A reader wrote earlier this month:

“I recently started taking high dose (about 150 billion) probiotics from Custom Probiotics. It’s their D Lactate-free probiotics made up of 5 different bacteria strains.

• L. Salivarius
• B. Lactis
• B. Bifidum
• B. Infantis
• B. Longum
  The psoriasis has improved incredibly in the 16 days I’ve been taking it.”

I believe that the over production D-Lactate is likely a factor for many CFS patients (and excessive histamines for others). This lead to my recommendation to take  Miyarisan (Clostridium butyricum) because it converts lactic acid to butyric acid. An additional factor for some patients is the desired to be histamine-free. This is reasonable, one patient in the uBiome result had Morganella, a major histamine producer. In addition to the one from Custom Probiotics, there is BIFIDO|Maximus which adds Lactobacillus rhamnosus and Lactobacillus gasseri.

So based on their claims, we have three species, see The Dilemma of D-Lactate Free Probiotics – they do not work 😦

• Lactobacillus Gasseri
• Lactobacillus Rhamnosus
• Lactobacillus Salivarius

Unfortunately evidence suggests they do not change d-lactate levels. https://atomic-temporary-42474220.wpcomstaging.com/2020/12/28/the-dilemma-of-d-lactate-free-probiotics/

In addition to this, the KyberKompakt Pro report found low levels of Hydrogen Peroxide producing Lactobacillus species. This adds an additional constraint to selection.

• “several L. plantarum strains, have been shown to produce different antimicrobial agents such as organic acids, hydrogen peroxide” [2016]
• “Lactobacillus gasseri CRL1421 and Lactobacillusgasseri CRL1412, which share some probiotic properties, produce H2O2,” [2006]
• “Lactobacilli were identified in 215 (71%) of 302 women. The 3 predominant species identified were L. crispatus (32%), L. jensenii (23%), and lactobacillus 1086V (15%). Among these species, 95%, 94%, and 9%, respectively, produced H₂O₂. Surprisingly, L. acidophilus was not detected in any women. ” [1999] [2012]
• Other H₂O₂-producing species or strains have been proposed to have probiotic properties, such as Bifidobacterium bifidum (6) and Lactobacillus johnsonii (7), or are prevalent in the commensal vaginal microbiota, such as Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus gasseri (8). [2014]

The last constraint is not killing E.Coli

• ” strains L. plantarum 106 and 107 were the most active microorganisms against E. coli” [2016]

Kyo Dophilus 9

This probiotic almost hits a sweet spot containing only L.Gasseri, L. rhamnosus (H2O2 producer) and Bifidobacteria:

• L. gasseri B,
• L. rhamnosus,
• L. gasseri M,
• B. bifidum,
• B. longum M,
• B. longum B,
• B. infantis,
• B. breve
• B. lactis

An alternative is Kyo-Dophilus contains Lactobacillus gasseri, Bifidobacterium bifidum and Bifidobacterium longum. It is unclear if it contains one or two strains of L.Gasseri.

Bottom Line

• Lactobacillus gasseri – is the best candidate and available from Swanson as a single species probiotic and in Kyo Dophilus
  •  Relatively low impact on E.Coli [2012]

Oral probiotics containing either Lactobacillus crispatus, Lactobacillus jensenii, Lactobacillus vaginalis could not be found.

• Lactobacillus Reuteri – all human strains produce histamine 😦
• Lactobacillus Delbrueckii — weak producer of histamine [1995] [1998]

The strain used was discovered around 1931 by Prof. Dr. Ernst Laves. The company is still owned by the Laves and based in Germany.

“Colibiogen^® is a cell- and protein-free preparation obtained from the metabolic products of the Escherichia coli strain Laves. Colibiogen^® is a mucous membrane therapeutic with anti-inflammatory and immunoregulatory effects. The site of action is the mucosa as immunological unit.

As it contains no living organisms, it is not a means of symbiotic control and therefore not used for direct build-up of the bacterial flora of the intestine.” [From Site]

“Colibiogen^® oral and Synerga^® are identical in terms of concentration and active ingredient: They contain the highly purified metabolites of Escherichia coli strain Laves. However, Synerga^® is free of any aroma additives and therefore particularly suitable for patients with allergic problems (citrus fruits), while Colibiogen^® additionally contains natural orange flavour. (Colibiogen inject naturally contains no flavourings, because it is intended for injection!)” [faq]

PubMed

• “The use of E. coli lysate is effective in the amelioration of murine colitis.” [2003]
• “These results suggest a positive benefit-risk ratio of the additional application of lysed E. coli, Laves strain Extract to 5-FU in the treatment of advanced colorectal cancer” [2001]
• “A pharmaceutical containing lysed cells of this strain initially isolated from human faeces, is commercially available (Colibiogen^®; Laves-Arzneimittel GmbH, Schötz, Switzerland) for the treatment of intestinal inflammations, but its capacity to inhibit Salmonella has never been tested before. Genome sequencing analysis of E. coli L1000 (study name) was performed to identify the putative bacteriocin produced by this strain…E. coli L1000, a natural strain carrying the mcb-operon for microcin B17-production, inhibited a majority of tested Salmonella isolates (94%), as well as E. coli O157:H7 and Sh. sonnei. ” [2009] – it works against bad E.coli

Bottom Line

This will not result in E.Coli growth, however it may deliver some of the benefits of E.Coli  and can be taken with any probiotic. It should help to shift the balance (in theory).

• In Spain: Source
• In UK: Source

Looking forward to feedback from anyone that tries it.

Since I started this blog, some 530 posts ago, there have been significant changes in probiotics available and information available (for example uBiome results). My original model favored the reports from the University of Newcastle in Australia in 1998. The uBiome results from a sample of over a dozen readers of this blog confirmed parts of this report and also raise questions on other parts. In re-reading the report, there was only 4 controls to 27 patients — which may account for the differences they saw. I summarized below:

In short, we do not see the overgrowth, but can confirm the undergrowth matches from the uBiome results.

There was a match up of the antibiotics used by Jadin with the overgrowth and undergrowths, which reinforced the model. There may a different reason that her antibiotics protocol works for many — for example, inhibiting “normal” bacteria allowing the undergrowth to increase. I do not have clarity on this.

My rotate rotate rotate was based on the belief that there was there was significant overgrowth that could become resistant. I have now diminish it’s importance (I have not abandoned it).

Suggestions for an updated Probiotic Protocol

All of the above resulted in my recommendations to discuss with your medical professional:

• Start  with General Biotics Equilibrium – you will keep taking it while you have CFS symptoms
• Add in Prescript Assist after 1-2 weeks – you will keep taking it while you have CFS symptoms
• Add in Bifidobacteria Probiotics after 1-2 weeks — See this post for some possible brands.
  • You may (for cost reasons) to rotate thru different brands so you get as many species as you can find.
• Add in MegaSporeBiotic or Just Thrive (for many Bacillus species) after 1 week – at this point you will be taking every Bacillus probiotic available.
  • Warning: Some of these are histamine producers. If you are histamine sensitive, use Enterogermina.
  • I have a poll to collect actual experiences.
• After 2 weeks, rotate between Mutaflor and Symbioflor-2 every week – you will be taking every E.Coli probiotic available
• After 6 weeks, stop the E.Coli and take the Lactobacillus Gasseri (explained in my next post).
  • You want D-Lactic free and H2O2 producing Lactobacillus species/strains
  • Lactobacillus usually kill E.Coli so it is one or the other.
• After 6 weeks, stop the Lactobacillus and rotate back to the E.Coli

After 2 Lactobacillus/E.Coli cycles, if there is not significant improvement (or improvement has stopped), then consider a uBiome test. When you get the results, consider using herbs/antibiotics if appropriate. For example, one uBiome results had Rickettsia which would suggest antibiotics.

• Propionibacterium freudenreichii (Securil) is not included because it depends on  Lactobacillus helveticus. It is suggested that you eat  Emmental cheese instead “An estimated one billion living cells of P. freudenreichii are present in one gram of Emmental.”[Wikipedia]

“Add in” – start with a low dosage (where practical) and increase to recommended dosage on the bottle or higher (2x — to be discussed with your medical professional).

WARNING: Prescript Assist  and Prescript Assist Pro are two different products made by two different companies.  Only Prescript Assist has had studies on PubMed, the other one is recent to the market and has less variety.

NOTE: This post has been updated by    https://atomic-temporary-42474220.wpcomstaging.com/2017/10/08/update-and-recap/ , which is now pinned to the home page.

I took a dozen results from readers of this blog. Some have CFS diagnosis, some have IBS, some have something. There was no filtering to specific symptoms, diagnostic criteria, etc.  As a statistician, I would expect a need to cluster them to get meaningful results. To my surprise, these random people reading my blog had very consistent results showing the same general pattern. This pattern is summarized below.

A single uBiome results shared with me had a surprise, while the pattern was there — there was a Rickettsiales result (14%). This was the only Rickettsiales in all of the samples and hints that the items with only one or two results may be ‘bad bacteria’ infections.
The tree below shows where items were deemed significantly low in prior posts by being marked in red. In some cases the low values started at Phylum level, on other at the Genus level.

I have annotated with known probiotics available that may raise low levels (except for Lactobacillus amd Bifidobacteria which I will cover in future posts).   In some cases when probiotics are available, I rechecked the uBiome results and added notes. In my next post I will revisit what the model and this information would suggest for treatment.

If you know of additional probiotics not reported below, please email me with the details.

WARNING: Prescript Assist  and Prescript Assist Pro are two different products made by two different companies.  Only Prescript Assist has had studies on PubMed, the other one is recent to the market and has less variety.

Ø – Indicates not in uBiome Results (i.e. no information)
Þ – Indicates a Probiotic is available

• Actinobacteria
  • Actinobacteria
    • Bifidobacteriales
      • Bifidobacteriaceae
        • Bifidobacterium
    • Coriobacteriales
      • Brevibacteriaceae (2 /12 had trace amounts)
        • Brevibacterium (2 /12 had trace amounts)
          • Ø Lipolyticum Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Stationis Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
      • Coriobacteriaceae
        • Eggerthella
  • Actinomycetales
    • Corynebacterineae
      • Corynebateriaceae
        • Corynebacterium
          • Kurtha zopfil  Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
      • Ø Micrococcaceae
        • Arthrobacter
          • Agilis Þ Prescript Assist Pro (USA)
          • Citreus Þ Prescript Assist Pro (USA)
          • Globiformis Þ Prescript Assist Pro (USA)
          • Luteus Þ Prescript Assist Pro (USA)
          • Simplex Þ Prescript Assist Pro (USA)
          • Calcoaceticus Þ Prescript Assist Pro (USA)
          • Chroococcum Þ Prescript Assist Pro (USA)
          • Paspali Þ Prescript Assist Pro (USA)
      • Ø Streptomycetaceae
        • Ø  Streptomyces
          • Ø Fradiae Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Celluslosae Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Griseoflavus Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
    • Propionibacteriaceae (1/12 had trace amount, rest none)
      • Propionibacterium (1/12 had trace amount, rest none )
        • Freudenreichii Þ Securil (France) 
• Bacteroidetes
  • Bacteroidetes
    • Bacteroidales
      • Bacteroides
        • Ø Lipolyticum Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
        • Ø Succinogenes Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
      • Prevotellaceae
        • Prevotella
• Firmicutes
  • Bacilli
    • Bacillales (only 4/12 with measurable amounts)
      • Bacillaceae (only 2/12 with measurable amounts)
        • Bacillus (only 1/12 with measurable amounts)
          • Ø Cereus
          • Ø Clausii Þ Enterogermina (Italy), Þ MegaSporeBiotic (USA)
          • Ø Brevis Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Coagulans Þ MegaSporeBiotic, Þ Thorne (USA), Swanson (USA), Schiff (USA) etc
          • Ø Indicus Þ MegaSporeBiotic
          • Ø Licheniformis Þ MegaSporeBiotic
          • Ø Marcerans Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Pumilis Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø  Polymyxa Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø  Substilis Þ Prescript Assist (USA), Þ MegaSporeBiotic Þ Prescript Assist Pro (USA)
    • Erysipelotrichia
      • Turicibacter
  • Lactobacillales
    • Enterococcaceae (4 low amount, rest none)
      • Enterococcus  (4 low amount, rest none)
        • Ø Faecalis Þ Symbioflor-1 (Germany),
          • Þ Biofermin+S+Tablet (Japan)
          • Also part of many mixtures
    • Lactobacillaceae
      • Lactobacillus
    • Streptococcaceae
      • Streptococcus Þ many providers
        • Ø Salivarius
        • Ø Thermophilus  Þ In some Yogurts
  • Clostridia
    • Clostridiales
      • Clostridiaceae
        • Clostridium
          • Ø Butyricum – Þ Miyarisan (Japan)
      • Clostridiales Family XI. Incertae Sedis
        •  Ø Myrothecium verrucaria Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
      • Lachnospiraceae
        • Marvinbryantia
        • Shuttleworthia
      • Oscillospiraceae
        • Oscillibacter
      • Peptoniphilaceae
        • Finegoldia
      • Ruminococcaceae
        • Candidatus Soleaferrea
        • Oscillospira
  • Mollicutes
    • Anaeroplasmatales
      • Erysipelotrichaceae
        • Dielma
  • Negativicutes
    • Selenomonadales
      • Veillonellaceae
        • Megasphaera
• • Proteobacteria
    • Alphaproteobacteria
      • Rhodospirillales (3 high, 5 low, rest none)
        • Ø Azospirillum
          • Ø Brasiliense Þ Prescript Assist (USA)  Þ Prescript Assist Pro (USA)
          • Ø Lipoferum Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
    • Betaproteobacteria (75% were low)
      •  Burkholderiales (75% were low)
        • Comamonadaceae (2 low amounts, rest none)
        •  Þ General Biotics Equilibrium (USA)
    • Deltaproteobacteria
      • Desulfovibrionales
    • Gammaproteobacteria
      • Ø Aeromonadales (3 with low amounts)
        •  Þ General Biotics Equilibrium (USA)
      • Pseudomonadales (only 1 with trace amount)
        • Þ General Biotics Equilibrium (USA)
        • Ø Arthrobacter
          • Ø Agilis Þ Prescript Assist (USA)
          • Ø Citreus Þ Prescript Assist (USA)
          • Ø Globiformis Þ Prescript Assist (USA)
          • Ø Luteus Þ Prescript Assist (USA)
          • Ø Simplex Þ Prescript Assist (USA)
          • Ø Calcoaceticus Þ Prescript Assist (USA)
          • Ø Chroococcum Þ Prescript Assist (USA)
          • Ø Paspali Þ Prescript Assist (USA)
        • Pseudomonas (one 1 with trace amounts)
          • Ø Calic Þ Prescript Assist Pro (USA)
          • Ø Dentrificans Þ Prescript Assist (USA)  Þ Prescript Assist Pro (USA)
          • Ø Flourescens Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Glathei Þ Prescript Assist (USA) Þ Prescript Assist Pro (USA)
          • Ø Stutzeri Þ General Biotics Equilibrium (USA)
      • Enterobacteriales
        • Enterobacteriaceae Þ General Biotics Equilibrium (USA) – dozens of species
          • Kluyvera 
          • Ø Escherichia
            • Ø E.Coli – Þ Simbioflo-2 (Germany)
              • Ø Nissle 1917 – Þ Mutaflor (Germany)
• Verrucomicroba
  • Verrucomicrobiae
    • Verrucomicrobiales

New Scientist’s issue of Nov 4th, 2016 had a commentary by Ester Crawley, below is my response that I sent to the New Scientist. Commentary is here.

Ester Crawley’s desire to recruit for online cognitive behavioural therapy is commendable; unfortunately, it is contributing to a deepening division in the CFS/ME community. CFS/ME has been a condition that keeps enticing specialists to hope that they have found an application for their expertise, with funding for this activity.

The root cause of CFS/ME and many co-morbid conditions was identified in Australia in 1998 by a team at the University of Newcastle [ http://www.ahmf.org/98access/98butt3.html  ]. The root cause is a dramatic shift of bacterial population in the gut. Dynamic evidence of the correctness of this cause had been demonstrated by the immediate remission of CFS/ME by fecal transplants which has been reported more than once in this journal. An older treatment for CFS using a Rickettsia antibiotic protocol had a significant remission rate but the long term use of antibiotics has ceased being politically correct.

I recently examined the uBiome results of a dozen CFS patients and found that five Families had a median value below 20% of the reference range ( Bifodobacteriaceae, Enterbacteriaceae, Lactobacillceae, Peptococcaceae, Streptococcaceae). At the Genus level we found 16 of 120 Genus had a median value below 20%.

Standard medical practice for overgrowth of a bacteria is the use of antibiotics. For undergrowth there are very few probiotics. Most commercial probiotics are selected with the undesirable characteristics of not taking up residence, non-producers of toxins against other species and very susceptible to all antibiotics. “Here today, definitely gone tomorrow!”

In the US, there is an additional challenge – if a probiotic is demonstrated effective against a disease, it immediately becomes regulated. A probiotic that makes no claims is unregulated. Mutaflor (E.Coli Nissle1917) is not sold in the US despite being used in Europe for almost 100 years. This is unfortunate because most CFS/ME patients have very low or no E.Coli in their microbiome.

I am a citizen scientist with an M.Sc.(Operations Research) who has had CFS/ME three times over 40 years and recovered each time. The model of a microbiome dysfunction fits all of the studies but presents major treatment challenges. Bacteria strains are co-inherited with DNA which present challenges of rejection by the host, similar to organ transplants and blood transfusions. This rejection is often seen with CFS/ME patients about 6-9 months after a fecal transplant, when symptoms return.

Ken Lassesen

Seattle, WA
(ex-Amazon, ex-Microsoft, currently at Starbucks!)

https://atomic-temporary-42474220.wpcomstaging.com/