Probiotics have a very positive effect on health – but only if you use high-quality preparations and know what to look out for when taking and using them.

Probiotics – The correct application and intake

We use the term probiotics to describe preparations that contain active or inactive probiotic (gut-friendly) bacterial strains. Probiotics are usually taken to influence a disturbed intestinal flora in such a way that it can regenerate and consequently improve overall health. Because the healthier the intestines and the more balanced the intestinal flora, the stronger the immune system and the healthier the person.

Since the state of the intestinal flora affects every acute or chronic illness, including obesity, probiotics can be used for almost all complaints and physical problems.

However, it is often not known what to look out for when taking probiotics correctly, when these products are best taken and which probiotic is suitable for which purpose.

Probiotics in capsules or in liquid form?

Probiotics in capsules usually consist exclusively of probiotic bacterial strains. A prebiotic substance is often added in small amounts, e.g. Inulin. Prebiotic means “nourishing the intestinal flora”. A prebiotic consists of food for the probiotic strains and is given to probiotic preparations as “provisions” for the intestinal bacteria.

If a probiotic also contains prebiotic elements, then one no longer speaks of a probiotic but of a symbiotic. In order not to create confusion, most manufacturers still use the term probiotic.

Liquid probiotics such as Probioform can also contain fermented herbal or medicinal plant extracts in addition to bacteria, and depending on the product, medicinal mushroom extracts, shilajit, prebiotics or other active substances. All of these substances should help to influence the environment in the intestine so that the beneficial intestinal bacteria feel comfortable there and at the same time the harmful bacteria and fungi are deterred.

Very good results can be achieved by combining a capsule probiotic with a liquid probiotic.

Probiotic Foods

Sometimes fermented foods are also referred to as probiotics, such as sauerkraut or lactic acid fermented juices. However, since it is never possible to say which bacteria are actually present and to what extent, these foods can be easily integrated into the diet, but specific statements on the effect on specific health problems cannot be made.

Yogurt and other fermented milk products in particular are often considered valuable probiotics. If these foods are supposed to have a positive effect on health, it is in large part due to their probiotic cultures, which could, however, be consumed entirely without dairy products.

Yogurt also only contains a few probiotic strains – and if you’re unlucky only small amounts. Since there are also indications that the effect of yogurt on health is overrated, increased consumption of yogurt is not a solution if you want to build up your intestinal flora in a targeted manner or contribute to its regeneration.

Of course, fermented foods also include kefir & co. However, if you want to take concrete action against dysbiosis (a disorder of the intestinal flora), protect yourself from diseases, strengthen the immune system and improve general health, then high-quality and high-dose probiotics in capsule form or in liquid form make more sense.

What should you look out for when buying probiotics?

When buying probiotics, you can pay attention to the following points:

The number of bacterial strains contained – the more, the better

Many probiotics on the market contain only a few strains of probiotic bacteria, some as little as one or two to three. However, the human intestinal flora consists of 200 to 400 different strains. It is therefore advisable to take probiotics that have the widest possible variety of beneficial intestinal bacterial strains.

Since there are now also research results for various strains that prove very specific effects of these strains, the greater the range of effects achieved, the more beneficial bacterial strains are contained in the respective preparation.

1. For example, we know that Lactobacillus reuteri can reduce dental plaque and alleviate inflammation of the gums, so it has a positive effect on oral and dental health. If there are problems with an elevated cholesterol level, then L. reuteri supports the regulation of the same. Children who took this strain of bacteria showed a reduced risk of allergies.
2. Lactobacillus helveticus, takes care of bone health. The strain promotes the absorption of minerals and also the formation of osteoblasts (cells that build bone substance)
3. The three strains L. gasseri, L. plantarum and L. rhamnosus,  help people who are overweight to reach normal weight more easily without subsequently being overtaken by the yo-yo effect.
4. L. rhamnosus is also known to have therapeutic effects on vaginal yeast infections, while L. plantarum can be used on Helicobacter pylori (stomach germ) infections.

You can already see from this small selection of different effects that a probiotic from many different strains is much more helpful and is therefore preferable to preparations with a small number of bacterial strains.

Ultimate Probiotic capsules, for example, contain 36 different probiotic bacterial strains, including almost all of those just listed. In addition, the preparation contains the yeast strain Saccharomyces boulardii, which can stop acute diarrhea and also prevent antibiotic-related diarrhea.

Active bacteria

When buying probiotics, also make sure that the preparation contains active, i.e. living and not inactivated bacteria.

No superfluous additives

Of course, probiotic preparations should be free of sugar, sweeteners, flavors, and release agents such as e.g. magnesium stearate (also called magnesium salts of fatty acids) and other unnecessary additives.

Better no gastric-resistant capsules

Manufacturers often advertise that their probiotic is enteric-coated. This sounds good at first because it means that a larger amount of the bacteria it contains gets into the intestine. However, since this bypasses the stomach’s natural control and protective mechanisms, probiotics in enteric-coated capsules are more likely to have undesirable side effects than regular capsules.

How do you store probiotics?

While some probiotic strains are not heat-sensitive, we would recommend storing probiotics in the fridge.

The right time to take it

It is ideal to take on an empty stomach, as the probiotic bacteria then pass through the stomach particularly quickly and therefore do not come into contact with stomach acid and digestive enzymes as intensively. After just half an hour – so it is said that almost all bacteria (90 percent) have arrived in the intestine with this intake variant.

The pH of the stomach also varies over the course of the day. It is particularly high (i.e. less acidic) in the morning before breakfast, during meals and in the evening before bed. It is low (i.e. more acidic) after meals.

If you take the probiotic with meals, they should contain a little fat (1 percent is enough), but not high in fat and not rich in protein, since such meals cause the release of a lot of stomach acid and large amounts of digestive enzymes, which in turn can also attack the probiotic bacteria and reduce their quantity.

A study from 2011 confirmed these statements. It examined different intake times. It was found that most probiotic strains arrived in the gut intact when taken either just before meals (up to 30 minutes before) or taken directly with meals. On the other hand, the fewest probiotic bacteria arrived in the intestine when they were taken half an hour after meals.

In summary, the following applies to the correct intake of probiotics

1. Take probiotics best before breakfast (at least 30 minutes before), or if with breakfast or with another meal than make sure it is not too high in fat and not too high in protein.
2. Since probiotics also have a positive effect on the quality of sleep, you can also take your probiotic before going to bed if you suffer from insomnia.
3. If you have never taken probiotics before, start with a small dose and gradually increase to the manufacturer’s recommended dose. You can also split the daily dose into several intakes. In this way you avoid possible side effects (bloating or similar) developing. At the same time, you will be able to find the dosage that you tolerate best.
4. Unless you have just purchased an enteric-coated capsule preparation, you can open the capsules and split the contained dose if the dose contained in one capsule is too much for you or if you cannot swallow capsules well.
5. If you have a preparation with enteric-coated capsules, but the capsules are too big and you cannot swallow them, you should first ask the manufacturer/supplier whether it makes sense to open the capsules and only take the contents. If it contains strains of bacteria that are sensitive to gastric juice, it would of course be better to swallow the capsules whole or – if that is not possible – to give the preparation away and buy something more suitable for yourself.
6. If you have an enteric-coated capsule product, then you can take it at any time.
7. If you want to combine capsules and a liquid probiotic, then you can take the liquid probiotic together with the capsule.

The duration of the intake

Not much can be said about the duration of the intake, as this is based on the respective symptoms and personal well-being. Typically, probiotics are taken for 4 to 12 weeks.

If you take probiotics alongside antibiotic therapy and afterwards, then a minimum intake of 3 weeks makes sense – according to a review of 82 studies with a total of 11,000 participants. If you have to take antibiotics longer than the usual week or even longer than 3 weeks, then you take the probiotic preparations in any case for just as long and then for another 4 to 6 weeks.

If you have an irritable bowel, it is recommended to take it for a period of up to 8 weeks – at least according to the evaluation of 21 randomized controlled studies from 2016.

A meta-analysis from 2012 showed that taking probiotics over a period of 3 to 4 weeks was not as effective as long-term use for gastrointestinal complaints. This covered periods of at least 9 weeks up to 240 weeks, from which it can be concluded that probiotics can also be taken permanently in the case of corresponding symptoms.

The possible applications

Uses of probiotic supplements include the following:

1. Development of the intestinal flora during or after antibiotic therapy

Probiotics are used to build up the intestinal flora, i.e. when the intestinal flora has lost its healthy balance, e.g. after antibiotic therapy. Because antibiotics not only fight harmful bacteria but unfortunately also bacterial strains that are useful for humans and in this way permanently damage the intestinal flora.

Direct side effects are often diarrhea and nausea. It is not uncommon, however, for the damage to the intestinal flora to become noticeable only over time (a few weeks after antibiotic therapy), for example as a result of secondary diseases such as e.g. chronic digestive problems, fungal infections (e.g. vaginal thrush ), chronic fatigue, skin problems, itching, increased susceptibility to infections and much more.

Ideally, probiotics should not be taken after the end of the antibiotic therapy, but already during (and about 4 weeks afterward), since they can reduce antibiotic-related digestive problems, among other things. The interval between taking antibiotics and taking probiotics should be as long as possible, e.g. one in the morning, the other in the evening.

2. Structure of the intestinal flora in dysbiosis

A healthy intestinal flora is characterized not only by a large number of intestinal bacteria overall (it could also be the wrong strains, which are numerous) but in particular by the variety and the right composition of the desired beneficial bacterial strains.

Many factors can lead to a disturbed intestinal flora: poor nutrition, chronic stress, lack of sleep, infections, lack of vital substances, some medications, and even lack of exercise. The consequences of an imbalance in the intestinal flora go far beyond digestive problems. In the meantime, it has been established that almost every chronic disease also has a dysbiosis.

Of course, the cause of the complaints in particular must now be eliminated, if it is apparent. However, a probiotic should always be used as an accompaniment. It gives the intestinal flora the necessary impulses for regeneration, also provides important strains of bacteria, and often also the right bacterial food (prebiotic) in the form of inulin or similar.

In these cases, probiotics help to restore the balance of the intestinal flora. The useful bacterial strains it contains displace the harmful bacteria and fungi and in this way ensure a balanced composition of the intestinal flora.

3. Chronic diseases

As already mentioned in 1. and 2., dysbiosis is one of the contributory causes of many chronic diseases. No matter what the symptoms are, intestinal cleansing with high-quality probiotic preparations is part of almost every holistic concept, together with the right diet, exercise, vital substances, and sufficient sleep.

Common chronic diseases include those of the stomach. If these are caused by excessive multiplication of the stomach germ Helicobacter pylori, a very special probiotic is recommended. In this case, it contains an inactivated probiotic strain that can bind the stomach bacterium and render it harmless in this way (inactivated lactobacillus reuteri DSM17648).

If you keep suffering from flatulence or diarrhea, you can use probiotics that are combined with activated charcoal.

4. Bacterial vaginosis and vaginal thrush

If bacterial vaginosis (vaginal infection with pathogenic bacteria) or vaginal thrush occurs, then the vaginal flora is out of balance. An important component of both diseases can therefore be seen in probiotic preparations. Probiotics can be taken as a vaginal suppository and/or orally.

5. Prevention

If you don’t suffer from any symptoms but want to prevent them, you can also take probiotics as a preventative measure, for example after a phase in which you have neglected your diet or even if infections are circulating.

In addition to certain probiotic bacterial strains, special probiotics to strengthen the immune system also contain medicinal plants that activate the immune system and numerous vital substances such as zinc, biotin, vitamin B12 and vitamin C.

6. Overweight

As described above, selected probiotic bacterial strains support weight loss. Anyone who is toying with the idea of ​​reducing their excess weight should also integrate a probiotic into their weight loss program.

7. For children

For children, one should resort to probiotics that have been specially developed for children, as they only contain those bacterial strains that have been tested for children’s intestinal flora.

Who should not take probiotics

In the case of chronic illnesses, you should of course always first consult your naturopath as to whether it is possible to take probiotics without risk in your case. In the case of a severely weakened immune system, e.g. after an organ transplant immunosuppressants are necessary, it is better not to take probiotic bacterial strains.

If there is a miscolonization of the small intestine, warnings are often given against probiotics. There are different study results on this. Excessive amounts of probiotics can increase the problem, but correct dosing should be able to alleviate the symptoms. You can find a summary of this here: Treating small intestinal overgrowth naturally

Intestinal flora – the test

You can have a dysbiosis or the condition of your intestinal flora determined by your naturopath using a stool test. There are now various tests, but there are also home tests:

1. Basic Microbiome check
2. Detailed Microbiome check
3. vaginal-microbiome-test

You simply take a stool sample at home (according to the instructions), send it by post to the specified laboratory and within a few days you can access your results online. If you are unsure what measures are required, you can use a hotline and you will receive advice there. It is of course even better if you could discuss the results with your naturopath.

Probiotics: positive effects and possible side effects

Probiotics in general have many beneficial health effects. But there can also be side effects – mostly unproblematic. In some cases, however, one should be careful with the application. Because in the case of critically ill people or people with a suppressed immune system, probiotic products should only be taken under medical supervision.

Beneficial effects of probiotics	Possible side effects of probiotics
Suppression of potentially pathogenic germs
Improvement of the barrier function of the intestinal walls
Strengthening of the immune system, reduction of allergies and autoimmune diseases
Shortening the duration of various acute diarrheal diseases	temporarily diarrhea
Normalization of bowel activity, relief from irritable bowel symptoms	temporarily bloating
Suitable strains can fight Streptococcus mutants in the oral flora
The proportion of lactobacilli in the vaginal flora can be increased, thereby reducing the risk of bacterial vaginosis and urinary tract infections.	If the probiotics are fermented they can be difficult for people with histamine issues

^{Source: Burgerstein Handbook Nutrients, Dr. Lothar Burgerstein, TRIAS Verlag, 13th edition, 2018}

The correct intake of probiotics in a colon cleansing

Probiotics are – together with psyllium husk powder and a mineral clay (bentonite or zeolite) – one of the three basic components of a natural intestinal cleanse. For a natural intestinal cleanse, take the mixture of psyllium husk powder and mineral earth with a lot of water 30 to 60 minutes before a meal. Take the probiotic just before the meal.

Or talk to us for more ideas on how to build your microbiome.