There's no need to take a probiotic supplement to improve your gut health.
In fact, Dr. Will Bulsiewicz, a gut doctor and medical director at nutrition startup Zoe, said on a recent podcast that he no longer recommends probiotics on a routine basis.
For a long time, Bulsiewicz, like many gastroenterologists, would recommend a probiotic supplement to patients — especially after an antibiotic prescription, which can damage a person's gut flora.
But not anymore.
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He started to question the practice after a small study published in 2018 showed that probiotic supplements can actually slow down people's gut recovery after antibiotics.
"Surprisingly, to all of us, the use of probiotics may actually negatively affect the recovery of the gut," Bulsiewicz said. "In the vast majority of people, I don't actually give probiotics anymore after antibiotics."
Turns out, there's a cheaper, and more delicious way to improve your microbiome. Eat foods that are alive.
Fermented foods have live bacteria inside them, that are working to break down bacteria, yeasts, and sugars, preserving fresh products like produce and milk which would otherwise spoil quickly.
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In addition to functioning as natural preservatives, the live bacteria and active cultures in fermented foods also foster a healthy microbiome inside the walls of your gut, and may enhance gut health better than a probiotic supplement could, Bulsiewicz said.
Eat things like kimchi, yogurt, and kefir
Epidemiologist Tim Spector, a genetics professor and Zoe co-founder, says what's happening when you take a probiotic supplement is that it disrupts your own, unique microbial community, by introducing something powerful, specific, and new into the mix.
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"At the moment, the current evidence suggests you're better off not taking commercial probiotics, but just taking fermented foods," Spector said. "Fermented foods are basically probiotics — live microbes — but actually in food, as opposed to in a capsule."
Fermented foods have been enjoyed by people around the world for thousands of years, and include:
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Yogurt
Cheese
Kefir
Kombucha
Sauerkraut
Miso
Pickles
While they aren't always as potent as probiotics, fermented foods are more microbially diverse, which Spector considers a plus. Foods like kefir, kimchi, and kombucha have anywhere from 20 to 40 different types of live bacteria and yeasts inside them, while yogurt usually has around three.
"Getting five or six little portions a day, in a few weeks, can actually reduce inflammation and boost your immune system," Spector said.
You can also nourish the good bacteria in your gut by eating a diet rich in fiber, which is plentiful in plant-based foods like fresh veggies and whole grains.
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Red flags to look for on probiotic food labels
Even with fermented foods "you can be conned very easily" into buying things that aren't really alive, Spector said.
Make sure you're picking out items that have not been pasteurized or include lots of additives. Pickled items should be a simple combination of plants, water, and salt (no vinegar). Kombuchas should have plenty of sediment and fizz.
Foods labels that say "live active cultures" or "live probiotics" are generally a good sign, Bulsiewicz said.
If you want to starve the bad bacteria in your gut, avoid added sugar and ultra-processed foods.
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Sometimes probiotic supplements are worth it
Bulsiewicz cautioned that there are exceptions to the general no probiotic supplements rule for people with a family history of diarrhea issues like C. difficile or other gut abnormalities.
However, he is still very intentional about which specific probiotic supplements he might use in those rare cases.
