This summary is in development, with more information to come.

Probiotics, Prebiotics and Synbiotics

Probiotics are living microorganisms (bacteria and some yeasts) that, when consumed in sufficient numbers, can provide health benefits that go beyond basic nutrition, such as supporting gut and immune health and keeping the gut microbiota in balance. Examples of probiotic foods are yogurt, kefir, sauerkraut, tempeh and kimchi. Probiotics are typically consumed in foods such as yogurt and other fermented foods. The effects of probiotic supplements separate from dietary sources are not always reported in the scientific literature. 

Prebiotics are dietary fibers that feed the friendly bacteria in your gut. Most prebiotics are soluble fiber substances like inulin, found in chicory root and foods like bananas, onions, jerusalem artichokes, jicama, garlic and others. Your helpful bacteria turn inulin and other fibers into energy for the colon cells and create protective immunity. Inulin is increasingly being added to a number of processed foods and probiotic supplements. 

Synbiotics simply means consuming both prebiotics and probiotics together.

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Lab and Animal Evidence

  • Suppressed colon tumor incidence/number and size and increased cell death (apoptosis) in animals1

Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

  • During chemotherapy and radiation treatment, probiotics may reduce treatment-related diarrhea.2
  • Colorectal cancer
    • Probiotics may reduce irritable bowel symptoms, improved function-related quality of life and cancer-related quality of life scores in patients with colorectal cancer3
    • Some evidence shows that perioperative prebiotic or probiotic use may reduce postoperative infections and help maintain the intestinal mucosal barrier, but some studies have shown no effect.4  

Clinical Practice Guidelines

The Society for Integrative Oncology’s 2009 guidelines on botanicals cite research indicating that probiotics are useful in reducing enteritis related to radiation therapy and Fluorouracil (5-FU), as well as reducing diarrhea induced by 5-FU and Irinotecan.5

Optimizing Your Terrain

  • Immune response6
  • Improves the intestinal microbial environment7


The About Herbs summary on Probiotics lists contraindications to taking probiotics as well as adverse events and herb-drug interactions.

Much is still unknown about the influence of supplements on cancer outcomes. A study presented at the 2019 annual meeting of the American Association for Cancer Research found that melanoma patients taking over-the-counter probiotic supplements had a 70 percent lower chance of response to cancer immunotherapy treatment with anti-PD-1 checkpoint inhibitors.8

Neil McKinney, ND, and Lise Alschuler, ND, FABNO, do not give probiotics if the absolute neutrophil count is 1.5 or less.910

BCCT advises consulting your physician before taking probiotic supplements. It may also be a good idea to work with a healthcare provider experienced in using probiotics in people with cancer, as many different types of probiotics are available, and taking the appropriate probiotic for your particular situation is important.


BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated.

Dosage recommendations are available from these sources:

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.
  • Programs and protocols
    • Alschuler & Gazella complementary approaches:11
      • Post-operative support
      • Bladder cancer
      • Breast cancer
      • Colorectal cancer
      • Gastric cancer
      • Pancreatic cancer (to reduce infection risk after Whipple procedure)
      • Healthy digestion
      • Hormone balance
      • Immune enhancement
      • Anti-inflammatory support
      • Insulin-resistance reversal
      • Managing diarrhea
      • Enhancing immune activity
      • Reducing inflammation and systemic inflammatory diseases
      • Reducing anxiety and depression
      • Improving insulin sensitivity
      • Improving digestion and detoxification
      • Reducing cancer risk
      • Reducing risk of dysbiosis from antibiotics
      • Colorectal cancer
    • Block program12
      • Core diet plan
      • Preventing/managing diarrhea from antibiotics
      • Radiation-induced enteritis
      • High-intensity nutritional support diet for cachexia (wasting)
    • Lemole, Mehta & McKee colorectal cancer protocol13
    • McKinney protocols14
      • Post-op diarrhea
      • With radiation therapy to protect gut and immune competence
      • Treatment-related diarrhea
      • With platin drugs (such as cisplatin) to prevent gut bacteria translocation to liver/blood
      • Protocol for better nutrition
      • Side effect alleviation protocol
      • Health restoration and creating healing conditions—detoxification
      • Cancer risk reduction plan
      • Reducing dysbiosis risk from antibiotics
      • Breast cancer
      • Colorectal cancer
  • Traditional systems

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