I just started on it on Monday....Scott F who has been on it for a while says he takes 4 packets of VSL#3 DS (double strength- prescription strength) per day, whereas I was prescribed by my Doctor to take 2 a day. The box says take anywhere from .5 a packet to 4 packets a day, so I guess you need to figure out where your baseline is. I asked my Doc about the prescription and what he said was to take 2 a day and if I am still symptomatic, increase as needed. He said 4 is really a lot and it is better to start off lower and then adjust as needed.

I take it dissolved in cold water. Taste is not bad, something similar to protein powder. The directions say to take it in cold food or cold non-carbonated beverage.

CT has my dose right (4 DS packets/day), though I've tried to cut back a little now that my insurance company has stopped paying for it.

It's *very* hard to tinker with probiotic doses based on results. The results are delayed in time, and (even tougher) are most significant for what doesn't happen (e.g. pouchitis). So probiotic dosing is mostly based on research studies (which are few) and very patient experimentation on yourself. OTOH, most people can tolerate a maximum dose with no side effects at all, and at least the side effects are straightforward (gassiness, usually transitory).

I mix the stuff in Greek yogurt, which is a bit lower in lactose than regular yogurt. If I'm travelling I might mix it in water, but I find it kind of yucky that way. I sometimes mix both VSL and Metamucil in water together, which improves the still-yucky taste.

VSL does come in capsules, but you have to take a very large number of capsules to get to the same doses, and there's no chance of insurance coverage, since the capsules are not prescription strength.

Do you space all 4 doses out or double up?

There won't be any authoritative advice, but I use two packets at breakfast and two packets at dinner. This works best if you don't have an AM dose of antibiotic, but I've gotten used to treating the yogurt I mix it in (with some fruit) as "breakfast." So I try to take my antibiotic early and stall breakfast a bit. Most folks who advocate VSL while on antibiotics prefer spacing the VSL a few hours apart from the antibiotic, but no one really knows for sure if it matters.

Thanks, I did that for a while as well. Was just curious if I was doing the right thing. Been thinking of starting it up again. My surgeon told me to rotate different probiotics every three week.

The VSL#3 at 1 packet per day was too strong for me.It caused butt burn.My GI said that is a common complaint he hears.I am trying a milder product called Ultimate Flora (80 billion -14 strains)by Renew Life and tolerate it well.I take it spaced between antibiotics 2 times a day.Maybe it's possible the VSL #3 is too strong for some people ?

it was for me when i tried it many years ago..made me worse..did not want to keep going with it..