lassesen 6:12 am on February 6, 2017

What is the ideal probiotic for CFS / IBS / FM patients?

I have yet to find the magical ideal — I do know the characteristics that it should have.

Human sourced with evidence of taking up residency.
- Best documented to date is Symbioflor-2
Does not produce histamine (implicated in a subset of CFS), ideally converts histamine to other chemicals
Does not produce d-lactic acid (implicated in a subset of CFS), ideally converts d-lactic acid aggressively
1. Best documented to date is Miyarisan
Resistant to many antibiotics
- Best documented is Lactobacillus Fermentum ME3
Effective against Candida
- Best documented is Lactobacillus Fermentum ME3
Encourages microbiome diversity
Create toxins against bad bacteria strains but not their good cousins
- Best documented is Lactobacillus Fermentum ME3
Produces B12
- Best documented is L.Reuteri — but human strains produce histamines and lactic acid also!
Produces chemicals that are anticoagulants
- “Strong acidification and coagulation activities of Lactic acid bacteria strains were recorded.” [2009] i.e. Lactobacillus in general encourages coagulation! There are exceptions

Problem with most commercial probiotics

The source is never identified (i.e. a chicken strain is very unlikely to take up residency)
The strain is rarely identified, i.e.
- Lactobacillus Casei — is a family
- Lactobacillus Casei Shirota — is the strain
Often the family is incorrect (especially for Bifidobacteria) if no strain is given
There is no independent certification agency for the content of probiotics
Even with strains that have PubMed studies published, only a few answers to the above questions are found. The rest is guessing!
Often health professional will make up answers about it being “high quality” etc and there is zero evidence based research supporting the benefits they claim.

Drew 6:07 pm on February 6, 2017

Excellent musings here, Ken. Symbioflor-2 has produced the most positive results of any probiotic for me, by quite a wide margin. Next up will be the ME3 as I have a recurring candida infection confirmed many times over by testing.

Overall, I have improved by following and experimenting with the suggestions and findings here. However, I am still very disabled by CFS/Post-Infection, some weeks I can work 10-15 hours a week, but some I can still barely function. I’m wondering if you’ve gotten any feedback from readers who are now in remission because of probiotics. It seems even you yourself had to have many antibiotics onboard (via the Jaden protocol). And what should those of us do who don’t have access to such rotations of antibiotics? Should we rotate herbal antibiotics or are they not strong enough? Or should I focus most of my attention and efforts on finding a doctor who will listen to my requests to follow the Jaden protocol?
- lassesen 7:46 pm on February 6, 2017
  
  There is a group in Spain on Facebook (https://www.facebook.com/groups/VIVIRCON.SFC.EM/ ) where several people have made major improvement. Some are actually looking for work (and was earlier restricted to their apartment).
  
  My take is that you are in an instability period. Before seeking out antibiotics (which can be a major stress! — not good), I would suggest trying the herbs — especially those with good results on the last survey summary. https://cfsremission.com/2017/01/30/updates-of-survey-results/
  
  Neem, Oregano, Ashwagandh, Licorice.
  
  GB Equilibrium is batting 100% for improvement but with a small sample size.
  
  For antibiotics, IF the above does not work — Macrolides.
  
  Again, this is based on readers experience…. your own response may vary.
  - dqs5563 11:03 pm on February 6, 2017
    
    I would like to ask, besides symbio flor-2, do you find any benefit in introducing any of the enterococcus species into the gut flora? I know enterococcus can produce Vitamin K2, however I’m also aware of e coli doing the same thing.
    
    If someone had to choose between Equilibrium and Bioflorin due to financial costs, which would be a better choice?
    - lassesen 11:36 pm on February 6, 2017
      
      My own choice would be Equilibrium — because of the large number of species. Bio-diversity is a target.
      - dqs5563 3:20 am on February 7, 2017
        
        Do you have any input on PerfectPass with it’s Bacillus species? Apparently they have the HU58 Bacillus Subtilis strain which is human sourced.
        
        lassesen 5:42 am on February 7, 2017
        
        See https://cfsremission.com/2016/11/21/just-thrive-probiotics-update/
        
        One of the three strains is a histamine producer.
        
        It is human source as is Bacillus Indicus HU36
jericho 5:43 am on November 28, 2017

“Human sourced with evidence of taking up residency.”

It just occurred to me: Seems like an FMT would hit this particular criterion out of the park.
- lassesen 6:14 pm on November 28, 2017
  
  If the FMT has the right (healthy) mixture. Just got an note from someone with FMT. They had the donar’s ubiome done (based on my suggestion)…. and the donor had ZERO bifidobacterium… Needless to say, the hoped for impact did not materialize…
  
  Test before FMT always…. IMHO.. not just from a healthy person, but a healthy microbiome (in terms of CFS).
dom 4:06 am on January 14, 2018

hello.
i have multiple food allergies, eg gluten, corn, legumes, nuts, seeds, dairy, seafood…
these cause eczema, IBS, chronic fatigue..
if i take all the probiotics on this page at one go, is that bad?
also, do you have an email?
- lassesen 4:14 pm on January 14, 2018
  
  Taking all at one go has increased major herx risk. I usually advocate working up to all by starting with a low dosage of one and increasing the dosage until you herx or at a high dosage. Then add the next one and repeat.
  
  What is a high dosage? that varies from probiotic to probiotic with manufacturers making greatly varied recommendations (without publishing much evidence). If you go to http://www.customprobiotics.com, you will see that their daily recommended dose is around 80 BCFU/day for L.Reuteri (see http://www.customprobiotics.com/l-reuteri-custom-probiotic-powder.html ). Microbiome Plus L. Reuteri is 3.5 BCFU per capsule (see https://www.amazon.com/Microbiome-Plus-Gastrointestinal-Probiotics-Supplements/dp/B01MEG1Y9C/ ).
  
  IMHO, it seems that a lot of commercial probiotics are likely under strength, which may be to the manufacturer’s benefit.
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Problem with most commercial probiotics

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