Deborah T. writes:
“I enjoy reading your columns in our local newspaper, as they are informative and relevant. Would you do a column on when to take probiotics? The bottles say to take according to the advice of your practitioner. I have asked a dentist, an endocrinologist, a nurse practitioner, and numerous friends. Everybody has a different answer (or no answer at all). Take them half an hour before eating. Take them two hours after you eat. Take them in the morning. On and on! There seems to be controversy over how enough probiotics can get to one’s GI tract alive so that they can do their job. Thank you.”
Great question, Deborah.
It appears that the exact time of day you take a probiotic is not as important as other considerations, such as why you’re taking it in the first place. Most research is focused on the effect of various strains of probiotics on certain health conditions, not on the exact time of day to take them. (More on that in another column.)
For example, there is good evidence from at least 19 published studies that taking probiotics within a day or two of starting antibiotic therapy was the most effective way to prevent Clostridium difficile (C. diff) infection in hospitalized patients. C. diff is a bad bug that causes severe diarrhea.
Effective doses of probiotics for various conditions vary from one to three times a day, depending on the medical condition — and the particular strain of probiotic, according to an intensive report on this subject by the World Gastroenterology Organisation (WGO).
Probiotic manufacturers usually recommend one or two doses a day, depending on why you are taking them. One product label, for instance, says to take one capsule daily. But “when traveling, take two capsules (one in the morning, one at night). During antibiotic use, take one capsule twice daily and continue for 10 days after completion of antibiotics.”
Another manufacturer states that it doesn’t matter when (time of day) you take their product — just take it as part of your daily routine, at a time that will be easy to remember. That makes sense.
And don’t forget that we can also get probiotics in fermented foods such as yogurt. Whatever the source, remember that only products with live cultures are effective for health promotion.
Live organisms can also die, so look for products that list the total number of colony forming units (CFUs) on the expiration or use-by date. Avoid products that list the number of CFUs “at time of manufacture,” advises the International Scientific Association for Probiotics and Prebiotics, since that information does not take into account the limited lifespan of these good bugs.
Barbara Quinn is a registered dietitian and certified diabetes educator affiliated with Community Hospital of the Monterey Peninsula. She is the author of “Quinn-Essential Nutrition” (Westbow Press, 2015). Email her at firstname.lastname@example.org.