Probiotics can be deadly

Probiotics are not a zero risk treatment, contrary to popular belief.

“There is an urgent need to better define their appropriate clinical use, especially as probiotics are not always benign. There are many reports of probiotics causing infections, and in particular there is an increased risk of invasive infection in patients with in dwelling intravenous noeters. Probiotic use can even turn deadly: in one clinical trial examining probiotics for pancreatitis, the trial had to be stopped early because the probiotic group actually fared much worse. There were 24 deaths in the probiotic group and 9 in the control group, and 9 cases of bowel ischemia reported in the probiotic group, whereas none were seen in the control group. The results of this trial provide a good illustration of how we still do not entirely understand the complex mechanisms of action of probiotics, and of the urgent need to better determine the scientific basis for their function. This clinical trial used rigorously-tested probiotics, so it is not difficult to imagine the additional potential dangers lurking in probiotics of inadequately controlled quality. Fortunately, probiotic use is generally safe and it shows much promise for clinical efficacy in many gastrointestinal disorders, but we still have a long way to go. Ongoing research in this area, and a better understanding of host-microbial interactions through ongoing research on the human microbiome, will undoubtedly lead to further advances in this important field of Gl research”.

Elaine O. Petrof, Probiotics and Gastrointestinal Disease: Clinical Evidence and Basic Science

Probiotics can also cause inflammation for some conditions.

Which Probiotics?

Unless a mixture of probiotics has been explicitly tested and found effective, it should not be used. The reason is simple:

  • Some species will reduce species that are low already, further
  • Often species in a mixture will fight each other. You may get better result from just one of the species.

Exceptions are when the only way of obtaining a specific species is getting it in a mixture (far from ideal).

My research from reading thousands of PubMed articles are that the following have significant clinical evidence supporting their use for CFS/IBS/FM. One of the interesting results seen was that the dosage was very important for some, too little and there was no effect, too much and there was no effect. The best estimate for dosage is about 10(8) cfu/mL.

All of the others are either untested, have no effect (except on the pocket book), have contrary results (good and bad – thus risky) or bad effect. I have all of the links to the appropriate studies in my forthcoming book. Many of the Lactobacillus will reduce the E.Coli population that are already very low. E.Coli produces NADH which is low in CFS patients . Remember: all E.Coli are not bad; many are needed for your health.

There is a classic test if other probiotics will help, do taking them produce a Jarisch-Herxheimer Reaction? If they do not (especially if you increase the dosage 4x above recommended), then they will likely be of low value.  I have seen Nissle 1917 consistently produce significant to major herx, and some other probiotics less impact (but the person definitely was herxing).

WARNING: Nissle 1917 can cause a major herx at a low dosage, try the other probiotics first. It will also have the greatest change of symptoms in a short period of time.