A Gastroenterologist’s 8 Essential Supplements for Gut Health–and How to Use Them Correctly
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You’re not eating enough fiber, so you start a prebiotic. You feel bloated, so you add a probiotic. Your energy is dragging, so you pick up vitamin D. Before you know it, you’re swallowing a handful of pills you’re not even sure are working—and honestly, your gut still feels off.
Gastroenterologist Dr. Will Bulsiewicz said that such a scattershot approach is why many people see little benefit from supplements—and that a personalized plan is the way to go.
“Gut health should be a daily priority for literally everyone, and supplements are a part of that package,” he told The Epoch Times. “I wouldn’t argue it’s the number one thing, but strong, strategic supplementation is an opportunity to improve our health starting today.”
The Foundation: 8 Evidence-Based Supplements
Bulsiewicz, who details his supplement protocol in his latest book “Plant Powered Plus,” recommends eight specific evidence-based, foundational supplements for his patients. Not everyone needs all eight, and some may benefit from others not on this list. Ideally, he said, you’d want to formulate your plan with a health care provider who can determine what your body is lacking and monitor whether the supplements improve your health.Prebiotics: Feed Your Gut Microbes
Prebiotic fiber supplements feed your gut microbial community, and the benefits extend beyond improved digestion to an increase in satiety hormones, better calcium and magnesium absorption, and enhanced cognitive function.However, increasing fiber, whether through supplements or diet, can cause uncomfortable abdominal symptoms such as bloating, gas, and pain. It’s best to resolve constipation before starting prebiotics and then begin with a low dose of 1 to 2 grams or less, especially if you have small intestinal bacterial overgrowth, Bulsiewicz said.
“I’m a big believer in prebiotic fiber supplements. You'll never be able to convince me otherwise, because I’ve witnessed it in my own life and in thousands of patients,” he said.
Dietitian Cassie Madsen, who works mostly with patients with irritable bowel syndrome (IBS), told The Epoch Times that 60 percent or more of her clients end up taking a fiber supplement—usually psyllium or a brand containing guar beans, which are gentler on the gut.
Probiotics: Target Your Specific Problem
Probiotics are good microbes, found abundantly in fermented foods, but they don’t always stick around in the gut for long. General probiotics marketed like multivitamins are the wrong approach, Bulsiewicz said.- Saccharomyces cerevisiae for IBS with bloating
- Saccharomyces boulardii for antibiotic-associated diarrhea
- Lactobacillus rhamnosus GG for acute diarrhea
- Bifidobacterium lactis DN-173010 for constipation
- Escherichia coli 1917 for ulcerative colitis that’s in remission
Vitamin D and Omega-3s: Test First, Then Supplement
Both vitamin D and omega-3 fatty acids, which help strengthen the gut barrier and immune system, can be part of your strategic supplementation plan, depending on deficiencies that can be measured through blood tests.Those with inflammatory conditions should aim for higher levels, Bulsiewicz said. For vitamin D, that would be 40 to 60 ng/mL. For omega-3 index results, the high end is 10 to 12 percent of EPA and DHA fatty acids.
If you don’t have access to lab testing, Bulsiewicz said he would recommend a maintenance dose of both, on the assumption that most people are deficient and that there’s a low risk in taking them. For vitamin D, that’s 1,000 to 2,000 IU per day; for omega-3, 500 milligrams per day of combined DPA and DHA.
Melatonin, Magnesium, and Zinc: The Sleep-Gut Connection
Bulsiewicz lumps melatonin, magnesium, and zinc together for regulating the circadian rhythm, noting that sleep affects gut and overall health.Most of us don’t have adequate zinc and magnesium intake, Bulsiewicz added, and levels can be tested. There is no target baseline or test for melatonin, so it’s best to start supplementing with a low dose of 0.5 milligram taken about an hour before bed.
Curcumin: Anti-Inflammatory Without the Side Effects
Curcumin has anti-inflammatory properties. Not only is it a better option than nonsteroidal anti-inflammatory drugs such as ibuprofen that can damage the stomach, intestines, and kidneys, but it can also promote the growth of beneficial bacteria, Bulsiewicz said. Curcumin can also lower systemic inflammation and suppress the growth of microbes that degrade the gut barrier.He noted that curcumin is better absorbed when taken with black pepper or healthy fats, such as your morning omega-3 supplement. If your inflammation is worse at night, it might be better to take it before bed, he said.
Mistakes That Undermine Your Supplements
Taking the right supplement is only half the battle. There are several common mistakes people make with supplements that sabotage results.Misunderstanding the Label
Choosing the right supplement brands can be daunting. Products often include marketing language on the front of packaging that may be false claims or not match the dosing, Bulsiewicz said.“You’re basically being marketed to as you walk down the aisles just like in the supermarket,” he said.
Bulsiewicz started his own supplement company because of industry issues with quality, efficacy, and safety, but he said that shopping for the best supplements is a skill that can be learned.
Then, verify the dosing to see if it matches what you need based on your individual labs or product clinical trial. Avoid any with artificial colors or flavors, preservatives, or other additives, which can be damaging to the gut, he said.
Starting Too Many at Once
Each supplement should have a meaningful effect on your health, he said. The best way to gauge how it makes you feel is to try only one at a time.Giving Up Too Soon
Just as clinical trials measure a supplement’s effect from a starting and ending point, you need to use the supplement long enough to determine if it’s working.Ignoring Timing
Taking supplements at random times throughout the day misses a crucial opportunity.Human genes flip on and off throughout the day, and microbe levels in the gut also rise and fall at different times, too, Bulsiewicz said. “We were designed with a 24-hour schedule in mind. Our body is not the same at all times.”
Overdoing It
Some supplements might not be effective or needed. Madsen reviews supplements with new clients, who are often taking several for unknown reasons. “We usually pick a few that they can come off of. I do take kind of a minimalist approach,” she said.“Sometimes there are other health care providers involved that recommended them, so I usually tell them to discuss whether it’s worth continuing with your doctor, because supplements are expensive, and there is potential for harm,” she added.
More isn’t always better, Bulsiewicz added, particularly when it comes to taking higher dosing. Follow evidence-based dosing and have regular laboratory blood work done, which can be monitored by your doctor, who should be able to detect problems, he said.
Part of a Bigger Plan
Ideally, advice on gut health supplements would come from or be managed by a physician, Bulsiewicz said, noting that when he meets with patients, each plan is tailor-made. In any event, he said you should discuss any additions or changes to your supplements with your doctor.He also suggests a comprehensive lifestyle approach to accompany supplement use, including foods to add and avoid, stress and emotion management, and light exposure.
Every strategy points back to one foundational element to human health—the microbiome, Bulsiewicz said. Not only does the microbiome offer a snapshot of how someone has been living their life, it profoundly affects physiology through metabolism, hormone production, cognition, and mood.
“It makes sense to orient that through the microbiome, because it has such a powerful impact on what I’m trying to accomplish,” he said. “I think of it as command central for our health.”
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