The Importance of Probiotics
Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host” [1]. In other words, probiotics are beneficial microorganisms that support human health. Probiotics are typically bacteria naturally found in the human gut microbiota that play a part in supporting human physiology as part of a healthy gut ecosystem living in symbiosis with the human body.*
Probiotics can be taken in the form of probiotic supplements, but they are also naturally found in many foods, namely in fermented foods—they are the microorganisms that fermented them. These include some yogurts, cheeses, kefir, miso, kimchi, and sauerkraut, for example.
Probiotics can support human health through several processes: by promoting a healthy composition of the gut microbiota; by modulating microbial metabolism and supporting the production of microbial metabolites that promote healthy immune, endocrine, and neural signaling; or even by directly interacting with human cells in the gut (e.g., immune or endocrine cells) [2–4].*
Research has shown several benefits of probiotics to human health, including supporting immunity, antioxidant defenses, cardiometabolic health, gastrointestinal function, digestive health, skin health, and even mood and cognition [5–10]. However, these are not necessarily general benefits of probiotics—each microbial species may have its specific effects.*
When Is the Best Time to Take a Probiotic?
There’s a lot of conflicting information around this topic, but here is our best take based on the available research.
Should Probiotics Be Taken in the Morning or at Night?
There are many compounds and ingredients for which the time of day they are taken influences their effects. This can be because of the time a certain compound takes to generate a certain benefit following intake, which can dictate the timing of intake; it can also be because of the circadian rhythms of the body that influence how certain compounds are absorbed or metabolized. The presence of other compounds from food may also influence how things are absorbed or metabolized.
However, probiotics are neither absorbed nor metabolized; they are live microorganisms that will temporarily inhabit the gut after intake. What can make the most difference in the efficacy of a probiotic supplement is whether or not they reach the intestines alive.
One argument that can often be found in favor of taking a probiotic at night is that the relative inactivity of the GI tract while we sleep may favor colonization of the gut by probiotics. However, this notion is largely a myth.
Colonization by a probiotic would entail a permanent (or at least long-term, months or years) establishment of a microbial species that was not part of the ecosystem within the gut microbial community, maybe even displacing some of its native members. That’s not really what happens with probiotics. Probiotics are more like temporary visitors that benefit the native gut microbiota and help shape the ecosystem to create a more favorable gut environment that promotes a balanced and stable gut microbiota and supports gut health [1].* They’ll be found in the gut as long as you’re taking them, but after you stop, they’ll be gone, probably within days.
A more important concern regarding the viability of probiotics may be whether or not they make it through the harsh environment of the stomach intact, i.e., if stomach acid will inactivate or harm them. Time of day may make a difference: stomach acid has a circadian pattern unrelated to meals and typically produces the most acid at night, peaking between 10 PM and 2 AM [11]. This means that not only is the GI tract not inactive at night, but it may actually be more harmful to probiotics than earlier in the day.
Should I Take Probiotics on an Empty Stomach?
The acidic environment of the stomach helps to protect us from harmful microbes, but the fact is that beneficial probiotic bacteria may just as easily be inactivated by stomach acid and bile acids.
The production of stomach acid increases after a meal, which is why it is often recommended to take probiotics on an empty stomach, first thing in the morning, when the levels of acid are lower. The rationale is that the lower acid levels in the stomach following an overnight fast may improve the survival of probiotics, especially those that may be particularly sensitive to a low pH (i.e., high acidity). However, although acid levels are lower on an empty stomach, acid is still present. Another view is that taking probiotics with food may increase the survival of probiotic microorganisms because food helps to buffer the effects of stomach acid.
There is not a lot of research on the subject that we could find, but a 2011 study aimed to determine how the timing of intake relative to a meal and meal composition influence the survival of a probiotic preparation containing four microbial species (Lactobacillus helveticus R0052, Lactobacillus rhamnosus R0011, Bifidobacterium longum R0175, and Saccharomyces boulardii). However, it was carried out in an in vitro digestive system model simulating the human upper gastrointestinal tract (i.e., stomach and duodenum), not in humans [12].
To assess the effect of timing, the study evaluated the survival of the probiotic species when taken 30 minutes before, during, or 30 minutes after a meal of oatmeal-milk gruel (the milk was 1% fat). Results indicated that the survival of probiotics through the upper GI was highest when provided 30 minutes before or simultaneously with the meal (it was slightly better when taken before the meal but the difference was small). The worst survival rate was seen when probiotics were taken 30 min after the meal.
The study then assessed the effect of different foods—oatmeal-milk gruel, just milk (1%), apple juice (pH 3.5), and spring water—on the survival rate. Results showed that survival was highest when the probiotics were administered along with milk or oatmeal-milk gruel relative to apple juice and water. It was also observed that milk and oatmeal-milk maintained the content of the stomach less acidic for close to 2 hours, which was likely what determined the higher survival rate.
Therefore, foods that raised the pH of the stomach, making it somewhat less acidic, seemed to have a buffering effect that allowed a larger amount of probiotics to reach the duodenum alive. However, these differences were only observed for the Lactobacilli and the Bifidobacterium strains (all bacteria), whereas S. boulardii (a yeast species) maintained high survival rates in all conditions [12]. This highlights an important fact about probiotics: different organisms have different resistance to acid and are likely to have better survival rates as they pass through the stomach.
Therefore, this study suggests that taking probiotics right before or along with a meal that raises the pH of the stomach may be a good approach. However, whether or not it’s the best approach will likely vary depending on the probiotic strain you’re taking.
Conclusion: Is There a Best Time to Take a Probiotic?
There’s no clear answer to this question. Based on the limited available research, some probiotics may have a better survival rate if taken before or along with a meal, while others will be unaffected.
Our science team has read a lot of human clinical studies on probiotics. Sometimes researchers have instructed participants to take the probiotic about 30 minutes before meals. Other times they’ve been told to take them with a meal. In some studies probiotics have been taken once a day; in others twice a day; and still others three times a day. Timing and dosing instructions have varied a lot.
Rather than worrying about the time of day at which to take probiotics, it may be better to focus on finding the right product for you and taking it consistently to obtain its full benefits. Ultimately, the best time is the one that works best for you and better fits your habits.
Probiotic Supplements
Check out Qualia Synbiotic. It is more than a probiotic: it is a combination of probiotics, prebiotics, postbiotics, fermented foods, herbs, and digestive enzymes that work complementarily to support digestive health, gastrointestinal performance, the gut microbiota, the gut-immune axis, and the gut-brain axis. We developed Qualia Synbiotic to support gut health, gastrointestinal performance, and the gut-brain axis.*
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
References
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