This last weekend our shipment of Symbioflor-2 (6 strain E.Coli probiotic) arrived. As was the case with Mutaflor (E.Coli Nissle 1917) there was a package insert warning of some side effects. This does not happen with most probiotics — inserts with warnings! A local friend also message me, she has started Mutaflor and had a massive herx for three days and with it passed, she is feeling significantly better. Side effects include:
- ” At commencement of treatment distension of the abdomen, release of wind or upper abdominal pain may occur occasionally.”
- “After the beginning of administration, flatulence is common. Very rarely, undesired effects of the gastrointestinal tract such as abdominal pain, gut noises, meteorism, loose stools or diarrhea, nausea and vomitting may occur. Again very rarely, cases of headache may occur.”
Typically studies start with low dosages and work up
“Symbioflor 2 was administered in standard dosage starting with two times five drops daily and a daily increase by two times one drop until 15 drops daily were reached. Fourteen drops are 1 ml containing 1.5–4.5107 viable bacterial counts. The total duration of treatment was 21 days.” 
And yes this probiotic does not come in capsules, but in a droplet bottle! Symbioflor 2 is preferred over Mutaflor (2 capsules = 1 day vs 15 drop = 1 day) because it is easier to slowly increase the dosage.
Why E.Coli Probiotics?
The first question is always why go thru the side effects!!!! The answers are:
- “Escherichia coli (E. coli) bacteria normally live in the intestines of people and animals. Most E. coli are harmless and actually are an important part of a healthy human intestinal tract.” [cdc]
- ” The harmless strains of E.Coli are part of the normal flora of the gut, and can benefit their hosts by producing vitamin K2, and preventing colonization of the intestine with pathogenic bacteria.” [Wikipedia]
- “In 1885, the German-Austrian pediatrician Theodor Escherich discovered this organism in the feces of healthy individuals.” [Wikipedia]
- Often CFS patients will have ZERO E.Coli in their system
- It is suspected that the bacteria replacing E.Coli are heavy d-lactate acid producers, thus E. Coli probiotics will lower d-lactate levels
- ” E. coli can synthesize all 20 amino acids, all vitamins, all nucleotides, and all fatty acids that it uses during growth and metabolism.” [Course]
- “We pretty much depend upon E. coli in our intestines for our source of Vitamin K and B-complex vitamins.” [Kansas University]
- Niacin  and NADH – which may be why CFS responds to NADH.
So, the absence of E.Coli result in low levels of Vitamin B (B12, Niacin, etc) and Vitamin K. More important, it has a major role of keeping pathogenic bacteria controlled.
If you stop and think about it — a lot of the abnormal lab results could be caused by the lack of E.Coli…. (speculation!)
Feeding of E.Coli
In earlier posts we saw that sulphur in food (dark green vegetables) encourages the growth of E.Coli or / and MSM. Also d-ribose sugar encourages the growth of E.Coli (which may be why it helps CFS patients). E.Coli grows best at…. 98.6F (37C)… [Course]
Per earlier posts, it should be taken before meals with some fat. My wife is trying drops of Symbioflor-2 into warm 2% milk (i.e. close to 37C) with a little d-ribose in it.
Do NOT take with C. butyricum MIYAIRISAN Probiotics
“1.1 C. butyricum MIYAIRI antagonistic effects on toxinogenic Escherichia coli and 20 E. coli strains isolated from live stocks (cows, pigs and chickens) were evaluated by the plating method. C. butyricum MIYAIRI inhibited the growth of all E. coli strains tested” [Source]
See also this post on feeding E.Coli with baking soda.