A Hodgepodge of Probiotics/Prebiotics, ADHD, Critically Ill Patients on Ventilators, and More

As you know, I’m always looking for published clinical trials on things-that-can-help now, and thought that today, I’d cover one I’ve had on my to-read list for a while. Earlier this year, a double-blind, placebo controlled study was conducted on children and adults with ADHD, testing to see how a combined probiotic and prebiotic affected their symptoms.[i]  And this study led me to a few other items of interest.  Read on!

The trial was 9 weeks long, and conducted on a sizeable number of individuals – 182.  These people could not have a diagnosis of autism, although some had autistic-like behaviors.  The researchers also measured levels of inflammatory chemicals in their blood.  The product used was something called Synbiotic 2000.  After some research, I discovered that it is made in Sweden and consists of 4 probiotic bacterial species (Lactobacillus paracasei, Pediococcus pentosaceus, Lactobacillus plantarum and Leuconostoc mesenteroides) all of which are lactic acid producing), and 4 types of prebiotics (pectin from citrus fruits, inulin from chicory root, resistant starch from corn, and beta-glucan from oats).  Strangely, in the paper itself, it says that the product contained 3 species of bacteria, so there may have been some update to the product since this trial took place – the product they used did not contain Leuconostoc mesenteroides.  I am also a little confused as to the dosing.  In the paper they say that they used 400 billion units daily but the product comes (in its higher dose form) at a strength of 40 billion. I suspect there is another product made by this company that may be available to only to doctors or researchers that is of much higher strength.

Either way, the results are interesting.  They found that there were no statistically significant differences in ADHD symptoms between the treatment and placebo groups, nor on mild “sub-diagnostic” autistic behaviors.  However, they did find that the product (in those with higher levels of inflammation) did reduce behaviors of restricted, repetitive and stereotyped behaviors in children, and also, helped with emotional regulation in adults.

I looked around for more information about this product and found a 2005 randomized clinical study done on critically ill patients on ventilators.[ii]  Synbiotic was compared to prebiotics only.  Inflammatory cytokine levels were measure in the blood, as well as days on ventilators, total days in the ICU, gut function, infection rates, and death rates (including from sepsis):  “From day 7, all patients of the Synbiotic group exhibited a progressive reduction of all inflammatory indexes in relation to the prebiotics only group.  Similarly they had a significantly shorter ICU stay and days on mechanical ventilation, less episodes of antibiotic-associated diarrheas and less distension and cramps…The overall infection rate was 34% versus 90%, respectively, while three patients from the prebiotics group died after sepsis…”

Holy smokes.

I don’t know if you’ve all been staying on top of recent research regarding COVID-19 and the biome, but of course, spotting an article about reducing days on ventilators and in the ICU made me think of the latest findings.  A good summary article of this appeared in The Conversation a month ago:  “Different species of the gut microbiome have pro- or anti-inflammatory properties and play different roles in regulating the immune system. In the context of COVID-19, a recent preprint study (not yet peer reviewed) showed that specific members of the gut microbiome were associated with severe disease and with immune markers known to be elevated in severe disease. The association of these gut bacteria with the immune markers was even higher than that of the known risk factors of COVID-19 severity: age and obesity.”[iii]

You can’t help but wonder if a product like Synbiotic wouldn’t help those in severe COVID distress.  ???   In the meantime though, at least we know there’s a chance it can perhaps help some symptoms of ADHD.

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[i] Skott E, Yang LL, Stiernborg M, et al. Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder – A double-blind randomized controlled trial [published online ahead of print, 2020 Jun 1]. Brain Behav Immun. 2020;S0889-1591(20)30057-X. doi:10.1016/j.bbi.2020.05.056

[ii] Voudouris, A, et. al. Benefits of Synbiotic 2000 Forte in critically ill patients: a randomize controlled trial.  Critical Care. 2005;9(2upp 1): P362.  doi: 10.1186/cc3425

[iii] https://theconversation.com/gut-reaction-how-the-gut-microbiome-may-influence-the-severity-of-covid-19-139094