When is the best time to take Probiotics?

When is the best time to take probiotics? Morning or night? With or without food?

Many people who start taking a Probiotic struggle to figure out when it’s best to take it. Does time of day matter? Does it matter if I take it with food? Or, for that matter, without food? There are a lot of opinions on this subject, but the truth is that there’s some pretty simple science behind when the best time to take your Probiotic is, and how to take it. Your manufacturer will often put on the packaging how and when they recommend that you use the product, and it’s always best to follow their instructions, but in this article we’ll dive into a few of the factors that can affect this, and when it’s best to take your live bacteria to make sure you get the most out of your probiotic.

Stomach Acid

As most people know, our stomach is very acidic. It naturally produces hydrochloric acid, and can often reach a pH of as low as 2-3 when the stomach is empty, which is extremely acidic! The stomach acid is there specifically to kill bacteria, as well as fungi, parasites, viruses, or anything else that might come in with your food. It’s your body’s first line of defence, although it also serves other purposes within the digestive process.

This of course has a massive impact on your probiotic, as most bacteria can be severely damaged by exposure to stomach acid. The truth is though, the degree of this damage varies a lot from bacteria to bacteria. For example, both LGG and BB12, the two bacteria we use at Better Guts, have shown very good survivability of stomach acid. We actually protect ours from stomach acid anyway, but it means that even if they did get exposed, they would have a good chance of survival. But not all bacteria are like this, and many will be mostly killed after as little as half an hour of exposure.

So, what can we do to mitigate this? Let’s take a look.

Should I take probiotics on an empty stomach?

As a general rule, no. If your stomach is empty then there is no food there to buffer the effects of the stomach acid, so the bacteria you’re sending in will have a tougher job of surviving to the gut.

It’s also worth noting that if your stomach is in a fasted state, so it’s been empty for several hours, then it’s likely that the pH will be at its lowest, making your stomach very acidic. Again, this makes your probiotics have to work harder to survive, and many may not survive at all.

So just buffering the effects of the stomach acid by taking your probiotic with food can make all the difference.

Is it better to take probiotics with food?

One option that has shown some evidence of success in various studies has been to take your probiotic with food. The theory here is simple really, when you eat, the food buffers the stomach acid, temporarily increasing the pH of the stomach, making the stomach less acidic and therefore less harsh on the bacteria. This effect varies from food to food as some foods are more acidic or alkaline than others. So for instance, in one study it was found that oatmeal and milk led to a better survivability than apple juice or water, because apple juice is fairly acidic already, and oatmeal is not.

The results of this specific study found that the probiotics had the best chance of surviving when taken either with food or 30 minutes before eating, with 30 minutes after eating actually showing a reduction in survivability. So, here we can see that by taking the probiotic with or just before food we can actually help to increase its chances of survival.

It should be noted though that this is not a guarantee, and it still is very dependent on the strain of bacteria used, and how well it deals with acid. There are, however, other options…

Do delayed release capsules work?

One way to protect the bacteria from stomach acid is to use a special capsule. This way we can ensure that the bacteria never has to worry about the acid as it’s protected through the stomach, and therefore never gets exposed to it.

We won’t go into too much detail on this as we already have an article on capsule technology, but basically there are two options here.

The first is enterically coated capsules. These are capsules coated with special chemicals and often plasticisers that are designed to only dissolve in an alkaline environment. They’re typically the ones favoured by the Pharmaceutical industry, and are shown in studies to be highly likely to only open once in the gut. However, the chemicals they use are not necessarily good for you, and in fact some commonly used chemicals in these products come with EU health warnings, so perhaps they’re not best for a product you take every day in the long run.

The other option, and the one we take at Better Guts, is to use delayed release capsules. These are a special variety of cellulose, often mixed with gellan gum, that essentially act as a timer on the release of your probiotic. They’re designed to dissolve very slowly, often taking almost an hour to open, by which time they’ve normally passed through the stomach into the gut, where they can release your probiotic safely. This is a more natural approach than the enterically coated one, and has been shown to work in multiple studies. Using this technology, alongside bacteria that can survive stomach acid well like LGG and BB12, gives the probiotic bacteria the best chance that they will make it to the gut intact. This is the approach we take at Better Guts.

Is it better to take probiotics during the day or at night?

This is a very common question we get asked. We know that the stomach acid plays a big role, and so taking our capsules with food can make a difference, but does it matter if we take them in the evening or in the morning?

The simple answer is no. But it’s a bit more complicated than that.

First thing in the morning your stomach has been empty all night, it’s in a fasted state, and so is most likely to be at its most acidic. So, if you take your probiotics in the morning as most of us do, it’s best to take them with breakfast to help keep that acid exposure down.

Taking them in the evening is just fine too, and there’s no real evidence that either time is better than the other.

It’s best to take them with or just before food, and to make sure that you take them at around the same time every day. It doesn’t have to be to the minute, but if it’s with breakfast every day, then that’s good enough on the timing front to just keep that cycle regular.

Can I take my probiotics with coffee?

Many of us start our day in the morning with a cup of coffee to pick us up and get us going, so it’s only natural that people will ask if they can take their probiotic alongside their morning coffee.

Coffee itself should have no real impact on the bacteria, but the high temperature of it can. High temperatures can kill bacteria, and so if you take your probiotic with a hot drink, you could be risking damaging them before they ever get to your gut! At Better Guts we generally recommend people take their probiotics with water. If you want to take them with your coffee, just make sure it’s warm and not too hot, and this should help keep your bacteria alive and ready to work.

Can I take my probiotics with antibiotics? What about medication?

For those on routine medication, working in your supplements around your medicines will be something with which you’re familiar. It’s important to make sure that we take our probiotics and other medication at the right times to get the best out of both however!

For antibiotics, generally speaking the further apart you make the times when you take each, the better. Antibiotics kill bacteria, and most of them used today are ‘broad spectrum’, which means they kill a variety of bacteria, not just a specific one. So if you take your probiotics and antibiotics together, there’s a good chance the antibiotic will kill the probiotic before it ever reaches your gut! If you only take antibiotics once a day, try to take them at a totally different time of day to your probiotics, so for example probiotics in the morning and antibiotics at night. It is important however to take any medication at the time of day that your doctor has prescribed it for. If you need to take them more often than that, then try to work your probiotic in to be as long after or before you take your antibiotics as possible. As a general rule, a buffer of 2 hours is best. To learn more about how antibiotics can affect your probiotic see our article on antibiotics.

For routine medication, it’s best to check with your doctor about the impact it might have. Probiotics aren’t known for having contraindications with pharmaceutical medications so there is very rarely any danger in taking them together. However, some medications can have effects in the body that might make it inappropriate to use a probiotic, for example in severely immunocompromised individuals, so if you’re taking a regular medication it’s best to check with your doctor before you start any supplement.

When should I take my probiotics?

The upshot of all this is fairly simple, if we break it down into a few parts.

Firstly, if you can, take them with food. Most take their probiotic with breakfast to help keep it routine. This just helps protect those bacteria that little bit more from the stomach acid, and helps to prevent people from forgetting to take them as it’s part of their daily routine.

Secondly, avoid hot drinks. Heat can kill bacteria, so a piping hot coffee might not be the best idea. Warm drinks should be fine, but the best option really is a glass of water.

Thirdly, try to take them at a different time to medication, especially antibiotics. This just ensures that the medication won’t have a chance to damage the bacteria you’re sending in, making sure that as much of those probiotic bacteria as possible survive to your gut.

One final point, and a major caveat to all of this information, is to follow the manufacturer recommendations! Probiotic manufacturers will know when it’s best to take their products, and it’s best that you follow their instructions. This way you know you’ll be getting the most out of your probiotic.

References:

-              Tompkins TA, Mainville I, Arcand Y. The impact of meals on a probiotic during transit through a model of the human upper gastrointestinal tract. Benef Microbes. 2011 Dec 1;2(4):295-303. doi: 10.3920/BM2011.0022. PMID: 22146689.