You’ve probably been hearing a lot of stories about probiotics and the myriad of benefits they provide for health. These “friendly” bacteria can be found in numerous parts of your body, and they play a large role in repelling or disabling unwanted microbial invaders. While probiotics occur naturally in many different foods, the best way to ensure that you are incorporating these health-boosting microorganisms into your lifestyle is by taking probiotic supplements.

The “When To Take Probiotics” Debate

Even though scientists have known about probiotics for decades, there still doesn’t seem to be a consensus about one of the most basic aspects of these supplements: how and when they should be taken. Some health experts suggest taking a probiotic supplement with food, while others insist that you take them on an empty stomach. There are those who insist that taking probiotics first thing in the morning provides the most health benefits, but others claim that the evening meal is the ideal time to get your recommended dosage. And then there are those probiotics advocates who feel that the time of day is irrelevant when it comes to taking supplements.

So, who is right? The best answer is also the simplest one: check the product label. If the dosage directions on your probiotic packaging call for taking the supplement at a certain time or with/without food, then make sure to adjust your regimen accordingly.

Other Labelling Info: CFUs, Storage, and Expiration Dates

While your attention is focused on the label of your probiotic supplement, let’s go over a few other pieces of information that you should take note of. The first detail is the concentration of the probiotic that you’re taking, which is measured in colony-forming bacterial units, or CFUs. These will be measured in millions or billions, and they may be broken out my bacterial strain. Generally speaking, adults should target a daily dosage of 15 to 20 billion CFUs each day. In addition, some probiotic supplements are time release, meaning that they introduce the probiotics into your system gradually, instead of all at once.

Next, you should take note of the directions for storage of your probiotic supplements. While most probiotics will call for storage in a cool, dark, dry place (like a cabinet, drawer, or pantry), a few products require refrigeration in order to maintain maximum potency. And like all consumer products, it’s important to check the expiration date of your probiotics. After all, because the supplements contain live bacteria, they won’t do you any good if they’ve died off before they enter your body.

Strains Are Important

One thing to keep in mind when it comes to probiotics is that unlike many over-the-counter medications, the main ingredients for similar probiotic supplements can vary widely. Even though all probiotic supplements contain active bacteria, the types, strains, and subspecies of bacteria differ significantly from product to product. The supplements that are labelled properly will identify all bacterial strains on the side of the container, with the strains listed in descending order from highest to lowest concentrations (i.e. from more to less CFUs).

The reason this is important is because certain probiotic strains have been shown to protect you from specific diseases or ailments. Here is a partial list of conditions, along with the specific strains that have been shown to combat them:

  • – Acne treatment: Lactobacillus acidophilus and Bifidobacterium bifidum1; Bifidobacterium longum and Lactobacillus paracasei
  • – Acne prevention for in vitro babies: Enterococcus faecalis2
  • – Antibiotic-associated diarrhea in elderly patients: Lactobacillus casei,3
  • – Lactobacillus bulgaricus, Streptococcus thermophilus4; Saccharomyces boulardii5
  • – Anxiety associated with chronic fatigue: Lactobacillus casei6
  • – Bacterial vaginosis: Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-147
  • – Colic in babies: Lactobacillus reuteri 8
  • – Depression: Lactobacillus casei9
  • – Diarrhea (acute): Saccharomyces boulardii10
  • – Diarrhea in children: Lactobacillus rhamnosus 11; Bifidobacterium lactis;12
  • – Eczema risk reduction for in vitro babies: Lactobacillus rhamnosus LPR or Lactobacillus paracasei and Bifidobacterium longum BL99913
  • – Food allergy prevention in babies: Lactobacillus GG14
  • – Gas after meals: Bacillus coagulans GBI-30, 608615
  • – Glucose tolerance: Bifidobacterium lactis16
  • – Halitosis: Streptococcus salivarius17
  • – Irritable bowel syndrome: Lactobacillus plantarum 299V18
  • – Lactose maldigestion: Streptococcus thermophilus19
  • – Mood regulation: Bifidobacterium animalis Lactis, Streptococcus thermophilus, Lactobacillus bulgaricus, and Lactococcus lactis20
  • – Skin sensitivity reduction: Lactobacillus paracasei CNCM 1-2116 and
  • – Bifidobacterium lactis21; Bifidobacterium longum22
  • – Sleep regulation in elderly people: Lactobacillus helveticus23
  • – Stress: Lactobacillus helveticus and Bifidobacterium longum24
  • – Tooth decay prevention: Lactobacillus reuteri25
  • – Tooth decay prevention in kids: Lactobacillus rhamnosus GG26
  • – Urogenital tract protection against infection: Lactobacillus rhamnosus GR-1;24
  • – Lactobacillus rhamnosus GR-127 and Lactobacillus fermentum B-54 or RC-1428
  • – UV skin damage: Lactobacillus johnsonii29
  • – Weight and fat loss: Lactobacillus rhamnosus30; Lactobacillus gasseri SBT205531

Finally, there are a few other recommendations regarding probiotic supplementation. You should never take these supplements along with coffee, tea, soup, or another hot liquid, since the bacteria’s effectiveness could be eroded by the heat. Also, if you will be traveling for any length of time (especially by air and/or to another country), it’s wise to take some extra doses of probiotics to combat pathogens and boost your immune system before, during, and after your trip.

Researchers are discovering more and more benefits of probiotics every year. So if you could use a little health boost, try a probiotic supplement for a month or two to see if you achieve satisfactory results. Since side effects are minimal and no prescription is required, what do you have to lose?

Read More:

Your Ultimate Probiotics Guide (+ why you absolutely need them)

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20 Tillisch K, Labus J, Kilpatrick L et al. Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity. Gastroenterology. 2013;144(7):1394-1401.e4. doi:10.1053/j.gastro.2013.02.043.

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31 Kadooka Y, Sato M, Imaizumi K et al. Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. European Journal of Clinical Nutrition. 2010;64(6):636-643. doi:10.1038/ejcn.2010.19.

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About the Author

Dr. Amy Lee

Dr. Amy Lee has board certifications in internal medicine, physician nutrition and obesity medicine specialty. She practices internal medicine with a heavy emphasis on nutrition, wellness and weight management. Her Clinical nutrition fellowship training at UCLA has allowed her to incorporate realistic lifestyle modification in all her medicine patients.