Can you take prebiotics and probiotics together?

Wondering if you can take prebiotics and probiotics together for double the gut health benefits? Or perhaps you are wondering if it is safe to take both at the same time?

The answer is not so simple, particularly if you have IBS. In this article, we will learn about their benefits on gut health and if you can take both together.

What are probiotics?

Probiotics are defined as “Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host” (1). 

Before you panic, these are natural forms of bacteria that help to support the gut to break down food, and we already have lots of bacteria living in our gastrointestinal tract.

Probiotics for IBS have been shown to reduce symptoms such as (2, 3): 

• Increased complete defecation 
• Reduced abdominal pain
• Decreased flatulence 
• Reduced bloating 

What are prebiotics?

Although the name is very similar, probiotics are not the same as prebiotics.

Prebiotics do not contain any live bacteria; instead, these are nondigestible carbohydrates that promote growth of specific bacteria in the gut.

Prebiotics have been shown to be effective at increasing levels of good bacteria such as Lactobacillus and Bifidobacteria. This has been evidenced by an increased level of short chain fatty acids such as butyrate and propionate (4). 

Short chain fatty acids have antibacterial and antiviral effects (5).

However, prebiotics are often made from non digestible carbohydrates such as inulin.

Inulin and the low FODMAP diet are a no go due to the high FODMAP content. This might answer your question as to whether prebiotics help IBS symptoms. 

Some foods naturally contain prebiotics, such as chicory root, leek, onions, and Jerusalum artichoke (6).

Should I be taking prebiotics and probiotics?

As prebiotics are food for bacteria it is sensible to think that a prebiotic would help feed your probiotic. If the probiotic is ‘fed’ then it will work better.

However there is no strong research to back up this theory.

This means that no approved claims would support the use of probiotics and prebiotics. For supplements to have an approved claim would mean that there is a proven nutritional benefit to the host. 

Nutritional claims are approved by regulatory bodies depending on your residence such as the European Commision (EU), the department of health and social care (UK) or the Food and Drug Administration (USA).

This is not to say that research is not there or emerging. 

What is a synbiotic?

Taking prebiotics and probiotics together in the same supplement is known as ‘synbiotics’. Taking prebiotics and probiotics together in one capsule (or form of synbiotic) might reduce the number of tablets you take in the morning. 

Not only this, synbiotics have been shown to significantly improve inflammatory markers in the body and increase levels of good bacteria in the gut (7). 

The study mentioned above was based on a relatively small sample of 106 individuals and were all healthy adults. Therefore results may not apply to the general population or those with diseases.

Is it safe to take prebiotics and probiotics together?

Yes it is safe to take prebiotics and probiotics together. 

In theory the prebiotic encourages the growth of the good bacteria found in the probiotic within the gut. Although it’s not completely necessary, as they work independently of each other (8). 

Additionally if you were to start taking these together it would be hard to determine which is most effective for you or if they do in fact work together. 

Soluble fibres including galacto-oligosaccharides, pectins and partially hydrolysed guar gum result in lower gas production (9). These are the kinds of prebiotics that might be more suitable for those with IBS. 

Synbiotics on the market:

• Biokult everyday 
• Biomel complete gut
• Garden of life – Ultimate care
• The Neu co pre + probiotic 
• Inessa advanced biotic complex
• VSL # Fibre

Summary

It is important to note that there are lots of variations in the evidence for probiotic use. Including the strain of the bacteria, the timing of probiotic taken, the quantity and duration. 

This is why it makes it difficult to recommend probiotics to you if you have IBS and it’s also not a one size fit’s all solution. 

It would be advised against taking prebiotics in IBS as it is likely to increase severity of symptoms due to the oligosaccharide content. 

If you are looking to try to work on your gut health, probiotics have a stronger evidence base to potentially aid with IBS symptoms. If you are currently taking one and not finding it effective then discontinue the probiotic.