According to family physician Bindiya Gandhi, M.D., if eating fermented foods and taking multiple probiotic supplements causes someone to feel worse (think bloating, gas, nausea, or abdominal pain), then there is most likely a medical problem beyond dysbiosis, or an imbalance of bacteria in the microbiome. In this case, they should consult a doctor. “Some people who have a histamine intolerance may actually have a problem with fermented foods, as well,” Singh says. “They may get reactions or rashes as a result of taking too much.” “I wouldn’t eat fermented foods and take a probiotic literally at the same time,” Gandhi says. Instead, she recommends taking a probiotic supplement first thing in the morning on an empty stomach and eating fermented foods throughout the day. If possible, Singh recommends incorporating probiotic-rich foods into the diet in addition to your probiotic supplement. “Not only do you get the probiotic benefit of the food itself,” he explains, “but you’re also getting the nutritional value of actually eating something that has other vitamins and minerals, as well.” If you’re wary about increasing probiotic intake, the best thing to do is monitor your body for any reactions or discomfort. You can also ease into it by taking “one pill every three days and slowly come back to the recommended dose,” says Singh. “There’s no rush.” Alternatively, since most probiotics come in capsule form, you can open up the capsule and take a fraction of the dose to see how you do with it, and build up to a full dose as tolerated.
