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Evidence based

Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

The 6 Best Gut Health Supplements

Written by on May 9, 2024

Unpacking Which Research-Backed Supplements Are Worth Their Salt to Address Your Gut Challenges

Gut health sits at the center of overall health and well-being. Nearly every nutrient our body needs comes to us through the foods we eat, and we rely heavily on our gut microbiome to break down and assimilate those nutrients. When digestive function begins to degrade, so too do other systems and processes that help our bodies and health thrive.

If you’ve been experiencing digestive health symptoms like bloating, constipation, diarrhea, cramping, or indigestion, it’s likely time to start thinking about some diet shifts and possibly gut health supplements. If you’ve been experiencing seemingly unrelated symptoms like skin irruptions (acne, rash, rosacea), brain fog, mood changes, unexplained fatigue or headaches, or even sudden hormonal changes, then improving your gut health should be prioritized. 

When it comes to finding the best gut health supplements, some support overall gut health and can benefit a wide variety of people. Others target specific issues like leaky gut, small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and other gut challenges that could be causing some of the more disparate symptoms.

Let’s take a look at what I consider the best gut health supplements based on thorough research and my own clinical experience. I’ll start with the ones that are our top picks in the clinic for overall gut health and then drill down into those that may improve more specific gut issues.

The Best Supplements for Gut Health

The supplements I’ll list below have varying amounts of evidence to back up their efficacy for gut health and human health generally. I’ve listed them in order, starting with the one with the most research and clinical evidence

You’ll notice in the sections below that certain nutrients on this list, like vitamin D for example, are better obtained through means other than supplementation. That doesn’t mean there’s never a reason to supplement. I’ll dive deeper into details in the sections where it’s relevant.

The best supplements for improving overall gut health include:

  1. Probiotics
  2. Glutamine
  3. Curcumin
  4. Butyrate
  5. Vitamin D
  6. Collagen

I don’t mean to imply that it’s time to buy every last one of these today. You might find that one or two work great to noticeably improve your digestive system function. A more scientific and cost-effective approach is to start one at a time and be methodical with a gut-healing protocol. After I go through these, I’ll also share a few more targeted supplements for specific gut situations.

1. Probiotics

Probiotics are almost always the first supplement I reach for when it comes to addressing anything gut-related. The health benefits of probiotics can hardly be understated when considering the abundant research supporting their efficacy. Probiotics introduce good bacteria and fungi into your microbiome to provide a host of health benefits that reach far beyond gut-related symptoms. Benefits of probiotics include [1, 2, 3, 4, 5, 6, 7, 8] 

  • Correcting dysbiosis
  • Improving leaky gut
  • Reducing immune system activation
  • Anti-inflammatory properties
  • Reducing visceral hypersensitivity
  • Improving motility
  • Improving bowel movements and regularity
  • Treating infections like SIBO, Giardia, and vaginal Candida (yeast infection)
  • Reducing antibiotic-related digestive side effects like diarrhea
  • Improving inflammation-related mood and cognition issues like anxiety, depression, and brain fog through the gut-brain axis 

High-quality research shows that probiotics are consistently better than placebos at improving leaky gut, reducing inflammation, increasing beneficial bacteria and biodiversity, and correcting dysbiosis [2]. Each of these conditions is linked to all manner of health challenges, so correcting at the gut level has far-reaching benefits across the whole picture of your health.

Probiotics are an excellent treatment for common gut ailments like IBS, IBD, constipation, and for preventing the side effects of antibiotic treatments [1, 6, 9, 10, 11]. Low biodiversity in the gut microbiome has been associated with mood issues like anxiety and depression, IBS and IBD symptoms, as well as decreased immune function.

This isn’t to say that taking a daily probiotic will cure every ailment you have, but it’s a key ingredient to improving certain health issues at the root cause. By taking a daily supplement and adding probiotic-rich foods like sauerkraut, kimchi, kefir, kombucha, and plain yogurt to your diet, you will be consistently adding those beneficial microbes into your gut bacteria ecosystem, improving the microbial diversity in your gut, and giving yourself the best chance at getting on top of your health challenges.

How to Choose A Probiotic

Probiotic supplements come in serving sizes of billions—sometimes trillions—of live bacteria and fungi in each capsule or packet. The best probiotics offer a wide variety of probiotic strains and species. Based on observation in my clinic, I recommend including all three categories into one formula for maximum impact. The three types and my recommended dosing are below.

Dosing by Type of Probiotic:

  • Lactobacillus/bifidobacterium: 1–50 billion CFU
    • 2–3 months
  • Bacillus (soil-based) species: 2–6 billion CFU
    • 2–3 months
  • Saccharomyces boulardii: 10–15 billion CFU
    • 2–3 months
best gut health supplements

You may also want to simplify the process by trying my Triple Therapy Probiotic Powder Sticks, which contain the proportions of all three categories above.

Key Point: Probiotics are the most researched gut-supportive supplement available and have been shown to improve all manner of gut challenges. Combine two or three categories for maximum impact.

2. Glutamine

Glutamine is the most abundant free amino acid in human blood and the main energy source for intestinal cells [12]. Studies suggest that it may reduce inflammation and leaky gut by supporting the integrity of tight junctions in the intestinal lining [12, 13, 14, 15].

In the case of leaky gut, those tight junctions become less tight and more permeable, allowing partially digested food and sometimes harmful bacteria out of the intestine and into the bloodstream. When this happens, it can set off a cascade of inflammatory reactions, sometimes leading to an overactive immune system and compromised immune health. When compared to placebo, glutamine was shown to reduce leaky gut and improve IBS symptoms to a large degree [13].

How to Dose Glutamine

While our bodies make glutamine, it can sometimes still be useful to supplement it for additional gut support. When supplementing glutamine, you’ll likely see a label that says “L-glutamine,” as that is the type found most often in foods and supplements. Research suggests that a daily intake of about 15 grams of glutamine per day may reduce leaky gut and improve IBS symptoms by as much as 80% [13].

If you’re looking for a supplement, you’ll likely see dosages anywhere from 500mg to 5000mg per serving. You’ll want to check with your healthcare provider, nutritionist, or registered dietitian to determine an ideal dosage for you based on your diet and other particulars of your health.

My product Gut Rebuild Nutrients contains 1500 mg, which is a great supplement to add to a diet rich in dietary sources of glutamine like beef, poultry, pork, dairy products, raw spinach, and cabbage.

Key Point: Glutamine may reduce leaky gut and gut inflammation.

3. Curcumin

Curcumin is an anti-inflammatory, antioxidant compound found in the culinary spice turmeric. It’s what makes turmeric and curry yellow and has been used medicinally in India for at least 4,000 years [16]. Curcumin may block inflammatory pathways and reduce oxidative stress. Oxidative stress occurs when there are more free radicals than antioxidants in the body, leading to cell damage over time, including cells in the digestive tract [16]. 

Human studies have found that curcumin can benefit IBS and IBD symptoms, has the potential to help eradicate H. pylori infection, and is better than a placebo at reducing gut pain, diarrhea, constipation, and indigestion [17, 18]. An in vitro study suggests it has the potential to reduce leaky gut as well [19]. Curcumin also stimulates bile and supports healthy digestion of fats [20].

In the clinic, many patients have noticed that taking 1–2 tablespoons of turmeric or 500–1,000 mg of supplemental curcumin daily improves their gut health. 

Key Point: Curcumin is an anti-inflammatory, antioxidant compound that may benefit those with those with a range of gut issues.

4. Butyrate

Healthy gut bacteria actually create the short-chain fatty acid butyrate when they digest the fiber we eat [21]. Even though your gut bacteria make butyrate, you can also supplement it.

(Side note: Without the live microorganisms in our gut, we wouldn’t be able to digest fiber at all.)

Researchers found that those with digestive issues like IBS and IBD have lower butyrate levels than healthy people with healthy gut function [22, 23]. Based on these findings, it would theoretically make sense that supplementing butyrate may improve those issues, and the research actually bears this out, although results are mixed within the category of IBD.

A large 2022 study of 2,990 IBS patients were all treated with butyrate (no placebo group). After 3 months, 99.7% of them had improvements, and 94% said they would continue using butyrate after the study. Patients saw improvements in abdominal pain, gas, diarrhea, constipation, urgency, nausea, and quality of life after 3 months [21].

Ulcerative colitis patients may not benefit from butyrate, based on current research, but it shows promising results for increasing long-term remission rates for other IBD patients like those with Crohn’s disease [24, 25, 26].

How to Supplement Butyrate

Butyrate may be safely taken as a supplement to help address symptoms of IBS, Crohn’s disease, traveler’s diarrhea, and diverticulitis flares [21, 22, 26, 27, 28, 29, 30].

As a supplement, it’s safe and well-tolerated at dosages between 300 mg to 4 g/day for up to a year [21, 26, 28, 29, 30]. 

Key Point: Butyrate is produced by gut bacteria, but supplementing may still benefit those with GI symptoms, although we need more research.

5. Vitamin D

Vitamin D is a key component in immune system regulation, metabolizing calcium, the growth and development of cells, and bone health [31, 32, 33]. Low vitamin D levels may contribute to obesity, malnutrition, autoimmunity, and gastrointestinal, liver, and kidney diseases [34]. 

When it comes to gut support, early evidence suggests that vitamin D may help regulate gut microbiota. However, the most consistent findings on this front were when vitamin D was obtained through sun exposure rather than supplementation [35, 36, 37, 38, 39, 40]. 

As you may have guessed from my previous sentence, the most ideal way to obtain vitamin D is to make it yourself through sun exposure—as long as you’re careful not to get burned [41]. Through safe sun exposure, your skin actually synthesizes the correct amount of vitamin D your body needs to optimize all the functions vitamin D facilitates.

That being said, your location on the globe, your skin tone, and your ability to be outside enough during peak sunshine may not allow you to get your full dose of sunshine every day. In this case, you’ll want to supplement.

Take a look at this chart to determine where you fall based on skin type and geography.

Table 1. Each skin phototype (lightest to darkest skin), response to UV, cancer risk, SED (amount of UV required to burn), and time in the sun at each UV Index level before burning [42, 43, 44, 45].

Skin phototype Skin response to UV Cancer risk SED(J/m2) Green(Low) Yellow(Moderate) Orange(High) Red(Very high) Purple(Extreme)
I – Extremely sensitive Always burns ++++ 1.5 15 min– 1.5 hr 18–30 min 12–15 min 9–12 min 7.5 min
II – Very sensitive Burns easily +++/++++ 2.5 1 hr 15 min–2.5 hr  30–50 min 20–25 min 15–20 min 12.5 min
III – Sensitive Burns moderately +++ 3 1.5 hr–3 hr 36 min–1 hr 24–30 min 18–24 min 15 min
IV – Mildly sensitive Burns minimally ++ 4 2–4 hr 48 min–1 hr 18 min 32–40 min 24–32 min 20 min
V – Resistant  Rarely burns  + 6 3–6 hr 1 hr 12 min–3 hr 48 min–1 hr 36–48 min 30 min
VI – Very resistant Almost never burns +/- 9 4.5–9 hr 1.8–3 hr 1 hr 12 min–1.5 hr 54 min–1 hr 12 min 40 min

More work needs to be done to clearly define the gut health benefits of vitamin D, but the early research is promising.

How to Choose a Vitamin D Supplement

The most bioavailable form of vitamin D is vitamin D3. Look for labels that say D3 [46]. Studies at the NIH have found that vitamin K and vitamin D have a synergistic effect when taken together, so it makes sense to find one that contains both [47]. Additionally, a 2020 meta-analysis of 8 randomized controlled trials found that combining the two significantly increased bone mineral density in people [48].

Key Point: Vitamin D may help regulate gut microbiota. It’s ideal to get your vitamin D from sunlight; however, if you need to supplement, choose a vitamin D3 that also includes vitamin K2.

6. Collagen

Collagen is the most abundant protein in the body. It’s found in the bone matrix, muscle tissue, tendons, ligaments, and cartilage, and it’s the reason so many functional doctors and holistic practitioners recommend drinking bone broth to support gut health [49].

Evidence for using collagen to support human gut health is thin, but animal and in vitro cell studies show interesting findings for what’s possible. Animal studies have shown collagen may improve dysbiosis, reduce inflammation, and increase short-chain fatty acid production [50, 51, 52].

Cell studies suggest collagen may have the potential to reduce leaky gut and inflammation, and increase short-chain fatty acid production [51, 53, 54]. This brings us back to butyrate—collagen may support your body’s production of more butyrate.

In the clinic, I’ve seen improvements when patients include collagen powder in their diet—increased energy and decreased fatigue. Collagen is a protein, so adding it to your diet as an additional protein source can also be really beneficial to your overall health. It’s also been shown to support skin health and reduce fine lines and wrinkles when ingested (not topically) [55]. 

How to take Collagen

Collagen comes in powder form and can be added to smoothies, soups, or even whisked into your morning coffee for a morning protein boost. It’s an animal product sourced from cows, pigs, or fish, so isn’t suitable for vegetarians. Your body makes collagen, but adding high-quality protein into your diet and shooting for 30 grams per meal, is a great goal to boost collagen production for your overall health. Collagen supplementation can help you achieve that goal. Most collagen supplements recommend around 10 grams/day, but up to 40 grams appears to be well-tolerated for most people.

If you want to make your own collagen-rich bone broth, using the most cartilaginous parts of a chicken is the easiest (and, in my opinion, the most delicious) way to go—chicken feet and wings work best.

Key Point: Collagen may reduce leaky gut and inflammation. It’s also a great source of protein and may improve skin health.

Supplements Geared Toward Specific Gut Health Conditions

After the top six I listed above, there are a few others I’d like to mention for their potential efficacy in addressing specific gut conditions. Here they are:

  1. Berberine
  2. Hydrochloric Acid (HCl)
  3. Herbal Antimicrobials
  4. Fiber
  5. Oral Fecal Microbiota Transplant (FMT) or “Microbiome Pills”

Berberine

Berberine is a plant compound often used for improving metabolic health and lowering inflammation. It also has antimicrobial effects. 

While there’s little research to support berberine for addressing gut health, what’s available is promising and worth investigating. A fairly large randomized controlled trial found that berberine may be effective at treating IBS symptoms, including diarrhea, abdominal pain, bowel urgency, anxiety, and depression [56]. These findings are encouraging for future research on berberine’s effects on SIBO, since SIBO and IBS tend to go hand in hand. A new clinical trial is underway comparing berberine’s efficacy to that of rifaxamin, the gold standard for treating SIBO with antibiotics [57].

It’s also worth noting that berberine may lower blood glucose, which means it could cause hypoglycemia in some people, so talk to your healthcare provider before starting this one.

Key Point: Berberine may be effective in treating IBS symptoms, including urgency, anxiety, and depression.

Hydrochloric Acid

HCl, or hydrochloric acid, is made in the stomach when the brain tells the stomach you’re about to eat. Its purpose is to break down protein, increase nutrient absorption, enhance digestion in the small intestine, and defend against pathogens. 

If you’re dealing with upper GI symptoms, HCl could be a good solution to consider. Risk factors are low if you don’t already have an ulcer, and you can easily run an at-home assessment to determine whether you’ll benefit from it.

Upper GI issues that HCl may improve include:

  • Burping
  • Reflux
  • Heartburn
  • Indigestion 
  • Bloating
  • Feeling full quickly 
  • Difficulty digesting animal protein

How to Use HCl

You can look for Betaine HCl at your local health foods store or grab a bottle here. For our patients in the clinic, we recommend starting with one capsule 15 minutes prior to each meal. If they don’t experience any relief with just one pill after two to three days, we’ll often have them increase to two capsules before each meal. Some may eventually work up to as many as four capsules to find the ideal dose.

A good rule of thumb in our experience is that if patients see improved symptoms, it’s safe to assume that their body needs supplemental HCl. If there’s no change after two weeks, we’ll recommend they stop taking it and try another avenue.

If you decide to try HCl on your own or, preferably, with a practitioner’s help, be sure to stop taking HCl right away if you feel any burning in your esophagus or stomach after taking it.

Key Point: HCl may be beneficial for those experiencing upper GI issues like burping, indigestion, and reflux.

Herbal Antimicrobials

Herbal antimicrobials are used for dysbiosis and certain gut infections. Curcumin (mentioned in the first section for general gut health) can offer some antimicrobial benefits, especially in combination with other herbs. Other herbal antimicrobials may include oregano oil, boswellia, wormwood, peppermint oil, and STW 5 (Iberogast), although this isn’t an exhaustive list.

Herbal antimicrobials can be effective against: 

Always use herbal antimicrobials with the guidance of a knowledgeable healthcare professional. People with compromised immunity should take extra caution. Just because herbal antimicrobials are natural doesn’t mean they aren’t potent and can’t cause problems if used incorrectly. We also don’t know if they might eventually contribute to antimicrobial resistance if used too frequently and unnecessarily [81].

Key Point: Herbal antimicrobials are intended for those with symptoms of gut dysbiosis and should only be taken under the guidance of a healthcare professional. 

Fiber

The reason fiber is listed here in this section rather than in the top six supplements above is because fiber is best consumed in the foods we eat rather than through supplements [82, 83, 84]. I see the best results when our patients work in five servings of fiber-rich food per day. This amounts to about 25-30 grams of fiber per day. It’s also true that certain gut conditions specifically require a deliberate reduction in fiber as part of the treatment protocol, like SIBO. SIBO protocol calls for a low-FODMAP diet, which may impact your total fiber intake. If you focus on low-FODMAP veggies, you may still be able to reach that 25-30 gram goal.

That being said, you might want to try fiber supplements if your diet is low in fiber and you have constipation, diarrhea, high cholesterol, and high blood glucose [85]. Fiber may aid in lowering blood glucose and cholesterol levels. This type of supplement is meant only for brief, temporary use rather than as an ongoing solution to gut challenges [86].

The best fiber to choose is dependent on your goals and needs. Based on available research,  psyllium husk seems to be the most effective at lowering blood glucose and cholesterol [85]. Use the recommended dosing on the label as your eventual goal dose, but don’t stop there. I usually have my patients who may benefit from supplemental fiber start with a ½-teaspoon and then slowly work their way up to three full teaspoons over the course of a few weeks to help reduce any potential side effects.

Risks of Fiber Supplementation

Fiber supplements, especially higher doses, may cause a number of mild GI side effects for people who have IBS, such as:

  • Diarrhea [87]
  • Constipation [87]
  • Nausea and vomiting [87]
  • Difficulty swallowing [87]
  • Back pain [87]
  • Fatigue [87]
  • Flatulence and gas [87]
  • Heartburn [87]
  • Pelvic pain [87]
  • Joint pain [87]
  • Bloating [88]
  • Sense of fullness [89]

People who are malnourished, sick, very young, or very old, or people with impacted bowels or who can’t tolerate the side effects should avoid supplemental fiber [86].

Key Point: Fiber is best consumed in the diet, but supplements may benefit some. Those with IBS have a greater risk of experiencing negative symptoms.

Oral FMT or “Microbiome Pills”

FMT stands for fecal microbiota transplants. Yes, poop pills. These capsules are filled with matter from the GI tracts of healthy people and are used to introduce live, beneficial bacteria to someone with signs of gut imbalance or poor gut health.

FMT research has shown it is effective for treating:

Risks of FMT

The risks of this treatment are low beyond the slight “ick” factor. Side effects may include mild bloating, abdominal pain, diarrhea, and constipation, but generally resolve on their own [115]. That being said, this is a newer intervention, and you should try it only after other treatment options fail.

If you go with FMT pills, it is vital to make sure you only source them from reputable sources. Two people reportedly died after using fecal samples from donors who were not properly screened for intestinal pathogens [116]. Please don’t ever follow DIY instructions that describe how to take someone else’s poop and introduce it into your own body.

Key Point: FMT is a new intervention that may improve a number of gut issues. This intervention should always be explored under medical supervision.

Start Simply

I’ve given you a LOT of information here. Instead of feeling overwhelmed with the array of potential supplements, start by adding a probiotic and probiotic foods into your daily routine. There are endless dietary supplements on the market making claims about what’s effective for gut health, but the one with absolutely rock-solid research to back its efficacy is probiotics.

The most important thing in choosing supplements is to buy from a reputable company. That’s because the FDA doesn’t regulate supplements the way they regulate pharmaceuticals. Look for the Truth in Labeling logo or other evidence of third-party testing, and ensure that the ingredients underneath the nutrition facts don’t’ include anything you’re allergic to before you buy.

From there, if you’re not experiencing relief, you can make your way down the list of the top six I listed here. Importantly, your diet is a huge factor in your gut health, and supplementation will only go so far if you’re not giving your body the correct inputs. If you’d like to explore on your own, check out my book Healthy Gut, Healthy You. If you’d like more support on your gut health journey, we’d love to help. Reach out to our clinic to set up a consultation.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.
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