A month or two ago, a friend wrote to me suggesting that I address the question, “are probiotics always good for you?” I promised I would – and fully intended to keep that promise soon – but one of the big news headlines this week made soon into now.
By the way, sorry in advance. This is one long post. The more I wrote, the more I found I had to write! Please bear with me.
First, the big headline: a study[i] of 30 patients at the Digestive Health Clinical Research Center at the Medical College of Georgia at Augusta University, who came in reporting issues with confusion, difficulty concentrating, gas and bloating, abdominal pain, found that all were taking probiotics and all were suffering from SIBO (small intestine bacterial overgrowth). While bacteria are found throughout the digestive tract, the vast majority are in the large intestine. When there’s an overgrowth in the small intestine, which can be caused by a variety of factors (anything that affects gut motility like diabetes, the use of proton pump inhibitors, obesity, etc.), gastrointestinal (GI) symptoms – and mental ones – can be the result.
D-lactic acid is one byproduct of bacteria and in cases of SIBO, where there may be some inflammation in the intestinal wall leading to leaky gut, these byproducts can get into the blood stream and cause intoxication – that is, they are literally toxic to brain cells. The patient may experience a variety of “mental” symptoms including profound brain fog. These 30 patients, who had the GI symptoms and brain fog, had 2-3X the normal amount of D-lactic acid in their blood.
The patients were taken off the probiotics, put onto antibiotics, and mostly recovered.
Now here is where I let off a little steam.
Firstly, Dr. Satish Rao, the lead author of the paper, claims that this is the “…first time the connection has been made between brain fogginess, bacterial overgrowth in the small intestine, high levels of D-lactic acid in the gut and probiotic use…”[ii] Two things to keep in mind though:
“The presence of undigested and unabsorbed carbohydrates within the small intestine can encourage microbes from the colon to make up residence in the small intestine and to continue to multiply. This, in turn, may lead to the formation of products, in addition to gas, which injure the small intestine. Examples are lactic, acetic, and other acids which are short-chain organic acids resulting from the fermentative process. In addition to the damage to the intestine, there is a growing body of scientific evidence that lactic acid formed from fermentation in the intestine causes abnormal brain function and behavior.”[iii]
Secondly, Dr. Rao goes on to say, “Probiotics should be treated as a drug, not as a food supplement…”
Uh oh. (You think there’s any chance of me getting feisty shortly?!) 🙂
I’ll come back to that statement later. Firstly, let’s look at this paper in a little more detail:
Just a few weeks ago, a report came out in the Annals of internal Medicine that pointed out that few studies done on probiotics reported side effects or, if they did, they did so insufficiently.[iv] These French researchers, from Paris Descartes University, note that of the 384 clinical trials they reviewed, 37% did not report safety results, and only 28% presented harm-related data.
Now, let’s look objectively at what that means:
As one US doctor, from Baylor College of Medicine, noted, “The French researchers ‘did not find evidence suggesting that these products are unsafe…Rather, they highlight the need to report safety data more rigorously in the future.’”
Now back to Dr. Rao’s statement suggesting we start to regulate probiotics as pharmaceutical drugs. My opinion for what it’s worth….
You must be kidding me. Just what we need all need – even more regulation. What ever happened to good, old fashioned, common sense? If you are healthy, and choose to take probiotics, they may or may not help you but the choice of where to spend your money is still yours. If you are sick, running supplements by your doctor is already a pretty damn good idea. If you don’t, then that’s on you. There is such a thing (or at least there should be a thing) as personal responsibility. Do we or do we not believe in personal freedom any more?
Maybe some people love the idea of living in a nanny state. Me personally – I’ll take my chances and keep the right to choose, thank you.
[i] Satish S. C. Rao, Abdul Rehman, Siegfried Yu, Nicole Martinez de Andino. Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis. Clinical and Translational Gastroenterology, 2018; 9 (6) DOI: 10.1038/s41424-018-0030-7
[iii] Gottschal, Elaine. Breaking the Vicious Cycle. 2000. Kirkton Press:Baltimore, Ontario.
[iv] Swaminath, A, Novak, J, Preidis, G. Annals of Internal Medicine, July 16, 2018.