Can You Take Prebiotics And Probiotics Together?

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You would be forgiven for thinking that prebiotics and probiotics are the same things. Both are dietary supplements taken to improve your gut health, but they are not interchangeable.

The practice of taking both prebiotics and probiotics is known as microbiome therapy.

It is not necessary to take them together, although many people believe that you get additional benefits from the combination. 

What Are Prebiotics?

Prebiotics are made from indigestible carbohydrates, also known as dietary fibers. The aim of taking prebiotic supplements is to provide the beneficial bacteria in your gut microbiome with a food source.

Fiber is good for this purpose as it is a long chain of carbohydrate sugars. This means that it takes a long time to break down and get the energy from the sugar. 

Prebiotics also help to promote the growth of anaerobic bacteria. These are vital for gut health, meaning these supplements are very beneficial to consume.

A common prebiotic used is inulin, which is found in more than 36,000 plants. This is a fiber found in asparagus, bananas, and chicory root. Inulin is a great food source for the bacteria in your gut.

Oligosaccharides, fructooligosaccharides, galactooligosaccharides, and resistant starch are other commonly used prebiotics. Other good sources of prebiotics are legumes, garlic, artichokes, leafy vegetables, whole grains, and onions. 

Prebiotics on their own are not known to have a particularly significant effect on your health and overall wellness. Recent studies have experimented with incorporating prebiotics into infant baby formula.

The idea behind this was to make the formula milk more nutritionally similar to breastmilk.

What Are Probiotics?

Probiotics are the healthy bacteria found in your gut naturally. The purpose of these bacteria is to help break down food in your intestines, making digestion easier.

They are also required to support a multitude of functions within the body such as the absorption of nutrients, memory, mood, and immune function. 

There are 2 main types of probiotic bacteria used for good gut health – Lactobacillus and Bifidobacterium. Both of these bacteria are closely associated with probiotic formulations. 

You will often see a high probiotic content in fermented foods such as kimchi, sauerkraut, kombucha, and some types of yogurt. Pickles are also a natural source of probiotics. 

You will often need to store your probiotics in the refrigerator. The cool temperature helps to keep the bacteria alive and ready to reproduce.

Different strains of probiotics work in different ways in the body. There is growing scientific evidence to suggest that the strains work together in teams.

Experts believe it is important to take the right combination to maintain a balanced biodiversity in the gut microbiome. 

There are 2 main types of probiotics in the gut – anaerobic and aerobic bacteria. Anaerobic bacteria can only survive in the absence of oxygen.

This means that these bacteria cannot be made into supplements as they would die off in the process of manufacturing. 

What Are The Health Benefits Of Prebiotics?

As we have mentioned, prebiotics help to provide a food source for the beneficial bacteria in your gut and support their growth. This can help to improve the health of your overall digestive system and promote healthy, regular bowel movements. 

Prebiotics can help boost the production of SCFAs (short-chain fatty acids). These acids prevent harmful microorganisms from growing.

These bacteria are vital for the optimal functioning of your immune system, helping to keep you healthy overall.

Prebiotics are made of a type of insoluble fiber. This supports optimal digestive health and keeps food moving smoothly through the intestine. This allows waste to be expelled from your body easily.

Fiber has also been closely linked to weight loss. The ingestion of fiber makes you feel more full and reduces your appetite. Fiber also takes much longer to be mechanically digested (chewed).

This raises the production of saliva and gastric acid. These can cause you to become bloated and feel full.

What Are The Health Benefits Of Probiotics?

There are a number of health benefits to probiotics too. They are used to balance the bacteria in your gut microbiome and maintain diversity.

These bacteria are vital for the absorption of nutrients, healthy bowel movements, and a healthy digestive system. These bacteria are closely linked to the alleviation of IBS related pain, diarrhea, and constipation symptoms. 

A diverse and balanced microbiome will increase the strength of your immune system. Your gut is linked to all areas of your body, especially the brain.

When the gut microbiome is thriving it will be able to produce a lot of hormones and neurotransmitters.

It is estimated that around 90% of the body’s serotonin (which helps with a good mood) is produced in the gut. Fluctuations in serotonin can be responsible for mood swings, anxiety, and depression.

What Are The Signs That You Need Probiotics?

There are a variety of signs that could indicate you should incorporate probiotics into your diet. If you notice your digestive system is irregular, this could indicate a lack of beneficial bacteria in your gut.

This can be made better by the inclusion of probiotics. 

Another sign you could require probiotics is a constant craving for sugar. This is a common food source for bacteria, who find it easiest to consume simple sugars for energy.

These bacteria will send signals up the vagus nerve from the gut to your brain, triggering hunger signals to be released. 

If you think that your metabolism has slowed down, this could suggest a lack of biodiversity in the gut microbiome. There is a link between obesity and a low diversity of gut flora. 

If you have recently completed a course of antibiotics, many of the bacteria in your body will have been killed off. This is good to rid the body of infection, but the antibiotics are not sophisticated enough to be able to distinguish between the good and harmful types.

It can be a wise idea to supplement your diet with probiotics to help restore the biodiversity in the gut.

Combining Prebiotics And Probiotics 

As we have mentioned, prebiotics are often used to provide a food source for the bacteria in your gut, the probiotics. This is why many probiotic supplements will contain a small quantity of prebiotics, to support the microbiome growth.

This allows the probiotics to survive the journey through the body and into the gut where they can grow colonies in the intestine. 

Combined supplements are commonly taken in the form of a capsule.

The outer shell keeps the prebiotics and probiotics safe during the journey through the stomach until the capsule reaches your intestine. At this point, the capsule will open and the supplements will be released. 

As soon as the probiotics reach the intestines, there is a food source readily available. This supports the reproduction of beneficial bacteria, allowing them to fight off the harmful bacteria.

If the capsule opens before it is in the gut, the probiotics will be released into a hostile and acidic environment that could cause them to die before reaching the intestine and reproducing.

Taking probiotics on an empty stomach may help prevent capsule breakdown too early.

What Are Synbiotics?

Synbiotics are food sources that contain both prebiotics and probiotics. It is a relatively new term as we have only recently begun to understand the benefits of combining prebiotics and probiotics.

Examples of synbiotic foods include some yogurts, cheese, and kefir.

Synbiotics are believed to increase the number of probiotic bacteria in your gut. This is because the supplement provides them with a food source, allowing the beneficial bacteria to become more established within your system. 

It is not necessary for your health to consume both at once. That being said, prebiotics and probiotics should both be a regular element of your diet.

It is not yet known whether synbiotic products are more or less beneficial than taking prebiotics and probiotics independently. 

When Should I Take My Supplements?

If you are taking fiber supplements in addition to prebiotics and probiotics, you should try and space out their ingestion. If you consume too much fiber then the bacteria in your gut can overconsume and become proliferant. This can cause a lot of bloating, abdominal distention, gas, and pain. 

You should try to take your probiotics once per day. This will give your system the best level of support and will help to maintain optimal health.

Some people choose to only take them periodically or during periods of intense stress. Ultimately the frequency with which you consume these supplements will vary according to your personal preference. 

What Is The Best Way To Take My Supplements?

You can purchase prebiotic and probiotic supplements in a variety of forms, including liquids and tablets. One of the best ways to take these supplements is in a freeze-dried and water-activated form.

The freeze-drying protects the bacteria during storage and transportation, preventing them from dying or reproducing excessively.

Combining the supplement with water activates it, waking up the bacteria. They will then start to consume the prebiotics, giving them a much higher chance of survival. 

When selecting a supplement, you should check the label for more details about the product. The strain of live bacteria should be clearly stated, and so should the number of CFUs.

This stands for colony-forming units or the number of active bacteria found in each serving. 

There are often specific care instructions for supplements. Many require being stored in the refrigerator to prevent the bacteria from becoming harmed or inactive. 

Are There Side Effects From Combining Prebiotics And Probiotics? 

As your body adjusts to their intake, you might notice a slight increase in gas in your body. You may also notice bloating, stomach distention, or mild digestive discomfort as your body adapts. 

This can be as a result of the increased fiber consumption. Alternatively, the beneficial bacteria are known in some cases to kill off harmful bacteria found in your intestine.

As the harmful bacteria die off and the beneficial bacteria proliferate, you should notice your intestinal discomfort beginning to ease. 

There are no known contraindications between prebiotics, probiotics, and other medications. Medications that have antifungal and antibacterial properties are known to limit the efficacy of prebiotics and probiotics.

An example of this is garlic. You should leave about an hour or two between the supplement and the antibacterial/antifungal to prevent damaging the bacteria.

What is SIBO?

In some cases, excessive consumption of prebiotics can lead to the development of SIBO (small intestinal bacterial overgrowth).

Typically there are very few bacteria living in the stomach due to harsh and acidic conditions.  In the small intestine, there are more bacteria and in the colon, many more bacteria.  

In some people, too many bacteria begin to thrive in the small intestine.  When you consume food, the sugars in your food are then metabolized by the bacteria and a byproduct of this is gas, which leads you to feel bloated and uncomfortable.

Common symptoms of SIBO include a loss of appetite, abdominal bloating, and pain. It can also make you feel uncomfortably full, even after eating small amounts of food.

SIBO can cause nausea, diarrhea, malnutrition, and unintentional weight loss too. 

You should schedule a visit to your doctor if you are experiencing ongoing bouts of diarrhea, fast and unexplained weight loss, or abdominal pain that does not subside after a few days or becomes very severe.

There are many different treatment options for SIBO. The most common first step is for your doctor to prescribe antibiotics.

This is often a short course, designed to drastically decrease the number of harmful bacteria in the small intestine. When the course is complete the bacteria can sometimes repopulate, so some sufferers may need to take several courses of medication.

Sometimes your doctor will cycle through a number of different antibiotics to prevent the bacteria from building up a resistance.

Some antibiotics can worsen stomach conditions such as diarrhea, and switching between a few types can reduce the likelihood of this happening. 

You may be told to remove lactose from your diet. This is a sugar found in milk that can be difficult for the small intestine to digest. As yogurt is a cultured milk product, some SIBO sufferers can tolerate this in their diet. 

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Written and Medically Reviewed By

  • Chelsea Cleary, RDN

    Chelsea is a Registered Dietitian Nutritionist (RDN) specializing in holistic treatment for chronic digestive disorders such as Irritable Bowel Syndrome (IBS), SIBO, and Crohn’s disease. She educates patients on how they can heal themselves from their conditions by modifying lifestyle and dietary habits.

  • Julie Guider, M.D.

    Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.