Can Butyrate Supplements Improve Gut Health?

Butyrate for Gut Health: Distinguishing the Truth From the Hype

• What is Butyrate?|
• How Butyrate Works in the Body|
• Pros and Cons of Butyrate Supplements|
• More Isn’t Better|
• Are Prebiotic Supplements Safer?|
• How the Low FODMAP Diet Works|
• Probiotics (Not Butyrate) Help Tackle Gut Issues|
• The Bottom Line on Butyrate Supplements|

Butyrate is a new buzzword in gut health. Butyrate supplements and prebiotics that stimulate your gut to produce butyrate are often promoted as a way to help gut health problems, as butyrate theoretically has a number of digestive system benefits.But does research back the benefits of butyrate supplements? In this article, we’ll look at butyrate, its functions, and whether upping your intake by taking butyrate supplements can help conditions such as IBS, dysbiosis, weight loss, and inflammatory bowel disease.

What Is Butyrate?

Butyrate (butyric acid) is a short-chain fatty acid (SCFA). That means it’s a type of “good fat,” though it’s not widely found in food. Butter is the best source, but most of the butyrate in our bodies is produced by bacteria in the bowels [1].

Good gut bacteria that live in the colon “eat”, or ferment, fiber and carbs (such as resistant starch) that our gastrointestinal tract can’t digest. This fermentation process produces SCFAs as a byproduct. Of these, butyrate is the most well-known. Other common SCFAs include propionate and acetate.

The most prolific butyrate-producing bacteria in the human gut include [2, 3, 4]

• Faecalibacterium prausnitzii (up to 14% of the total fecal microbiota)
• Eubacterium rectale (up to 13% of the total gut microbiota)

Other more minor butyrate-producing microbes include: 

• Roseburia spp.
• Blautia
• Lachnospiraceae
• Ruminococcus
• Clostridium
• Anaerostipes
• Butyricicoccus pullicaecorum

You’ll notice that the common names you’d expect to see on the label of a probiotic supplement, like Lactobacillus and Bifidobacteria, aren’t listed above. This is because many of the beneficial effects of probiotics are likely unrelated to butyrate production. In other words, we don’t know for sure that supplementing from the list above will improve butyrate levels or digestive health. More research is needed—what we have gleaned so far is mixed.

Bacteria that are butyrate-producing in the lab may not significantly increase butyrate levels in people when you consume them. For example:

• A 2020 review to determine the effect of probiotics on SCFA production in the human intestinal microbiome found only one study where butyrate was increased, and this was a non-significant increase [3].
• An eight-week randomized clinical trial of supplementation with a butyrate-producing probiotic (Butyricicoccus pullicaecorum) found no difference in butyrate levels between the probiotic and placebo group [5].
• In a 2021 review of the butyrate-producing probiotic Clostridium butyricum, only one study measured stool butyrate levels, finding only a small, statistically insignificant increase in butyrate [6].

How Butyrate Works in the Body

Butyrate is the primary energy source for colon cells, known as colonocytes, that line the inside of the bowel (colon or large intestine) [2, 7]. After it’s manufactured by microbes in the human colon, butyrate carries out various helpful roles in the gut. Butyrate can also be distributed beyond the large intestine, for example, in the brain, liver, and fat tissue [8].   

In vitro (lab) and in vivo (animal and/or human) studies have shown that butyrate:

• Plays an important role in modulating immune system function and inflammatory responses in the gut [7, 9, 10]
• Helps maintain intestinal barrier function (i.e. reduce gut leakiness) [7, 9, 10]
• Has antioxidant properties [7]
• Stimulates absorption of fluids and electrolytes [7]
• Functions as a histone deacetylase inhibitor, encouraging the controlled destruction, or apoptosis, of mutated or precancerous cells, which in turn may reduce colon cancer risk [2, 7]
• May alter gene expression in the brain via the gut-brain axis, helping to prevent cognitive decline [1]

How butyrate affects gut health in people in daily life, as opposed to in lab tests on humans and animals, is not clear-cut. Human clinical trials involving a range of gut conditions have produced mixed results. Let’s take a look.

Pros and Cons of Butyrate Supplements

When it comes to butyrate supplementation, the assumption is essentially that more butyrate = better gut health. However, this is not necessarily true in all cases. For example, while patients with certain types of digestive conditions have been shown to have lower levels of butyrate in their guts, patients with other conditions have been shown to have higher levels. In other words, more butyrate doesn’t automatically equal better gut health. 

A few clinical trials have shown that butyrate can help to improve symptoms of IBS, diverticulitis, and traveler’s diarrhea [11, 12, 13]. However, there is much more evidence to support interventions like the low FODMAP diet — which may actually decrease butyrate levels — for the treatment of IBS, SIBO, and other digestive conditions [14]. 

The bottom line is that while butyrate supplements may offer benefits in some cases, they’re not the first step if you’re experiencing digestive symptoms. If you do try a butyrate supplement, make sure to monitor your symptoms and check with your medical provider, especially if you have a pre-existing condition like diverticulitis or IBS. That way, you can see if they’re improving, staying the same, or worsening. If the latter occurs, of course, you’ll want to discontinue supplementation.

The Good News 

Bacterial imbalances and dysbiosis: Studies show that butyrate supplements can increase the levels of “good” microbes such as Akkermansia muciniphila, Butyricicoccus, and Lachnospiraceae [15, 16, 17].

IBS (irritable bowel syndrome): A 2013 RCT involving 60 patients with IBS found that 12 weeks of sodium butyrate supplementation (on top of standard medicinal therapy) was associated with significantly decreased abdominal pain, reduced pain during bowel movements, and less constipation compared to placebo supplementation [11].

Diverticulitis: A 2014 RCT found that 12 months of supplementation with sodium butyrate (300 mg per day) was associated with significantly decreased episodes of diverticulitis (acute inflammation of pouches that can form in the intestine) compared to a control group. Subjective quality of life was also higher in the sodium butyrate group compared to the control group [12].

Traveler’s diarrhea: Sodium butyrate (250 mg per day) taken for three days in combination with other SCFAs before and during traveling was associated with a reduced risk of abdominal symptoms like pain, bloating, nausea, and fevers [13].

The Bad News

Obesity and impaired glucose tolerance: Levels of butyrate seem higher in people with obesity [18, 19]. So, consuming extra butyrate in the form of supplements probably isn’t a good idea if you already have unintended weight gain, diabetes, or metabolic syndrome.

• A 2019 observational study involving 441 adults found that higher fecal butyrate levels were significantly associated with obesity, high blood pressure, poor metabolic health (including raised cholesterol, triglycerides, and blood sugar), more gut permeability (a leaky gut), and gut dysbiosis. The researchers hypothesized that these high levels may indicate that butyrate isn’t being properly absorbed [20].
• In animal research, butyrate supplements given to pregnant and lactating rats induced insulin resistance and fat deposition in the offspring [21].
• Excess butyrate can increase fat synthesis in the body, which could potentially contribute to obesity [22]. 

Ulcerative colitis:

• A systematic review of eight randomized controlled trials (high-level evidence) found that butyrate enemas weren’t effective for treating ulcerative colitis (a type of inflammatory bowel disease or IBD), with only one study showing a significant improvement in disease activity compared to placebo [23].
• In another study, high-dose prebiotics, which stimulates butyrate production, helped patients with mild and moderate ulcerative colitis go into remission. However, the prebiotics also caused more flatulence and bloating [24].
• Butyrate treatment did not significantly improve inflammation or the health of tissues examined via endoscopy (a camera down the throat) [23].

Autism in children: Increased levels of SCFAs in the bloodstream due to increased gut permeability or abnormal microbiota may be detrimental to children with autism. The study below was an animal study, so we can only glean so much from the results. More work needs to be done in this area, but this is still interesting information. 

• While the underlying issue here is much more likely to be the leaky gut and dysbiosis, it still seems wise for pregnant women and infants not to be exposed to large amounts of supplemental butyrate or other SCFAs [1].

Colorectal cancer: A 2021 systematic review and meta-analysis of 20 clinical trials concluded that in human health studies, resistant starch and inulin (butyrate-stimulating prebiotics) didn’t lower the risk of colorectal cancer or significantly increase butyrate levels [25].

More Isn’t Better

It’s also not a simple case of higher butyrate levels equals better gut health. For example, in people with IBS-C (irritable bowel syndrome, where constipation is the main symptom), levels of butyrate in the stool tend to be lower than in controls. By contrast, in IBS-D (irritable bowel syndrome with diarrhea), butyrate levels have been found to be higher than in controls [26]. 

People living with obesity also tend to have higher butyrate levels [18, 19], as do people with poor metabolic health, including insulin resistance and raised blood glucose [20]. 

One theory as to why butyrate levels can sometimes be higher in certain people is that acute inflammation could reduce the ability of intestinal cells to utilize butyrate correctly. Increased levels of SCFAs in the blood could also occur because of increased gut permeability in patients with poor gut health [27, 28].

Are Prebiotic Supplements Safer?

Prebiotic-rich diets and supplements, or eating a diet rich in fibrous foods such as fruits, vegetables, and beans, is, in theory, a healthier way to enhance bacterial production of butyrate in the gut [29].

Studies confirm that prebiotic supplements are an effective way of increasing butyrate production and probably more effective than consuming butyrate-producing probiotics directly.

For example: 

• When HIV-positive subjects took a  prebiotic for six weeks, there was a significant increase in butyrate production and an increased abundance of butyrate-producing bacteria [30]
• A 2017 systematic review and meta-analysis found that resistant starch (a prebiotic) increased stool weight and butyrate concentration in healthy adults while also benefiting colon function [31].
• Seven studies found that prebiotic supplements such as inulin, fructans, and raffinose increased the butyrate-producing bacteria F. prausnitzii [15].

That said, not all studies show a significant increase in butyrate when prebiotics are consumed [25, 32]. 

More than this, while consuming prebiotics is a key way to feed the gut microbes and optimize butyrate production in healthy people, it can have the opposite effect in people who have compromised gut health.

If you experience bloating and gas when eating these foods, consider taking a digestive enzyme as a dietary supplement before you eat these foods to aid your stomach in breaking them down before they reach your small intestine. If they still cause problems, chances are it’s time for a low-FODMAP diet (which involves severely limiting these types of carbohydrates and dietary fibers for a period of time to give your gut some time to heal).

Strong research supports that the low FODMAP diet can:

• Improve IBS symptom severity and offer significantly better quality of life to IBS patients (compared with control diets) [33]
• Improve gastrointestinal symptoms and abdominal pain with no reported side effects [34]
• Help improve symptom relief in inflammatory bowel disease (Crohn’s and colitis) [35]

A low FODMAP diet helps tackle gut sensitivities despite temporarily reducing butyrate levels. In one randomized controlled trial, butyrate was significantly lower after people began a low FODMAP diet, but signs of inflammation were also significantly lower—a sign that the gut is beginning to heal [14].

Later on, when your gut has begun healing and you’ve built up some tolerance, you can very likely reintroduce and consume enough healthy, high-fiber foods to optimize butyrate production.

How the Low FODMAP Diet Works

The low FODMAP diet is an elimination diet that cuts out fermentable carbohydrates found in foods such as wheat, milk, onion, mangos, asparagus, and garlic. There are three main phases of the diet:

1. Elimination: During this initial stage of the diet, you avoid high FODMAP foods for up to three weeks in order to obtain quick relief of symptoms such as bloating, abdominal pain, flatulence, and diarrhea.
2. Food reintroduction: In the reintroduction phase, you test one high FODMAP food at a time, adding a new food every few days if the previous food didn’t lead to any adverse effects. This helps you identify which FODMAP foods most aggravate your symptoms.

Personalizing and maintaining: In this phase, you use what you’ve learned during the elimination and reintroduction phases to broaden your diet (as long as symptoms stay reduced).

The low FODMAP diet has been shown to temporarily reduce butyrate production as well as gut microbiota diversity. Gut bacteria diversity is usually a sign of a robust and healthy gut flora [14, 36]. However, it’s still a much better option than increasing prebiotic fiber intake and/or taking butyrate supplements for people who have recent gut issues. 

This helps us to see that higher butyrate levels are not necessary for better gut health or improved symptoms: On a low FODMAP diet, symptoms often significantly improve, even if butyrate levels are decreased. 

In one randomized controlled trial, short-chain fatty acids and butyrate were significantly lower after people began a low FODMAP diet, but signs of inflammation were also significantly lower—a sign that the gut is beginning to heal [14].

Later on, when your gut has begun healing, and you have built up some tolerance, you can very likely reintroduce and consume enough healthy high-fiber foods to optimize butyrate production.

Probiotics (Not Butyrate) Help Tackle Gut Issues

While the evidence for butyrate is inconsistent, the research on the benefits of probiotics for gut sensitivities is much more solid. How a probiotic might affect your butyrate levels isn’t a concern. In fact, most studies where probiotics have benefited gut health haven’t measured butyrate levels at all.

Before experimenting with butyrate supplements, it makes sense for people with inflammation, gut dysbiosis, and other gut issues to take a well-formulated broad-spectrum probiotic supplement. Extensive research shows that they can:

• Help to correct imbalances in your gut microbiome [37] 
• Fight pathogenic (harmful) bacteria and the toxins they produce [38, 39, 40]
• Reduce the gut inflammation behind many gut conditions as well as decrease gut permeability (leaky gut) [36, 41, 42, 43]

A recent literature review to determine the effect of probiotics on butyrate and other SCFA production in the microbiome found only one study involving humans where butyrate and other SCFAs increased [3]. 

The same review found cell and animal studies where butyrate production increased from taking probiotics. However, none of the other clinical trials, which involved both healthy and unwell patients, mentioned increases in butyrate from supplementing with Lactobacillus or Bifidobacterium probiotics.

Though probiotics are really useful for gut health, it appears that increasing butyrate isn’t a primary route of action.

To choose a quality probiotic, look for one that is:

• Manufactured to good manufacturing practice standards
• Has a high potency
• Broad spectrum (containing more than one species of bacteria)

The Bottom Line on Butyrate Supplements

Butyrate undoubtedly has an important role to play in gut health. Ordinarily (in people with robust gut health), a varied diet including different plant fibers and prebiotics will help your gut bacteria create optimal levels of butyrate without the need for butyrate as a gut health supplement.

However, for a sensitive gut, research-based evidence supports cutting down on fermentable carbs and fibers through a low FODMAP diet. 

Research suggests several health benefits of butyrate supplements, but may have negative effects in some situations, particularly in obesity, where levels are often already raised anyway.

My book, Healthy Gut, Healthy You, has a comprehensive step-by-step plan for gut healing. Or, for more individualized healthcare support, request a consultation.

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