All About Gut Health Supplements, from An MD

Immunity, weight, mood, sleep, digestion — gut health is key to all of these important health markers, and more. If feeling energetic and well is your goal, no doubt you’re already thinking about your microbiome. And because of that, the market is full of gut health supplements promising superior wellness.

With so many choices, how can you begin to know which ones to choose? We spoke with a gut health doc to help you wade through the offerings and find what’s best for you. As always, check with your healthcare professional before starting any new supplements.

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You asked: What is the best supplement to take for gut health?

As you probably know already, there isn’t one be-all, end-all supplement that will work for everyone. In general, these are the most common:

• Prebiotics: “Prebiotics are plant fibers that feed the good bacteria in your gut, such as psyllium [the main ingredient in Metamucil],” says Dr. Elena Ivanina, integrative board-certified gastroenterologist and founder of the Center for Integrative Gut Health. “Prebiotics can be helpful for many conditions, from constipation to metabolic conditions such as obesity and high cholesterol.” Some foods also contain prebiotics, including onions, asparagus, and oats.
• Probiotics: “Probiotics are the live organisms that are considered healthy bacteria in your gut, such as Lactobacillus acidophilus,” Dr. Ivanina says. “Probiotics can be helpful for many conditions, such as preventing antibiotic-associated diarrhea during antibiotic courses.” Foods with probiotic benefits include yogurt, kefir, sauerkraut, and miso. 
• Digestive enzymes: “Digestive enzymes are the various enzymes in your body to help digest food, such as lipase for fat, that come from saliva, your pancreas, or found throughout your gut,” Dr. Ivanina says. People sometimes take digestive enzymes in an effort to relieve symptoms such as bloating, gas, and acid reflux.

Related: What’s the Difference Between Prebiotics and Probiotics?

Are gut health supplements worth it?

Along with relieving symptoms, some people choose to take supplements like probiotics preventatively. Whether or not this is a good idea depends on the individual (and, again, check with your healthcare provider) — plus, remember that supplements are meant as additions to other healthy habits, not a replacement.

“One useful exercise is to keep track of how many grams of fiber you’re eating a day,” Dr. Ivanina says. “To help boost that number, you can slowly increase the dose of a fiber supplement until you get the desired results and get to your goal fiber intake. Optimizing your fiber is an important preventive strategy, as many gut health issues arise from fiber depletion, which is common when eating the Standard American Diet.” 

Along with a supplement, you could also boost your fiber intake by swapping in more servings of vegetables, fruit, legumes, and other fiber-rich foods in place of refined foods.

In addition, “Prebiotics may be a helpful preventive tool for many people to improve their gut and overall health,” Dr. Ivanina says. 

But whether or not gut health supplements are worth it depends most on whether you’re taking the right thing, she adds.

“Always keep in mind that supplements are not FDA approved or regulated, and therefore there is a lot of variation as well as risk in finding an effective supplement,” Dr. Ivanina says. “Precision supplementation, or taking the right supplement for the right indication, can be a helpful tool, but is most successful with a knowledgeable practitioner who can help guide dosage, response, side effects, and interaction with other supplements or medications. Instead of just piling on one supplement after another, work with a practitioner to try one protocol and evaluate for efficacy at one month. If it’s not helpful, then you may increase the dose or try another protocol.”

Related: Why Drinking Water Is Important for Your Gut Health, Says Expert

What to watch out for

When it comes to gut health supplements, it may seem like there’s no harm in just adding something new, but that isn’t always the case. 

“One pitfall is starting a probiotic without a specific goal in mind,” Dr. Ivanina says.  “Consumers may not be aware that bacteria have specific functions or effects that they may not find desirable. For example, Saccharomyces boulardii has traditionally been effective for diarrhea. Many times I see constipated patients who start taking it and feel nothing, or even worse.”

It’s also easy to overdo it, which can have consequences, she warns. “’Too much of a good thing’ holds true with supplementation,” she says. “You may think you’re doing the right thing by adding one supplement after another, but then one day there are 30 supplements on your list and your liver is inflamed. Focus on precision, on individualized supplementation with intention.”

Read next: The 8 Best Gut Healthy Foods to Eat, Says a Gastroenterologist