Note: The Prescript-Assist supplements discussed in this article are no longer available. Please click here to learn more about a substitute, the Daily Synbiotic from Seed.
I wrote this a while back when I had more time, thinking it might come in handy during the book tour. I was right!
A few years ago, I wrote an article about the often devastating effects that antibiotics can have on the gut flora. While it’s extremely important to avoid unnecessary antibiotic use, what about those who have carefully considered their options and decided that antibiotics are necessary in their situation? Is there no hope for recovering a healthy microbiome?
Need to take antibiotics? You need to read this article.
While having to take antibiotics is never ideal, there are many cases where it is absolutely necessary, and don’t worry – the situation is far from hopeless. It will take some time and effort, but there are many things you can do both during and after a course of antibiotics to minimize the damage and encourage regrowth and diversification of your gut flora.
Probiotics
To some, taking probiotics during a course of antibiotics might seem contraindicated. After all, won’t the antibiotics just kill all of the probiotics anyways? First, keep in mind that probiotics don’t need to actually colonize the gut to be beneficial; even transient strains can have powerful therapeutic effects.
For example, a study on 135 hospital patients taking antibiotics found that only 12% of the probiotic-receiving group developed antibiotic-associated diarrhea, compared with 34% of the placebo group. (8) Additionally, while 17% of the placebo group developed diarrhea specifically from C. difficile, nobody in the probiotic group did.
One interesting study tracked changes in gut bacteria in three different groups of people receiving antibiotics, with one group receiving placebo, one group receiving probiotics beginning after the antibiotic treatment ended, and the third group receiving probiotics both during and after antibiotic use. (9) The group receiving placebo had significantly higher levels of facultative anaerobes (their chosen marker for gut dysbiosis) 20 days after finishing antibiotics compared with baseline, while the two groups receiving probiotics had no significant difference. But even though both of the probiotic groups ended up back at baseline levels, only the group taking probiotics during as well as after antibiotic treatment maintained stable levels of facultative anaerobes throughout the experiment. In the group receiving probiotics only after completion of antibiotic treatment, facultative anaerobes increased significantly during antibiotic treatment, and decreased only after beginning probiotic supplementation. This clearly demonstrates the importance of taking probiotics during antibiotic treatment, as well as after.
Most of these trials used different strains of Lactobacilli, Bifidobacteria, or Saccharomyces boulardii. Lactobacillus and Bifidobacterium are two of the most common genera used as probiotics, so these supplements are readily available in most health food stores or vitamin shops. S. boulardii is actually a beneficial yeast rather than a bacteria, so it’s particularly useful during antibiotic treatment because the antibiotics can’t kill it. S. boulardii is also preferable under these circumstances because there’s no risk of it harboring genes for antibiotic resistance and later transferring those genes to pathogenic bacteria. (10)
Another option for probiotics is a blend of soil-based organisms, such as Prescript Assist. I haven’t located any studies on their effectiveness in conjunction with antibiotics, but based on my clinical experience, I believe they’re a great choice.
As with anything else, the best probiotic to take will depend on a person’s particular circumstances (such as the antibiotic they’re on and the state of their digestive system), but the two supplements I recommend most often are S. boulardii and Prescript Assist. If you don’t do well on either of those supplements or just wish to add more variety, feel free to add in a supplement with strains of Lactobacillus and Bifidobacterium. Do your best to take any probiotic supplement as far away from your antibiotic dose as possible.
Prebiotics
As I’ve mentioned before, prebiotics are much more effective than probiotics at promoting the growth of beneficial bacteria in the gut. Thus, prebiotics are an incredibly important part of any regimen to protect or rebuild a healthy microbiome.
However, one type of insoluble fiber that can be extremely helpful for supporting healthy gut flora is resistant starch. (11) I’ve talked about resistant starch before here and here, and the easiest way to get a concentrated dose of RS is to use Bob’s Red Mill unmodified potato starch. As with any supplemental prebiotic, it’s a good idea to start with a small amount and work your way up. In this case, you could start with 1 teaspoon and work your way up to 2-4 tablespoons per day. If you find that RS doesn’t work well for you, you might consider trying an inulin-based prebiotic.
If possible, introduce any prebiotic supplements before beginning the course of antibiotics so your body can get used to them. That way, you won’t have to deal with possible side effects from introducing the prebiotic on top of possible side effects from the antibiotics.
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Supporting diversity
As I mentioned in my article about the impact antibiotics have on gut flora, the main difficulty after a course of antibiotics isn’t recovering the number of flora present; it’s recovering the diversity. As we’ve seen, probiotic supplements can be incredibly helpful for preventing antibiotic-associated diarrhea and lowering the risk of a gut infection, and I recommend continuing with probiotic supplementation for a period of time after finishing your treatment. However, you can’t expect manufactured probiotic and prebiotic supplements to achieve the diversity of an ancestral microbiome on their own.
These can include kefir, beet kvass, sauerkraut, kombucha, kimchi, and other fermented vegetables or fruits. Keep in mind that foods like yogurt and kefir will probably only have a handful of bacterial strains if you buy them from the store, so homemade is best.
Another way to diversify the bacteria you’re exposed to is by gardening or otherwise getting your hands dirty, although I haven’t seen any research on whether that exposure translates to a more diverse set of gut bacteria.
As far as prebiotics go, just try to get as much variety in your plant foods as you can, in addition to supplementation with resistant starch or another prebiotic formula. Some of the best sources of soluble fiber include carrots, winter squash, summer squash (especially peeled), starchy tubers, turnips, rutabagas, parsnips, beets, plantains, taro, and yuca. Green bananas and unripe plantains (which you can dehydrate to make chips) are good whole-food sources of resistant starch.
Support for the Gut and the Liver
When antibiotics throw your gut flora into turmoil, the gut lining and digestive function as a whole take a hit too. To soothe your digestive system, it’s a good idea to ramp up your consumption of bone broth and other glycine-rich foods while you’re on antibiotics, and continue to consume these foods after the treatment is finished to promote healing.
If you experience nausea or other digestive upset from the antibiotics, ginger can be extremely helpful for reducing inflammation and calming the digestive system. (12, 13) It’s best to use fresh ginger, and you can easily make ginger tea by slicing it and simmering it in water until the tea reaches your desired strength.
Antibiotics can also take a toll on your liver, particularly if you’re on them for an extended period of time. Not only is the liver is responsible for processing and detoxifying medications, it also has to deal with extra circulating lipopolysaccharides from the increased bacterial death and intestinal permeability. Milk thistle is one of my favorite supplements for supporting liver health, and can be taken in a pill (like this one) or as a tea. (14, 15) Glycine is also important for liver detox, so be sure to drink that bone broth!
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I am 39.5 weeks pregnant. My 2.5 year old son was diagnosed with whooping cough 9 days ago and I was tested and got my results back 3 days ago. When I my son tested positive we both started a very strict diet recommended by my naturopath that is high in fruit and vegetables and we are excluding grains (still eating oats with chia and LSA) and no dairy, that included high vitamin c supplements and I was taking a mix of raw garlic, onion and manuca honey, and we have been on lots of bone broth.
However when I got my results back and I was positive it was very firmly recommended to start s course of antibiotics (clarithromycin) to make sure we are not still contagious when the baby is born. We started them 3 days ago, I am taking probiotics, continuing with the diet my naturopath recommended and introduced coconut kefir, and dill sauerkraut which are both store bought. My mother in law is making me some homemade kefir.
I really want to get my gut bacteria into the best condition before the baby is born, hoping the baby comes late to give me more time. Can you recommend anything else I can do?
On the rare occasion I have had to take antibiotics, I can definitely feel my body is off. I have terrible cravings, no energy, and an overall sense of blah. After the antibiotic cycle is complete, I have found a healthy diet of nutrient dense foods, fermented foods and quality probiotics, I also take a liver blend of essential oils to support natural detoxification. I just found a new line of clinical grade essential oils and they have been a very beneficial addition to my family’s life! I got them at honest.oils.myameo.com if anyone is interested.
Hi Chris
I am 36 weeks pregnant and have just been diagnosed with GBS in urine. Have been prescribed amoxicillin.
I had been on a strict regime to eradicate gbs and the vaginal swab came back negative.
Is there anything else you think I could do instead of taking the antibiotic?
Doctors are also saying I should take in labour.
If I did have treatment, what can I do other than breastfeed, skin to skin and give probiotics to help newborns microbiome?
Thanks
I have also been diagnosed with MAC and bronchiectasis. It took 2ys to establish a diagnosis and there is a moderate damage to my lungs already. I am otherwise a 42-yo healthy non immunocompromised, non-smoking woman.
Although I am terrified of the potential side effects of the three-antibiotics treatment for Mac, this includes blindness and deafness, I started this treatment three days ago. I already have mild side effects – extreme fatigue, somnolence, and excessive bowl movements without diarrhea and slight abdominal pain. All is mild and I can tolerate it so far and determined to continue.
Unfortunately this treatment, in my case Myambutol (Ethambutol), Rifampin and Azithromycin, might go on for years if I don’t become blind or deaf during it. However, I have to get this infection treated and would like to manage the side effects better. A professional advice would be immensely helpful. My physician is great regarding MAC treatment but not with anything beyond the Western medicine. What could help to reduce the possible dreadful side effects?
I purchased Jarrow Formulas Jarro-dophilus EPS and will start it tonight. Was thinking about taking milk thistle but was told that it might increase the potential side effects of the antibiotics. Sadly, I just cannot get any question about how to manage these side effects and still in the midst of the unknown.
I would greatly appreciate an educated piece of advice or someone else’s successful MAC treatment story.
Thank you!
Lydia, I am starting the treatment too and am very scared. Are you done now? How did it go? and I’m hoping you don’t say anything too bad because I really need to do this and am so scared.
I am caring for my elderly mother who has advanced Akzheimers Disease and other ailments. At the moment I have her on cephalexin for a uti. She is unable to tolerate dairy or fermented foods. Can I still give her her probiotics? How long after the antibiotic?
Thank you
Do you have any information or resources on long term antibiotic use during pregnancy? I have chronic Lyme Disease and have treated it naturally for years. I’ve been advised (by a naturopath who does not readily prescribe them) to take antibiotics during pregnancy to reduce the risk of passing the bacteria to baby. My concern is that the antibiotics will negatively effect the baby’s microbiome and immune system. Any info, studies, etc you could direct me to?
That’s interesting that the naturopath thinks you should take antibiotics. I don’t have a clear answer for you.
Antibiotics can be a double edged sword. They can help and hurt. What antibiotic does he say you should take and what did he say to your concerns ?
Make sure your baby isn’t given any vaccines.
They always say that pregnant women shouldn’t take this or that supplement without a doctors ok. Of course if your doctor is one of the few who knows about nutrition then it may be a different story.
There are two products that are proven thru research to help the immune system, they are moducare and micronized beta glucans. Moducare balance overactive and underactive immune systems. The micronized beta glucan helps the Th1 and it is the only beta glucan that works. The regular high mg beta glucan does not work.
I’d consider taking higher than normal doses of nutrition. In autism for instance, they say what causes the damage is that the selenium get depleted. I think if the baby has sufficient nutrition, it improves the odds.
Antibiotics are recommended during pregnancy because research has shown they greatly reduce the risk of passing the infection on to the baby. In the presence of antibiotics the spirochete goes into a form of “hiding”. They are recommending amoxicillin or azithromyocin. Their opinion is that the benefits out weigh the risks in this case, but I still feel uneasy about it.
The herbal remedies I am currently taking haven’t been studied during pregnancy, so we don’t know how safe they are during pregnancy or effective they are at preventing transmission.
How does one know if they are th1 or th2 dominate. I have hashimoto and just recently read of this.
Please don’t pressure people not to immunise their babies.
Everyone is entitled to make up their own minds but they should be aware of the science and history behind diseases such as measles, whooping cough and polio before making their decision.
Babies and children still die today from whooping cough and measles: these diseases are still very much out there in the community.
I have to take antibiotics for a ‘bacterial’ case of bronchitis – that I now realized was from acid reflux and eating some possible tainted meat. I was very sick so ultimately relented to antibiotic. Was prescribed Azirthromycin after just 2 doses I had diarrhea – so now was given Keflex.
I started taking sacrro 2xa day – and I had Klair Labs probiotics (Factor 1 ) which helps with diarrhea. It has seemed to help calm everything down but my problem now is a loss of appetite. I have to start Keflex tomorrow – and so worried as to whether the antiobiotics are going to damage all the work that I have done on my digestive issues.
I did take some notes on comments below – lglutamine and will get GSE oil. What are recommendations for loss of appetitie and what causes that ?
I have been on Augmentin 875 mg twice a day for 10days in Dec, 2014 for a sinus infection, then in Jan. 2015 got on 250mg Ciprofloxacin twice a day for five days, that was for a UTI , I go back to be checked in Feb., 2015 and it didn’t get rid of it so they put me on Bactrim twice a day 875 mg and then got the flu I call it the doc called it a virus, but I ached, had low grade fever with chills, cough and coughing up clear sputum but have never coughed up as much for as long and couldn’t eat or drink during this time but tried to sip on few fluids and crackers. Then I started with blood in my urine the third week of the flu actually blood in urine making it red due to I guess not drinking and urinating as often, so I go to urgent care in March 7, 2015 and they put me on 500 mg of Ciprofloxacin twice a day for seven days and I stopped on the 7th day completed that seven days on the 13th of March and today is March 15th. How do I get back to normal with my strength as I am 65-1/2, have been healthy other than a UTI about once a year since I turned 60 I think. I am weak and bought Probiotics but haven’t started taking yet due to being so afraid that it may start something else up, or I have had reactions to certain things in the far past. I am not sure what to do.
I am a healthy 57 yr. old woman. I have been diagnosed with H Pylori bacteria. I was tested for this because of tightness in my chest and irregular heart beat.
( an EKG and test for blood clots was also given prior).
I’m on, due to choice, mega doses of antibiotics and thus found your article as I was concerned about taking 8 large meds a day.
The good news is my heartbeat and tightness are gone.
But I am not sure how much milk thistle and probiotics to take. Garden of Eden has a probiotic grown in soil I will take and the S. BOulardi I have on board.
Any suggestions on Milk Thistle or other items to consider?
I have read your article above twice and made notes.
Thank you! Great article and support. Susie
look here for ideas
http://www.earthclinic.com/cures/h-pylori-alternative-medicine.html
Thank you for the info on H Pylori. Very interesting to know there are solutions to deal with this bacteria without using antibiotics. I choose to use them since I was having
serious irregular heart beat issues and wanted to be sure these were addressed.
As we know this is also no guarantee. I am not 100% convinced now that this was the H Pylori was the cause. Rather I am now thinking it may have to do with hypothyroid and
Hashimotos antibodies. I seem to have a trigger, chocolate. I talked to a pharmacist who recommended I try Glutathione and go off my compounded T3/T4 for 1 day.
This converted my heart rate back to normal. I am taking care and following Chris’s suggestions while I finish the antibiotic protocol. Thank you again for the info.
Hello Susie… Can you email some of the things you took for your heart I have the same issues with my heart. And now I’m sick with ear pain and a sore throat the Dr. gave me Amoxicillon but I feel like its not helping me it’s hurting me.
Hi Chris and friends,
I haven’t taken antibiotics for years and then last month had a scorching UTI which I took 3 rounds of antibiotics for followed by fluconazole, AKA: drug from hell.
I have had a stomach ache all week but yesterday it was stomach ache with delirium, joint ache, headache, exhaustion, and chills. I started researching and thought (think?) maybe its because of a toxic liver from all the meds. I have been resting now for 24 hours, doing coffee enemas, drinking dandelion tea, eating cooked vegetables, salt baths, etc. I’m doing all that I can – I am afraid that this is early sign of acute liver failure or drug induced hepatitis?
I woke up feeling MUCH better but am still tired, not hungry, stomach ache. Should I go to the ER? Proceed as I am doing? Other ideas? I don’t feel like it’s an emergency right now, maybe I’m on the upswing?
FYI
there are many remedies for UTI’s. No need to resort to antibiotics.
For E. Coli, there is D-mannose or cranberry capsules.
For other UTI infection, there is Uva Utis capsules which is very potent. You take two 450mg capsules with alkaline water (1 tsp of baking soda in water). The alkaline solution is important because the herb requires an alkaline solution to release active ingredient. Take it twice a day.
I have a problem taking antibonics the dr just gave me kelfex for uti i dont do well with any antibonics my stamach hurts and i jave lbs so it makes it worse my mouth dry and my muscles hurt i am allegic to sulfa And penillian i wish there was something i could take thats natural with no side effects can you help me thamk you
I used to have a lot of respiratory infections, every year during winter season, last time I had bronchitis, and I had to take antibiotics every time. After my treatment, I went to this Dr. who gave me a diet called Food Combination and I had to take, first time in the morning, one lemon, a little piece of fresh peeled ginger, one tbsp of honey and 1 small glass of water, everything goes to the blender, washed the lemon and the ginger very well, and dont forget to peel the ginger, and the lemon goes with everything you just cut it in 4 and the ginger cut it in small pieces. you liquify this and use the colander and drink it with a straw, to protect your teeth. Some people experience a little softness in their bowels, I dont. Since then, I havent experience a cold or flu or anything like it. No flu or cold in 4 years, and I am 55. Hopes this helps.
Hey chris i had a question, ive been on and off about 3 antibiotic prescriptions in the past month and ahalf from different infections. This most recent infection is strep throat. I feel it slowly going away without antibiotic treatment but im really worried about the complications of strep without antibiotic treatment. And advice will be greatly appreciated!
you should take antibiotics immidiately because it can cause more complicated infections.GO to a doctor
Yes strept can lead to heart problems scarlet fever, etc. Go see a doctor. It doesn’t just go away by itself. U may become immuned and then become what is called a “carrier”. Be safe rather than sorry!
I would like to know, can auro amoxiclav be used to remove gallstones?
there are natural ways to remove gallstones
http://www.earthclinic.com/cures/gallstones.html
Does anyone know if there a natural way of combating respiratory infection with the same power and speed as an antibiotic? I eat fermented food, kefir water and kefir milk, but I have to go on antibiotics at the first hint of a respiratory infection due to asthma and reactive airway that was caused by intubation. I’m on antibiotics now, but they’re not helping my lungs much. I wanted to take probiotics, but was afraid it would negate the antibiotic.
Fungal infection may be behind your asthma. i would look into things that fight fungal infections and experiment.
Hi Chris, my adult daughter has recently been diagnosed with Rhuematic fever. She is 27 and the mother of 4 boys. It came on very quickly, with in one week I had to push her in a wheel chair the the rhuematogist. Thankfully with the antibiotics it was brought under control. However, the treatment is 15 or so years on antibiotics. This greatly concerns me knowing what this will do to her gut. Do you have any other information on long, long term use of antibiotics and how deal with side effects.
Thanks so much
My mother also suffered from Rheumatic fever (hers was due to undiagnosed strept) she was so sick she nearly died. Doctors wanted her to go on heavy steroids and anti biotics. She chose to do apatherapy instead, she gets stung by live bees. Took about two years but thank g-d she is now back to herself. Her doctors are amazed. She lives in israel but im sure would be very happy to speak to you or your daughter and share any info.
You mentioned not knowing any studies of the health benefits of “soil”- there are some (it’s good for you!) Including this one: http://mobile.nytimes.com/2013/11/10/opinion/sunday/a-cure-for-the-allergy-epidemic.html?pagewanted=all&_r=0
http://eds.a.ebscohost.com.ezproxy.uws.edu/ehost/detail/detail?vid=23&sid=a560bd08-cf69-4f6e-b639-b58b4fc30a0d%40sessionmgr4002&hid=4108&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=cin20&AN=2009328000
This study shows that milk thistle has no effect on the liver enzyme in vivo mentioned on the article you posted, luckily for us. 🙂
Excellent… Thank you so much for sharing … My gut thanks you too…
Hi, my 4 month baby has swollen gland behind his one ear. We took him to the hospital. The Dr did a sonar and said it is a infection of the gland. Dr prescribed a antibiotic and probiotic. Antibiotics must be taken in the morning and evenings and the probotics in the afternoon. After the first day the gland started to look less swollen, but the next 2 days it started to look more as it looked the first time. Why does the gland not go back to normal?
If they have swollen glands. Put a goop amount of extra virgin olive oil on it everyday. You could also use something for the lymph nodes/glands like IMMUNE BOOM.
My granddaughter has been diagnosed with “Cyclic Vomiting Syndrome”. She began with this just in the mornings when she would get up at age of 10. She is now 15-1/2 and the doc wanted to do an endoscope but I didn’t want her put to sleep honestly at 10 or 11. This started when she was being bullied at school. I put her in private Christian school but that didn’t help that much. She drinks about 80 ounces of water a day, give or take, I know it’s a lot, since this started and doesn’t eat well at all. She also drinks juices. Soda, etc. When she does decide to eat it’s late afternoon and she I think is afraid to eat because of the sickness. She frowns on all kinds of food. Will only eat now certain kinds usually Mexican and use to love veggies but refuses most now. Pediatrician put her first on Omeprazole a.m. and p.m. and she took for few years then stopped that about a few months ago due to still getting sick on it. She was Vit D depleted at a physical a year or so ago and took Vitamin D then doc said she was fine so we stopped that. She didn’t throw up while taking that. Now she started on Ondansetron ODT 8mg for nausea which 99.9% helps her from being sick in the a.m. She has throw up when taking a vitamin pill so she won’t take vitamins and does not get adequate supply of food to maintain a normal balance for a growing teenager. She is now home schooled and not doing well with that and I’m at a loss as to what to do with this situation. My 8 yr old and 11 yr old grandchildren eat lots better than her. She has sleep problems now over past couple months and I’m scared for her honestly. Please help me with any advise which would be deeply appreciated. She also has been diagnosed with asthma which she isn’t bothered with too often. However, if she gets sick with a cold it’s hard to get her over it, antibiotics is only way always and she’s never been on any Probiotics as I have a hard time getting her to take or eat anything. I am so afraid of what the outcome of all of this will manifest into for this beautiful child. Thank you for any help you may advise us on.
I would highly recommend your granddaughter sees a competent psychotherapist who understands the physical effects of stress and anxiety and psychosomatic disorders. Many symptoms (vomiting, nausea) that you describe are explained by severe stress. It is not a cooincidence that the symptoms started while she was being bullied at school. I know because I had very similar symptoms at a similar age and it was all stress related. Unfortunately, no one knew it was stress related at the time, most doctors look for physical causes. I also vomited, had nausea, wouldn’t eat much, was a very picky eater and had sleep problems. Your description of her sounds very familiar. It is surprising what the body can do from stress and anxiety. A good mind body specialist should be able to help, although finding one may not be easy. In the meantime, you can read some books on the subject, look into what can be causing her stress (if she is homeschooled, is there conflict at home for example?) teach her some stress relieveing techniques, take her in nature and help her relax. At a young age it is hard to understand how to relax, but you can guide her. Best of luck!
I have been taking 3 x500 mg. of keflex antibiotics daily since last January. I am on this for life to treat a bacterial infection of the aorta which caused 2 aneurysms in the aorta. About 2 months ago I developed a change in my bowel movements and now feel bloated and sometimes feel nauseated. I am wondering if the antibiotics are causing this.
you may want to look at nattonkinase and serrapeptase for your aorta aneurysms. these can help with biofilms. you need to find natural alternatives to any so called lifetime medication.
sure it can cause that bloating. you should consider taking a probiotic using beadlet or enteric form as long as you are on antibiotic.
MILK THISTLE SHOULD NOT BE MIXED WITH ANTIBIOTICS
Or some other medications.
As always – consult your doctor when mixing ANY medications herbal or otherwise.
This is a useful article;
http://www.hcvadvocate.org/hepatitis/hepc/mthistle.html
What could be done about gastritis and inflammation of the colon brought on by antibiotics? I never had a problem before.
Where there is inflammation, there is an infection. We could assume that the antibiotics caused dysbiosis so you have an imbalanced flora. One cause of gastritis is h pylori bacteria. It may be that you just need to balance your gut.
I’d rather take a more broader approach because there is also a possibility that the problem started before the antibiotics but was just simmering. When one is dealing with medical conditions especially in the colon, there is the unknown so maybe a broader approach is more practical
Here are some things to consider
I would experiment with varying doses (2g to 30g) of L-glutamine. This helps repair the lining of the colon. I would recommend you put the L-glutamine in water and sip it through out the day. That will keep you colon more bathed in it. For some people, just this has worked wonders.
I would consider that fungal infection MAY have got out of control also so considering throwing in some Candida Gone into the mix.
I would take a probiotic with good amount of ACIDOPHILUS and BIFIDUS
I would take grapefruit seed extract for the colon inflammation
I would consider taking Apple Cider Vinegar (with mother) in water. The acidic environment can make it more difficult for some microbes to survive.
See if these improve things.
Inflammation of colon in general (IBD, Crohns, UC etc) may require more a more heavy approach. Your going to have to experiment. I would consider getting the AMP if less expensive methods aren’t working. Try for 2 months.
Hopefully this gives you some kind of start
I avoid antibiotics at all costs, When I had kidney infection my doctor wrote a presription for antibiotics had I been thinking would of all for IV antibiotics to sAve myself undue suffering
Anyhow my doctor is super genuis sought after doctor he put me on saccharomyces. boulardll 3 times a day and 15 drops grapefruit seed extract twuce a day I took plus vital 10 probiotic i also drank kefir he told me to avoid sugar. You can also ask the doctor for pharmaceutical grade probiotics which had gazillion cfu
I believe one day antibiotics will one day be rarely used they will come up with a stronger super probiotic that will play defense,
Wow that is so impressive to have a Dr so proactive do you mind sharing the name of your Dr? I am in desparate need of a good one.
Thanks