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r/HumanMicrobiome•
MaximilianKohler

Guide to probiotics.

Probiotics

Reposting here because the other one was deleted. If there are dead links let me know.

If you find this overwhelming, just try the recommended probiotic combo by itself while minimizing fermented food intake. If your main problem is constipation maybe a food-sourced probiotic or fermented foods could help reports of bb536 curing IBS-C in multiple people, you might also try Miyarisan and/or s.boulardii. If you've tried a variety with poor results perhaps try adding phages.

#Intro:

What's effective for someone is going to vary between person to person because it depends on the current microbes that are in each person's gut. You sort of have to try a wide variety of products and see which one works for you. Though the following information should help narrow it down. People who have taken certain antibiotics or a lot of antibiotics will likely benefit from the same probiotics (probably human-derived ones, since that's what the abx kills off).

The current products on the market are extremely limited in comparison to the vast amount of microbes in a healthy human gut, so one should not expect to find a probiotic that completely cures them. Up until early 2016 we were only able to culture around 1% of gut microbes [1, 2].

Unfortunately, less than 1% of Amazon reviewers actually say whether a product helped with "constipation" or "diarrhea", which makes the reviews completely useless. Please be specific when you share your experiences here and elsewhere.

The most important factor seems to be whether a probiotic is human-derived or food-derived. Human-derived strains seem to have the widest range of benefits. Most human-derived probiotics are native strains that would be the most likely to colonize the gut (but still typically do not). Whereas most food-derived strains seem mostly transient. Additionally, most human-derived strains seem to have anti-diarrhea effects, whereas food-derived strains seem to mostly be anti-constipation. I started a list below of products and the sources of their strains.

This lists specific strains/products which have been shown to be effective for specific conditions. Another from World Gastroenterology Organisation Global Guidelines. And a similar 2015 one from Yale & Harvard.

#Spore formers, soil-based bacteria:

Just a warning that some spore-forming bacteria like these soil-based ones in Prescript-Assist, are very risky since they can take over the gut. I've had extremely severe detrimental affects ^((additional citations included)^) from this one, and haven't yet been able to get rid of it. Additional citations against SBOs in my probiotic archive.

There's an "appeal to nature fallacy" that is common in health topics. IE: we used to be naturally exposed to these things therefore they must be good for us. This fallacy is being applied to soil bacteria.

Currently the science shows the beneficial microbes are the ones given to us in the womb, during birth, and from breast feeding & early healthy diet. It's very probable that these microbes prevent other commensal microbes from doing us harm. So there is risk with just introducing random microbes that are "typically found in the gut"[1][2].

#Variability:

An example of the variability: I found some probiotics that have really good, powerful benefits for me. Then I added Prescript-Assist and it almost completely negated the affects I was seeing from the others. Another example is that brewer's yeast seems to only have beneficial affects for me when I take it along with unheated Monterrey Jack cheese (and same for the cheese). And others like s.boulardii may have short term benefits (because they seem to work like a bulldozer/disrupter) but detriments the longer you take them (the case for me).

Another example is that if I'm on a milk-ONLY diet and add some raw milk it will cause diarrhea. But adding 1/2cup raw oats per day to the milk-only diet prevents the raw-milk-induced diarrhea.

And to get the strongest benefits from the probiotic combo below I had to stick with a low fat, low protein, vegan diet consisting of primarily fruits, sweet potatoes, and white rice.

And after an FMT or two, Align makes the soil-bac-symptoms worse, but the Lactobacillus probiotics are still helpful. My guess is that it has something to do with niches being filled or not, and maybe the corresponding phages play a role.

Synbiotics: Taking probiotics with the same meal as synergistic prebiotics can boost their power and change the effect the prebiotics would otherwise have.

#Strain identifiers:

Strain identifiers (the numbers/letters after the genus and species) are probably the most important factor when looking for a probiotic. I had no positive results with probiotics until I figured this out. I originally read that maximizing number of strains & CFU counts were the most important things, and I got no results (besides stool softening) with that approach. Many probiotics don't even list the strain, and often contain many inaccuracies.

A major downside is that you can't find a single product with a bunch of different "good" strains. So purchasing separate products for single strains gets expensive. I don't see this being resolved until a "synthetic FMT" product is available.

#Recommendations:

With this in mind, I have a history of a lot of different antibiotics (along with CFS, IBS-D and others) and these are ones that I've gotten great benefits (boosts to energy, brain function, strength, skin, sleep & dreams, sex drive, happiness, anti-diarrheal, etc.) from: Reuteri Pearls, plus culturelle , plus align, plus Bimuno. Plus maybe s.boulardii temporarily(?). For me, the affects of these individually are much smaller compared to the affect when taking all of them. Reuteri and b.infantis are ones found in breast milk. Bimuno is GOS (galacto-oligosaccharide), which is food for these specific bacteria. GOS is found in human milk, but I think Bimuno is synthesized from cow's milk. And Lactobacillus GG is the most studied probiotic strain.

Most of these are human-derived.

Culturelle + mushrooms are synergistic so I'd take them in the same meal.

Align & Bimuno are synergistic so you could take them together in another meal.

Other prospects:

This is one I haven't tried yet but looks extremely promising (EDIT: nope, another let down. No positive benefits for me. Doesn't seem to do much more than soften stool.) due to the fact that it lists the strain identifiers for every single one, and it uses the strain of L.Reuteri that I've found to be the most effective. This tells me this company knows what they're doing, rather than just being another fish in the sea trying to make money.

#High CFU counts, multi-strain probiotics, home ferments like sauerkraut, yogurt, and kefir:

This is the "anti-constipation" or "disruptor" category. The primary mode of "anti-constipation" effects is making you poop more. This can be accompanied with other unwanted side effects though, such as bloating & gas. So these are not necessarily a "cure for constipation".

Currently I believe that products (& fermented foods) have this affect due to the strains they contain (typically food-derived strains). And it just so happens that most multi-strain products use these kinds of strains since they're cheaper and not patented. I think most/all human-derived strains are patented, thus you'll only find them in one product.

The more different strains & species one product has, the more likely it is for them to confound or contradict each other.

The benefits of fermented foods are typically WAY oversold by health advocates. They do have some benefits but they are not the right strains that live natively in the human gut. Their primary mode of action is producing compounds like hydrogen peroxide, acids, & alcohol that suppress other microbes (thus a beneficial affect on pathogens). But they will not colonize the gut or perform the necessary roles of native strains. Remember that fermenting cabbage (sauerkraut) is done to preserve it.

Another thing to keep in mind is that more of a good thing is not always better. I've experienced it myself, and seen reports from others having the same experience. High CFU counts and muti-strain products (especially of the wrong strain) may be too strong and disrupt your microbiome too much. More than a pea-sized amount of homemade sauerkraut is too much for me. And with certain probiotics some people resort to breaking/opening each pill and taking about 1/8th the amount.

One of the signs that I'm basing this off is that high CFU/multi-strain probiotics, and probiotic foods like kefir and sauerkraut all have the similar effect (for me) of acting like a stool softener, and causing the stool to contain much more undigested food. Whereas the specific strains that I mentioned previously do the opposite. I've also read many reports of this same phenomenon in other people. I'm also pretty sure sauerkraut was the cause for a stool test of mine to show low pancreatic enzymes.

They (multi-strain probiotics & fermented foods) also clear/suppress the soil bacteria as long as I continue to take them. Unfortunately they also increase my fatigue (CFS).

Moderate to high strain diversity, possibly along with high CFU counts, is likely more beneficial to people who need to clear one or more invaders [1] [2], and/or have constipation (S.Boulardii & Miyarisan (Clostridium butyricum) also belong in this category). Whereas specific strains (like align & culturelle) are likely more beneficial to people who are missing good bacteria (IE: after taking antibiotics), and/or have diarrhea.

But after the soil bacteria and an FMT, one of the human-sourced strains that used to help me (Align) now behaves similar to "disruptors" (as does reuteri pearls) as well so... ¯\_(ツ)_/¯

Some additional citations/info:

I'd recommend the book "The Art of Fermentation" to learn about fermented foods.

In his book “I Contain Multitudes,” Ed Yong, a writer for The Atlantic, argues that, contrary to their reputation as champions of microbe health, probiotic products found in supermarkets - such as yogurt and kefir - do minimal good because they contain bacteria that are transient and chosen not because of their importance to humans but because they’re good travelers and easy to grow.

Administration of probiotic kefir to mice with Clostridium difficile infection exacerbates disease: http://www.sciencedirect.com/science/article/pii/S1075996416300610

Study showing higher doses of Align were worse due to the organism's tendency to "coagulate" into a firm glue-like mass in higher CFU doses: https://www.ncbi.nlm.nih.gov/pubmed/16863564

Each animal host seems to have a host-specific strain of L. reuteri, e.g. a rat strain for rats, a pig strain for pigs, etc.: https://en.wikipedia.org/wiki/Lactobacillus_reuteri#Prevalence | Each animal species hosts a unique microbial community: https://news.vanderbilt.edu/2016/11/28/each-animal-species-hosts-a-unique-microbial-community-and-benefits-from-it

Benefits/importance of specific strains (and more): [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

The recommendations for neonates are essentially the same as adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163616/ - also confirms the importance of specific strains & human-sourced strains.

Attempting to extend/boost probiotics with home ferments part 1. Part 2: https://redd.it/499oar (tldr: failed)

Personal collection of articles & studies on microbiome: https://paper.dropbox.com/doc/Microbiome-ArchiveIntro-0Buskk5GY8phCwYaR3h7s

Probiotic-specific archive: https://paper.dropbox.com/doc/Probiotic-specific-archive-ZbwL7yju2DPuf6xki2KYB

DISCLAIMER:

The microbiome is a developing area. New discoveries are constant. The above information will change with time, and I'll make regular updates.

Posted Jun 29, 2017, 2:32 AM UTC · edited

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