How to Repair Your Gut After Antibiotics

With cold and flu season upon us antibiotic prescriptions will inevitably be increasing (1). As a general rule, I recommend avoiding antibiotics if you can.

Although antibiotics have saved countless lives, it’s important to know their use doesn’t come without risk. They can cause long-term detrimental effects on your health. The problem with antibiotics is they not only kill the intended infection, but they also alter your microbiome by killing the good bacteria. One study found that taking a course of antibiotics for one week could affect the microbiome for a full year (2). This is a bigger issue than you might think, an altered microbiome is associated with causing or contributing to many diseases (3) from obesity and cardiovascular disease to autoimmune diseases and allergies to name just a few, and the research continues to grow.

Clinically, here are the most frequent issues I see associated with antibiotics:

IBS symptoms: bloating, irregular bowel movements, abdominal pain
Acute or recurrent vaginal infections
Dysbiosis: imbalanced gut organisms
Intestinal permeability which is associated with autoimmune diseases, allergies and many chronic inflammatory conditions
Clostridium difficile infection: a gut infection that causes severe symptoms and can become recurrent with future antibiotic use

Not only can they be harmful, the CDC (center for disease control and prevention) also estimates that at least 30 percent of antibiotic prescriptions in the US are unnecessary. Unnecessary antibiotics are prescribed for conditions caused by viruses, not bacteria. This includes common colds, viral sore throats, bronchitis, sinus and ear infections (4). For natural ways to treat an infection check out my other article here.

Another issue to tackle is the use of longterm antibiotics for problems that are treatable by finding and addressing the root cause with functional medicine. For example, I’ve seen countless patients who’ve been on antibiotics for years to treat their acne that resolved by addressing their underlying hormone imbalance or gut issue. If you currently take antibiotics long-term or very frequently, I highly recommend working with a naturopathic doctor or functional medicine practitioner to get off of or avoid them.

With all that being said, sometimes antibiotic use is unavoidable and necessary. Here is a plan of action to prevent and reverse adverse effects.

What do if you have to take antibiotics

Absolutely take probiotics during and after the course of antibiotics! It really aggravates me that doctors are still prescribing antibiotics without recommending probiotics. We know too much now for this to be okay.

What to look for in a probiotic:

Multiple strains of Lactobacillus and Bifidobacterium
Strength: take 100 billion per day. You can find this in a single capsule or just take several capsules of a weaker one

When to take probiotics: at least 1 hour away from antibiotics during treatment and for at least 2 weeks after treatment

Also take prebiotics: look for a probiotic that contains FOS (fructooligosaccharides) or take a food based prebiotic (see below)

You can also take gut repair nutrients and herbs

L-glutamine: 5 grams per day
Zinc carnosine: 75 mg 1-2 x per day
Omega-3 fats: 2,000 mg per day
Marshmallow, slippery elm, aloe vera: dose is variable based on product/form
Colostrum: 1000-2000 mg daily

Foods for gut repair

Bone broth: 1 cup per day
Prebiotic fiber such as bob’s red mill potato starch (start with 1/4 tsp and work up to 1 tbsp per day), or hyperbiotics prebiotic powder (1 scoop per day)
Fermented foods including sauerkraut, kimchi, and non dairy yogurt and kefir
Eat a diet rich in colorful fruits and veggies