Is It Effective to Take Prebiotics and Probiotics Together?

Gut health is a growing trend, and research is just beginning to uncover how gut microorganisms impact overall well-being. Prebiotics and probiotics, found in foods and supplements, both aim to support gut health. But can you take them together? Keep reading to learn how they work and when to take them.

Prebiotics vs. probiotics

It's important to know the difference between prebiotics and probiotics to understand how they each may benefit you and your gut.

Prebiotics are substances, usually non-digestible fibers, in food or supplements that feed the beneficial microorganisms in the gut. They don't contain live bacteria themselves but instead help nourish the good bacteria already in your gut, enabling them to thrive and maintain a healthy balance. Examples of prebiotic fibers include fructooligosaccharides (FOS), inulin, and galactooligosaccharides (GOS). You can find prebiotics in whole grains, onions, artichokes, apples, beans, and supplements.

Probiotics are live microorganisms, like beneficial bacteria and fungi, that directly add to the population of healthy bacteria in your gut. By supporting digestion, producing nutrients, and enhancing immune function, probiotics help maintain gut health and general health. Probiotics are found in fermented foods such as yogurt, kefir, and kimchi, and are also available in supplements.

Can you take prebiotics and probiotics together?

You can take prebiotics and probiotics together. Supplements that combine probiotics with prebiotics are called synbiotics — a mixture of the beneficial microorganisms and the foundational elements that support them.

However, there are different ways to combine prebiotics and probiotics. Synbiotic supplement formulas are either complementary, with probiotics and prebiotics that work independently to support the host, or synergistic, where prebiotics are aimed at enhancing the actions of probiotics.

In either case, taking prebiotics with probiotics may enhance the survival and colonization of the beneficial bacteria in the digestive tract.

Benefits of combining prebiotics and probiotics

Scientific researchers work tremendously on investigating the potential benefits of combining prebiotics with probiotics. Beyond supplementing and supporting the health of the microorganisms in your digestive tract, prebiotic and probiotic supplements may provide additional potential health benefits.

Gut health improvement

Synbiotics support digestive health by aiming to increase the levels of beneficial bacteria in the gut. A 2024 review study published in Nutrition Reviews found that taking prebiotics with probiotics modified the gut's microbiome by increasing Lactobacillus cell count, a genus of beneficial bacteria that supports digestion and may protect against pathogenic bacteria.

The synbiotic formulas that had the highest impact on Lactobacillus cell counts had at least one strain of Lactobacillus and different prebiotics including inulin, cellobiose, GOS, or psyllium. The formula that had the greatest impact on gut microbiota in healthy adults contained Lactobacillus acidophilus, Bifidobacteria lactis, and inulin and was given over four weeks. A study in people with constipation noted improvements in Lactobacillus count using a formula containing Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium breve, and psyllium given over two months.

Synbiotics may also support Bifidobacteria levels, a beneficial bacteria that contributes to digestion and immune function and produces certain vitamins and short-chain fatty acids. However, the results from studies on synbiotics are less conclusive due to inconsistencies in study designs and formulations. These studies often include Bifidobacteria with or without Lactobacillus strains, along with varying prebiotics such as inulin, cellobiose, GOS, or FOS.

In terms of gut health, the increase in certain genus strains of bacteria in the gut highly depends on the strains used in the symbiotic, and more research is needed to determine what strains and doses offer the most benefits.

Immune system support

Taking synbiotics may support immune function. A 2023 clinical trial published in Gut Microbes found that synbiotic supplementation lowered pro-inflammatory markers better than a placebo in a group of healthy adults. However, this was a small study with 170 participants, and more research is needed to better understand how synbiotics may potentially benefit the immune system and what combinations of strains, prebiotics, and dosage may get the optimal results.

IBS symptom relief

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that causes abdominal pain, gas, bloating, and changes in bowel movements. IBS doesn't cause structural damage to the digestive tract, but the symptoms affect quality of life. Though in the very early stages of research, a 2024 multi-center, randomized, double-blind, placebo-controlled trial published in Nutrients found that synbiotic supplements may help IBS symptoms.

This 12-week study included 202 adults with IBS who received either a placebo or a multistrain synbiotic containing nine strains of probiotics — four Lactobacilli, one Lactoccous, three Bifidobacteria, and one Streptococcus thermophilus strain — and FOS. The study found significant improvements in the severity and frequency of IBS symptoms in the group receiving the synbiotic compared to the group receiving the placebo.

Potential side effects and risks

Taking prebiotic supplements with a probiotic supplement is likely safe for most people. However, it can cause adverse effects such as:

• Gas
• Bloating
• Stomach pain
• Headaches

Adverse effects are usually mild and temporary. Starting with a small dose and gradually increasing to the target dose may prevent or reduce the risk of side effects.

How to choose the right prebiotics and probiotics

Despite a plethora of options, not all probiotic supplements are the same. Most prebiotic and probiotic studies looked at specific strains and doses to evaluate potential benefits. Supplement formulas may contain studied ingredients, but formulas and doses may differ, affecting potential results.

When looking for the right prebiotic and probiotic supplement, choose products that contain scientifically-backed strains and species of bacteria. Your doctor can provide guidance on what strains to look for based on your health goals. They can also provide recommendations on how to take them.

Supplement dosage also varies, and there are no set guidelines for optimal probiotic doses for general needs. However, choosing a formula that allows you to gradually increase the dose over time may reduce the risk of adverse effects.

Choose prebiotic supplements that contain specific fibers, such as inulin, fructooligosaccharides (FOS), galactooligosaccharides (FOS), or resistant starch.

Natural sources of prebiotics and probiotics

You can also get prebiotics and probiotics from natural sources. Prebiotics are naturally found in many plant foods high in dietary fiber. However, not all high-fiber foods are a food source of prebiotics.

Both dietary fiber and prebiotics are indigestible fibers, but prebiotics are a special class of fibers fermented by the gut bacteria, stimulating their growth and activity. Dietary fibers are classified based on solubility (soluble or insoluble) and support health by adding bulk to stool, improving bowel regularity, and lowering blood cholesterol (by grabbing cholesterol in the digestive tract and eliminating it in stool).

Probiotic foods are made through a process called fermentation, using microorganisms that change the chemical composition of food.

Bottom line

You can take prebiotics and probiotics together. Combining them may lead to better results and beneficial bacteria balance to support gut health. Talk to your doctor before adding any dietary supplement to your routine to make sure it can help you achieve your health goals.

Article history

Our experts strive to provide up to date information and update articles when new information becomes available

September 06, 2024

Fact checked by Sandra Vigelienė, BSc

September 06, 2024

Updated by Jill Corleone, RD

April 18, 2023

Written by Patricia Weiser, PharmD