How to Restore Gut Health After Antibiotics - Ask a Nutritionist

Transcript:

LEAH: Hello, and welcome to Dishing Up Nutrition's “Ask a Nutritionist” podcast, brought to you by Nutritional Weight & Wellness. My name is Leah Kleinschrodt. I am a Registered and Licensed Dietitian and your host for the show today.

On today's show, I will be answering a question submitted by one of our Dishing Up Nutrition listeners, and it's a question I get asked semi-regularly when I'm counseling clients, and this question is, how can I repair my gut after taking a round of antibiotics?

So this question actually comes at a good time. I personally just finished up with a round of antibiotics for a nasty little sinus infection I had. Most of us need antibiotics at one time or another to combat a bacterial infection. So sinus infections are pretty common; pneumonia or bronchitis, those are common; strep, throat ear infections, especially in little kids.

UTIs, Lyme disease, or if you get some kind of cut or scrape or a wound that ends up getting infected. These are some reasons why we might need antibiotics at some point. We also might need an antibiotic during or after a surgery that we're having. Maybe we're getting some dental work done and we've got a little bit of a higher risk for infection there.

So the dentist recommends or requires an antibiotic to be taken beforehand, or some people end up on antibiotics to combat acne. So again, lots of different scenarios where we could need some antibiotics and most of us have used an antibiotic at one point in our lives or another. And thank goodness for antibiotics when we need them.

They can absolutely be lifesaving. The story doesn't stop after you take that last pill in the bottle or that last pill in the packet. Nowadays there is a lot more awareness about the effects antibiotics have overall on our gut health, on all the little critters that live in our intestinal tract.

There's a lot more knowledge and information available now about how our gut health then connects to health in other parts of our bodies. So, I mean, we certainly don't know everything, but we do have some ways to provide a little TLC for our gut after we encounter say seven to 10 days of an antibiotic.

I'm actually going to back that statement up a little bit and propose that we start with a little of that TLC while taking the antibiotic. Most people I know and most of the clients I talk to, and you know, most of us experience low to no side effects while taking one round of an antibiotic every once in a while.

However, I have worked with some clients who just get wrecked when they need to take an antibiotic. They might experience a lot of digestive distress, so diarrhea, nausea, loss of appetite, reflux, gas, bloating, or they might feel like their energy gets zapped.

They might break out in a rash. They might feel like they have the flu or there could be a whole culmination of other negative reactions. And then, you know, one round of antibiotics, usually not a huge deal for most people, but sometimes you need end up needing more than one round or you're on a longer duration antibiotic.

So I think about, my teens or my younger adults who either are on or have been on antibiotics for acne. You might be on them for weeks or months or, you know, possibly even years. So the risk then of those side effects goes up the longer that you're on them.

Take probiotics during the course of also taking antibiotics (& how to time them)

Now, despite popular belief and despite kind of what our brains think about logically, you can take probiotics during a round of antibiotics. So not only can this help you manage the side effects a little better, but there's some evidence in the literature that says probiotics may actually help the bad bacteria become more susceptible to the effects of the antibiotics.

So in other words, the antibiotics actually may be more effective at their job if there's some probiotics on board also. So one example of this is, you know, I'd say maybe the more common thing that happens if people get side effects from antibiotics, it just, it tends to be more diarrhea.

So the literature shows if we can get a probiotic started within 24 to 48 hours of starting on an antibiotic, this could cut your chances of getting diarrhea due to the antibiotic by a third or even up to a half. So even if you aren't able to start probiotics right away, I think it's still worth starting them anyways.

Even if you do end up with a little diarrhea, I think it really does help with the healing and recovery of the microbiome after the antibiotics are done. So don't fret if you miss that first like 24 to 48 hour window, like there is still benefit to be had.

Now when you are taking probiotics while on an antibiotic in general, we say, okay, if we can take those probiotics about two hours away from the antibiotics, probably in our best interest to do that. Most antibiotics, or at least the way most people take them, it's like once a day, maybe twice a day, you're taking that antibiotic.

So if I have a client who's taking an antibiotic twice a day, which is usually, you know, take it once in the morning, take it once at night, usually about 12 hours apart from each other. Then I usually have my clients try to slip that probiotic in midday. So we're kind of as far away from those antibiotics as we can get.

Unfortunately there are some antibiotics that require you to take them three or four times a day. That can get a little trickier, and if that's the case, I'll just have that client take a probiotic with one of the antibiotic doses. So, in my mind, again, I think it's better to just get those probiotics in than worry about perfect timing again, like there is evidence to say that the probiotics actually help the antibiotics work better even if the timing is close together. So there will still be the benefits even if you're taking them together.

Now before I go on, I'm going to pause here, take a quick break, and when we come back I'll talk a little bit more about considerations for our gut after we've completed the antibiotics. So we'll be back in a moment.

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How to support gut health after antibiotics (& which probiotics might be the best fit)

LEAH: Alright, we are back. So we talked about what, there are things we can do to actually help support our gut while we're on antibiotics. So now let's talk about what do we do to help support our gut after a round or two of antibiotics. I guess I'd first start off with either initiating, if you haven't already, or continuing on probiotics to help restore balance to the microbiome and prevent some of those opportunistic or some of those bad bacteria from coming in and taking over while the good guys have been knocked down.

And so that's a, a fancy name called dysbiosis, where we have more of the bad guys than we have of the good guys. If I am looking at our probiotic lineup at Nutritional Weight & Wellness, I'm probably going to go with either our Bifido Powder or the Bifido Balance capsules.

They're one and the same. Those are just a single strain probiotic. It's just one thing, so it's simple. Or I'm looking at our Nutrikey Biotic 7 Capsules, which is a multi-strain  probiotic. I really like the Biotic 7 capsules because it gets you a mix of some lactobacillus bacteria, some bifidobacteria strains, and it also has this special little yeast in it called saccharomyces boulardii, which has its own microbiome benefits.

And I like the Biotic 7 because it's a little higher dose, so you can get away with taking fewer capsules. I'll usually have clients take one capsule a day, sometimes two capsules, just depending on what's going on. If I'm having people take two capsules, I'll have them do one in the morning, one in the evening, just to kind of split it up.

But if I have someone with a really sensitive system, though, I'm probably going to keep it simple: stay with a single strain probiotic, bifido products, and if they tolerate it, I do recommend clients take bifido at a half a teaspoon, even up to a full teaspoon of the powder three times a day, usually with those main meals, or taking two to three capsules per meal.

We can always start lower and slower if the gut is just having a little bit of a hard time adapting to the input. That is one reason I do kind of like the Bifido Powder a little bit more in those scenarios because we can dial it up, dial it down a little bit easier. But that one does live in the fridge.

Many people really like the convenience of just being able to toss the capsules into a bag or keep a bottle at work and not have to worry about the refrigeration piece. I've seen great results with both of them, so don't shy away from one just because of the refrigeration issue or not.

Another one I will just mention briefly. We do have a probiotic that I might consider for women who are either prone to UTIs or they're prone to yeast infections after an antibiotic. And this probiotic is called Women's Biotic Balance. So this probiotic has something in it called lactobacillus acidophilus, which is super helpful in the gut for reflux, but it is also really important for the urogenital system.

And then this probiotic also has a couple other class of probiotics that are just shown to be helpful for the pH balance and just kind of balancing out that ecosystem of the vaginal tract and the urinary tract. So for that particular probiotic, that one is not refrigerated. I would do at least two capsules a day maybe for, again, just depending on kind of what this person is struggling with.

Nutritional considerations after an antibiotic

After an antibiotic, in terms of any kind of nutritional tweaks, I would think about during this time, again, it would probably depend just how that person is doing on the antibiotic, if they're dealing with any side effects, either during or after the antibiotic.

And just kind of how they've managed antibiotics in the past and what we can expect. So if this person is experiencing more side effects, more digestive upset, anything, this would probably be a great time to just call for a lot of simplicity in the diet.

I tend to think about, you know, slow cooked meats that are easy to digest, cooked vegetables, maybe staying away from the raw roughage for a little while, cooked mashed root veggies like sweet potatoes or the winter squash, and also bringing in some of the healthier fats like butter, olive oil, nut butters, canned coconut milk, all of these really healing fats.

And then I would also think about, well, we probably want to at least for a little while, lay off the extra sugar and the treats, just so we're not feeding the bad bacteria, giving it something that it can take hold of. So soups are a great way to accomplish this if we kind of have a meat and vegetable based soup. We've kind of got all of our components there.

Another meal I would think about is maybe some cooked eggs with some sauteed zucchini, leftover mashed sweet potatoes, or maybe toss a few berries on the side. Protein smoothies are another way to get in a good punch of nutrition in a liquid and easy to digest form. So again, it would just hopefully help us get some of that great nutrition in if the gut is having a little trouble rebalancing or kind of getting back on its feet.

Some people might feel a little bit better with a short stint of more of a low FODMAP type of eating plan. Low FODMAP just means like we're eliminating certain types of carbohydrates that might be a little harder for the gut bacteria to break down. That would be an option. But honestly, most of the time I do find our clients, they do just fine with the usual kind of real food balanced eating approach that we talk about all the time here on Dishing Up Nutrition.

One thing I will have clients just be on the lookout for is if you, some people might notice an uptick in sugar cravings in the weeks after taking an antibiotic, and that's mostly because again, we've kind of gone in and disrupted the delicate balance between the good bacteria and the bad bacteria in our gut.

So if we don't have enough of the good guys in there, the bad guys can kind of rear their ugly heads and then they crave sugar, they crave more of those refined carbohydrates. And so I have seen this with some clients coming out of it and they are just, they're like, these are things I have either never craved before or like I have not craved the cookies in an awful long time, and so all of a sudden these cravings are back and I don't know what to do.

So usually, again, I'm trying to just help, I help clients with, with combating that, usually with just some extra attention with their probiotic regimen and making sure that overall we're still prioritizing still some good protein, some of those healthy fats to balance out the sugar cravings. Usually after a week or two, maybe a little longer, but I'd say most of the time, a week or two things, calm back down.

So I hope this was helpful and maybe keep this episode in your pocket if you are either on an antibiotic now or, if that comes up again for you in the future. Pocket this episode, and maybe take a listen again if you're ever in that scenario. And I want to thank everyone so much for listening to Dishing Up Nutrition’s “Ask a Nutritionist”.

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