Panic Attacks, Anxiety and the microbiome

A reader ask about anxiety and panic attacks. I was delighted to find a lot of interesting material published this year, 2019.

Pro-inflammatory members of Clostridiales such as Lachnospiraceae and Ruminococcaceae have also been associated with social avoidance behaviors in mice  … In particular, strains of Lactobacillusand Bifidobacterium are found to exert a profound anxiolytic influence through the production of γ-aminobutryic acid (GABA), 5-HT, and SCFAs, and by dampening HPA adrenergic reaction [26,34,38,41,42]. Moreover, the regression of anxiety after treatment in these studies was often associated with positive neurological changes such as increased BDNF, altered expression of PFC and hippocampal GABAA and GABAB receptors, increased circulating glutathione, and a reduction in inflammatory markers. … Through the gut microbiota, it is apparent that GABA and 5-HT are produced by specific bacterial strains [42], and that supplementation with these bacteria correspondingly attenuates presentation of anxious behaviors in animal models. 

DETAILS: Bifidobacterium infantis UCC35624, Bifidobacterium dentium NFBC2243, Bifidobacterium dentium DPC6333, Bifidobacterium adolescentis DPC6044, Lactobacillus brevis DPC6108

Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome [2016]
  • “Of 91 intestinally derived bacteria assessed, one Lactobacillus strain and four strains of Bifidobacterium produced GABA. Lactobacillus brevis DPC6108 was the most efficient of the strains tested, converting up to 90% [corrected] of MSG to GABA.” [2014]
  • commensal Bifidobacterium dentium produces GABA [2017]
  • “Further biological testing and purification led to the isolation of GABA as the growth factor produced by Bacteroides fragilis. GABA” [2019]
  •  We conclude that the anxiolytic and antidepressant effects of B. adolescentis are related to reducing inflammatory cytokines and rebalancing the gut microbiota. [2019]
  • “The anxiolytic-like effect of Bifidobacterium adolescentis IM38 was comparable to that of buspirone (1 mg/kg). Moreover, this anxiolytic-like effect was blocked by treatment with flumazenil (3 mg/kg, i.p.), ” [2018]
  • “The probiotics ( Lactobacillus acidophilus  ATCC 4356, Bifidobacterium lactis  DSM 10140, Lactobacillus fermentum ATCC 9338) were obtained from Zist Takhmir Company, Tehran, I R Iran. Different studies have shown that this composition of the probiotics alleviate anxiety-like behaviors, improve spatial memory and decrease corticosterone and adrenocorticotropine hormone (3739).” [2019]
  • ” We find that more than half of the studies included showed it was positive to treat anxiety symptoms by regulation of intestinal microbiota. There are two kinds of interventions (probiotic and non-probiotic interventions) to regulate intestinal microbiota, and it should be highlighted that the non-probiotic interventions were more effective than the probiotic interventions.  ” [2019]
  • ” Probiotics were observed to improve panic anxiety, neurophysiological anxiety, negative affect, worry, and increase negative mood regulation. Furthermore, post hoc analyses revealed that the CFU (colony-forming unit) level was more effective than species counts in accounting for the number of significant improvements ” [2019]
  • The Preventive and Curative Effects of Lactobacillus reuteri NK33 and Bifidobacterium adolescentis NK98 on Immobilization Stress-Induced Anxiety/Depression and Colitis in Mice. [2019]
  • Lactobacillus sakei Alleviates High-Fat-Diet-Induced Obesity and Anxiety in Mice by Inducing AMPK Activation and SIRT1 Expression and Inhibiting Gut Microbiota-Mediated NF-κB Activation. [2019]
  • ” This study reveals that these commonly used food additives ( Dietary emulsifiers carboxylmethylcellulose (CMC) and polysorbate 80 (P80) ) may potentially negatively impact anxiety-related and social behaviors and may do so via different mechanisms in males and females. ” [2019]

Association between Psychosocial Stress and Fecal Microbiota in Pregnant Women. [2019]
Yellow indicate high levels with anxiety, n.d. in right indicates absence with high anxiety

Bottom Line

Low Veillonellaceace family shows up again, it seems to be haunting my recent posts. This time it is the Megamonas genus which is only seen in 10% of samples uploaded. Remember that the above is using averages, thus a n.d. means that no one with high anxiety had any!

My main take away is that MOST lactobacillus and bifidobacteria will have no effect. The probiotics targeting mood are the best option.

The next take away is simple: the higher the CFU, the better. I would be inclined to target 100 BCFU if I had to deal with it.

I also went to my site page that allows Genus changes to be directly entered. To my amusement, #1 was Lifted Naturals! The Jarrow’s was only 1.2 with a lot of others with the same rating.

Why amused? We put in the above genus shifts associated with high anxiety and the AI system determined that the best out of 137 probiotics in the database was one that was branded for Mood (whose bacteria were found in independent studies to help moods). It suggests that the AI system is doing a very respectable job of coming up with suggestions!