Stress microbiome and Transient Ischemic Attack

I had a chat with a work colleague this week, his wife like mine, has suffered from Transient Ischemic Attack induced by stress. This post explores what we know from medical literature about these two things.

An excellent starting point is an article release yesterday: How stressed-out gut bacteria may trigger autoimmune response, Neuroscience News, May 14, 2019.

Bacteria Shifts Seen with Stress

At the genus and species levels, significant enrichment in the
Social defeat [stressed – SD] group feces included OscillospiraRuminococcus (FDR = 0.003), and Dehalobacterium (P value = 0.028) (Firmicutes, 2- to 3-fold), Mucispirillum schaedleri (FDR = 0.004) (Deferribacteres, ∼3-fold), and Bilophila (FDR = 0.0004) (Proteobacteria, ∼6-fold) ….
fourteen days after the last exposure of the mice to the aggressor, the structure of the SD-associated bacterial community nearly returned to homeostasis without any significant change 

Genera/species that were significantly enriched in at least one of the experiments included Adlercreutzia (P value = 0.0259; Actinobacteria), Brevundimonas diminuta (P value = 0.044; Alphaproteobacteria; an opportunistic pathogen in immunocompromised hosts [32]), and Helicobacter (P value = 0.022; Epsilonproteobacteria; highly prevalent pathobiont that can lead to gastritis, peptic ulcer disease, and possibly autoimmune diseases [33]), whereas genera/species that were relatively less abundant in SD group MLNs included Sutterella (P value = 0.0163; Betaproteobacteria; reduced in the gut of human patients with MS) and Prevotella (P value = 0.010; 

Social-Stress-Responsive Microbiota Induces Stimulation of Self-Reactive Effector T Helper Cells , 2019


We show that an environmental trigger such as social stress affects the bacterial composition and transcriptional patterns in a way that enforces an immune response with potential deleterious consequences to self-tolerance. This might be a hit-and-run effect since although the gut microbial community recovered after the cessation of the stress, the microbial alterations and the immune response in the MLNs persisted, highlighting the consequences of an early stress-inducible disturbance on the homeostasis later in life. In that aspect, many of the stress-responsive bacteria that we found are known to be associated with autoimmunity and other diseases.

The stress-associated virulent phenotype can explain, for example, how under healthy conditions, the relative abundance of Proteobacteria in the human gut can transiently increase from 2.5% to 45% without clinical signs, whereas under certain undefined circumstances, they do trigger inflammatory responses (5557). 

Social-Stress-Responsive Microbiota Induces Stimulation of Self-Reactive Effector T Helper Cells , 2019

Simple translation, stress alters the microbiome is a way that persists and potentially leaves the person stress intolerant (see this post for the list of medical conditions that are recognized as being stress intolerant).

TIA Microbiome

  • “Stroke and transient ischemic attack patients had more opportunistic pathogens, such as Enterobacter, Megasphaera, Oscillibacter, and Desulfovibrio, and fewer commensal or beneficial genera including Bacteroides, Prevotella, and Faecalibacterium. This dysbiosis was correlated with the severity of the disease.”  [2015]
    • Note: higher Oscillibacter and lower Prevotella is seen with stress as reported above.
  • “a decreased amount of RoseburiaBacteroidesFaecalibacterium prausnitzii and increased proportion of EnterobacteriaceaeBifidobacteriaceae, and Clostridium difficile has been detected in gut samples of stroke patients, as compared to healthy volunteers, intensive care patients, patients with active ulcerative colitis or with irritable bowel syndrome [2012].  “

Bottom Line

The relationship seems self evident from the literature. The question arises, what can be done when under stress? Using the microbiome prescription site at the genus level, we can enter the above shifts and see what is suggested. Note: that if stress cause a condition, then there may be significant shifts as a response.

Increase the following:

lactobacillus rhamnosus gg (probiotics)
lactobacillus casei (probiotics)
inulin (prebiotic)
Ferric citrate
galacto-oligosaccharides (prebiotic)
arabinoxylan oligosaccharides (prebiotic)
bifidobacterium animalis subsp. lactis (probiotics)
cellulose (prebiotic)
oligofructose (prebiotic)
proline (amino acid)
lactobacillus salivarius (probiotics)
mannooligosaccharide (prebiotic)
lactobacillus gasseri (probiotics)
sialyllactose (oligosaccharide ) (prebiotic)
vitamin d

Avoid the following

On the other side, we should avoid the following. Note that here we see some probiotics should be taken and others avoided. Probiotics are not a universal cure-all!

zinc oxide
melatonin supplement
vitamin b7 biotin (supplement) (vitamin B7)
thiamine hydrochloride (vitamin B1)
retinoic acid (prescription)
lactobacillus kefiri (probiotics)
lactobacillus plantarum (probiotics)
pyridoxine hydrochloride (vitamin B6)
chicory (prebiotic)
Cyanocobalamin (Vitamin B12)
folic acid (prescription)
fructo-oligosaccharides (prebiotic)
polymannuronic acid
bifidobacterium longum (probiotics)
saccharomyces boulardii (probiotics)
resistant starch
vitamin b3 (niacin)
resistant starch type 4
saccharomyces cerevisiae (probiotics)
Bifidobacterium bifidum (probiotic)
clostridium butyricum (probiotics)
jerusalem artichoke (prebiotic)
lactobacillus acidophilus (probiotics)
lactobacillus brevis (probiotics)
Prescript Assist (Original Formula)
lactobacillus fermentum (probiotics)
lactobacillus reuteri (probiotics)
mastic gum (prebiotic)