Probiotic sauerkraut vs probiotic pills, what's the difference?

Note: I'm not a dietician and I'm writing this based on my own experience and research.  Before you make decisions for your own body check in with your doctor.

I get this question all the time: what's the difference between getting my probiotics from fermented foods versus taking a probiotic pill?  What should I eat or take to get the best bang for my buck?  How can I get the most benefit from my probiotics?

Short answer: For best results, eat a variety of fermented foods with each meal. Take a probiotic only if you feel you really need it.

Looong answer:
Fermented foods and probiotic pills contain the necessary bacteria for supporting the balance of your microbiome health.  What is your microbiome?  Its the balance that exists in your intestines between different bacteria.  Events in life can change your microbiome, things like taking antibiotics, stress and poor diet can all affect you microbiome.  Coupled with the fact that modern-day food is super sterile (i.e. we don't eat much dirt) and you could find that your microbiome is out of balance. 

But how would you know if your microbiome wasn't optimally balanced?  The most comprehensive way is to go to your doctor and have tests.  Another option is to incorporate fermented foods into your diet or begin taking probiotic pills regularly and see if you feel a difference. You'll need to keep this regime up for about 2 weeks to begin to see results or changes.  After 2 weeks if you feel good, sleep well and have better bowel movements, then great, you've begun the process of healing your gut.  If you notice no change then your gut was probably in pretty good shape to being with.  Of course there are other factors that can affect your gut health, things like gut-related diseases, parasites and auto-immune diseases may make your journey to optimal gut health longer or more complicated. This may mean that you need to take a probiotic pill, or it could mean further complications (i.e. go see your doctor).

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But you can still reap benefits from eating fermented foods without the benefit of the probiotics.  The fermentation process make vitamins and minerals more available to your body, adding value to your food.  When you body is getting the nutrients it needs this can lower your appetite, make you sleep better and strengthen your immune system.  Think of eating fermented foods as a maintenance plan you would have for your car or another major appliance; you regularly get the appliance serviced to get the junk cleaned out and the fluids topped up.  When you regularly eat fermented foods you are adding more bacteria to your microbiome, to sustain your gut health.

There are so many different types of bacteria, which is the best?  The answer is that there are many different types of bacteria that you need for gut health, but they can basically be divided in to 2 groups: Resident and Transient.  Resident bacteria are groups that once introduced to your gut with live and thrive.  Transient bacteria support gut health by doing other important things like supporting your immune health and protecting your gut from harmful bacteria.  Transient bacteria don't stay in your gut, but act more like tourists; they hang around for awhile and then leave.  For this reason it's important to take probiotics or eat fermented foods regularly.

Now lets talk about probiotic pills.  Years ago I was spending a fortune on supplements and probiotics and I wasn't sure that they were doing anything.  So I chose to divert all the money I spent on these supplements towards whole foods (like leafy greens, beans, grains, seaweed) and fermented foods.  My reasoning for this was myriad but at the core, I couldn't understand how this little probiotic pill (which was surprisingly shelf-stable) could contain so many bacteria.  I mean, they're just in there, waiting?  What if they got a little warm in transit, would they wake up from dormancy?  Were they even still alive?  To answer this question I went to YouTube (I can hear you yelling from here but just hear me out).  There are a bunch of videos where people with more equipment and time than I, have taken the contents of probiotics, revived the little bugs and looked at them under a microscope.  What did they learn?  That most probiotics are filler material and not all of the probiotics are actually viable (not all the bacteria came back to life after dormancy).  This convinced me that I don't need pill-bottle probiotics and instead I'll eat fermented foods.  I can tell that the probiotics are viable in fermented foods by the taste, feel, acidity, saur flavor and the bubbles that occur when I leave the jar on the counter too long.

"Whoa whoa whoa, slow down, that was a lot and you didn't even answer my question"

We've worked through a lot of information, but now we can make an educated decision about whether we should take probiotic pills or eat fermented foods.  For my own microbiome, I think it's best to eat fermented foods with each meal.  I try to make it varied, sometimes I eat kimchi, sometimes kraut, sometimes curtido or pickles or kefir or water kefir or yogurt or cottage cheese or miso.  Eating a wide spectrum of foods that contain probiotics give my microbiome variety.  When I feel like I really need extra support (like if I have a stomach bug or have to take antibiotics) I could take a probiotic pill, however I haven't felt the need in years. 

Let me know in the comments what you chose for your own microbiome.


References and further reading:
https://www.omicsonline.org/open-access/a-review-about-probiotic-foods-kefir-kimchi-and-kombucha-2157-7110-1000636.php?aid=82169

https://www.genuinehealth.com/en-us/genuine-hub/resident-strains-vs-transient-strains/

http://thedigestersdilemma.com/probiotics-vs-fermented-foods-which-is-better/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977097/