Can you take probiotics and antacids together?
As a pharmacist, a big part of my job is to look out for harmful drug interactions. As far as I can tell in the medical literature, there are no harmful interactions between probiotics and over the counter antacids, which means healthy individuals should be able to safely take probiotics and antacids together.
The other major question is if the supplement and the over the counter medicine make each other less effective. If you have lower acidity in your stomach, does that help?
One item that I go over on in my article on when is the best time to take a probiotic is that stomach acidity is actually bad for the bacteria or yeast in the probiotic supplement – acidity can kill the living microbiotics. They obviously need to be alive to make it into your gut to provide any health benefits, so acidity is bad!
So, it would make sense that having lower acidity in your stomach would help the microbiotics – maybe even making them more effective.
Of course, as a pharmacist, I looked to see if there is any medical literature on this, and it turns out that there is!
In the wonderfully titled Encapsulation of bifidobacterium in alginate microgels improves viability and targeted gut release, researchers added an an antacid coating to probiotics, and found “Antacid alginate-microgels greatly improved the stability of the probiotics during storage” and “The antacid agent/antacid and nanoemulsion improved the viability of the probiotics during digestion.” So, basically, the antacid actually helped the probiotics do better! Pretty great!
My conclusion is that it’s safe and not a problem to take these two together.
However, if you are having serious stomach issues or health problems, you should consult your doctor – not some blog on the internet. See a doctor if you are having GI issues.
Other evidence that probiotics and antacids are ok to take together
I did come across another interesting research paper in my reading on this topic. This one was called Evaluation of main functional dyspepsia symptoms after probiotic administration in patients receiving conventional pharmacological therapies, and it focused on FD, for Functional Dyspepsia.
Functional dyspepsia is an all too common disorder of the upper digestive tract. It can be quite painful and really make a patient’s life a lot more difficult. The term “functional” is used because no abnormality or disease is detected with tests, including endoscopy, even though the patient may experience severe discomfort. This is a major problem with some of the gut issues that people experience. Like a lot of IBD (inflammatory bowel disease), there is no clearly identifiable reason for the problem, but the symptoms are very real.
Symptoms of FD often include:
– Persistent or recurrent pain or discomfort centered in the upper abdomen (above the navel).
– Feeling full too soon while eating (early satiety).
– Feeling overly full after eating (postprandial fullness).
Unlike conditions like peptic ulcers or gastric reflux disease, functional dyspepsia is not linked to inflammation, ulcers, or acid damage in the esophagus, stomach, or intestines. The exact cause of functional dyspepsia is unknown, but it is believed to be related to increased sensitivity of the gut or impaired movement of food through the digestive tract.
If you have this disorder, you should see a doctor. They may be able to recommend medications and diet changes that can help, although this is a pretty frustrating problem that doesn’t easily resolve.
Anyway, the study I referenced had people with FD try a few different treatments, common options with probiotics. The study involved 2676 patients with FD who were given one of a few different treatment options, including a probiotic combination alone or alongside prokinetics, antacids, or proton-pump inhibitors, and were administered for 30 days. Symptoms were evaluated using a progressive-score scale before the trial and 15 days after treatment concluded. The results were that all patients demonstrated significant improvement. Among one of the groups, the patients who got only probiotics had the biggest improvement, although there was a second group who had Epigastric Pain Syndrome showed about the same improvement with all treatments.
The authors concluded that probiotics may be a promising treatment for FD. From my option, it seems like probiotics were at least not harmful when combined with the other treatment options, which again shows that it’s safe to take probiotics with antacids.
Again – see a doctor if you are having serious GI issues!
Other interactions that I have researched included looking into the clinical data round apple cider vinegar and coffee with probiotics. The nice thing about taking these supplement for stomach issues is that they usually work together if you get the timing right.