Digestive Vita Gummies Fibre Probiotics 30 Pack

With fibre, the wrong choice can make the very problem you came in for worse. These are the questions our naturopaths ask in store.

A good fit if

• Hard or infrequent stools are the problem, and you want the fibre with the most evidence behind it
• You tried a prebiotic and it didn't help you go, because feeding bacteria and bulking stool are different jobs
• Other fibres have left you gassy, and you'd like one that ferments slowly instead
• You're happy to start small and build up over two or three weeks rather than all at once

Check with us first if

• You take any prescription medicine. Fibre slows or reduces how well several medicines are absorbed, so leave an hour either side.
• You take thyroid medicine, lithium, carbamazepine, warfarin or phenytoin. Each has a known interaction with psyllium and needs advice, not just careful timing.
• You take an opioid or loperamide. Together with fibre, these carry a risk of the bowel stopping (ileus), and the guidance says use only under medical supervision.
• You take diabetes medicine. Psyllium and glucomannan both add to its blood sugar lowering effect.
• You take metformin, digoxin, penicillin V, glipizide, glyburide, trimethoprim or lovastatin. Guar gum and oat bran can reduce how much of these you absorb.
• You're pregnant or breastfeeding. The guidance for acacia gum, glucomannan and chicory all says to avoid them, because there isn't enough data.
• It's for a child. Australian rules require psyllium to carry the words 'Should only be used for children on medical advice'.
• You have coeliac disease. Australian ingredient rules list gluten as a required part of oat, oat bran, wheat bran, rye bran and wheat dextrin.
• You want it to support healthy cholesterol. The European guidance says using ispaghula (psyllium) this way should be under medical supervision.
• You're also taking iron. GOS and FOS raised iron absorption by about half in one trial, while oat bran lowers it.

• Psyllium husk (Plantago ovata). Best known for: Hard, infrequent stools. It has the strongest evidence of any fibre. Absorption: Forms a gel and resists fermentation; it's the only fibre shown to still form a gel in stool. Typical use: 5-10 g a day. Trials that worked used over 10 g for four weeks or more.
• Oat and barley beta-glucan. Best known for: Helping maintain healthy cholesterol. Absorption: Forms a gel, and the effect follows its molecular size, which is another way of saying how thick it gets. Typical use: About 3 g a day, roughly what's in 90 g of oats.
• Glucomannan (konjac). Best known for: Thickness. It's the thickest fibre here and swells hugely in water. Absorption: Works through its thickness, with a bigger effect on the rise in blood sugar after a meal at higher doses. Typical use: 1-4 g a day, never as a tablet. Tablets have been banned here since 1985.
• Inulin (chicory). Best known for: Feeding bifidobacteria. It's the classic prebiotic. Absorption: Not thick, and fermented early in the large bowel, so it doesn't reach the stool. Typical use: 5-10 g a day; 10 g of native inulin was well tolerated in healthy adults.
• FOS (fructooligosaccharides). Best known for: Feeding bifidobacteria. Short-chain, sweet, and the gassiest, gram for gram. Absorption: Fermented faster than inulin, and it didn't change any blood sugar measure where inulin did. Typical use: 5-10 g a day.
• GOS (galactooligosaccharides). Best known for: Bowel regularity and growth of good bacteria. It's the closest to the sugars (oligosaccharides) in breast milk. Absorption: Fermentable, and higher doses raised Bifidobacterium in stool more. Typical use: 3.6-11 g a day. It's the only fibre here with numeric Australian limits.
• Acacia gum (gum arabic). Best known for: Being easy on the gut. It's soluble but not thick and ferments slowly, so it's the least gassy, gram for gram. Absorption: No effect on blood fats at 15 g a day, where a thick fibre mixture gave a 10% fall. Typical use: 10-30 g a day.
• PHGG (partially hydrolysed guar gum). Best known for: Being easy on sensitive guts. It's guar gum broken down to remove the thickness. Absorption: With the thickness gone, guar gum's blood fat data doesn't carry over to it. Typical use: 5-10 g a day. We hold no trial of it on its own.
• Resistant starch (high-amylose maize). Best known for: Butyrate. It reaches the large bowel intact and is the classic fuel for making it. Absorption: Raised butyrate and propionate in stool and blood as part of a diet high in short-chain fatty acids. Typical use: 10-20 g a day; the main trial used 16 g.
• Wheat bran and other insoluble fibre. Best known for: Physical bulk. Coarse particles stimulate the bowel wall. Absorption: Not fermented. Particle size decides how it works, and fine bran can be constipating. Typical use: Food amounts. Brans are allowed in listed medicines only as inactive ingredients.
• XOS (xylooligosaccharides). Best known for: A low dose, 1-3 g, with less wind than FOS. Absorption: Fermentable. One 29-person pilot study shifted gut bacteria but changed nothing measurable. Typical use: 1-3 g a day, as a food. XOS isn't in Schedule 1 under that name.

Reference values. Australia sets an Adequate Intake for total fibre, not a recommended daily intake. Adults: 30 g a day for men 19 and over, and 25 g for women. In pregnancy it's 28 g (25 g at ages 14-18), and when breastfeeding 30 g (27 g at 14-18). Children need 14 g at ages 1-3 and 18 g at 4-8. After that it's 24 g for boys aged 9-13 and 28 g at 14-18, and 20 g for girls aged 9-13 and 22 g at 14-18. The source we checked listed no Suggested Dietary Target.

Typical supplemental range. Doses vary as much as tenfold between fibres, so the number on one pack tells you nothing about the next. Psyllium husk is 5-10 g a day, with the European guidance setting 7-11 g for constipation and 7-20 g for raising your overall intake. Inulin, FOS and PHGG are 5-10 g; GOS 3.6-11 g; glucomannan 1-4 g; acacia gum 10-30 g; guar gum 5-15 g; resistant starch 10-20 g; and XOS 1-3 g. Oat beta-glucan is about 3 g, compared with 250-500 mg for the unrelated yeast and mushroom beta-glucans.

Upper level. No upper limit has been set for fibre. Reviews of how well people tolerate it say current recommendations set no upper limit based on gut comfort, and that these carbohydrates cause discomfort, wind and diarrhoea at high or excessive intakes. Some individual ingredients do have Australian limits, and you'll find those figures in the Australian status section.

Worth knowing. Start low and build up over a few weeks, and drink more fluid as you add more fibre. That's not just folk wisdom; Australian law already requires that instruction on guar products. Never take a fibre powder dry. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Oats, about 90 g: roughly 3 g of beta-glucan, the amount used in the cholesterol trials
• Barley: beta-glucan, alongside oats, in the highest-graded soluble fibre reviews
• Wholegrains: three servings a day is the intake the large cereal-fibre cohorts studied
• Chicory root: the commercial source of inulin
• Konjac (elephant yam, konnyaku): the source of glucomannan
• Kiwifruit, prunes and rye bread: named among the foods that helped in chronic constipation

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• If you have a narrowed or blocked gut, a paralysed bowel (intestinal paralysis) or megacolon.
• If you have trouble swallowing or a condition of the oesophagus.
• If you have unexplained bleeding from the bottom, or a change in bowel habits lasting over two weeks.
• If you take levothyroxine, lithium, carbamazepine, warfarin or phenytoin.
• If you take opioids or loperamide.
• If you take medicines for diabetes.
• If you take metformin, digoxin, penicillin V, glipizide, glyburide, trimethoprim or lovastatin.
• If you're pregnant or breastfeeding.
• Children, who need medical advice before taking psyllium.
• If you have coeliac disease and use oat, bran or wheat dextrin fibres.
• If you're allergic to ispaghula, chicory, acacia gum or oats.