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.
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
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
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
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)
All three categories have been found to provide important benefits, including reducing gastrointestinal inflammation:
A 2018 review found the lactic acid producers reduce factors causing inflammation in those with inflammatory bowel disease [7 Trusted SourcePubMedGo to source].
A 2017 review determined the lactic acid producers provide important benefits related to immune and inflammation regulation [8 Trusted SourcePubMedGo to source].
A 2017 systematic review found S. boulardii to increase the clearance of H. pylori infection. H. pylori is a cause of atrophic gastritis (chronically inflamed stomach lining) [17 Trusted SourcePubMedGo to source].
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?
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].
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.
Barkhidarian B, Roldos L, Iskandar MM, Saedisomeolia A, Kubow S. Probiotic supplementation and micronutrient status in healthy subjects: A systematic review of clinical trials. Nutrients. 2021 Aug 28;13(9). DOI: 10.3390/nu13093001. PMID: 34578878. PMCID: PMC8472411. Trusted SourcePubMedGo to source
Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013 Jul;98(7):2944–51. DOI: 10.1210/jc.2012-4262. PMID: 23609838. Trusted SourcePubMedGo to source
Hoppe M, Önning G, Hulthén L. Freeze-dried Lactobacillus plantarum 299v increases iron absorption in young females-Double isotope sequential single-blind studies in menstruating women. PLoS ONE. 2017 Dec 13;12(12):e0189141. DOI: 10.1371/journal.pone.0189141. PMID: 29236734. PMCID: PMC5728536. Trusted SourcePubMedGo to source
Whisner CM, Martin BR, Schoterman MHC, Nakatsu CH, McCabe LD, McCabe GP, et al.28914794Galacto-oligosaccharides increase calcium absorption and gut bifidobacteria in young girls: a double-blind cross-over trial. Br J Nutr. 2013 Oct;110(7):1292–303. DOI: 10.1017/S000711451300055X. PMID: 23507173. Trusted SourcePubMedGo to source
Amer M, Nadeem M, Nazir SUR, Fakhar M, Abid F, Ain Q-U, et al. Probiotics and their use in inflammatory bowel disease. Altern Ther Health Med. 2018 May;24(3):16–23. PMID: 29135456. Trusted SourcePubMedGo to source
Dhama K, Latheef SK, Munjal AK, Khandia R, Samad HA, Iqbal HMN, et al. Probiotics in Curing Allergic and Inflammatory Conditions – Research Progress and Futuristic Vision. Recent Pat Inflamm Allergy Drug Discov. 2017;10(2):105–18. DOI: 10.2174/1872213X10666161226162229. PMID: 28029082. Trusted SourcePubMedGo to source
McFarlin BK, Henning AL, Bowman EM, Gary MA, Carbajal KM. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World J Gastrointest Pathophysiol. 2017 Aug 15;8(3):117–26. DOI: 10.4291/wjgp.v8.i3.117. PMID: 28868181. PMCID: PMC5561432. Trusted SourcePubMedGo to source
Nyangale EP, Farmer S, Cash HA, Keller D, Chernoff D, Gibson GR. Bacillus coagulans GBI-30, 6086 Modulates Faecalibacterium prausnitzii in Older Men and Women. J Nutr. 2015 Jul;145(7):1446–52. DOI: 10.3945/jn.114.199802. PMID: 25948780. Trusted SourcePubMedGo to source
Du S-X, Jia Y-R, Ren S-Q, Gong X-J, Tang H, Wan-Shui W, et al. The protective effects of Bacillus licheniformis preparation on gastrointestinal disorders and inflammation induced by radiotherapy in pediatric patients with central nervous system tumor. Adv Med Sci. 2018 Mar;63(1):134–9. DOI: 10.1016/j.advms.2017.09.005. PMID: 29120854. Trusted SourcePubMedGo to source
Dinleyici EC, Eren M, Dogan N, Reyhanioglu S, Yargic ZA, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection. Parasitol Res. 2011 Mar;108(3):541–5. DOI: 10.1007/s00436-010-2095-4. PMID: 20922415. Trusted SourcePubMedGo to source
McFarland LV, Goh S. Are probiotics and prebiotics effective in the prevention of travellers’ diarrhea: A systematic review and meta-analysis. Travel Med Infect Dis. 2019;27:11–9. DOI: 10.1016/j.tmaid.2018.09.007. PMID: 30278238. Trusted SourcePubMedGo to source
Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, et al. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr. 2016 Mar;62(3):495–506. DOI: 10.1097/MPG.0000000000001081. PMID: 26756877. Trusted SourcePubMedGo to source
Ganji-Arjenaki M, Rafieian-Kopaei M. Probiotics are a good choice in remission of inflammatory bowel diseases: A meta analysis and systematic review. J Cell Physiol. 2018 Mar;233(3):2091–103. DOI: 10.1002/jcp.25911. PMID: 28294322. Trusted SourcePubMedGo to source
Feng J-R, Wang F, Qiu X, McFarland LV, Chen P-F, Zhou R, et al. Efficacy and safety of probiotic-supplemented triple therapy for eradication of Helicobacter pylori in children: a systematic review and network meta-analysis. Eur J Clin Pharmacol. 2017 Oct;73(10):1199–208. DOI: 10.1007/s00228-017-2291-6. PMID: 28681177. Trusted SourcePubMedGo to source
Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review. Clin Exp Gastroenterol. 2015 Aug 14;8:237–55. DOI: 10.2147/CEG.S85574. PMID: 26316791. PMCID: PMC4542552. Trusted SourcePubMedGo to source
Abboud M, Rizk R, AlAnouti F, Papandreou D, Haidar S, Mahboub N. The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials. Nutrients. 2020 Dec 30;13(1). DOI: 10.3390/nu13010111. PMID: 33396898. PMCID: PMC7824176. Trusted SourcePubMedGo to source
Raygan F, Ostadmohammadi V, Bahmani F, Asemi Z. The effects of vitamin D and probiotic co-supplementation on mental health parameters and metabolic status in type 2 diabetic patients with coronary heart disease: A randomized, double-blind, placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jun 8;84(Pt A):50–5. DOI: 10.1016/j.pnpbp.2018.02.007. PMID: 29432877. Trusted SourcePubMedGo to source
Ostadmohammadi V, Jamilian M, Bahmani F, Asemi Z. Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome. J Ovarian Res. 2019 Jan 21;12(1):5. DOI: 10.1186/s13048-019-0480-x. PMID: 30665436. PMCID: PMC6340184. Trusted SourcePubMedGo to source
Gasparri C, Perna S, Spadaccini D, Alalwan T, Girometta C, Infantino V, et al. Is vitamin D-fortified yogurt a value-added strategy for improving human health? A systematic review and meta-analysis of randomized trials. J Dairy Sci. 2019 Oct;102(10):8587–603. DOI: 10.3168/jds.2018-16046. PMID: 31400903. Trusted SourcePubMedGo to source
Melse-Boonstra A. Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits. Front Nutr. 2020 Jul 24;7:101. DOI: 10.3389/fnut.2020.00101. PMID: 32793622. PMCID: PMC7393990. Trusted SourcePubMedGo to source
Bird JK, Murphy RA, Ciappio ED, McBurney MI. Risk of deficiency in multiple concurrent micronutrients in children and adults in the united states. Nutrients. 2017 Jun 24;9(7). DOI: 10.3390/nu9070655. PMID: 28672791. PMCID: PMC5537775. Trusted SourcePubMedGo to source
Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. The Evolving Role of Multivitamin/Multimineral Supplement Use among Adults in the Age of Personalized Nutrition. Nutrients. 2018 Feb 22;10(2). DOI: 10.3390/nu10020248. PMID: 29470410. PMCID: PMC5852824. Trusted SourcePubMedGo to source
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