Healthy shopping: Probiotics for when you’re on antibiotics

Joanna Evans shares what to look for and what to buy if you’re looking to take probiotics alongside a course of antibiotics

There are plenty of promising natural alternatives to antibiotics. But if you do need to take antibiotics, supplementing with probiotics can help to ease some of the side effects.

Antibiotics are notorious for disrupting the gut microbiome, wiping out good bacteria as well as bad, and this commonly causes diarrhea and other gastrointestinal symptoms. In the past, people were advised not to take probiotics while on antibiotics—to wait until afterward because it was thought the antibiotics would kill ingested probiotics.

But research now shows that taking certain probiotic strains, like Lactobacillus rhamnosus GG and Saccharomyces boulardii, during antibiotic treatment can reduce the risk of antibiotic-associated diarrhea (AAD) by 50 percent.¹ And as S. boulardii is a yeast rather than bacteria, it’s not affected by antibiotics, so it’s especially useful during antibiotic treatment.²

Here are a few pointers on what to look for when choosing a probiotic to take alongside antibiotics.

What to look for

Science-backed strains. Look for well-researched probiotic strains specifically shown to work during antibiotic treatment. Besides the two above, some of the ones proven to prevent AAD are Lactobacillus bulgaricus, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium longum and Bifidobacterium subtilis.³

An effective dose. Clinical trials suggest daily doses of 5 billion CFU (colony forming units) or higher are better at preventing AAD than lower doses.1 Check how many CFU you’re getting per capsule and per strain, if possible.

Clean formulas. Check the ingredients list on the label to see if the product is free of unnecessary extras, like sugars, sweeteners, bulking agents, and artificial colors, flavors and preservatives. Also watch out for allergens if you have any allergies or intolerances.

Quality control. Has the product been tested, ideally by a third party, to ensure potency (the dosage is what it claims to be on the label) and purity (it’s free of potentially harmful contaminants)? If you’re not sure, get in touch with the company to check.

Products to try

Here’s a handful of high-quality probiotic products containing strains known to be helpful for AAD. Just remember that the usual advice is to leave a gap of at least two hours between taking probiotics and antibiotics (although S. boulardii can be taken at the same time). All products apart from Smart Strains are available in the US and UK, and none require refrigeration, so they are suitable for use when traveling.

Inessa
Advanced Biotic Complex, $54.99/£38.99 (30 capsules)
inessawellness.com

This multi-strain formula contains 50 billion live organisms from seven well-studied strains, including S. boulardii (5 billion CFU), L. rhamnosus GG (7.5 billion CFU) and L. acidophilus (7.5 billion CFU). It’s third-party tested for potency, free of unnecessary ingredients and supplied in a delayed-release capsule to ensure the live cultures survive the acid in your gut. A single-strain L. rhamnosus GG supplement is also available.

Seeking Health
Saccharomyces Boulardii, $22/£14.49 (60 capsules)
US: seekinghealth.com; UK: healf.com

This heat- and acid-resistant supplement features a proprietary strain (Lynside® Pro SCB) of the probiotic yeast S. boulardii at a dose of 5 billion CFU per capsule. It’s third-party tested and free of genetically modified ingredients as well as all the common allergens and artificial colors and flavors.

AMMD by Amy Myers, MD
Probiotic 100 Billion, $51.97/£43.49 (30 capsules)
US: amymyersmd.com; UK: healf.com

Developed by functional medicine doctor Dr Amy Myers, this high-strength probiotic blend contains 14 clinically studied strains, including several known to be helpful for AAD, such as L. acidophilus, L. rhamnosus and B. longum. It’s third-party tested and compliant with Good Manufacturing Practices (GMP), and it provides 100 billion CFU per capsule.

Smart Strains
For When You’re on Antibiotics, £22.99 (30 capsules)
smartstrains.com

Formulated by The Gut Health Doctor® Dr Megan Rossi, this single-strain probiotic contains L. rhamnosus GG, a widely studied strain recommended by the World Gastroenterology Organisation guidelines on probiotics for when you’re on antibiotics. There are no added sugars, sweeteners, emulsifiers, bulking agents, flavors or preservatives, and each batch is quality tested to ensure every capsule provides 10 billion CFU right up to the expiry date.

The supplement is currently available only in the UK, but you can register your interest to be notified when international shipping is available.

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