A Functional Health Guide
Dr. Paul Deglmann
Meghan Feir Walker
Antibiotics are one of the greatest discoveries and creations in the history of medicine. However, while they’ve saved millions of lives and can be vital in acute situations, antibiotics are also frequently over-prescribed. While taking antibiotics is sometimes extremely necessary, they don’t come without complications. A single course of antibiotics can change the microbiome for days to years, which can greatly affect your microbiome, mood, and overall health. Antibiotics’ effect on gut bacteria can lead to major dysbiosis, which is why knowing how to restore gut health after antibiotics is so crucial.
In this article, we’ll cover how and why antibiotics affect the gut and how to help restore gut flora balance while taking antibiotics and after the round is done.
Our approach at Restorative Health Solutions is to always take a holistic approach toward whole-body health, and the gut cannot be ignored. Keep reading to learn how to restore your gut health and gut microbiome balance with natural support.
How antibiotics affect the gut
Why gut health matters, especially after antibiotics
There are roughly 100 trillion bacteria in the microbiome. While most of the bacteria are beneficial/good bacteria, some bad bacteria are always present as well. Unfortunately, antibiotics not only target the bad bacteria in the microbiome, but they also deplete some of the beneficial/keystone bacteria. They only target bacteria, too, which can set the stage for dysbiosis or an imbalance of the microbes in the gut by lowering the amount of beneficial flora and creating yeast/candida overgrowth and other problems.
Broad-spectrum antibiotics disrupt the microbiome, mainly due to their designed purpose of killing a wide range of bacteria (both gram-positive and gram-negative). However, narrow-spectrum antibiotics are targeted to kill a smaller and more specific group of bacteria.
This matters because your gut health can impact your digestion, absorption of nutrients, inflammation/immunity, mood/brain health, and more. The impact on your gut flora cannot be ignored.
How long does it take to recover?
Although many people don’t notice a negative impact on their gut health after taking a round of antibiotics, the long-term effects can take time to manifest into symptoms. However, it’s extremely common for people to notice immediate symptoms, such as upset stomach, nausea, gas, bloating, and/or diarrhea, while on the course of antibiotics.
For those with temporary symptoms, gut recovery time for milder symptoms is usually within a few days to 1-2 weeks after being off the antibiotics. But if significant diarrhea occurs that isn’t caused by C. Diff, that can take anywhere from 1-4 weeks to resolve, depending on the person.
Changes in the microbiome can last for days to over a year for some people after taking a single course of antibiotics, and if someone has to take multiple rounds of antibiotics in a year, the impact can be far greater.
The following can be potential factors that impact recovery after antibiotics:
- Type of antibiotic (broad-spectrum vs. narrow-spectrum)
- Class of antibiotics
- Dose of antibiotic
- How long you were on the antibiotic
- Whether it was an oral or IV antibiotic
- Your age
- How healthy your gut microbiome was prior to taking the antibiotic
- How healthy your diet was prior to the antibiotics
- Genetics
- Stress load
- The amount of sleep you were consistently getting prior to the antibiotics
- Environmental toxin exposure
- And other factors
Probiotics and prebiotics
To restore your microbiome after antibiotics, work with your functional doctor or healthcare practitioner to discover which strains and balance of probiotics and prebiotics may help you recover more quickly.
What are probiotics?
Live beneficial bacteria that help repopulate the gut and maintain balance in the gut microbiome.
What are prebiotics?
Prebiotics are a type of dietary fiber or polyphenols that play a major role in maintaining and restoring a healthy gut microbiome.
When and how to take probiotics and prebiotics
Should you take probiotics while on antibiotics?
Research shows that taking probiotics during a course of antibiotics significantly decreases the risk of developing diarrhea while on the antibiotics. Some studies also show that probiotics can reduce the risk of developing a C. Diff infection.
More research shows that taking a probiotic during the course of taking antibiotics does not decrease the effectiveness of the antibiotic.
The key to supplementing with probiotics during the course of an antibiotic is to stagger the probiotic at least 2 hours away from the antibiotic doses.
How long should you continue taking probiotics after finishing antibiotics?
In functional medicine, we also use probiotic supplementation after the course of antibiotics is over. The amount of time someone supplements with probiotics after the completion of the antibiotic course can differ from person to person, so always consult with your healthcare practitioner to find out what type and duration of taking probiotics is right for your gut health.
What are the best strains of probiotics to take during and after taking antibiotics?
Often, the best strains for recovering from antibiotics are Lactobacillus and Bifidobacterium, but this can be specific to the individual person as everyone is different. Saccharomyces Boulardii and spore-based probiotics are also commonly used.
How to rebuild gut health
To rebuild gut health, you can’t ignore your daily lifestyle choices, including your diet.
Support your gut microbiome and cellular health with whole, nutrient-dense, fiber-rich, probiotic and prebiotic-rich foods, and minimize sugar and processed foods in your diet.
Eat whole, nutrient-dense, fiber-rich foods
Choose single-ingredient, whole foods that are nutrient-dense to help restore your gut health and whole-body wellness.
Nutrient-dense, whole foods:
- Grass-fed, pasture-raised meats
- Wild-caught fish
- Pasture-raised eggs
- Organic fruits/veggies
- Organic nuts/seeds
- Healthy oils like olive oil, avocado oil, coconut oil, etc.
Fiber feeds beneficial, good bacteria. While some people don’t tolerate large amounts of fiber well because of their particular gut health issues, in general, fiber is highly beneficial and even helps the body remove toxins more effectively and efficiently.
Fiber-rich foods:
- Leafy greens
- Fruit (especially apples, berries [strawberries, blueberries, raspberries], bananas [less ripe bananas contain the most prebiotics], pears, and avocados)
- Vegetables (especially broccoli, brussels sprouts, carrots, cauliflower, green beans, potatoes, and sweet potatoes)
- Legumes (beans [black, kidney, pinto], lentils, peas)
- Nuts and seeds (such as almonds, chia seeds, flax seeds, pistachios, and sunflower seeds)
Try to include a wide variety of fiber sources to not only add interest to your diet but to include food sources of other needed nutrients.
Add fermented and cultured foods
If tolerated, adding fermented and cultured foods to your diet can help restore balance to your microbiome. Even if you don’t have conditions (such as SIBO, MCAS, and/or histamine intolerance) that are impacted negatively by ingesting fermented foods, introduce fermented foods gradually into your diet to minimize initial, potential symptoms like bloating.
Fermented, probiotic-rich foods:
- Yogurt with live cultures (try to avoid the high-sugar varieties)
- Kefir
- Sauerkraut
- Kimchi
- Kombucha
- Pickled vegetables
Bone broth and gut-soothing foods
Bone broth is an excellent food rich in collagen and amino acids like glycine and glutamine that are necessary to repair the gut lining. Other warm broths/stocks can be gentle on the stomach while still being nutrient-dense.
Please note that bone broth can be high in histamine, so if you have conditions like MCAS or histamine intolerance, this might not be the best choice for you at this time.
Limit sugar and processed foods
Since sugar feeds harmful bacteria and yeast, try to limit your consumption of it. Processed foods and seed oils, along with other harmful food additives, can majorly impact your digestive health, along with cellular health function and other systems in the body.
Foods to limit:
- Processed foods
- Added sugars
- Seed oils
- GMO foods
- Artificial dyes
- Artificial sweeteners
- And other harmful additives
As mentioned earlier, choose whole, nutrient-dense, minimally processed foods over sugar-laden, highly processed meals.
Healthy habits to optimize gut health
Along with testing and understanding what your body is going through and what it needs, you can help support your gut naturally by making good daily decisions.
These lifestyle factors can significantly improve your gut microbiome:
- Getting daily sunshine
- Exercising and moving your body within your tolerance
- Drinking clean water (hydration can help digestion and fiber work more effectively)
- Breathing clean air
- Eating really clean, nutrient-dense foods
- Practicing good stress-management strategies (because excessive stress hormones can harm the gut lining)
- Getting good, restful sleep (aim for 7-9 hours)
FAQs about gut health after antibiotics
Q: Can I drink coffee while healing my gut?
A: The acidity of coffee, even low-acid coffee, can be too much for some people when their guts are in rough condition. While we suggest patients take a break, for a time, from drinking coffee every day, pay attention to your symptoms. If you don’t notice a difference in symptoms when you’ve removed your daily cup o’ Joe for a week, then you may consider reintroducing it back into your routine. It may be fine for you to have a cup in the morning as you continue on your personalized gut protocol. Try to buy low-acid, organic coffee to offend the microbiome the least. Make sure to consult with your functional medicine practitioner to find out what’s best for you.
Q: Should I avoid dairy while restoring gut balance?
A: For many people, avoiding certain types of dairy for a time can help relieve some strain on your digestion as you rebalance your gut microbiome. Dairy can cause more inflammation and mucus production in many people, so lessening the inflammation while healing the gut can be extremely helpful.
Q: How do I know my gut is healthy again?
A: Retesting and paying attention to your symptoms are the best ways to determine whether you still have gut issues occurring. When your gut is balanced, you shouldn’t regularly feel bloated and uncomfortable. You should easily be able to have two to three bowel movements a day without straining, and your other digestive symptoms should be alleviated.
Q: What if my digestion is worse after antibiotics?
A: Seeing a functional medicine practitioner who can test gut health and interpret the results for you is step No. 1. They will put together a plan to rebalance your gut flora after interpreting your test results and symptoms.
Key takeaways for rebuilding gut health
- Antibiotics can majorly disrupt your gut microbiome and, in turn, the rest of your health. While they are totally necessary in many cases, they should always be taken alongside a probiotic to combat the negative side effects on your gut.
- Gut recovery takes time and is impacted by your daily choices.
- Food, lifestyle, and supplement choices all make a difference.
- Small steps can lead to big improvements.
- Seek functional health support to understand and address the root cause of your digestive troubles and restore gut balance.
- Eat prebiotic, fiber-rich foods
- Consider adding in fermented/probiotic-rich foods
- Consider adding in gut-soothing foods like bone broth, which is rich in collagen and certain amino acids like glycine and glutamine that are important for gut healing (if tolerated well)
- Choose single-ingredient, whole foods that are nutrient-dense (grass-fed pasture-raised meats, wild-caught fish, pasture-raised eggs, organic fruits/veggies, organic nuts/seeds, healthy oils like olive oil, avocado oil, coconut oil, etc.)
- Limit processed foods, added sugars, seed oils, GMO foods, dyes, artificial sweeteners, etc.
- Stagger taking your probiotics at least 2 hours away from doses of antibiotics.
- Often, the best strains for recovering from antibiotics are Lactobacillus and Bifidobacterium, but other strains are also commonly used like S. Boulardii and spore-based probiotics. Consult with your functional medicine practitioner to see what’s best for you.
- We also recommend our patients take probiotics after they are done taking antibiotics. The recommended duration, dosage, and strains vary from person to person.
- For more tips on restoring your gut health, click here.
How to support your gut health
If you have chronic gut health issues, have tried various diets and supplements, have had several tests done, but still don’t have answers, working with a functional medicine practitioner may be the missing link in your healing journey.
You need to understand the root cause(s) of your gut health issues, and you need a one-size-fits-one approach to heal. Using a general protocol for everyone won’t solve the problem for many patients because everybody has unique issues they’re experiencing.
Thorough, accurate, and honed-in testing, paired with a skilled functional medicine practitioner who can translate the results, can make all the difference when you’re trying to get better. They can then create a detailed, tailored plan to improve your gut health.
Ready to support your gut? We can help
By learning more about your digestive health and conditions and the reasons they developed, you can take proactive steps toward enhancing your digestive health, whole-body health, and overall quality of life.
Are you ready to learn more about gut health support and how to improve your digestive health? Read more on our blog about gut health, or schedule your free 15-minute consultation with Dr. Paul to explore a personalized, functional approach for a helpful and effective path to recovery.
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