Though personal, the probiotic journey has a common narrative arc—especially for those of us entering our first foray into the land of gut flora. Story goes a little something like this: Person realizes they want to support their gut health. Person purchases probiotics (ideally, after confirming the strains are clinically-backed and packaged with the utmost attention to viability). Person takes them home, excited to begin their new “good bacteria” regimen—maybe they even pop a pill, just to kick things off.

But sooner or later, questions inevitably arise: “Am I… doing this right?” “When should I be taking these for maximum impact?” “Are probiotics best on an empty stomach? With food? First thing in the morning? At night before bed?” Clearly, it’s time for a gut check. Here’s what the experts have to say.

Why Take Probiotic Supplements?

Even a healthy person who eats a balanced diet has reasons to add a probiotic supplement to their routine. Probiotics can provide support for gut health, digestive health, and immune health—and considering that imbalances in our gut microbiota can be caused by poor diet, stress, travel, the use of certain medications, and other lifestyle and environmental factors (basically, modern life in general), it’s a smart option.* (2,4,5)

Fermented Foods May Not Always Be Enough

In the quest for supporting a healthy gut, many people turn to fermented foods and beverages that contain probiotic bacteria (kefir, sauerkraut, kimchi, kombucha). But research shows that might not actually be the most effective approach. While many fermented foods do include live and active cultures—and these cultures can indeed sustain well during a product’s shelf life—after consumption, these microbes are typically unable to survive passage through the stomach and small intestine. (2)

Translation? The cultures naturally present in fermented foods may not be able to reach and colonize the large intestine, which is where the magic happens—and that kind of defeats the whole purpose. Plus, survival rates aside, not everyone enjoys (or has access to) such picks. With all this in mind, you can see why probiotic supplements can be an especially attractive choice. (2)

How Often Should Someone Take Probiotics?

“Research shows that when it comes to probiotics, consistency is definitely key,” says Arianne Vance, MPH, Ritual’s Principal Scientist. That’s because even though the microorganisms in probiotics are able to successfully colonize the gastrointestinal tract, they don’t stay in there very long—evidence shows strains are only retained for days or weeks after supplementation stops, which suggests the importance of taking them continuously (ideally daily).* (2,3)

→ Essential Reading: Prebiotics vs. Probiotics: What’s The Difference?

Taking Probiotics With Medications: Yay Or Nay?

It’s generally safe to do so—in fact, some people take probiotics for the sole purpose of restoring gut bacteria after a course of certain meds (like antibiotics). That said, if you’re considering it, we recommend touching base with a trusted healthcare provider beforehand to make sure you can write off any potential interactions or side effects.* (2,6)

When to Take Probiotics, According to Experts

The best time to take a probiotic depends on the brand—in other words, it’s always best to follow the directions on the product label. Some brands recommend taking their probiotic on an empty stomach, while others suggest taking it with food. With that in mind, choosing a probiotic that can be taken at any time of day, with or without food, no matter your schedule, may be the most advantageous way to go—especially if you want to make a habit of it.

But timing is just one piece of the puzzle. Another integral part? Ensuring it’s high-quality. Here’s some questions to consider:

• Are the strains clinically studied? The effects of probiotics can be strain-specific, so you’ll want to look for supplements featuring probiotic strains that are actually supported by evidence from human clinical studies. (In other words, to maximize impact, it’s wise to ensure the supporting data reflects real people—not just any mammal.)* (1,2,3)
• What’s the delivery format? It’s also important to check that the actual packaging vessel takes preservation into account; for example, in-wall desiccants are a great method for keeping products dry and stable—especially important for a supplement containing live beneficial bacteria. When it comes to the actual delivery method itself, consider opting for delayed-release capsules. They’re designed to dissolve later, in the intestines, where they’re intended to get to work.*
• Do they require refrigeration? Contrary to popular belief, not all probiotics need to be refrigerated in order to maintain stability. It depends on the formulation: Some require colder temps to stay alive, while others are shelf-stable. In order to reap the benefits of probiotic supplementation and the “good” bacteria present, you’ll need to take them daily, which is why we recommend reaching for a shelf-stable one—that way, you can store them in plain sight (instead of forgetting them in the fridge).*

Bottom Line?

The best time to take your probiotic is whenever the label dictates. But by reaching for a shelf-stable product with clinically-backed ingredients, you’ve already won half the battle. After all, if consistency is key, convenience should be, too.*

P.S. Have questions about the gut microbiome or digestive tract, including things like bloating or constipation? We recommend speaking with a doctor or gastroenterologist. And if you’re looking to learn more about fermented foods (and creative ways to incorporate them into your diet), reaching out to a dietitian or nutritionist is never a bad idea.

References:

1. Guarner F, Sanders ME, Eliakim R, et al. World Gastroenterology Organization. World Gastroenterology Organisation Global Guidelines: Probiotics and Prebiotics. 2017.
2. Office of Dietary Supplements. Probiotics: Fact Sheet for Health Professionals. National Institutes of Health, Department of Health & Human Services. 2020.
3. World Health Organization. Guidelines for the Evaluation of Probiotics in Food. Report of a Joint FAO/WHO Working Group on Drafting Guidelines for the Evaluation of Probiotics in Food. 2002.
4. Gilbert JA, Blaser MJ, Caporaso JG, Jansson JK, Lynch SV, Knight R. Current understanding of the human microbiome. Nat Med. 2018;24(4):392-400.
5. Lynch SV, Pedersen O. The Human Intestinal Microbiome. N Engl J Med. 2016 Dec 15;375(24):2369-2379.
6. McFarland L. V. (2015). From yaks to yogurt: the history, development, and current use of probiotics. Clinical… : an official publication of the… Society of America, 60 Suppl 2, S85–S90.