Unless a mixture of probiotics has been explicitly tested and found effective, it should not be used. The reason is simple:
- Some species will reduce species that are low already, further
- Often species in a mixture will fight each other. You may get better result from just one of the species.
Exceptions are when the only way of obtaining a specific species is getting it in a mixture (far from ideal).
My research from reading thousands of PubMed articles are that the following have significant clinical evidence supporting their use for CFS/IBS/FM. One of the interesting results seen was that the dosage was very important for some, too little and there was no effect, too much and there was no effect. The best estimate for dosage is about 10(8) cfu/mL.
- Escherichia coli Nissle 1917: Used by Dr. Myhill (Wales) and Dr. De Mierlier (Belgium) with their CFS patients [Order]
- I order 3 month supplies from [Canada] and just hop across the border to pick it up there.
- Bacillus Coagulans
- Bacillus Subtilis [US Order] [US Order Mixture] [US Order Mixture-2] [EU Order Mixture-2]
- Bifidobacterium Bifidum – none found except as part of mixtures
- Lactobacillus Casei ssp Shirota (other species can cause adverse events) – source: Yakult, japanese beverage [EU Orders]
- Streptococcus faecium (enterococcus faecalis) [US Order Mixture] [US Order Mixture-2] [EU Order Mixture-2]
- The mixture VSL#3 is also well documented (although it is a mixture)
All of the others are either untested, have no effect (except on the pocket book), have contrary results (good and bad – thus risky) or bad effect. I have all of the links to the appropriate studies in my forthcoming book. Many of the Lactobacillus will reduce the E.Coli population that are already very low. E.Coli produces NADH which is low in CFS patients . Remember: all E.Coli are not bad; many are needed for your health.
There is a classic test if other probiotics will help, do taking them produce a Jarisch-Herxheimer Reaction? If they do not (especially if you increase the dosage 4x above recommended), then they will likely be of low value. I have seen Nissle 1917 consistently produce significant to major herx, and some other probiotics less impact (but the person definitely was herxing).
WARNING: Nissle 1917 can cause a major herx at a low dosage, try the other probiotics first. It will also have the greatest change of symptoms in a short period of time.
(c) 2012 Ken Lassesen