Does Taking Vitamins With Probiotics Affect Absorption?

How Healing Your Gut with Probiotics May Reduce Your Need for Vitamin Supplements

• Gut Imbalances and Nutrient Absorption|
• Probiotics Lay the Groundwork|
• Does Taking Vitamins WIth Probiotics Affect Absorption?|
• Safety Concerns|
• Do You Need Vitamins?|
• Probiotics Benefit Absorption|

Eating a whole foods diet is a great initial step for getting all the nutrients your body needs to function well, but what if you can’t digest and absorb the food you eat? Certainly, nutrient deficiencies can be the result of many different factors, but what I often find in the clinic is poor gut health and disrupted absorption tend to be preceding contributors.

While I advocate for a food-first approach, there are times when vitamins are necessary and helpful. But if you’re not absorbing food well, chances are you won’t be able to absorb vitamin supplements well either. So, what’s the answer? Because probiotics (healthy bacteria) can effectively treat many gut imbalances and inflammation [1], it’s possible that they’ll also improve the absorption of vitamins. And this is exactly what current research suggests.

In this article, I’ll discuss how taking vitamins with probiotics affects absorption, as well as if you need to be taking supplemental vitamins with probiotics. I’ll also dive into the research on the special relationship between vitamin D and probiotics. But let’s start with how various gut imbalances affect the way you absorb nutrients.

Gut Imbalances and Nutrient Absorption

Do you struggle with dry and thinning hair, dry skin, fatigue, cravings, nutrient deficiencies, bloating, and/or weight gain even though you’re eating a healthy diet? If so, a digestive system imbalance may be to blame.

Since you primarily absorb micronutrients (vitamins and minerals) and macronutrients (fat, carbohydrates, and protein) through your small intestine, disruptions affecting the health of this organ or its good bacteria, like infections, inflammation, and leaky gut, can impact how well you absorb nutrients — whether from food or from nutritional supplements [2].

So essentially, if you’re not absorbing the nutrients from the healthy foods you’re eating, it’s almost like you’re not eating at all or eating junk food. To better understand how gut imbalances affect the absorption of vitamins and other nutrients, let’s take a tour through the digestive process. 

A Tour Through Your Digestive System

Most of us eat every day without a second thought, so it’s easy to take digestion for granted. But it’s a very complex process with many moving parts. Everything you eat or drink has to be broken down into smaller molecules for absorption, so any disruption in this process can wreak havoc on your system. Without going into an extreme amount of detail, digestion starts in your mouth where digestive enzymes and the act of chewing start breaking your food down into more absorbable units.

The food bolus (the small, round mass of food that’s formed in the mouth) then travels through your esophagus into your stomach where it encounters stomach acid (hydrochloric acid). This further breaks down the food bolus and kills any unwanted or harmful microbes that could be present in your food.

The food then moves into your small intestine, which is arguably the most important section of your digestive tract, but also the most sensitive and prone to damage and inflammation. The vast majority of the food you eat and the supplements you take are absorbed here, assisted by bile secreted by your liver and enzymes secreted by your pancreas [2].

Once nutrient absorption in the small intestine occurs, the remaining food moves into the large intestine (colon) where a small amount of digestion and absorption take place.

It may seem simple from this description, but there are many factors that can interrupt the digestive process, which may lead to nutrient malabsorption [3]. Here are a few common ones I write about in my book, Healthy Gut, Healthy You:

• Low (or inadequate) stomach acid can lead to bacterial or parasitic infections and fungal overgrowths altering your microbiome, which can result in the malabsorption of micronutrients like iron, calcium, and magnesium [4, 5].
• Helicobacter pylori (H. pylori) infection can lead to atrophic gastritis (chronic inflammation in the stomach), which can cause malabsorption [6, 7].
• Leaky gut can occur if the thin mucous membrane of the small intestine is damaged. Leaky gut syndrome has been implicated in immune and autoimmune conditions, food reactivity, and nutrient malabsorption [8].
• Inflammatory diseases such as Crohn’s disease can lead to nutrient malabsorption via damage to the intestinal lining [9].

If you have any of these gut-health imbalances, it’s important to work through a gut-healing protocol, which often includes probiotics. While they aren’t a panacea for every gut health issue, probiotics are often an important piece of the puzzle, and they may help to improve your ability to absorb nutrients. Let’s take a look at how probiotics impact nutrient absorption.

Probiotics Lay the Groundwork for Healthy Nutrient Levels

As I mention in a moment, taking probiotics alongside your vitamins or a nutrient-rich diet can significantly boost your nutrient levels. But If you’ve been struggling with the signs and symptoms of micronutrient deficiency, it’s important to determine the root cause before simply downing megadoses of vitamins and/or minerals. 

After all, if you aren’t absorbing nutrients well, adding more nutrients (like biotin, folic acid, and vitamin C) won’t fix the problem. 

Rather than adding nutrients in the form of supplements, try working your way through a complete gut restoration program first. This will serve to reduce inflammation, calm the immune system response, and reestablish gut barrier integrity, which will in turn allow for better nutrient absorption.

I often recommend a probiotic blend as part of a gut-reparative protocol. Probiotics help to balance the gut bacteria that are responsible for fueling your intestinal cells and for maintaining a healthy intestinal barrier. They’re also extremely safe, so it’s definitely worth investigating probiotics if you have the symptoms of nutrient malabsorption [10]. Let’s look more closely at how probiotics target inflammation specifically.

Probiotics Are an Important Tool for Gut Inflammation

In the clinic, we like to address gut health before attempting to optimize micronutrient levels for the reasons above. Probiotics are key when it comes to healing the gut. Probiotics are microorganisms (beneficial bacteria or yeast)  that provide health benefits to their host. There are three categories of probiotics:

• Lactobacillus and Bifidobacterium
• Soil-based (Bacillus species)
• Fungal (Saccharomyces boulardii)

All three categories have been found to provide important benefits, including reducing gastrointestinal inflammation:

• Lactic acid-producing probiotics have been found to reduce inflammation in people with inflammatory bowel disease (IBD) [11] and to regulate the immune system and inflammation [12]. 
• Soil-based probiotics have been found to decrease leaky gut and inflammation [13, 14, 15].
• Saccharomyces boulardii has been found to:

o   Successfully treat irritable bowel syndrome (IBS), diarrhea, IBD, Crohn’s disease, and Clostridium difficile infection [15, 16, 17, 18, 19]

o   Increase the clearance of Helicobacter pylori infection [1]

o   Correct dysbiosis, which often leads to inflammation [20]

By improving inflammation and correcting dysbiosis, probiotics may lead to improvements in nutrient absorption, so let’s look at what the research says.

Does Taking Vitamins With Probiotics Affect Absorption?

Yes, most likely. While the research on the effects of taking vitamins with probiotics is scant, probiotics have been shown in a few clinical trials to positively impact the absorption of some vitamins and minerals, both from diet and from nutritional supplements. Here’s a chart summarizing the results:

As you can see, the research here is limited but does suggest overall that the healing effects of probiotics on gut health may improve nutrient absorption. Interestingly, some strains of probiotics may help manufacture vitamins and prevent malnutrition, increase antioxidant levels, and reduce inflammation [24, 26], which would suggest that vitamin supplements may be less necessary when taking probiotics.

Similarly, prebiotics, or compounds in food that help your commensal (friendly resident) microbes to flourish, have been found to increase nutrient absorption. A 2013 RCT found participants who consumed the prebiotic galacto-oligosaccharide (GOS) experienced increased calcium absorption [27]. 

Research hints at what may be a special relationship between vitamin D and probiotics, so let’s look a little closer. 

Vitamin D and Probiotics: A Special Relationship?

It appears that eating nutrient-rich foods and/or taking vitamins with probiotics can increase absorption and boost the body’s nutrient stores. But can probiotics actually increase the positive health effects of some nutrients? 

Vitamin D is key for overall health as it provides anti-inflammatory and antioxidant benefits, which can provide immune support. Several studies have suggested a synergistic relationship between probiotics and vitamin D:

• Athletic recovery: A 2023 RCT found MMA athletes who took probiotics with vitamin D had lower lactate levels during intense sprinting along with improved power, compared to supplementing vitamin D alone [28]. 
• Disease management: A 2020 meta-analysis of RCTs found combining probiotics and vitamin D resulted in greater health benefits related to disease severity, inflammation, mental health, and metabolic health, for a wide range of participants when compared to other interventions, including vitamin D alone [29].
• Metabolic health: A 2019 meta-analysis of RCTs found vitamin D-fortified yogurt (high in the probiotic Lactobacillus acidophilus) helped to improve vitamin D and cholesterol levels, metabolic function, and body measurements when compared to plain yogurt [30].

Additionally, research suggests that taking probiotics with vitamin D improves a variety of mental health parameters, general health, and metabolic and inflammatory markers in those with polycystic ovary syndrome [31]. Benefits may be boosted when adding selenium into the mix, as a 2022 study found that women with PCOS who took selenium and probiotics together experienced improved inflammation and oxidative stress [32]. 

Similar effects of vitamin D and probiotics on mood and cardiometabolic health were experienced in people with diabetes who also have coronary heart disease [33]. However, like the above PCOS trial, this research did not directly compare these outcomes to the use of vitamin D or probiotics alone, so it’s difficult to tease out the benefits of these two supplements.

Regardless, probiotics clearly play an important role in absorption and the effect that vitamins and minerals have on our bodies. At this point, taking vitamins with probiotics sounds like a great idea, but is it safe?

Is It Safe to Take Vitamins With Probiotics?

You may be wondering if it’s safe to take vitamins with probiotics. While there’s limited data on this subject specifically, studies in which people took both vitamins and probiotics showed participants only experienced positive effects [31].  

One 2023 randomized controlled trial found MMA fighters who took probiotics with vitamin D had no negative side effects [28]. Another found a combo of magnesium oxide and the probiotic, Lactobacillus reuteri, to be safe in kids with constipation [34].

Since taking both vitamins and probiotics at recommended levels has been found to be safe,  it’s logical to assume that combining the two would be safe as well. At our clinic, we’ve found that probiotics and reasonable doses of vitamins and other micronutrients are usually tolerated well. While more research on a wider variety of vitamins and probiotic strains is needed, taking probiotics with nutrient-rich foods is definitely very safe. 

Now let’s spend a little time on whether you need to be taking vitamin supplements routinely.

Do You Need to Take Vitamins?

With all the clever marketing out there, it’s tempting to think everyone needs various vitamin and mineral supplements to be healthy. But consider this: a 2020 literature review found many micronutrients to be more bioavailable in their whole-food form as opposed to a concentrated supplement. This is possibly related to “additive, antagonistic, and synergistic processes at the level of uptake and absorption,” so for the generally healthy person, it’s probably best to focus on eating a wide variety of whole foods before adding in supplements [35, 36].

Though a nutrient-dense diet will likely provide most healthy people with the micronutrients they need [35, 37, 38], there are certain situations when vitamin and mineral supplements are helpful, or even required. If you’re in any of these categories, remember to focus on healthy food sources, but you may also need a supplemental form of nutrients (such as a multivitamin) [38, 39, 40]:  

• Restrictive or nutrient-poor diet (the standard American diet is inadequate in several nutrients such as calcium, vitamin D, and potassium)
• Identified malabsorption (IBD, exocrine pancreatic insufficiency)
• Medications that deplete key vitamins/minerals (e.g. metformin, proton pump inhibitor)
• Pregnant and breastfeeding women
• Infants who don’t get enough iron
• Menstruating women who are more at risk for low iron (heavy, frequent, or prolonged menses)

But remember, if you’re struggling with poor digestive health and your digestive tract is having a hard time absorbing nutrients, it’s much more advantageous to identify and address the underlying dysfunction before loading up on supplements. But if you have a known, significant deficiency, addressing the root cause and starting supplements once might help you feel better faster.

Vitamin supplements come in many forms, from gummies to capsules to chewables. If you choose to take dietary supplements, speak with your healthcare provider, and look for high-quality products with a third-party certification such as the Good Manufacturing Practices seal. This is a set of standards aimed at safety and quality created by the Food and Drug Administration (FDA).

Probiotics Are Beneficial for Nutrient Absorption

A daily probiotic supplement (in the form of probiotic capsules or probiotic gummies) may improve the absorption of a variety of vitamins and minerals from food and supplements. So depending on the situation, taking vitamins with probiotics may be right for you. In addition, some probiotics can manufacture B vitamins, and there may be a synergistic relationship between vitamin D and probiotics.

If you’re experiencing the signs and symptoms of a micronutrient deficiency, it’s important to look for the root cause, which is often related to suboptimal gut health. Probiotics aren’t a panacea, but as part of a gut-healing plan, they can support immune health, provide digestive support, improve gut function, and help to restore the ability to adequately absorb nutrients, including vitamins. 

For a more personalized plan, contact us at the clinic.

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