Does Taking Vitamins With Probiotics Affect Absorption?

Does Taking Vitamins With Probiotics Affect Absorption?

Key Takeaways

  • Your ability to absorb micronutrients like vitamins and minerals depends on your overall digestive health.
  • Probiotics may enhance the absorption of certain micronutrients, including vitamins.
  • Vitamin D and probiotics may work synergistically.
  • At recommended doses, most people can likely take probiotics and vitamins together safely.
  • Micronutrients are more bioavailable when consumed from whole foods, so supplementing may not be necessary for healthy people who eat a varied, nutrient-rich diet.

Probiotics have been shown time after time to be beneficial for everything from clearing gut infections and resolving imbalances to supporting the immune system and enhancing the protective gut mucus lining. Research also indicates probiotics may also improve vitamin and mineral absorption. 

In this article, we’ll discuss how your digestive health and probiotics relate to micronutrient absorption. We’ll also discuss the research on the relationship between vitamin D and probiotics and why most people probably don’t need to take supplemental vitamins with probiotics.

Vitamins with probiotics: chalk illustration of the intestines

Gut Imbalances Can Impact Vitamin Absorption

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

Since you primarily absorb micronutrients (vitamins and minerals) and macronutrients (fat, carbohydrate, and protein) through your small intestine, disruptions affecting this organ or its good bacteria can affect your ability to adequately absorb nutrients from your food or from dietary supplements. 

Digestive system imbalances that might bring these sort of imbalances include: 

  • High or low stomach acid
  • Microbial dysbiosis
  • Leaky gut
  • Inflammation
  • Gut infections

To better understand how these imbalances affect the absorption of vitamins (and other nutrients), let’s review some important steps in the digestive process.

Digestion Is a Complex Process

Woman with her hands in front of her stomach

You may not know it, but digestion begins in your mouth. When you chew your food, digestive enzymes are released. Your teeth and these enzymes begin breaking your food 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 things get more intense with the release of stomach acid (hydrochloric acid). This further breaks down the food bolus and also kills any unwanted or harmful microbes (gut bugs) that could be present in your food. 

Continuing on, 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 pancreatic enzymes secreted by your pancreas. 

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

There are many times when the digestive process can go wrong, with several factors contributing to nutrient malabsorption. Here are a few common ones: 

  • 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.
  • Helicobacter pylori (H. pylori) infection can lead to atrophic gastritis (chronic inflammation in the stomach), which can cause malabsorption.
  • Leaky gut can occur if the thin mucous membrane of the small intestine is damaged. Leaky gut has been implicated in immune and autoimmune conditions, food reactivity, and nutrient malabsorption.
  • Inflammatory diseases such as Crohn’s disease can lead to nutrient malabsorption via damage to the intestinal lining [1 Trusted SourcePubMedGo to source].

Probiotics Can Help Improve the Absorption of Micronutrients

Vitamins with probiotics: woman in her kitchen holding a jar of supplements

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 won’t fix the problem.

A complete program for gut restoration that includes probiotics is important for improving nutrient absorption. And probiotics have been shown in clinical trials to positively impact the absorption of some vitamins and minerals:

  • One 2021 systematic review of clinical trials found probiotics improved micronutrient levels in healthy people, specifically vitamin B12, folate (vitamin B9), calcium, iron, and zinc [2 Trusted SourcePubMedGo to source].
  • A small 2013 randomized controlled trial of adults with high cholesterol found that while vitamin A and E levels weren’t affected by probiotic intake, taking probiotics significantly improved vitamin D levels compared to the placebo group [3 Trusted SourcePubMedGo to source].
  • A nonrandomized clinical trial in 2017 found participants who consumed a probiotic with an iron supplement experienced significantly more iron absorption with the probiotic than without [4 Trusted SourcePubMedGo to source].
  • A 2017 literature review described some probiotics as having the ability to naturally manufacture B vitamins and also promote the absorption of micronutrients [5 Trusted SourcePubMedGo to source].

Similarly, prebiotics (compounds in food that help your commensal microbes to flourish) have been found to increase nutrient absorption. A 2013 randomized controlled trial found participants who consumed the prebiotic galacto-oligosaccharides (GOS) experienced increased calcium absorption [6 Trusted SourcePubMedGo to source].

Probiotics Can Be An Important Tool for Gut Inflammation

At our clinic, we like to address gut health before attempting to optimize micronutrient levels. Probiotics are key when it comes to healing the gut. Probiotics are microorganisms that provide health benefits to their host. There are three categories of probiotics:

  • Lactic acid producers (Lactobacillus and Bifidobacterium)
  • Soil-based (Bacillus species)
  • Fungal (Saccharomyces boulardii)
3 categories of probiotics

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

Is It Safe to Take Vitamins With Probiotics?

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

Since both vitamins and probiotics are very safe at recommended levels, it seems safe to assume that combining the two would be safe as well. But additional research on a wider variety of vitamins and probiotic strains is needed.

At our clinic, we have found that probiotics and reasonable doses of vitamins/micronutrients are usually tolerated well.

Vitamin D and Probiotics: A Special Relationship?

Vitamins with probiotics: hand holding a pill

As I discuss in Healthy Gut, Healthy You, vitamin D is key for overall health as it affects areas such as immune system modulation. Several studies have hinted at a synergistic relationship between probiotics and vitamin D.

A 2020 systematic review and meta-analysis of randomized controlled trials found combining probiotics and vitamin D resulted in greater health benefits for a wide range of participants when compared to other interventions, including vitamin D alone, which suggests a synergistic relationship between vitamin D and probiotics [19 Trusted SourcePubMedGo to source].

Health benefits included:

Additionally, randomized controlled trials have found vitamin D supplementation along with probiotics to improve a variety of mental health parameters, general health, metabolic and inflammatory markers in those with polycystic ovary syndrome and people with diabetes who also have coronary heart disease. However, neither trial studied the effects of vitamin D and probiotics alone, so it’s difficult to conclude that the supplements worked best together [20 Trusted SourcePubMedGo to source, 21 Trusted SourcePubMedGo to source].

And finally, a 2019 systematic review and meta-analysis of randomized controlled trials found vitamin D-fortified yogurt (high in the the probiotic Lactobacillus acidophilus) helped to improve vitamin D and cholesterol levels, metabolic function, and body measurements. But again, there were no comparisons to each single component, so it’s unclear if the results were related to a combined effect of the two [22 Trusted SourcePubMedGo to source].

Do You Need to Take Vitamins?

While a nutrient-dense diet will likely offer healthy people with the micronutrients they need, people struggling with immune function, gut health, and malabsorption issues can benefit from vitamin and mineral supplements. However, until the underlying cause of the malabsorption is identified and addressed, supplementing with vitamins and minerals will likely not provide much benefit.

Additionally, a 2020 literature review found many micronutrients to be more bioavailable in their whole-food form as opposed to a concentrated supplement, possibly related to “additive, antagonistic, and synergistic process at the level of uptake and absorption” [23 Trusted SourcePubMedGo to source]. This is why at the clinic, we often advocate a food-first approach such as found in a Paleo-like diet.

The research on dietary supplements is mixed, and there aren’t many randomized controlled trials assessing the benefits of multivitamins and overall health. That being said, there are several groups that may benefit from taking multivitamin and mineral supplements [24, 25 Trusted SourcePubMedGo to source, 26 Trusted SourcePubMedGo to source, 27]:

  • Those following a restrictive or nutrient-poor diet (the standard American diet is inadequate in several nutrients such as calcium, vitamin D, and potassium)
  • Those with identified malabsorption (IBD, exocrine pancreatic insufficiency)
  • Taking medications that can deplete key vitamins/minerals (e.g. Metformin, proton pump inhibitor)
  • Pregnant and breastfeeding women
  • Infants who don’t get enough iron
  • Menstruating women who could lose iron

Vitamin supplements come in many forms, from gummies to capsules to chewables. If you choose to take dietary supplements, speak with your 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 may improve the absorption of a variety of vitamins and minerals from food and supplements. 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 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, reach out to our functional medicine center.

➕ References
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