but I also don't know of any studies on whether you eat a fermented food (or take a supplement) in the morning versus at night," says De Latour. The microbiome also changes constantly, she adds, and "it's a moving target."
No matter when or how you take a probiotic, make sure to be consistent, says Largeman-Roth.
“Most probiotics must be taken daily for them to provide a benefit, though some recommend taking for 5 days in a row, then taking 2 days off,” Largeman-Roth adds.
The same goes for food. “You should be able to get enough probiotics through your diet, but you do have to eat them consistently, so try to have a bit daily," says Zumpano.
Is it better to take probiotics on an empty or full stomach?
“Most supplements can be taken with or without food, but some specify that they should be taken with a meal,” says Largeman-Roth.
Many probiotic manufacturers recommend taking supplements on an empty stomach and many do not, the experts note. This may also vary depending on the strains included, says Zumpano.
In any case, make sure to read the dosage instructions on the label and talk to your health care provider if you have questions.
Additionally, follow the storage instructions on the label because some probiotic products require refrigeration, the experts note. Certain strains require specific conditions to survive, and if supplements are not stored properly, the probiotics may not even be alive by the time the pill hits your mouth, says De Latour.