I'm traveling out-of-town this week to a support group because their topic of discussion is probiotics. Researching via the internet leaves me unsure if what I read is factual or a sales pitch. I have a list of questions for the guest expert. However, answers usually create another whole new list of questions. Therefore, please supply input to (updating) questions to help tweak my list:

1. If probiotics help with constipation, how come I don't notice them helping? Could it be the brand, type, or strength that isn't correct?
2. What brand and strength is recommended for WLSer's? Refrigerated or non-refrigerated probiotic? Chewables best for WLSers? If a capsule, do WLSers need to open the gelatin capsule first before taking?
3. What time of day, with or without food, with or without other supplements is best to take probiotics? Some literature says probiotics should be taken 2 weeks ON with a 1 week OFF break? Is this correct, incorrect, or doesn't matter?
4. Is there such a thing as too much of a good thing? Buying too high strength or taking too long a duration? Is it okay to take a probiotic capsule, eat yogurt, and drink Kefir daily...can too much be counterproductive like too much fiber can be?
5. If yogurt is chosen as the only source of probiotic, how many ounces is recommended to eat per day? What brand yogurt is best? Does it matter if it's 2% vs 0%, Light vs Regular? Do artificial sweeteners in yogurt interfere in any way? Is homemade yogurt more beneficial than store bought yogurt?
6. Is it a good idea to switch strains of probiotics from time to time? If yes, how often and in any particular order?
7. Are the tests for gut flora relevant to gastric bypass patients? If yes, necessary to test? where is the best source of testing?
8. What else is important to know about probiotics and what other questions could be asked?

Great list of questions. I have no input, but very interested in hearing the results of your discussion.

Please let us know what you find out and what facts have scientific bases behind them.

1. If probiotics help with constipation, how come I don't notice them helping? Could it be the brand, type, or strength that isn't correct?
   1. If probiotics help with constipation, how come I don't notice them helping? Could it be the brand, type, or strength that isn't correct?

The could be dead. They have a shelf life. Buy before the expiration date, from the refridgerated section and those kept in dark glass bottles. Remember stomach acid kills a lot of them (i.e you literally digest them).

What brand and strength is recommended for WLSer's? Refrigerated or non-refrigerated probiotic? Chewables best for WLSers? If a capsule, do WLSers need to open the gelatin capsule first before taking?

I dont know. The crazy italian scientist I worked with swore the best pro-biotic was yogurt (like our normal containered stuff), left out on the counter at RT a few hours. The lid would start to bulge from the gas (showing the bacteria were alive, multipling and eating). This made him very happy and he would talk loudly and at great length about it daily as only italians can do (as a Northern minnesotan, you can appreciate the benefits of peace).

1. What time of day, with or without food, with or without other supplements is best to take probiotics? Some literature says probiotics should be taken 2 weeks ON with a 1 week OFF break? Is this correct, incorrect, or doesn't matter?

The crazy italian liked to eat it with food.

1. Is there such a thing as too much of a good thing? Buying too high strength or taking too long a duration? Is it okay to take a probiotic capsule, eat yogurt, and drink Kefir daily...can too much be counterproductive, in other words?
   1. Is there such a thing as too much of a good thing? Buying too high strength or taking too long a duration? Is it okay to take a probiotic capsule, eat yogurt, and drink Kefir daily...can too much be counterproductive, in other words?

-Not from what I read in the patent literature.

1. What else is important to know about probiotics and what other questions could be asked? -Sure. What strains should you be taking. HOw many different strains at once. Should you take some strains together over time, and then switch them out for others. HOw diverse should your gut fauna be?

And remember, when you take antibiotics..it kills/reduces what you have so...back to the drawing board.

I would love to know the answers to these questions as well. The Dietician at the surgeon's office said it is good to change up the type periodically as there are so many different strains and no one probiotic has all of them.

These are all really great questions. As someone who does take probiotics daily, I am really interested in what you find out. Please come back and share.

Here is my interpretation of helpful information: 1. website www.USProbiotics.org 2. either refrigerated or non-refrigerated versions okay, one-billion as effective as ten-billion with varying opinions, the two strains mentioned the most started with the letters Lacto and Bif, daily use okay, don't have to open capsule before taking, doesn't matter what time of day when taken, artificial sweeteners don't interfere, homemade yogurt not necessarily better than store bought, considered a dietary supplement and not regulated by the FDA implying there are uncertainties about the safety of use with more research needed, bacteria in our gut are affected by food choices/stress/sleep/environment/drugs, not willing to recommend specific brands of probiotics but favored foods like Activia/DanActive/Kefir/Kimchi/sauerkraut/cruciferous vegetables/beans. Lastly, the always-warning to consult your physician and pharmacist.