5 common probiotic misconceptions explained

Myth #1: Probiotics need to be kept in the fridge

The number one misconception we hear about probiotics is that they need to be kept in the fridge. So, do probiotics really need to be kept in the fridge? Many people were likely first handed a probiotic from a fridge in a pharmacy, and this introduction has left a lasting impression, leading many people to believe that probiotics need to be kept in the fridge in order to keep their beneficial microorganisms alive. It’s also a common perception that probiotics that are kept in the fridge are of a higher quality. While this may have been true when probiotics were a relatively new type of supplement, probiotic technology has come a long way in recent years. Now, probiotics can be kept alive on the shelf and out of the fridge for years!

Shelf-stable probiotic capsules and powders have been freeze-dried, a process which removes all of the moisture from the bacteria and puts them into a state of dormancy. This very deep sleep stops their activity and allows them to remain stable at room temperature for an extended period of time (typically 2 to 3 years). When these probiotic bacteria are taken as a supplement and exposed to the moist environment of the digestive tract, they are quickly reactivated.

It is generally recommended that they are kept at room temperature, which is around 25 degrees celsius. It is true that exposure to significantly higher temperatures, such as 30-40 degrees celsius, can reduce their potency but this also happens over days and weeks rather than hours. The same is true for many prescription medications, too.

All in all, probiotic bacteria are much more resilient than we think and advancements in probiotic technology mean that shelf-stable probiotics are just as effective as those kept in the fridge.

Myth #2: There’s no point taking a probiotic alongside a course of antibiotics

This is another common misconception, and a question we get asked quite often is “should you take a probiotic before, during or after a course of antibiotics?”. This is such a common point of confusion, we’ve dedicated a whole blog post to it.

To summarise, it’s absolutely beneficial to take your probiotic at the same time as your antibiotics. When the right probiotic strains are used, they can help to reduce unwanted side effects, such as diarrhoea, and protect the gut microbiome. Some people wait until after their course of antibiotics is finished before starting a probiotic because they are concerned that probiotic bacteria taken alongside antibiotics will be ‘killed off’ and unable to exert their beneficial effects. However, the research clearly shows that for probiotics to have the most benefit, they need to be taken as soon as the antibiotics are started – not after they’ve finished.

When taking a probiotic alongside an antibiotic, many people are advised to separate them by two hours. Again, this is a general recommendation that is not supported by any clear evidence. It’s thought that this two hour window may help to preserve the activity of probiotic bacteria for greater effects. Due to the way the body digests, absorbs and distributes antibiotics around the body, it’s possible that this doesn’t make much of a difference. As there is little evidence around this particular recommendation, it’s best to follow the advice of your healthcare professional until more conclusive evidence is available.

Myth #3: Probiotics become permanent residents of our gut

Many people think that probiotics have the ability to permanently colonise the gut (i.e. to become permanent members of our gut microbiome). As a result of this, probiotics are often thought to be used to replace beneficial bacteria in our gut which may have been lost (such as after antibiotics) or to add in new bacteria to enhance the existing community. This, unfortunately, is a misconception.

Permanent colonisers, also known as pioneering microorganisms, which form our native microbiota are mostly made up of the microorganisms that we were exposed to during our first 1000 days (approximately 2.7 years) of life, including gestation, birth and infancy. Our gut is sparsely populated during these first 1000 days, so it’s the ideal environment for new microorganisms to establish a permanent home. However, this window of opportunity is short lived. It’s a matter of first-in, best-dressed because after this rapid period of colonisation, there comes a time when there’s no more room at the inn (somewhere between two and five years of age). This becomes known as colonisation resistance, and it ultimately helps to protect us from gastrointestinal infections. After this time, the composition of the gut microbiome remains relatively stable.

Although the population size of specific microorganisms will ebb and flow under the influence of external factors, such as antibiotic exposure, introducing new strains of microorganisms as permanent colonisers of the gut microbiome is a difficult feat to achieve through probiotic supplementation – and it has not yet been shown to be possible.

Probiotics are believed to be ‘transient colonisers’. Transitory colonisers only remain in the gut for a limited amount of time (e.g. one to two weeks) so they don’t become permanent members of the gut microbiota and their numbers diminish when supplementation is stopped (3). In short, probiotics grab the two-hour parking because the all-day parks have been full for a very long time and nobody is coming to move their car. When their time is up, they have to leave. But rest assured, they work hard while they’re there.

Probiotics provide health benefits as they’re passing through. For example, they can encourage the growth of our existing beneficial bacteria by improving the health of the gut environment. Many of their beneficial health effects are mediated by their production of biologically active substances called metabolites, such as short-chain fatty acids, which bind to receptors throughout the body and trigger a cascade of beneficial effects (with the specific effects dependent on the strains used). So while probiotics may not become permanent residents of your gut microbiome, they are still incredibly powerful tools for improving health.

Myth #4: A higher dose of probiotics is always more effective

Knowing what dose or strength of probiotic you should take is also another point of confusion, and the answer really depends on which strain of probiotic you’re taking, what health benefit you are looking to achieve, and what the research says. When it comes to probiotics, a higher dose isn’t necessarily more effective – it’s not that simple. When you are looking to achieve a particular health benefit with a probiotic, the dose is arguably less important than the particular probiotic strains you are taking. You should select a probiotic strain that has been researched to target your specific health concern, and then supplement it at the dose that was prescribed in that research.

For example, a probiotic with a combination of Lactobacillus plantarum LP01, Lactobacillus rhamnosus LR06, Bifidobacterium longum 04, and Lactobacillus fermentum LF16 with only 1 billion CFU of each strain has been shown to improve mood and sleep in human clinical trials. On the other hand, a probiotic with 10 different probiotic strains and 400 billion CFUs may not include any strains at doses shown to provide benefits in human clinical trials. These products are often selected over other potentially higher-quality and better evidenced products because of the misconception that a higher dose is always more effective. Condition-specific and clinically-trialled probiotics, like those we have in our Activated Probiotics range, have done the hard work for you and will offer specific probiotic strains at doses known to target particular health concerns.

Myth #5: A greater number of strains in a probiotic product is always more beneficial

As above, this is not always the case. The effectiveness of a product is not determined by the number of strains it includes, but the evidence supporting the effectiveness of those strains. It is important to assess if they have been researched for the health benefit you are looking to achieve, and if they are included at a dose which has been shown to be effective. A combination of three carefully selected probiotic strains (or even just one) that have all been researched for a particular health concern can be more effective than a combination of twelve randomly selected probiotic strains.