September 24


Pre- and Probiotics – Best Practices

By Sunny Brigham, MS, CNS, LDN

September 24, 2018

minutes read time


Pre- and probiotics is a topic that comes up often. I don’t know if it’s the massive concern about balancing gut flora or if it’s studies showing no real benefits from probiotics. You can read that bad boy here.

But…it comes up often in sessions with my clients. So, I’ll expand on some information I’ve shared in the past. Previously, I provided the Top 5 Benefits of Pre- and Probiotics and Probiotics and Antibiotics. Today, I’ll tell you my personal and professional approach to using probiotics in my clinic.

New Study

First, I want to detail a few issues I have with the latest study. I get really annoyed when these studies are released and news outlets take them and run. It’s because they are sensational and go against everything everyone is currently saying. I get it. It doesn’t mean I like it though.

I’ve said before…I love reviews. Reviews are studies that look at all the published work on one subject. They throw out the bad or poorly designed studies and review the good quality ones. From these, they formulate an opinion based on the clinical research on that topic. These are my favorite studies to look at.

This new study was not a review. I also don’t love the design of it. If you read the paper (hyperlinked above), it’s easy to want to toss your probiotic in the trash. But I wouldn’t do that just yet. A study should contain a large population. This study looked at 15-21 people. That’s too small to really formulate any clinical opinions on.

Microbiomes are different for everyone. My biome is completely different than yours. Comparing them would be like comparing apples and oranges. But the study did just that…compared one to the next. I don’t think that was the best practice either.

However, I hope this gives them enough information to do further exploration in regards to the microbiome and probiotics. We definitely need more. Now…on to how I use them!


Let’s recap. Prebiotics are foods that ferment in the colon providing food for healthy gut bacteria to grow and flourish. Everyone should eat them daily. Some tolerate them more than others. Individuals with IBS will struggle with bloat and prebiotics. As will those with histamine intolerance. It’s a fun side effect of having a sensitive digestive tract.

I don’t usually recommend taking prebiotics in pill form. They are very easy to get in food form, plus you get the added benefits of the nutrients in the foods!

Here are some common prebiotic foods:

Jerusalem artichokes





Dandelion greens





The list continues. But, these are the easiest to get in. When IBS is at play, cooking them tends to reduce the flare associated with foods that ferment in the colon. However, some will be so sensitive that even cooking doesn’t help. This is a sign they need some gut healing first.

Best practice:  Consume 2-3 servings of prebiotics daily. 


Probiotics are good bacteria we need to help keep the gut healthy. We need a healthy gut to ensure your:

  1. happy hormone production is good,
  2. neurotransmitters are working,
  3. immune system is in tip-top shape, and
  4. the GI tract functions as it should.

There are 3 main ways to ensure your gut bacteria stays in good working order:

Consume probiotics

Consume prebiotics

Take care when consuming antibiotics

It’s hard to avoid probiotics in pill form today. There are so many options out there. All you need to do is look in the supplement aisle and you’ll see probiotics everywhere. Most may find this surprising, but I prefer food form probiotic over pill form. I have and will use probiotics when someone needs a high dose quickly.

Here is when I would use probiotics in pill form:

Histamine intolerance

Severe leaky gut

Presence of an autoimmune condition

Needs a specific strain

Aside from that, I’ll have my other clients work on getting food-based probiotics in daily. These foods are tasty and you may already be consuming them!

You can get probiotics from the following sources:

Fermented vegetables





Kombucha is technically a probiotic food but I don’t like it because of how much sugar it contains. Yes, some of the sugar is fermented off but you still get sugar in the system.

Best practice:  Consume 2-3 tbsp of probiotics daily to grow or maintain a healthy gut flora.

Tell me…how do you feed your microbiome? Drop a comment below and let me know your favorite prebiotic and favorite probiotic.

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