For many health-conscious people, the use of antibiotics is a double-edged sword. We understand their power in combating illness but also recognise that they pose risks for the gut microbiome.
I’m often asked for guidance about antibiotics by The Proof community, and in Episode #271, gastroenterologist and bestselling author Dr Will Bulsiewicz returns to the show to answer your most common questions. If you’ve ever wondered how antibiotics affect the microbiome and what you should do if you need to take them, this episode is for you.
“I’m not here to vilify antibiotics… they literally are what I would rank as the number one breakthrough in medicine of the last 100 years. But the choice is about risk and benefit, and we need to understand both sides of that equation in order to make a good choice.”
Dr Will Bulsiewicz, or “Dr B”, is an award-winning gastroenterologist, internationally recognised gut health expert and the New York Times-bestselling author of Fiber Fueled and The Fiber Fueled Cookbook. He is on the Scientific Advisory Board and is the US Medical Director of personalised nutrition company ZOE, has authored more than twenty articles published in peer-reviewed scientific journals, has given more than forty presentations at national meetings, presented to Congress and the USDA, and has taught over 10,000 students how to heal and optimise their gut health.
“If we can cut down on the unnecessary antibiotic use, that is the most powerful way for us to protect ourselves.”
In this episode, we hone in on the topic of antibiotics so you can better protect your gut microbiome. In this comprehensive discussion, we explore the fundamental nature of antibiotics, their role in medicine, and their impact on the microbiome. Dr Bulsiewicz breaks down what really happens when you take antibiotics, how to tell whether you should be taking them, and the measures you can take to help your gut recover before, during, and after their usage.
We also delve into more specific concerns, including frequent antibiotic usage (especially in early childhood), the concept of an antibiotic scar, and probiotic and prebiotic supplementation. Finally, Dr B answers some of your questions about yeast infections, SIBO, and non-dietary lifestyle factors.
Specifically, we discuss:
- Intro (00:00)
- What are antibiotics? (03:01)
- Efficacy, prescription, and ‘antibiotic scar’ (08:26)
- The healthy gut microbiome (15:58)
- Effects of antibiotics to gut the microbiome (21:32)
- Clostridioides difficile (28:30)
- Do you really need antibiotics? (31:04)
- High-fiber diet (39:44)
- Sprouts, lentils, and fermented foods (43:25)
- Prebiotics and prebiotic supplements (46:30)
- Probiotics and microbiome recovery after antibiotics (58:06)
- Who may benefit from taking probiotics? (1:05:00)
- Foods to limit to avoid dysbiosis (1:07:45)
- Why do antibiotics cause yeast infections? Do probiotics help? (1:09:35)
- Antibiotics and small intestinal bacterial overgrowth (SIBO) (1:11:04)
- Lifestyle changes to boost microbiome recovery after taking antibiotics (1:13:49)
- Outro (1:18:56)
After many insightful visits to the show, Dr Bulsiewicz once again delivers in this episode, translating complex science into practical, digestible information that you can apply to your daily life. This episode offers a trove of actionable guidance, directly addressing questions and concerns that many of us have. I’m grateful for Dr B’s insight into this topic, and I’m confident that you’ll find his advice useful in your health journey.
Connect with Dr Will Bulsiewicz on Instagram, Facebook, Twitter, and TikTok. Discover more resources and Dr B’s books on his website, theplantfedgut.com, and learn more about supplementation at 38tera.com. Listen to Dr B’s past appearances on The Proof here.
My team and I have also put together a PDF of resources for this episode, helping you better understand the science behind this conversation. Download it at theproof.com/drb.
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More about Dr Will Bulsiewicz
Dr Will Bulsiewicz (or “Dr B”) is an award-winning gastroenterologist, internationally recognised gut health expert and the New York Times-bestselling author of Fiber Fueled and The Fiber Fueled Cookbook. He is the US Medical Director and on the Scientific Advisory Board of personalised nutrition company ZOE, has authored more than twenty articles published in peer-reviewed scientific journals, has given more than forty presentations at national meetings, presented to Congress and the USDA, and has taught over 10,000 students how to heal and optimise their gut health. He lives in Charleston, South Carolina with his wife and children.
- Head over to the reference page.
- Acute and persistent effects of commonly used antibiotics on the gut microbiome and resistome in healthy adults • PMID: 35417701
- Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT • PMID: 30193113
- Recovery of the Gut Microbiota after Antibiotics Depends on Host Diet, Community Context, and Environmental Reservoirs • PMID: 31726029