Dr. Lybbert is wearing a white lab coat and smiling into the camera
Emily Lybbert, RD.

You’ve seen the supplements and heard the hype — promises ranging from easy weight loss to a stronger immune system. But do you really need probiotics? And, what’s the best way to get them?

With constantly changing information available from so many sources, deciding whether or not you need probiotics can be confusing. So, we went to Emily Lybbert, a registered dietitian at CoreLife Novant Health - Ardmore in Winston-Salem. Below, she explains the benefits, potential risks and best sources of probiotics to help you make the right decisions for your unique needs.

What exactly are probiotics?

“Probiotics are good bacteria, live microorganisms that live in your gut,” Lybbert said. “People often think bacteria and other microorganisms are harmful — but there are helpful bacteria, too, which can offer significant health benefits.”

These “good” and “bad” bacteria live in delicate balance inside your digestive system. But sometimes, due to illness, aging or poor lifestyle behaviors (like heavy drinking or not eating a healthy diet), this balance can be disrupted.

What benefits do probiotics offer?

“Probiotics help with digestion, making sure people are regular and preventing bloating and other discomfort,” Lybbert said. “They've also been shown to help boost immune function.”
Other conditions that can benefit from probiotics include:
Inflammation, which contributes to heart disease, stroke and other life-threatening conditions.
Obesity.
Frequent urinary tract infections.
Diabetes (Type 1 and Type 2).
Gastrointestinal disorders (irritable bowel syndrome, ulcerative colitis, etc.).

Research in this area is still new, but probiotics from different groups (Lactobacillus, Bifidobacterium, etc.) appear to serve different purposes, Lybbert said. Some, for example, may aid in the production of serotonin — the happy hormone. Others serve as antioxidants, help our bodies absorb nutrition and even fight tooth decay.

Who should try probiotics?

If you are generally healthy and eat a balanced diet, these beneficial bacteria are already present in your gut. That said, if you’re curious about whether probiotics might improve your overall health, boost your immune system or relieve occasional bloating, there’s little harm in introducing probiotic-rich foods (listed below) into your diet.

The same holds true for children, who may experience relief from conditions such as constipation, diarrhea or eczema when their intake of probiotic foods is increased.
Note: Before giving a probiotic supplement to your child — or taking one yourself — it is important check with your health care provider.

When we take antibiotics, should we take probiotics, too?

“While antibiotics are necessary to help get rid of bad bacteria that are causing problems, they unfortunately wipe out your good bacteria in the process,” Lybbert said.
We can’t always avoid taking antibiotics, though. So Lybbert encourages people who’ve been prescribed antibiotics continue to make foods high in probiotics part of their diet to help maintain the good bacteria in their systems.

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What’s the best way to get enough probiotics?

To get the highest quality probiotics, and to ensure they are delivered in a way your body can use, it’s best to take them in through a healthy diet, according to Lybbert. She suggests the following probiotic-rich foods:
• Fermented dairy products like kefir, yogurt and buttermilk.
• Unpasteurized sauerkraut and naturally fermented sour pickles (made without vinegar).
• Fermented soy products like miso and tempeh.
• Kimchi, a traditional Korean side dish of fermented vegetables.
• Kombucha, a sparkling beverage made of fermented tea.
Some aged cheeses contain good bacteria, but low-fat yogurt and kefir deliver higher numbers of active bacteria with less saturated fat (associated with chronic illnesses like heart disease and Type 2 diabetes).

Are probiotic supplements helpful?

Probiotic supplements are primarily used to keep your gastrointestinal tract in good working order. So, unless you have symptoms of a GI illness — bloating, diarrhea, constipation — there’s little research that proves they will improve how you feel.

“I usually tell people they can try a probiotic supplement if they want to,” Lybbert said. “But if they don’t see any benefits, I wouldn’t recommend continuing to take it.”

Otherwise, the best option for replenishing good gut bacteria on a day-to-day basis is through a balanced, healthy diet that includes probiotic-rich foods.

Can probiotic supplements be harmful?

While they are generally considered safe for healthy individuals, people with compromised immune systems, those suffering from severe illness and anyone who has recently had surgery should discuss the risks and benefits of taking probiotics with their physicians.

Also, because probiotic supplements are not regulated by the U.S. Food and Drug Administration, manufacturers may make unsubstantiated claims or label products in a way that fails to accurately represent their contents.

"Some probiotic products have been reported to contain microorganisms other than those listed on the label, which could pose serious health risks,” Lybbert said. “But this kind of thing is rare. In all my years of practice, none of my patients have experienced negative side effects from taking probiotics.”

Prebiotics — good food for “good” gut bacteria

Like fertilizer for your garden, prebiotics are a kind of food that helps nourish your probiotics — the good bacteria in your gut.

Unlike probiotics, which are living organisms, prebiotics are undigestible plant-based fibers, according to Lybbert. Without them, your good bacteria would die off, resulting in a less varied microbiome (the community of microorganisms that lives on us and in us).

While prebiotic supplements are available, most people get plenty of prebiotics from a healthy diet, she said. Another benefit of prebiotic foods: They have been shown to improve metabolic health and even help prevent certain diseases. Foods that deliver prebiotics include:
• Fresh fruits and veggies.
• Whole grains, like oatmeal.
• Legumes (beans, lentils, peas, etc.).
• Nuts and edible seeds.
• Onions, garlic and leeks.

Looking for a great way to get both pre- and probiotics? You may want to consider synbiotics — combinations that deliver both. Here are just a few suggestions:
• Plain low-fat yogurt topped with sliced fruit.
• A garden salad tossed with a miso-based dressing.
• Kimchi or unpasteurized sauerkraut made with onions or garlic.