If someone reacts to a probiotic supplement is that an indication that there’s some underlying pathology??

Dr. Amy Nett: Absolutely. If someone is not responding well to a probiotic, that’s also telling me that there’s some sort of dysbiosis. What I would do in that case, let’s say somebody says they started Prescript-Assist, they had a really strong reaction, or they started MegaSporeBiotic, really strong reaction, what I’ll actually have people do is open up the capsules and take a quarter of a dose, half a dose. You can buy veggie caps and actually sort of make your own capsules and dose however you want. Sometimes there are probiotics that people just don’t react well to, and if they try something a couple of times, then I tell them, “That’s just not the probiotic for you. Let’s find some other options.” But if they take one full capsule, before giving up on that specific probiotic, what I’ll do is have them open up the capsule, empty out a quarter of the capsule, a third of the capsule, do a small amount, and sometimes it feels like baby doses. People can get frustrated sometimes, feeling like they want to move through things more quickly, but we can’t. Oftentimes we just can’t rush these things, so just take a quarter of the capsule, see how it goes, and work up slowly. But, yes, if someone’s not tolerating probiotics, test the gut, SIBO and stool testing. You’ll need to do both SIBO and stool testing because you’re not going to be able to differentiate based on that reaction alone.