For many of our patients, probiotic therapy is a gamechanger for reducing or even eliminating gastrointestinal symptoms like bloating and constipation. But after a while, many people begin to wonder: If I consistently feel good now, do I need to continue taking probiotics?
There has not been much scientific research around what exactly happens to your microbiome or your general health after discontinuing probiotic therapy. However, a few studies — in addition to clinical experience — can give you an idea of what happens when you stop taking probiotics.
To help you make an informed decision about whether to discontinue probiotic supplements, we’ll review some of the most common reasons for both taking and discontinuing probiotics, safety considerations, how to stop taking probiotics, possible side effects, and determining your minimal effective dose.
What Happens When You Stop Taking Probiotics
Keep in mind you will probably notice more gradual changes in your gut health, if anything, once you discontinue probiotics.
Remember, the important thing is that you pay attention to how you actually feel vs. knowing the exact composition of your microbiome at any one time. We are always changing, and our microbiomes are always changing too. Some people will have no trouble going off probiotics and continue to feel good. Others will notice a difference after some time has passed and may decide to return to probiotic therapy.
This has been our experience with our patients at the Ruscio Institute for Functional Medicine. Some patients can discontinue probiotics after their benefits have plateaued, and they feel just fine. But others notice after a while that they are experiencing returning symptoms like gas and bloating. These patients may choose to continue taking probiotics, and within days to weeks, they feel better again.
However, stopping probiotics can give these patients valuable data. Maybe now they know that they require a little extra support to maintain good digestion. Maybe another few months go by, and they decide to try stopping again or try decreasing their dose.
Why Take Probiotics in the First Place?
If you’ve reached a point where you are considering going off probiotics, it’s worth reviewing the reasons for taking them in the first place. Probiotics are different strains of beneficial bacteria that contribute to your microbiome, the community of microorganisms that live in your gut. Probiotics have many health benefits, including :
- Increasing levels of good bacteria in the gut
- Supporting immune function
- Reducing levels of harmful microorganisms like bad bacteria, yeasts, and even parasites
- Improving intestinal issues
- Easing constipation and improving bowel movements
- Increasing effectiveness when taking antibiotics
- Lowering cholesterol levels
- Improving skin health
- Helping to manage stress-related health conditions.
With all of these potential benefits of probiotics, it’s unsurprising that probiotics are the third most popular supplement taken by adults, behind vitamins and minerals .
A 2019 study of gastroenterology patients gave the following reasons for taking probiotics :
- Improving overall health and longevity
- Addressing gastrointestinal symptoms
- Weight management
- Addressing non-gut related symptoms
Scientific Support for Probiotics
A huge number of studies have shown that probiotics are effective in addressing a variety of conditions and health issues:
- Probiotics can help reduce inflammation, improve gut barrier function, and block pathogen binding in patients with irritable bowel syndrome (IBS) .
- By improving levels of healthy bacteria, probiotics can help promote a healthy immune response .
- Probiotics can help heal and seal a leaky gut, improving intestinal barrier function [5, 6, 7].
- If you have lactose intolerance, probiotics can help manage uncomfortable symptoms like abdominal pain, gas, and bloating .
- Many studies have connected probiotics to maintaining remission in ulcerative colitis patients [9, 10, 11, 12].
These are just a fraction of the studies that have been conducted on the therapeutic effect of probiotics across multiple conditions. They really are a remarkable tool for promoting wellness throughout the body.
Possible Reasons to Discontinue Probiotics
It’s clear from dozens of well-designed studies that probiotics can have beneficial effects on gut bacteria, the immune system, and many other systems of the body. So why would you stop taking them?
In our clinical experience, many people start to consider weaning off from probiotics — even after they’ve experienced significant progress in their health — for a number of reasons:
- Reducing the ongoing cost of their supplements
- Simple convenience
- Concerns about dependency
- Safety concerns
We know that when individuals choose to pursue alternative health therapies that aren’t covered by insurance, costs can quickly add up. For many people, this becomes a deciding factor in reducing or discontinuing probiotic therapy. If discontinuing probiotics is right for you at this time, there is usually a way to safely make that transition, or to reduce your dose (and therefore your cost) while maintaining benefits.
Safety of Probiotics
Let’s address one concern upfront: Probiotics are safe to take (and typically safe to discontinue, if you wish). While many medications begin to have concerning side effects with long-term use, probiotics are unlikely to cause harm over the long term.
While there haven’t been any significant long-term studies on probiotics, probiotics have been found to be safe for adults, children, and even infants and those with compromised immune systems [13, 14]. This appears to be true regardless of what type of probiotic species or strains are used, the dosage, and how long the probiotics are used.
- A systematic review of 57 clinical studies, in which probiotics were given to immunocompromised individuals, showed no safety issues with the therapy .
- Another systematic review of six probiotic strains added to infant formula concluded that there were no adverse effects or safety concerns .
Foods like kimchi, sauerkraut, kefir, and even kombucha have been consumed regularly for centuries without any issues. Foods that serve as prebiotics, fibers that support the growth of probiotic bacteria in the gut, have also been consumed by many cultural groups for hundreds of years, likely to their benefit.
But even with a lot of evidence supporting their safety, some theoretical risks with probiotic use remain, including interference with metabolic processes, overstimulating the immune system in susceptible individuals, possible risk of infections, and possible transfer of antibiotic resistance to the microbiota . But, from our clinical observation, most people don’t experience any side effects at all when using probiotics.
Are There Side Effects When Stopping Probiotic Supplements?
There is a theory that abruptly stopping probiotics could increase your risk of infection.
A study was performed on tilapias who were given the probiotic Lactobacillus plantarum over a period of 14 days. When the probiotic supplementation was abruptly stopped, the fish became susceptible to the bacteria A. hydrophila, which researchers intentionally introduced to the tilapias’ environment. The intention behind the study was to mimic the possible outcome of stopping probiotics in an immunocompromised person, but the research has not yet extended to human clinical trials . Still, this is a possible side effect to be aware of.
Probiotics Only Temporarily Change the Microbiome
Additionally, research suggests that probiotics only temporarily change the gut microbiota . So, if you begin taking probiotics with an unbalanced microbiome, your microbiome will likely return to that same microbial composition when you discontinue probiotic use.
For example, in one trial, participants took supplements of the probiotic strain Lactobacillus rhamnosus DR20. In 6 out of 10 patients, this became the dominant strain in the population of lactobacilli for participants over the six-month test period. But two months after stopping treatment, this strain was present in only 1 out of 20 patients in the fecal microflora .
However, a return of certain microbes in the gut does not necessarily guarantee a return of the same symptoms you experienced before. You may notice different symptoms, less of your original symptoms, or no symptoms at all.
Find Your Minimal Effective Dose
Here’s a method to finding your personal minimal effective dose of probiotics (keep in mind that these are general guidelines, and worth discussing with your practitioner if you have any concerns):
- Stop taking probiotics altogether. If you’re interested in discontinuing or reducing your dose of probiotics, it’s best to start by cutting them out completely. That way, you’re more likely to get a clear signal from your body about whether or not your symptoms are returning. If you continue to feel good after a few weeks, celebrate! No further action is needed. But remember you can always resume probiotics if you need to in the future.
- If your symptoms come back, start taking your probiotics again at the previous dose. Pay attention to your body, and notice when your symptoms fade once again.
- Take half of your current dose. Reduce your probiotics by half, and see how you feel in 2-3 weeks.
- If you feel good, cut it in half again. See how you feel on a quarter dose for another few weeks. If symptoms return, increase back to a half dose.
As you go through this process, keep an eye out for what’s known as the nocebo effect. The opposite of the placebo effect, the nocebo effect occurs when negative expectations worsen the outcome of a treatment change.
For example, if you believe that your fatigue will return once you stop taking probiotics, it may actually be more likely to happen. As much as possible, try to keep an open mind and approach this (and any) treatment change without significant expectations that may affect your response.
Knowing your minimal effective dose can help you save money and feel less dependent on probiotic supplements. Also, keep in mind that you often have more flexibility with probiotic use than you would with medication use. Once you’re on a maintenance dose of probiotics, it’s fine to skip a day or two every once and a while, or only take probiotics on weekdays and skip weekends. Find a schedule that works for you and allows you to feel your best.
Listen to Your Body
Ultimately, what happens when stopping probiotics will be different for each person. The important thing is to pay attention to how you feel and adjust as you go. You have the freedom to decide how you continue or discontinue using probiotics.
If you decide you need guidance on stopping probiotics, adjusting your dose, or addressing your gut health, a consultation with one of our experienced providers at the Ruscio Institute for Functional Medicine may be helpful. We can guide you through the process and answer questions you may have along the way.