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Taking probiotics and antibiotics concurrently

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    Great Les. Sounds like you got everything covered!
    Those bugs should be gone soon.


      What are others sources of probiotics besides yogurt?


        Kefir, homemade sauerkraut are two food sources. Garden of Life brand Primal Defence is a good supplement.
        "Let your food be your medicine" - Hippocrates


          FWIW a 'naturopath' was working at the store I bought mine from, when I said I was looking for potent probiotics he said, quietly, that a study found only 2 brands were effective, Pharmax -the one I bought- and I believe Metagenics was the other.
          Embrace uncertainty. Hard problems rarely have easy solutions. Jonah Lehrer


            I keep looking for the perfect bottle after reading this.
            Not all probiotics are the same & too little or too much can cause trouble.
            Eileen I'll check those 2 out compared to this report.
            We also need to take enzymes.
            It says to take probiotics on an empty stomach.
            I get overwhelmed trying to take the right ones & don't take any.
            This is a good read:

            The Barron Report: The Probiotic Miracle

            When you are healthy, over 100 trillion microorganisms, from some 400 different species, flourish in your intestinal tract, aiding in digestion, absorption, and the production of significant amounts of B vitamins and enzymes. But more importantly, they crowd out all harmful bacteria -- allowing them no place to gain a foothold.

            Unfortunately, the levels of beneficial bacteria decline dramatically as the human body ages. Some of the reasons for this decline include:

            • Over time, the colonies of friendly bacteria just naturally age and lose their vitality.
            • Disruptions and changes in the acid/alkaline balance of the bowels can play a major role in reducing the growth of beneficial bacteria. In addition, these changes tend to favor the growth of harmful viral and fungal organisms as well as putrefactive, disease-causing bacteria.
            • Non-steroidal anti-inflammatory drugs (NSAIDS) like Advil, Motrin, Midol, etc. are destructive to intestinal flora.
            • Chlorine in the drinking water not only serves to kill bacteria in the water; it is equally devastating to the colonies of beneficial bacteria living in the intestines.
            • Radiation and chemotherapy are devastating to your inner bacterial environment.
            • Virtually all meat and chicken and dairy that you eat (other than organic) is loaded with antibiotics, which destroy ALL of the beneficial bacteria in your gastrointestinal tract.
            • A diet high in meats and fats, because they take so long to break down in the human body, promotes the growth of the harmful, putrefying bacteria.
            • Constipation, of course, allows harmful bacteria to hang around longer, which allows them to proliferate.
            • Cigarettes, alcohol, and stress are also major culprits -- as are some antibiotic herbs, such as goldenseal (if taken in sufficient quantity).
            • And if you've ever been subjected to a round of "medicinal" antibiotics, you can kiss your beneficial bacteria good-bye. The problem is that antibiotics indiscriminately destroy both bad and GOOD bacteria -- allowing virulent, mutant strains of harmful microorganisms to emerge and run rampant inside the body. Antibiotics (both medicinal and in our food supply) are the #1 culprit in the overgrowth of HARMFUL pathogens in the gastrointestinal tract (a condition called dysbiosis) that may be at the root of many autoimmune disorders and certain cancers.


            Also in picking the perfect probiotics:

            (same link)

            There are many beneficial bacteria that can be contained in a good probiotic, but two are preeminent. Look for a formula based on these two:

            • L. acidophilus resides primarily in the small intestine and produces a number of powerful antimicrobial compounds in the gut (including: acidolin, acidolphilin, lactocidin, and bacteriocin). These compounds can inhibit the growth and toxin producing capabilities of some 23 known disease-causing pathogens (including: campylobacter, listeria, and staphylococci), as well as reduce tumor growth and effectively neutralize or inhibit carcinogenic substances.

              It's also important to note that L. acidophilus is the primary beneficia bacteria in the vaginal tract. When the presence of the acidophilus is compromised, this allows the bad guys such as Gardnerella vaginalis or E. coli or Chlamydia to take over.
            • Many researchers believe that declining levels of bifidobacteria in the large intestine actually mark the eventual onset of chronic degenerative disease. Bifidobacteria benefit the body in a number of ways. They; consume old fecal matter, have the ability to remove cancer-forming elements (or the enzymes which lead to their formation), and protect against the formation of liver, colon, and mammary gland tumors.
            More is not always better. Too many beneficial bacteria in one formula may find the bacteria competing with each other before they can establish themselves in separate areas of the intestinal tract. On the other hand, there are several other bacteria that are extremely beneficial in any probiotic formula.

            • L salivarius helps digest foods in the intestinal tract and makes vital nutrients more assimilable. It also works to eat away encrusted fecal matter throughout the entire colon; it helps repair the intestinal tract by providing needed enzymes and essential nutrients; and it adheres to the intestinal wall, thereby forming a living matrix that helps protect the mucosal lining.
            • L. rhamnosus is a powerful immune stimulator. It can increase the natural killing activity of spleen cells, which may help to prevent tumor formation. It boosts the ability of the body to destroy foreign invaders and other harmful matter by three times normal activity; and has been shown to increase circulating antibody levels by six to eight times.
            • L. plantarum has the ability to eliminate thousands of species of pathogenic bacteria. It also as extremely high adherence potential for epithelial tissue and seems to favor colonizing the same areas of the intestinal tract that E. coli prefers -- in effect, serving to crowd E. coli out of the body. At one time, plantarum was a major part of our diets (found in sourdough bread, sauerkraut, etc.), but is now virtually nowhere to be found.
            • Note: a good probiotic formulation will usually contain fructooligosaccharides (FOS) which help promote the growth of beneficial bacteria. For some friendly bacteria, such as the Bifidus, FOS can increase their effectiveness by a factor of 1,000 times or more!!
            Guidelines For Taking Probiotics

            One final note: start slowly. When you first start using a probiotic supplement, there is a chance that you will precipitate a die-off of bad bacteria in your intestinal tract. This can lead to gas, stomach rumblings, and cramping for up to three weeks.


              I keep seeing conflicting advice about whether probiotics are best taken on a full or empty stomach. Which is better?


                I just don't think there is a lot of information on probiotics at this point. They have just began to hit mainstream as far as popularity goes but many healthcare practitioners have been recommending yogurt for years to combat diarrhea and even yeast infections.

                There still seems to be conflict between many of these "natural" remedies and Western medicine. I definitely think they can be beneficial but I also believe there are several products out there that are essentially worthless.

                So do your research!


                  This meta-analysis summarized more than 20 studies on probiotics effects on antibiotic diarrhea and c diff. It found only the probiotic S. boulardii was effective against c diff.

                  I had trouble finding S. boulardii in most probiotic capsules being sold. Finally found it near me in a product called Florastor


                  More good stuff here too.

                  Last edited by quadfather; 1 Mar 2009, 9:42 PM.


                    when to take probiotics.

                    I eat a lot of kefir. And since antibiotics kill bacteria, no matter good or bad, is it safe to say i should eat kefir after i eat antibiotics?


                    Last edited by SCI-Nurse; 26 Apr 2009, 12:57 PM. Reason: Removal of spam links


                      I used to get diarrhea when taking certain antibiotics, and drugs like lamotil only helped sometimes. Now every time I'm on one I take one acidophilus tab with dinner daily and have not experienced this problem in years. Not sure how much is in each tab, but it's a brand available in the local grocery store and/or drugstore. I swear by the stuff.


                        I only get diarrhea with specific antibiotics so I just avoid being put on those when possible. Diarrhea is actually one of the first symptoms I get when I have a uti, once I get on antibiotics bowel return to normal. Never taken probiotics, never had to use I.V. antibiotics either.


                          hmmm... i didn't know that.. i guess i'll have to try it.. i'll let you guys know what happens. : )

                          Last edited by SCI-Nurse; 10 May 2009, 6:49 PM. Reason: Removed spam link


                            In the first article that leschinsky linked to it states that:

                            "During antibiotic therapy, taking probiotics as well keeps the intestinal flora in proper balance. They can be taken together, but not at the same time of day. In order for the probiotics to be the most effective, they should be taken at least two hours after each dose of antibiotic. When the treatment has been completed, double or triple the probiotic supplements for about ten days or two weeks. Probiotics should be taken with food or shortly after eating as food dilutes the stomach acids enough for them to survive their trip through to the intestines where they belong. "

                            Both of these points make sense when you think about it. Regarding the first: You want to reintroduce good bacteria after you have killed off the bad with the antibiotics. Not before because then the antibiotics will also will off the probiotic bacteria as well. Antibiotics are not going to select what bacteria to leave behind.

                            The science on this stuff is still pretty slim but in most cases probably can't hurt. I read that a main problem with the claims is that they market using huge sounding numbers like "1 billion colonies per dose!!!" but since your body can have up to 100 000 billion of bacteria in it it is unlikely to make as much of an impact as it sounds like. Sort of like throwing an ice cube in the bath and expecting it to cool it down immediately. They are still a cheap and easy thing that is worth a try before you have to go for a fecal transplant.


                              Here are some results from a more recent meta-analyses, published January 2009 in Current Opinion in Gastroenterology, on probiotics and antibiotic-associated diarrhea:

                              Antibiotic-associated Diarrhea. Antibiotic-associated diarrhea (AAD) occurs in about 5-25% of adult patients and 11-40% of children upon administration of broad-spectrum antibiotics. Clostridium difficile is a major agent, although diarrhea may be related to general changes in intestinal microflora. A systematic review[4] and a meta-analysis of RCTs[5] provided evidence of a moderate beneficial effect of Lactobacillus rhamnosus GG, Saccharomyces boulardii and a combination of Bifidobacterium lactis and Streptococcus thermophilus in preventing AAD. A recent Cochrane review of 10 RCTs carried out in 1015 treated and 971 control children reported a significant reduction in the incidence of AAD [Relative risk (RR) 0.49; 95% confidence interval (CI) 0.32-0.74], confirming the efficacy of LGG and S. boulardii. [6] The subgroup analyses provided evidence that probiotic dose may be responsible for the observed clinical and statistical heterogeneity of results. Interestingly, of the eight studies that provided dosage information, five studies in which children received 5-40 billion bacteria/yeast/day showed that probiotics had preventive effects (RR 0.35; 95% CI 0.25 to 0.47), whereas the combined results of three studies using less than 5 billion colony-forming unit (CFU) bacteria/yeast/day were not significant (RR 0.89; 95% CI 0.53 to 1.48, I2 = 61.4%). The number-needed-to-treat was between seven and 10. As suggested by the Cochrane review, more data are needed to consider the routine use of probiotics to prevent AAD in children started on large spectrum antibiotics. In particular, cost-benefit data are strongly needed.
                              Two recent double-blind RCTs suggested that other strains were effective in preventing AAD. The first, conducted on 135 adults, showed that a drink containing Lactobacillus casei, Lactobacillus bulgaricus and S. thermophilus twice daily prevented AAD and diarrhea caused by C. difficile (number-needed-to-treat five and seven, respectively).[7] The second was a pediatric trial in which Lactobacillus rhamnosus (strains E/N, Oxy and Pen) reduced the risk of any diarrhea in children undergoing antimicrobial therapy for common infectious diseases.[8]
                              The role of probiotics in C. difficile-associated diarrhea is still unclear. S. boulardii was found to be significantly effective in treating C. difficile diarrhea.[9] The benefit of probiotics in C. difficile diarrhea was mostly seen in adults and, particularly, in subgroups characterized by severe disease.[10] Despite the moderate evidence obtained in adults, the use of probotics to specifically treat or prevent C. difficile diarrhea has not been evaluated in a RCT in children. A recent meta-analysis showed that LGG and S. boulardii might be useful in treating or preventing recurrences of C. difficile diarrhea.[11] Nonetheless, the heterogeneity of the studies makes it difficult to draw definite conclusions.

                              The link to the full article, which addresses the role of probiotics in diarrhea from other causes also, can be found below. Registration, which is free, is required to view the article (I think).


                              Often the medical community is slow to embrace these complementary/natural healing type approaches, but they seem to be giving probiotics the two thumbs up. However some strains seem to be more effective than others. Sounds like LGG and S. boulardii are the two strains that seem to consistently end up with the best across the board results, so you may want to look for them if you find yourself shopping for a product.