Prebiotics vs. Probiotics: Can You Take Them Together?

Original Article

Prebiotics and Probiotics

Probiotics are bacteria that naturally live in your body and help break down food in your intestines.
Probiotics that are similar to the ones your body makes can be taken as supplements to help with
digestion. In recent years, a new type of supplement called prebiotics has been advertised to go along
with taking probiotics.

Prebiotics are made up of carbohydrates that your body cannot digest. They serve as food for the
probiotic bacteria you are putting into your body. Taking prebiotics and probiotics together is called
microbiome therapy. You do not need to take a prebiotic for probiotics to work, but taking them may
make your probiotics more effective.

What are Prebiotics?

Prebiotics do not actually contain bacteria. They provide fuel to help bacteria grow. All prebiotics are a
type of dietary fiber. The fiber inulin, found in chicory root, bananas, and asparagus, is a prebiotic that
gut bacteria can use as food. Onions, garlic, artichokes, and legumes also contain prebiotics. When a
food contains both prebiotics and probiotics, it is called a synbiotic. Foods that are synbiotics include
cheese, kefir, and certain yogurts. Prebiotics can also be added as a commercial food ingredient or
capsule supplement and come in liquid or powder form. On their own, prebiotics have not been found to
be very useful. Recently, prebiotics added to infant formula were found to make the formula more
similar to breastmilk. It is only when used together that prebiotics and probiotics seem to have an effect.

What are Probiotics?

When people talk about probiotic bacteria, they generally mean two families of bacteria. Strains of
Lactobacillus and Bifidobacterium are both associated with probiotic formulas. Many slightly fermented
foods naturally contain probiotics, such as sauerkraut, kimchi, and yogurt. Pickles also contain natural
probiotics. Probiotics can be purchased as a food-grade health supplement in powder or liquid form.
Probiotics usually need to be refrigerated to keep the bacteria alive and able to reproduce.

Risks and Side Effects of Prebiotics and Probiotics

The Centers for Disease Control and Prevention (CDC) point out that using commercial prebiotics and
probiotics is generally safe for healthy people. However, there are rare cases where a healthy person
gets sick after ingesting certain types of bacteria in probiotics. Probiotics are not regulated like “drugs”
by the U.S. Food and Drug Administration (FDA). This means that some of the live bacteria used in
probiotics have not been evaluated for safety as strictly as they could be. It is important to keep this in
mind when considering prebiotics and probiotics. Common side effects when starting a synbiotic
regimen include gas, constipation, loose stool, and loss of appetite, especially at the beginning.
Bloating and acid reflux have also been reported. Having an allergic reaction to the added bacteria is a
dangerous side effect of probiotics. If you break out in hives or have extreme stomach pain after
ingesting a prebiotic or probiotic, stop taking the supplement and see a doctor to determine if you are
having a reaction. Talk to your child's doctor before giving probiotics to a child under 12. Probiotics and
prebiotics are believed to generally be safe during pregnancy and breastfeeding, but check with your
doctor first before starting any new supplement.