Rebuilding a Healthy Gut: Probiotics and Prebiotics

Probiotics and prebiotics are essential to healing the gut for different reasons. Probiotics primarily play an immunoregulatory role—they help balance and regulate the immune system and reduce inflammation in the gut. Contrary to popular belief, most probiotics do not quantitatively change the composition of the gut microbiome over time. That is the role of prebiotics, which provide a food source for beneficial bacteria that already live in our gut and increase their numbers significantly over time.

Functions of ProbioticsFunctions of PrebioticsIn simple terms, probiotics (and fermented foods that contain them) are bugs themselves, and prebiotics are the food the bugs need to survive and multiply. All long-term gut healing protocols should include both probiotics and prebiotics for optimal results.

The strategy with probiotics is to take a broad spectrum of microorganisms, including lactic-acid producing bacteria, soil-based organisms, and beneficial strains of yeast.

The strategy with prebiotics is to include a range of fermentable fibers such as resistant starch (e.g. unmodified potato starch, green banana flour, or plantain flour), non-starch polysaccharides (such as inulin, FOS, larch arabinogalactan, etc.), and soluble fiber (psyllium husk, acacia, glucomannan, etc). Each different type of fiber stimulates the growth of various beneficial bacteria in the gut, so it’s essential to include all of them.

Supplements You’ll Need

Probiotics
• Prescript-Assist
• FloraMyces by Designs for Health (a special strain of Saccharomyces boulardii)
• Primal Defense Ultra

Prebiotics
• Unmodified potato starch**: Bob’s Red Mill All Natural, or other certified gluten-free brands
• Glucomannan powder: Now brand
• Psyllium husk powder: Now brand

**If you are following an autoimmune protocol, or don’t tolerate potatoes, choose one (or rotate between both) of the following. You can also take these even if you tolerate potato starch to further diversify your fiber intake:
• Green banana flour: WEDO brand
• Plantain flour: any brand you can find

Fermented Foods

The fermentation process makes foods more digestible, but it also produces healthy bacteria that are beneficial to the gut. Fermented foods include sauerkraut (and any other fermented vegetables), beet kvass, kombucha, yogurt, kefir (water or dairy), kimchi, and more. Aim for one to two tablespoons at each meal, plus other fermented foods like kombucha or yogurt throughout the day.

Food Sources of Prebiotics

To ensure you are taking adequate amounts of prebiotics, supplementation is often necessary. However, there are some food sources of prebiotics that you may consider adding to your diet to increase variety if you tolerate these foods well:
• Cooked and cooled* potatoes, sweet potatoes, and yams
• Cooked and cooled* parboiled rice or other properly prepared rice
• Cooked and cooled* properly prepared (soaked or sprouted) legumes
• Dehydrated plantain chips 

* After cooling these foods completely in the refrigerator or freezer. They can be warmed for eating, but the temperature of the food must stay below 130 degrees for them to provide the beneficial prebiotics.

Starting Your Probiotics and Prebiotics

Start slowly with the amount of both probiotics and prebiotics that you take, and gradually increase the dose of both as tolerated, based on symptoms of GI distress. Know that some increased gas and bloating is expected—particularly as you begin taking prebiotics. For many people, this improves after a few days and may then occur only intermittently. 

In general, probiotics are best taken with your prebiotics on an otherwise empty stomach. 

Research on prebiotics is ongoing as to the specific benefits and role of each, so it is generally best to take a variety of prebiotics on a rotating basis. And just as our diets have seasonal and even daily variations, it’s okay to vary the amount of prebiotics you take each day. For example, if you have a short vacation planned, you may choose to take more prebiotics over the days leading up to your vacation so that you may go a few days without.

Most people find it easier to spread their prebiotics throughout the day. If you are focusing on weight loss, you may consider timing some of your prebiotic consumption 15 to 30 minutes before meals, as this may increase your feeling of fullness, help with weight loss, and even lower your blood sugar.

Consider mixing your psyllium husk powder with the unmodified potato starch for added benefit. You may mix these into water, almond milk, or a smoothie.

Specific Dose Recommendations 

Probiotics
• Prescript-Assist: Take one capsule daily for seven days, then increase to one capsule twice daily.
• FloraMyces: Take one capsule daily for seven days, then increase to one capsule twice daily.
• Primal Defense Ultra: Take one capsule daily for seven days, then one capsule twice daily for another seven days, and then one capsule three times daily if tolerated.

Prebiotics
• Unmodified potato starch***: Start with ¼ teaspoon daily and gradually increase over the course of a couple of months to 1–3 tablespoons daily.
• Glucomannan powder: Begin with ⅛ teaspoon once daily mixed in 8 ounces of water and slowly increase up to ½ teaspoon daily.
• Psyllium husk powder: Begin with ¼ teaspoon mixed in 8 ounces of water and gradually increase to 1–3 teaspoons taken in separate doses.
• Food sources: Eat freely within the context of a healthy diet.

***You may use plantain flour and green banana flour interchangeably with the unmodified potato starch. 

The timing of taking your probiotics and prebiotics is very flexible, and the combination of your prebiotics is best when varied. Here is one example of how you may take your prebiotics and probiotics when you are taking the full doses (as you build up to these doses you may omit the doses taken later in the day—for example, only taking the “on rising” supplements):

Probiotics Prebiotics
On rising One capsule of each:
Prescript-Assist
FloraMyces
Primal Defense Ultra
1 teaspoon psyllium husk powder
2 teaspoons plantain flour
1/2 teaspoon glucomannan
All mixed in 16 ounces of water
30 minutes before lunch One capsule:
Primal Defense Ultra
1 tablespoon unmodified potato starch mixed in 12 ounces of water

 

15 to 30 minutes before dinner If focusing on weight loss consider taking a few teaspoons of potato starch before dinner

 

Before bed One capsule of each:
Prescript-Assist
FloraMyces
Primal Defense Ultra
1 to 2 teaspoons psyllium husk powder
1 to 2 teaspoons unmodified potato starch
Mixed together in 12 ounces of water

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