Are there probiotics that PWME should avoid?

I'm thinking of ones related to lactic acid production but can't remember what they are and how well-established this is...

Are there any general principles of what probiotics might be good/bad for PWME?

 

Yes. Ken Lassesen states that PWME should (in general) avoid l. acidophilus, as they were high in the two studies he uses for his model. Don't have the studies at hand right now, but on this page from 2013 he gives his reasons why, mainly because it lowers the beneficial e.coli, something studies have shown we're low in.

Here's his page on ME-Pedia which gives a good overview of his model:

http://me-pedia.org/wiki/Ken_Lassesen's_model

 

I don't know of any that hold up.

I don't think the studies that Lassesen relies on mean much since the technique used for studying bacterial composition is unable to detect most species. Basically it is a culture based test which is heavily biassed towards anaerobes and species that can be cultured. Yes I know the Henry Butt technique attempts to preserve anaerobes in its collection technique and in this respect it does better than standard CDSAs, but you only have to look at the results obtained to see that it bears little resemblance to what we know is in the gut; most of the strict anaerobes are missing.

E.coli is not an important gut constituent - it is a very minor component with no particular beneficial effect that I am aware of. Ditto for Lactobacillus.

Probiotics containing these species can influence the host as they transit through the gut but I haven't seen any evidence that they affect microbiota composition.

There are lots of anecdotal reports from people have difficulties with various types of probiotics - which types vary with the individual as far as I can see.

Some people do seem to be sensitive to Lactobacillus-containing probiotics, some aren't (I'm not).

I think KDM did a small study showing that production of D-lactate might be an issue for some patients. This might be part of the sensitivity problem, or sensitivity to histamine producers might be the thing for others.

 

As I've mentioned in TOF (The Other Forum!) it's not so much the type as when the pill dissolves, in my case. Enteric-coated probiotics seem to be fine. Powders and gel capsules cause pretty serious neuro symptoms for me; the last time I had probiotics in food, my vision went dark in my right eye, and that pupil went unresponsive.

Pretty dramatic!

On the other hand, I take an enteric-coated cap twice a day. For those who are wondering if it ever dissolves, yes; if I don't take it, my digestion starts acting up in two missed doses.

 

Beside what´s already have been said in the thread, I think it´s also worth listening to Dr. Maureen Hanson at about 16:25 here.

She talks about the lack of knowledge in this area, and says that probiotics even might be harmful.

 

Which one do you take?

 

Dr Ohirra's, though I've stopped. The probiotic situation is now a huge narrative... I'll tell y'all the story once I've figured out what was going on.

Was taking for ...3 years? ... without problems.

 

Sorry to hear that

 

That's very interesting @alicec Do you know publications stating that? I've always read that e. choli AND Lactobacillus are a must have, especially in ME/CFS.

Watching it, thanks @Helen!

Yes, indeed: https://www.ncbi.nlm.nih.gov/pubmed/19567398

 

As mentioned earlier in this thread, I've heard that e. coli is, but lactobacillus is not, as it produces too much d-lactate. I'll try to locate references from Lassesen and post them in a day or two.

And of course I'm not a scientist so I can't say if the studies he bases his hypothesis on are valid, but he is in remission.

 

Here's that study:

http://iv.iiarjournals.org/content/23/4/621.short

 

Those statements are based on the distorted picture of the gut given by culture based tests. Once DNA sequencing techniques were applied to the gut microbiota it became apparent that the aerobic species detected by culture were very minor constituents.

If you look at any general survey of the gut inhabitants using techniques that can detect them all, not just the ones that can be cultured, E. coli and Lactobacillus just don't feature. See for example this study and in particular Fig 3 defining a common bacterial core.

 

I thought only a tiny proportion of gut bacteria had been detected/identified?

 

That's interesting @alicec ! I didn't know about that (I'm way behind ;-)

Thank you! Will need some time to read it all through.

Oh yes, that would be great @dannybex

 

Only a tiny proportion are identified by commercial culture-based techniques, but DNA sequencing techniques can detect everything that is there (including non-bacterial inhabitants). This is how we know about the completely distorted picture given by the older tests.

It is true that many of the newly identified species were previously unknown and we know little about some of them, though that is changing.

Here is a very useful review of the composition of the gut microbiota which puts things in a historical context and includes eukaryotes and archaea as well as bacteria.

Note that they emphasise the importance of culture to characterising the species identified by DNA sequencing. Using strict anaerobic techniques many, though not all, of the newly identified species are being characterised.

Note however that the culture-based tests that I am criticising do not use these difficult and time consuming anaerobic techniques. They fit into the first part of Fig 1 in the review.

 

Don't get too caught up in the detail. It is a very technical paper and you really don't need to know about most of it.

I linked it because Fig 3 gives a graphic summary of the identity of the common core of most abundant species.

In this paper, Fig 3 gives a graphical overview of the major categories of bacteria in the gut of 4 individuals along with an illustration of the complexity of the usually largest phylum, Firmicutes.

The blow up of Firmicutes shows you where Lactobacillus fits in - it is a very minor component of this huge phylum.

Note also that E.coli is a member of the minor Proteobacteria phylum in the class Gammaproteobacteria.

The review I linked in the post before this is also useful for an overview.

 

Do you know if the Ubiome test is using the same analyze technique as is used in the analyze of the MSA test from R.E.D. labs that KDM requests? Presented in this study. I couldn´t find out what Ubiome is using from their homepage.

 

Yes they both sequence segments of the 16S rRNA gene which is specific to bacteria and for which there is an extensive database. I'm not sure if they sequence exactly the same segment of the gene but even if they used different segments it would make little difference to the overall result.

 

Interesting to read this thread. I actually got very sick only after I used probiotics. The brand I used is called Theralac... A few weeks of that and my life was over. I was also trying to gain weight by eating a lot of rice and butter at the same time and it also didn't help, it seems.. I was literally having constipation and diarrhea at the same time, lol. Confused? Don't be. It wasn't anything like "mixed-IBS". I was pooping everything I ate, but in a constipation style and loosing weight. A lot of fun.
Until then, I was relatively well (compared to my current situation).

 

So sorry, @Pechius, to hear about you crash from Theralac. Or was it from your diet on a lot of rice and butter? I read this article today
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/ and it highlighted how bad carbs and fat (like in a typical Western diet) could be to the microbiome. Do you have a chance to get your microbiome analyzed? You might have an overgrowth of bacterias like Streptococcs and/or Chlostridium diff. that should need treatment, among other possible imbalances.

Are you tested for infections? I had Yersenia as one of three tick-borne infections, and it affected my gut badly. Also many of us have hypothyroidism causing obstipation if not properly treated. But rice itself might have caused it as well, as you surely know. Just some thoughts....