Probiotics are a cheap and low-risk. If you have any general inflammation type issues that don't seem to have a cause, it might be worthwhile to just try probiotics.
My Dr. told me to try them for a digestive issue - and they sort of helped that.
But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable, and my skin really cleared up. I had red, flaky skin on my face for 20 years and suddenly it's gone within 48 hours of starting probiotics.
Yeah... post hoc ergo propter hoc, but it's a cheap and harmless shot in the dark.
Worst case scenario, it doesn't work and you're out $10.
I have a sample size of 1 as well. Probiotics didn’t help me but I’ve dealt with digestive issues for the last 4 years after a bout of food poisoning. I used to think gut flora / microbiome was quackery but I recently did an oral FMT (fecal microbiata transplant) the results were unreal.
For reference, I’m a 37 y/o fit male and donor was 18 y/o female. After 2nd week I got the deepest sleep since I was a child (slept for 11 hours straight - went to bed, teleported to the morning) and woke up with this hard to describe feeling. I literally felt like I was 16 again. This sort of optimism / happiness I hadn’t felt in years. And I’m a generally happy dude! All my symptoms went away and the euphoric feeling persisted. Whatever the bacteria did was truly remarkable. The bad news is a few weeks after the FMT was finished, things went back to the way they were before. I’d continue to do them forever but it was very expensive, $1400 for the month. Fwiw, I tried it again with another donor with zero results so I could have been a fluke.
I do think I’ll try it again with the original donor. It was a spectacular month. I really think the microbiome is a major key to our health and wellness. Remember the blood boy from Silicon Valley? I bet we see ‘fecal boys’ for rich people in the near future.
If you’re interested, I’ll link the source and study I based my dosage off below. The guy who runs the fmt operation very passionate about the concept.
I have no medical training. This is speculation only. Consult a doctor.
Assuming the translated gut flora to be the cause of your improvement then I'd look at two things. What bacteria the beneficial transplant contains, you can have it assayed (I believe it's called a bacterial culture test) and then find a cheaper source for that bacteria. Two, what the diet of the donor is, so you can try to replicate the beneficial environment in which those particular bacteria flourish.
AIUI, your own bacterial flora are in competition with the transplant. So, I wonder if a doctor would prescribe antibiotics (or something else) to wipe out your own flora, then the new flora (possibly with a diet change) would have a greater chance of taking hold?
I wonder also if the causal flow is different here, that there's maybe an underlying condition that is causing the gut flora to not prosper (like making an excessively acid environment).
According to books such as "¡Es la microbiota, idiota!" (ISBN 8413440688 but I don't know if it's available in english) it's not that simple, I think they said that not all the strains are identified and even then there are strains that aren't easy to grow in vitro (I'm NOT a scientist, don't quote me on this, I just listened to the audiobook).
What they make a point on is diet, she insists on the importance of having a diet that gives desirable bacteria strains an environment where they can thrive to achieve a balance.
IIRC she also mentions how it's not as simple as having "good" and "bad" strains and how balance is key.
It's a really interesting and funny book to listen to if you have a few hours for it.
So in the case of OP I think you're right about finding out more about the donors diet and replicating it as well as adjusting anything necessary for the newly arrived colonies to last through time.
I don't know sh!t about it nor do I intend to sound like I do so please correct me if I'm wrong.
Ha! As someone who has done clinical research on human subject on gut microbiome following blood & marrow transplants, this title is truly, truly great. My old lab needs t-shirts with that on it!
Do you think you would have slept like a baby if you knew the donor was a longshoreman that looked like Larry the Cable Guy as opposed to an 18 y/o woman? The way you describe the details with such fervor I'm surprised you didn't ask the doctor to skip the trouble encapsulating the sample in pill form and offered to dispense it yourself. In all seriousness I wonder if there isn't a subtle psychological effect that isn't being taken into account here.
Placebo effect can be very powerful to IBS[1] and other digestive issues, as well as anything psychological. It seems very plausible that this was just the "honeymoon" effect.
I get the influence of 'mind' over perception of reality but OP seemed to have a better time than the best coke newbie ever. His word are describing some golden dream of all people after 30, not just "it made me healthier".
I wonder if it would be worth finding out about the donor's diet, and trying to replicate it after the transplant in an effort to maintain the gut flora.
Not at all. They are just 00 size capsules and easy to swallow. Didn't bother me one bit. Personally, the idea of consuming someone else's poop is less bothersome than taking most pharma pills. Terrible logic, but that's just how I feel.
I got in touch but he is reluctant to recommend a dosage, order size etc. presumably for legal reasons.
How much did you order, were they prepackaged capsules, did you go on an antibiotic regimen ahead of time? I'm not sure if I want to take a chance at 1400 for a month that things rebound to the way they are now but I'm desperate.
This was a fascinating read, thank you for sharing. Were there really no lasting effects? I'm curious why the introduced bacteria didn't flourish and permanently change your microbiome. Can anybody weigh in?
It might be that they have to hit a certain critical mass to become self-sustaining. Or they require a particular environment to thrive, which exists in the donor but not in the donee. It's such a new field, at least for prescriptive medicine, that it'll probably be a while before we get a good base of understand of what lives in our gut, what it does, and how to keep it healthy.
The problem I have with "take probiotics" is that there are hundreds or even thousands of species of bacteria that could be classified as "probiotics". Which ones of these have positive influence on mood or physical health? How can a person know what to expect from a bottle of stuff at Whole Foods or where-ever?
This may not be the answer you're looking for, but a good start is just to go with the ones that humans have been eating for millennia: whatever's in yogurt, sauerkraut, natto, fermented pickles, etc.
I wonder if prebiotics are a better choice, with fecal transplants done for when you have a real issue.
For what it’s worth, and doctors obviously don’t suggest this, you can easily do a fecal transplant at home. By “easily” I mean that the process is simple, not that it isn’t super gross.
Something was coming up that'd wipe out my intestinal flora, and I'd been feeling extremely healthy lately. So I preserved a chilled sample of the 'good stuff.'
Usually I'd have all sorts of problems as the gut bacteria sorted itself out, but this time it was... smooth sailing.
Sure, it's... WEIRD in the extreme to actually perform. But I can't argue with the results.
I didn't even want to joke about that on HN, but it did cross my mind. Find a happy healthy person and (somehow) ask them for some fecal matter and do a transplant. Or just start licking butts... ugh
I think they found out when studying maternal vaginal swabbing for seeding microbiota Caesarean newborns that the bacteria were actually either airborne from the maternal fecal route or somehow getting into the baby from there
In the absence of more precise evidence, I’d recommend to aim for diversity, you’re more likely to pick up what you’re missing that way. You can also try diy lactofermented veggies.
Not entirely risk-free, but the side effects of a negative reaction don’t last too long at least.
I felt notably worse for about a week after trying one of the mainstream probiotic brands with strange brain fog I couldn’t shake. This effect was repeatable and I could start the malaise again by resuming the probiotic. The same effect didn’t happen with another antibiotic with different strains.
Probiotics could be worth trying, but you have to go in with the understanding that the possible outcomes are more than just “no effect” and “improved health”. Worsening is also a real possibility.
The brain fog could have been a consequence of the ensuing biological war you started by introducing a new strain of bacteria to your digestion for which your metabolism had yet to adapt to.
I did not imply probiotics were a panacea. Difficult to imagine such a biological war playing out in every host beneficially. Although the study you mention is concerned with an unusual fermentation process, which may be caused by a different biological mechanism.
I read the study. The risk is real tho uncommon, but the study was unable to determine if bacterial overgrowth was the underlying condition responsible for the symptoms, because they appear the same as those from D-lactic acidosis, caused by the same bacteria as found in common probiotics.
So whether the issue is too much bacteria or poor compatibly with a host remains unanswered by your linked study.
Probiotics are not necessarily low risk when used during or after antibiotics usage.
Quoting directly from [1] "Effect of Probiotic Use on Antibiotic Administration Among Care Home Residents: A Randomized Clinical Trial"
"...participants who were randomized to the probiotic group were administered significantly more antibiotics for lower respiratory tract infections, had small but statistically significant lower self-reported generic well-being/capability scores at 3 months, and a prespecified sensitivity analysis found a significant increase in cumulative systemic antibiotic days.
These findings should be interpreted with caution, given multiple testing. However, this study does not rule out harm from probiotics. Certain probiotics may delay the return of the host gut microbiome to its normal state after antibiotic treatment,[2] and a retrospective single-center study found probiotic exposure was associated with C difficile infection in hospitalized patients.[3]"
[1] Butler CC, Lau M, Gillespie D, et al. Effect of Probiotic Use on Antibiotic Administration Among Care Home Residents: A Randomized Clinical Trial. JAMA. 2020;324(1):47–56. doi:10.1001/jama.2020.8556
[2] Suez J , Zmora N , Zilberman-Schapira G , et al Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell. 2018;174(6):1406-1423.e1416. doi:10.1016/j.cell.2018.08.047
[3] Carvour ML , Wilder SL , Ryan KL , et al. Predictors of Clostridium difficile infection and predictive impact of probiotic use in a diverse hospital-wide cohort. Am J Infect Control. 2019;47(1):2-8. doi:10.1016/j.ajic.2018.07.014
There is a risk here we are not talking about; Some significant number of people die every year trying low risk solutions to high risk problems, while not being qualified to judge risk.
Probiotics, tinctures, vitamins and a gluten free diet basically killed a friends mother who spent years on these things while her undiagnosed stomach cancer spread everywhere.
The issue as i see it, is that there is profit to be made stringing people along from one 'cheap and harmless shot in the dark' to the next.
I don't think people are advocating to not see a doctor and discuss issues, but that there are intermediary steps that can be tried. Sorry to hear what happened to your friend's mom. I've seen the opposite where doctors will over prescribe and rarely ever test and that ends up killing people too. There is absolutely nothing wrong with trying supplemental treatments and it is really no different than OTC remedies that people spend billions on each year.
Probiotics will compete with whatever is in your gut. If you have a messed up microbiota, then that would be a good thing. If you have a healthy microbiota, then taking probiotics could backfire. Taking probiotics can slow down the recovery of your original microbiota, after taking antibiotics:
> But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable
What are you even buying if you don't mind me asking? I don't get acid reflux often, but I definitely want to prevent it happening so often, because it continues for days when I do get it. There's all sorts of things that say they have / are probiotics, including a few different sodas out there.
Culturelle. Just their basic "Digestive Daily Probiotic". It's a single strain Lactobacillus rhamnosus. My Dr. suggested either that or Align.
The first thing I tried worked so I haven't tried anything else. A friend of mine had the same problem and he buys generic bulk acidophilus from amazon and he says it works for him.
I didn't expect it to work, but I didn't want to wonder if it failed because I cheaped out, so I went for the expensive stuff.
Definitely going to try this too. I go though periods of acid reflux and it wakes me up. I sleep with 2 pillows so raise my head and shoulders to prevent it waking me which helps most of the time. But will give the probiotics a try. Thanks.
They are not risk-free, also not in inflammation type issues. In this (RCT) trial in patients with acute pancreatitis, probiotics actually lead to death (with no deaths in the control group). [0]
Was that OTC probiotics? Most of them seem to need refrigeration, and I'm surprised they are not sold as such (just placed on non-refrigerated shelves in stores or sent by mail in a normal box without cooling).
The only one I've ever taken is "Culturelle Digestive Daily Probiotic". It comes to $0.50 per pill. There are much cheaper generics but I haven't had the guts (no pun intended) to switch away from what's working to try them.
Inulin is classified as a dietary fiber. It's an indigestible polysaccharide that ends up being eaten by microbes in your gut.
A lot of packaged foods that are high in fiber that you wouldn't expect to be, have inulin. I remember buying some plain 'greek' yogurt for a while that was advertising fiber per serving, and it had added inulin. Anything containing chicory or jerusalem artichoke is probably high in inulin.
If you're not used to eating it - and this is true of a lot of dietary fibers and prebiotics - be prepared for gas. Like potentially uncomfortably large amounts of it. That side effect is supposed to lessen as your gut adjusts to the change, though.
Not at all, although I'm beginning to feel like a bit of a shill for the company.
I use "Culturelle Digestive Daily Probiotic".
My Dr. suggested either that or "Align". His comment on that was that they are delivery systems that are designed to let the bacteria survive the trip through the extreme environment of the stomach.
I finally beat my digestive issues and chronic fatigue (physical depression) which lasted 3+ years from 2019-2021. Without getting too far into it, here's the stuff that finally worked, weighted by immediacy on a scale of 10:
- 10: Eating a serving of Brussels sprouts, preferably daily
- 10: Taking about 3 psyllium husk capsules occasionally with FODMAP and spicy meals
- 10: Taking a digestive enzyme occasionally with FODMAP and spicy meals (Digest Basic, no affiliation)
- 10: Taking a "stress" B complex with 100% daily, instead of 1000% weekly (Nature Made, no affiliation)
- 10: Avoiding all beans, unaged dairy, whole-grain wheat and most tree nuts for a few months
- 8: Drinking at least twice as much water as I feel that I need, from one big container over the course of the day
- 8: Eating plain giant salads with dressing, preferably spinach-greens mix, several times per week
- 8: Drinking Kefir daily
- 6: Trying several different brands of probiotics occasionally in no particular order
- 6: Eating 1-4 eggs per day, preferably on post-workout days
- 6: Taking an iodine supplement initially, a few times per week until the bottle was gone
I think what kicked this all off was dabbling with keto 5 years ago which might have cost me most of my tolerance to milk, and prolonged dehydration from intense workouts and large servings of protein without proactive hydration. When I lost my gut health, I may have picked up bad bacteria or parasites from food poisoning or raw seafood. I was also under debilitating stress during the last few years at my previous job, so began every morning on an empty tank spiritually. I never listened to my body until my health failed and it made the decision to stop for me.
The biggest change has been that being tired feels ordinary and rare, with no emotional component. Instead of the crushing "universe is against me" sense of being attacked, alone and hopeless knowing there was no end of it in sight, which I endured for many years before my physical health's deterioration finally caught up.
I can give some context for what may have happened because I went through something similar.
My two cents is the biggest factors were the keto and the stress. A low carb, high fat diet does not traditionally feature intact plant cell walls, or what we otherwise know as "fiber". There are literally thousands of different of variations of "fiber" of which we have catalogued only a few, but these structures feed the microbiota in your gut. And they really do depend on fiber in a profound way.
Without this fiber, they tend to starve and adjust to feed on the epithelial lining of your gut. It also gives an opportunity for the pathogens in your gut to "takeover", especially when paired with the stress since most of the "beneficial" microbes will tend to die off.
When you read stories of people who got an autoimmune problem, there's almost always a period of severe stress prior to it. My working hypothesis is this impairs the immune system which is what keeps the pathogenic bacteria in check through several mechanisms (pathogen-associated-molecular-pattern detection or PAMPs for instance).
Through much, much trial and error and a lot of scientific article research, I've found the most consistent way to restore microbiota ratios is with Vitamin D, followed by a clinically tested probiotic like Visbiome, followed by Kefir. The Vitamin D alone at moderate to high doses will get you very far, although it doesn't necessarily restore diversity (since Vitamin D in of itself does not contain any microbes) but it helps shift the balance of microbes through a variety of biochemical functions.
Vitamin D also helps with gum disease in my experience and in a way no other supplement or product has so far. Highly recommend and you don't even have to take a high dosage to see it for yourself. You just have to be consistent.
One last thing I'll say is that for whatever reason taking the supplement seems to work better than exposing yourself to sunlight, which is unusual, but there may be something about the biochemical pathway Vitamin D takes when consumed as a supplement as opposed through the cholesterol-synthesis that happens with UVB.
"Through much, much trial and error and a lot of scientific article research, I've found the most consistent way to ..." etc..
Unless one has done proper, randomized, medical trials, I don't see how anyone could use such unambiguous language.
These n=1 experiences lacking in objectivity and also likely proper measures might help us discover new ground for things that might work (i.e. the basis for a trail), but without any testing it's not something any reasonable person should be walking around saying 'works', unless you mean to indicate you're referring to the literature.
You remind me of those doctors that needed clinical evidence to prove babies don't feel pain during surgery lol.
But I will say, everything I've said lines up with the scientific literature, so I can have my cake and eat it too, backed by both personal experience (skin in the game) and an informed understanding of the biochemistry at play and randomized, controlled trials with large populations.
If you're curious, and not just trying to nitpick out of a deep, misplaced sense of cyncism, I highly recommended diving into the literature and doing some reading.
Elicit.org is one of my favorite tools for gathering information, although the "Takeaways" can be sometimes be wrong so I highly recommend reading the abstract too.
You remind me of the legions of people on the internet who think they have understood or discovered something due to dubious interpretation of relationships which are non-causal, especially among application of self care or care of others.
I have a colleague who hands out TCM 'remedies' every day, she and her patients all believe they work, in the medical sense, in a very rational way.
Even though 'Western Medicine' has a pretty good foundation, it's layered in complexity and ambiguity.
So if someone had some recurrent, acute issue, that was solved with some diet or action change that was discernibly impactful - maybe. That would be worthy of note.
For example: "I had chronic fatigue - mostly we changed my diet to low carbs, no alcohol, regular sleeping and basic cardio + vitamin D due to deficiency and within a few months it was gone". That rings reasonable.
But 'these are 10 things that worked' raises many red flags.
I've had CFS myself - and ran the gambit of different angles of attack on it, and it's a tricky set of symptoms that doesn't even represent a verifiable ailment: CFS, lethargy etc. is the result of a bunch of different things which we do not even fully understand.
More important note what I just said: 'symptoms' not an 'underlying condition'. There are multiple things that cause them. Even the notion of treating 'symptoms' before arriving at a proper diagnosis is a pretty giant red flag.
Some of symptoms described could feasibly be the result of forms of ulcers, cancer, HIV, iron deficiency, kidney problems, liver problems, adrenal gland problems, gluten intolerance etc. etc..
So no - we don't just go to 'Probiotics and Vitamin D' - necessarily.
Personally - getting rid of energy drinks and sleeping a regular schedule 'cured' me but it's rather impossible to tell what did what. But merely seeking medical advice, and knowing it was not 'something serious' (like Cancer) was a huge load off my shoulders, which can affect recovery dramatically. In fact, I literally started feeling better the day I knew I wasn't dying. But that's just me.
If someone is feeling tired consistently and it's clearly not due to some obvious event or issue - then they should !! see a doctor !! and go from there.
I’ve arrived at similar conclusions and it seems roughly inline with research on gut biomes. My own autoimmune condition began after a stressful period with a negative emotional aspect. I’d also been eating less “healthy diet too”, etc.
The first line is vit-d and pro-biotics, especially if you have heavy inflammation and microbiome issue or have taken antibiotics.
Alongside those would be eating a generally “higher quality diet” with a fair bit of variety. Reducing sugar and avoiding highly processed foods and preservatives helps significantly. Foods with less antibiotics help too, so items like free range eggs, organic milk can be helpful. Vegetables seem less affected by organic or non-organic.
Fermented foods are pretty important in providing a wide variety of microbes. I’ve noticed that lots of traditional spices like turmeric or black pepper are beneficial. I have a pet hypothesis that most “traditional diets” in a region would adjust to include useful spices and come to “taste good”. Almost every regional cuisine also used to have a staple fermented food. Nowadays fermented foods are generally replaced by vinegar substitutes nowadays (sauerkraut, pickles, Kim chi). Ketchup has roots as a fermented chutney like tomato sauce for example. Obviously kefir and such are different.
Going more keto or alternatively vegetarian doesn’t matter as much once your gut biome can shift. Though often going keto or vegetarian tends to get people to start eating better quality food. It also encourages a wider variety of foods which help prevent mono-cultures forming in the gut microbiome.
However good food isn’t a cure all, just a helper too keep the microbiome healthy. It can reduce chronic inflammation alongside vit-d.
Thank you for sharing about the importance of fiber. What seemed to work for my wife: a regimen of three times daily for two weeks of herbs for dysbiosis (dill, tarragon, thyme, olive leaf and wormwood) then repopulation with fermented foods (mostly sauerkraut) and large intake of various fibre from beans, seeds, greens, and fruits.
I've noticed my mental health is so much better when I'm outside for an hour a day. I worry about aging and skincare, but decided I'd rather look old but be happy vs be miserable and look good! I generally wear a hat and high spf on my face, neck and chest but let everywhere else soak up the Vitamin D.
You can't do all that stuff to yourself - and - go through COVID (and other things) which has caused widespread depression, and assume any of that had an affect one wary or another without a fairly big randomized trial isolating all of those elements.
Even just the notion of 'regime' will change people's psyches via placebo.
I mean, I would certainly 'feel' healthy if I did such a list of 'ostensibly healthy things'.
That said, I wouldn't doubt some of it did, and that we are just barely beginning to understand gut health.
Contrary to popular opinion, it is possible for an individual to somewhat confidently conclude that X helps them as an individual without checking it against large randomized trials.
It's handwavy about some things but it doesn't assert anything beyond "I did this list of things and I, as an individual, am better now."
It’s not as rigorous as a controlled double-blind clinical trial, but you can definitely experiment as an individual by trying different combinations on different days and looking for patterns. One example is the common recommendation to introduce new foods to babies one by one so any food allergies are more apparent.
It's a single comment covering an unspecified time frame with no explanation of how much research, tracking, etc was involved. It's the TLDR of their experience in hopes of nudging people in the right direction and saying, in essence, "anecdotally, fixing my own gut issues has correlated with fewer mood issues. Here is some food for thought if you want to try to do the same."
The OP isn't selling anything, so it's not infomercial logic which is designed to get you to buy a product.
The gut is complex. I wouldn't expect one single thing to fix it.
It's a very thorough comment, iterating very specifically a dozen 'medical solutions' down to a 'weighted rating out of 10' (!) of the value each one of them.
Again - I'm not doubting anyone's intentions, but I'm fully doubting the veracity of all of this.
'Self Medicating N = 1 Belief' - is extremely common among people.
Even among diligent, intelligent people who actually can and do 'research'.
But with a single 'blind spot' in self awareness, it goes awry with these kinds of 'beliefs'.
Everyone who works out at the gym consistently has a 'belief' about a lot of things.
There are dozens of magazines and quasi health magazine's offering these kinds of solutions.
It's frankly as old as time and probably more common than not.
I had similar issues. I went and saw a functional medicine doctor, had a stool test and he diagnosed me with candida overgrowth. Which may be what you had. Here is the diet protocol for beating back candida, which is similar to the diet you put yourself on. https://www.thecandidadiet.com/
Thank you, I suspect that I had a chronic infection of some kind like that. I'm leaving out a lot of details about my experience, because it's private and I lost hope several times. I want to stress that my self-medication and self-diagnosis prolonged my suffering. So please if anyone is reading this, see a doctor. They can run these tests and many more:
Antimitochondrial antibodies (AMA)
Baylisascaris Procyonis intestinal roundworm
Celiac
Epstein Barr virus
Exocrine pancreatic insufficiency EPI
Find a medication that does what ashwaghanda does (like Wellbutrin?)
H. Pylori
Hashimoto’s
Lactose intolerance
Lyme disease
Parasites
SIBO
Testosterone level
Thyroid level
Wheat sensitivity tests: 1) wheat allergy 2) celiac 3) non-celiac gluten sensitivity 4) non-celiac wheat sensitivity 5) non-celiac wheat intolerance
Worms
So half of those issues can be caused by candida overgrowth. If you get rid of the candida your body will reduce it’s heightened immune response and things like epstein barr and hashimotos will go away, testosterone will increase, etc.
Did you feel any different or notice change as it was dying off/reducing? I was treated for a fungal infection a while ago with some anti-fungal drugs and the side effects felt huge, but the doctor told me those drugs are considered very mild. It made me wonder if the fungus was affecting the way I feel and it dying down made me feel differently (better, but it was a big change).
I was also on antifungals and yes it was quite brutal. I was quite tired and had a red flush from the die off. I took off the shelf liposomal glutathione to help clear out the oxidative stress.
I can't give instructions that specific but despite my sometimes spastic post history, having a healthier diet (yogurt in the morning for "breakfast" + 2 small meals, (as in an espresso and a croissant) then a big meal in the evening + no liquid calories (booze counts) helped me drop 50lb.
Another key seemed to be avoiding artificial sugar.
Following these heuristics (not rules - strict diets encourage you to chase losses if you slip up) seemed to help more than any strict diet, though it helps with depression, not anxiety, which is mostly situational.
(This is a news site. The news is not good right now, even here, away from war and famine in the "tech world".)
I understand that you're both skeptical, as you should be.
My theory now is that ADHD is tied to diet and environment.
So basically what happened was, my psyche was already vulnerable to anxiety and depression when it got coopted by my physical health issues. I struggled chronically to make an appointment to see a doctor for years, always letting work and family obligations take priority, which prolonged and exacerbated my suffering. This all happened while I was broke and out of work too. After years of being gaslit about my instincts, going all the way back to childhood. That's why I didn't listen to my intuition and just take care of myself. I still thought there was nothing wrong with me, so projected my false confidence onto the world by blaming it for my problems.
Please view the list I posted more as leads than evidence. Also you're right, none of what I posted really applied to me until I hit 40, except maybe the general health advice about drinking more water and eating better. I do worry about leading people astray in their own journeys.
>My theory now is that ADHD is tied to diet and environment.
I agree that it is, and it has shown to be linked to diet & environment. ADHD isn't strictly defined enough to be only diet & environment though. There's a whole bunch of ADHD symptoms that present as a result of an underlying health condition. Hypo/Hyperthyroid problems look like ADHD-PI and ADHD-H. Vitamin deficiency and environmental poisoning can create symptoms too.
But also some people have it regardless of those factors, so it's really a broad label at the moment which could do with a lot more refinement.
Brussel sprouts grow on stalks and not in the ground like carrots or onions or potatoes. You may have gotten unlucky with an unusually dirty batch, but rinsing with water should be enough in any case.
Roasting with bacon is a delicious, if less healthy, alternative.
Sorry, I should have added some details to this one. My eyebrows had mostly fallen out by the end of 2018, and my dad (a dentist) pointed out that maybe my iodine levels were low. That used to be really common a century ago before iodized salt, and many of my elderly family members have had thyroid issues.
I took "thyroid energy" (NOW Foods, no affiliation) which has some additional micronutrients like selenium and felt shockingly better within just a few days.
Evidently gluten can sensitize the immune system into fighting proteins in the thyroid. Also Hashimoto's thyroiditis can cause the thyroid to spike up and down so it gets missed in yearly screenings. And celiac disease plays into it too. And it didn't help that where I live in Idaho had radiation levels 80 times higher than normal after Fukushima. Hormones are so powerful and glands are so sensitive to the environment that it doesn't take much to disrupt them. Also trace minerals like cobalt have been depleted from soils, but are involved with vitamin B12 which prevents anemia. I think that my high consumption of beans and foods high in anti-nutrients might have bound up minerals and made me deficient, even though I was eating plenty and working out.
Anyway, I was tested and my thyroid is fine, but it's important to remember that gluten is inflammatory for everyone. Even sugar and alcohol are inflammatory. So someone can get symptoms whose cause is difficult to isolate, even if their tests come back negative.
But I'm angry/concerned that I had to derive this information myself over several years. Why is this not one of the top news stories, when hypothyroidism and obesity are rampant? I blame the Big Ag lobby, factory farming and the passion with which people believe the mainstream news.
Wow thank you for the reply! I've heard similar things about soil being depleted of iodine (will research cobalt) in Australia and other places. They ended up putting a law in place in like 2008 to have all bread for sale be made with iodized salt to get the iodine intake back up.
>But I'm angry/concerned that I had to derive this information myself over several years. Why is this not one of the top news stories, when hypothyroidism and obesity are rampant?
Holy sweet crackers, yes. It's crazy how much information we have access too and so very little useful knowledge gets delivered, particularly on health and this topic.
Never even heard of an "anti-nutrient" and while I skim a google search, I'll read up on tannins as I drink some hot tea regularly. Thanks for the post again.
Skip down to Figure 1 to see the chart. Note that the response to placebo is normally extremely strong in depression studies, so it’s normal to see both groups improve drastically like this.
The only thing that jumps out to me is that the probiotic group started with HAM-D depression inventory scores that were notably higher. When measuring absolute reduction of HAM-D scores, this actually leaves the more depressed patients with more room to improve and can therefore inflate the perceived effectiveness of their response, placebo or otherwise. And indeed, both groups had basically identical scores at the end of the trial. They only really diverged at follow-up where the probiotic group had improved slightly more than placebo.
I’ve seen enough probiotic stories that failed to pan out later that I’d take this one with a huge grain of salt. Trying probiotics might be worthwhile if you can afford them, but the probiotic-depression link never seems to actually play out from online anecdotes of people taking them. Note that we’ve been seeing small studies about this exact topic for a long, long time.
Very good insights. Still I am surprised by one point: why do you use the verb "afford" for probiotics? Kefir from milk is home-made and 1.5 buck per liter at most.
HN users seem to have a habit of posting crap science wrapped up in impressive sounding news stories, and it's kind of annoying. This is meant to be a group of intelligent people who should have the ability to click on the link to the article and look at the actual results.
The community has grown a lot. A ton of junk is posted (a ton, browse new for a while) but the real deal here is that sometimes enough people upvote the junk to frontpage it. I don't know why but I think sometimes some people just want certain things to be true.
I'm speaking from anecdotal evidence here but I have seen a lot of research that indicate the digestive tract is basically the primary storage of serotonin. And whenever I get chronically depressed I also get chronically constipated. I don't necessarily think probiotics are a magical cure but I think anything that aids with digestion and moving things through the digestive tract can help.
> the digestive tract is basically the primary storage of serotonin.
What does this even mean? Monoamines aren't fat or glycogen stored in the body. The digestive tract has serotonin receptors, like the brain, but they differ in purpose entirely. Monamines are just messenger chemicals. Their context determines the actual message. I get it... it makes sense, humans are basically worms and worms are basically digestive tracts, that's our main thing, but taking this fact and making predictive science out of it is not trivial at all and anecdotal evidence means absolutely nothing so please never ever ever ever mention it in public forums.
Serotonin does not cross the blood brain barrier. Quite often neurotransmitters are used in different parts of the body and have different purposes.
Gut motility is driven by the autonomic nervous system. The sympathetic nervous system controls colon motility, and the parasympathetic controls digestion and stomach emptying. Depending on the type of depression you have, it can alter the HPA axis up or down. Let's say you have the "don't want to get out of bed and do anything" type. In that case your HPA axis is likely underactive. That results in reduced sympathetic nervous system activation (as it operates in parallel with the HPA axis). That then results in reduced colon motility and constipation.
Sometimes often I get constipation at weekends for this reason. I'm not depressed, but if I don't do much at the weekend after a busy week then (I assume) my HPA axis reduces, and that causes constipation.
A healthy gut microbiome has a diversity of bacteria. You want to have a healthy gut microbiome because it has an incredible number of interactions with your nervous system, which can impact mood, energy, and brain function.
Below is a quick rundown of the essential tools for feeding one's gut microbiome.
- Prebiotics: Carbohydrates and fiber that our body can't digest but act as food for the bacteria in our gut.
- Active culture foods: Yogurt, sauerkraut, kimchi, etc that contain active bacteria which support the growth of other bacteria.
- Probiotics supplements: contain live active cultures.
If you have a depleted gut microbiome due to stress, disease or recent usage of antibiotics, probiotics are useful to restart the gut microbiome but probably aren't needed for maintenance. Instead, you may be better off eating a diet that contains a healthy amount of prebiotics (fiber, complex carbs) and fermented foods.
I read this take somewhere that we are basically a vessel for our microbiome / gut Flora. Our moods, what food we crave, how social we are might all be impacted by them, in which case they do have some sort of control over not just how we feel, but how we behave. For instance if you eat a lot of sugar, you will crave more sugar, and the argument would be that it's the bacteria that have developed in your gut that are causing you to crave that sugar because that is what they consume (vs the more human-focused evolutionary argument of "sugar was rare and so humans have evolved to crave as much of it as they can get").
Reality is probably a mix of both (ie we are a complex system with wants/needs influenced by both our own body and the Flora that live within it).
Garbage in, garbage out. Everybody wants a pill or supplement rather than adopting healthy eating habits.
My "chronic" acid reflux disappeared by simply doing what I already knew I should be doing: Eat fruits and vegetables. Fish > chicken > beef > pork. Don't buy snacks or sugary drinks. You aren't hungry, you're bored.
I wish doctors would treat the whole person rather than prescribing a pill. I wish my doctor told me to do these things before prescribing me omeprazole when I had an issue.
However, the level of these health-promoting gut bacteria decreased again over the following four weeks. “It may be that four weeks of treatment is not long enough and that it takes longer for the new composition of the intestinal flora to stabilize,” explains Anna-Chiara Schaub, one of the lead authors of the study.
Or maybe it's a moving target and people eat every day and their eating habits are part of why their gut is a mess to begin with.
I have always had a significant mood boost from taking probiotics - either from food or as supplements. Some forms of probiotics make me overly happy to the point that it is detrimental to my life. Recently I started taking these probiotics - seed.com - and find them reasonably balanced. You will see improved mood and sleep for a few days but then not much - not sure why it doesn't persist. I am still continuing with these because they seem to be helping with other digestive issues. I also notice way more mood improvement when eating Sauerkraut so try to eat a couple of tablespoons of it everyday. I have experimented enough with microbiome related stuff that I am fully convinced they play a major role in ones health (including mood and energy). That said, there is way more to it than simply the species of bacteria. Where those bacteria are located in the gut (small or large intestine or colon), what other species are there, your genetics, your diet, lifestyle, your psyche, etc., all play a part in their functioning. I wish there was a more "big-data" approach to figuring out things than researching one species at a time.
Sample size of 1 here, but hopefully worth the read.
I got food poisoning while abroad shortly after college, and took some shitty OTC antibiotics. I was low-grade sick for ~1 month, and when I came home I started developing IBS which got progressively worse over the next few years. FODMAP saved me, but at the detriment of needing to eliminate a lot of foods that I loved eating.
Recently I started eating 2tbps of chia seeds with some lemon juice and water daily. Chia seeds are incredibly fibrous. Over the next month, my stomach seemed to get permanently better - I can now eat larger quantities of some of those "problem" foods without debilitating side effects.
The bacteria in your gut affect a whole lot of things. And there are competing cultures, all of which like to eat different things. My hunch is that I coaxed the fiber-loving ones back to health, and they in turn did me the favor of repressing the cultures that liked fermenting beans and cruciferous vegetables. There's a lot we don't know about our gut microbiome, but my guess is that eating high-fiber, high-diversity diets is a much better solution than taking a pill.
Hmmm not very impressive. See figure 1. Placebo and treatment group have identical depression scores post intervention, and the small difference at followup is the same amount as the difference between groups.
I've had bad gas most of my life. I just kind of assumed it was me and there was nothing I could do about it. I started on 10 Billion CFUs of Lactobacillus Acidophilus [0] a few weeks ago and my gas went away in literally one day. I take 10B CFUs every day or every other day now (every other is probably sufficient), and it's still gone. I'm literally amazed. I started taking it because I saw a video from Dr. Eric Berg [1] about how to deal with a potential candida overgrowth.
Antidotally, I recently started taking a probiotic and have had great improvements in digestive health. I also have a chronic digestive disease.
Ritual recently launched a probiotic which includes the two most studied strains, LGG and BB-12. Our formulation and technology is very much driven by science. Maybe it’s right for you.
Off-topic: Please don't take this the wrong way. What sorts of engineering does an engineer at Ritual do? From an outside perspective it's just a website selling healthcare products. Is there some sort of big data driven approach to developing the products?
None taken and thanks for asking! I'll speak generally about this, at some point eCommerce sites will out grow what Shopify/etc offers. They need better integration with their partners and better control of their data. We rely on data to help measure the outcomes of decisions we make. This is not just engineering, but the whole company. The engineering side operates very much like any other software startup where we iterate on features that will help us grow and support our existing customers.
A fun example is that we did not have the concept of a cart at the very beginning. You don't need a cart when you only have one product, so why spend development time building that? My most recent work has been performance because that was worth spending time on now. Before that, I worked on allowing customers to update their subscriptions via an email magic link for the launch of Synbiotic+ (the probiotic). We then look at our data to see how effective our efforts were in supporting the hypothesis which initially kicked off the work. Hope that helps!
Visibiome has OTC and rx-only probiotics products, the latter of which is used to treat severe IBS and ulcerative colitis. Their OTC products are also very high potency and regularly recommended by doctors as well.
Also, nicer grocery stores typically have a refrigerated probiotics section, and those are typically good brands as well (Garden of Life is one). Generally, shelf stable probiotics are less potent and varied in cultures than ones requiring refrigeration.
>Visibiome has OTC and rx-only probiotics products
It's worth pointing out that the actual biotic payload is exactly the same between the two products, only the dosage is different.
In other words, taking two packets of the regular unflavored powder should deliver the same payload as one packet of the rx-only "extra-strength" powder.
I suspect the only reason the higher strength product exists, and is rx-only, is so that it can be covered by health insurance for some people.
Sure, I was pointing this out only because it's a signal that their product has gone through a more rigorous approval process to be accepted by insurance
I think the market is flooded with supplements, while you can help your gut bacteria with natural products like kefir (kind of buttermilk), kombucha, kimchi like products. I happen to love all those mentioned.
Those are all very bad recommendations. Buttermilk is loaded with cholesterol and saturated fat, kombucha with sugar, and fermented vegetables like kimchi have shown to increase prostate adenocarcinoma. You want to regulate your gut flora with a variety of whole plant-based foods, not quick fixes like pills and a jar of stinky cabbage.
Neither dietary cholesterol nor saturated fat nor sugar are bad in moderation, and that's completely orthogonal to the point of them providing probiotics.
> "fermented vegetables like kimchi have shown to increase prostate adenocarcinoma."
Since you did not link to any literature backing up your claim, I want to share this paper[0] as a counterpoint. Kimchi has been found to have active ANTI-cancerous effects, opposite to your claim.
I have half glass of milk with kefir cultures, only, and I keep in the fridge. I use it also ad sauce, because the cultures get big and it gets concentrated and strong.
> Probiotics maintained microbial diversity and increased the abundance of the genus Lactobacillus, indicating the effectivity of the probiotics to increase specific taxa. The increase of the Lactobacillus was associated with decreased depressive symptoms in the probiotics group. [0]
Also, the citations in the wikipedia article are hilariously biased.
> Presented at the satellite symposium “First Global Summit on the Health Effects of Yogurt." The conference was organized by the ASN, the Nutrition Society, Danone Institute International, and the Dairy Research Institute
Another paper was straight up one paid consultant writing an industry-funded article. Here's who edited and reviewed it:
> Editorial assistance was provided by Chill Pill Media LLP, which was contracted and funded by Danone Institute International.
It's hilarious how desperate the dairy industry is to cook science.
Somehow I remain skeptical that the dairy (and meat) that humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns. I think it's a wee bit more likely that when you're morbidly obese with diabetes, like in that study, and you feel better after eating a controlled, healthy, low-calorie diet, it can be attributed to factors more relevant than veganism.
> humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns
They literally haven't eaten meat, dairy and eggs 3-5x per day. This is a new phenomenon in the last half-century. And to go back even further, our biochemistry is millions of years old, and is frugivorous in nature. We have no physical adaptations to eating meat. We only started doing it recently as a means of survival when humans left their tropical niche.
> a controlled, healthy, low-calorie diet
Plant-based foods are naturally low in fat, which is calorie dense, so such a diet is in fact ideal for weight loss.
How curious that we are so perfectly able to digest it and thrive from it! I wonder why so many other herbivores didn't get so lucky.
> Plant-based foods are naturally low in fat, which is calorie dense, so such a diet is in fact ideal for weight loss.
Yes, of course a low calorie diet is ideal for weight loss. What does this have to do with cows milk yogurt? Are you an obese diabetic? If not, I don't see the relevance between your links and the avoidance of milk.
> How curious that we are so perfectly able to digest it and thrive from it! I wonder why so many other herbivores didn't get so lucky.
Humans can also eat and digest shirts, pencils and small pieces of plastic. And you didn't provide any evidence of any adaptations we have to meat eating. Check and mate.
We can't derive nutrition from wood or plastic. We derive excellent nutrition from meat, because we have the requisite enzymes. That is the adaptation.
“What we now know is that probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid,” he said in the press release. “So, if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing lactic acidosis and brain fogginess.”
because probiotics are the "ones that mother gives you [that] don't do anything at all"
(Right up there with Vitamin D supplements. Everything good, like low blood pressure and your team winning the Superbowl seems to be associated with high vitamin D in the population and everything bad is associated with low vitamin D... But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl.)
> But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl
Because you need UVA to convert the vitamin D to nitric oxide, and if you're getting enough UVA to do that then you're also more likely to already be getting enough UVB to create sufficient vitamin D in the first place.[1] Not super complicated.
Taking vitamin D supplements is probably still better than not taking them if you're deficient, but if you understand the mechanism of action then it should be obvious as to why the science is always equivocal.
[1] Or, more precisely, vitamin D regulates nitric oxide synthesis.
You need to get it from sunlight. Modern man has way too little sun exposure, and the meme of everyone being afraid of sun and using sunscreen obsessively exacerbates the problem.
You're commenting on a post about an RCT that does show probiotics having an effect...? And AIUI, there's plenty of other evidence of a) their efficacy for changing the gut biome and b) the gut biome's causal effect on a variety of health issues.
An rct with n=40 is better than the junk non-controlled studies that inexplicably get funded and accepted by journals but probably meaningless for something involving something as subjective as mental health.
I'm doing a trial of Sugar Shift[0][1], inspired by William Davis[2]. There may be a small improvement in my mood, but not enough to say with certainty. I'm not doing any tests to monitor for the other possible benefits of the supplement. Two weeks into the trial, I have a mouth sore, which is rare for me (less than one occurrence per year). This may be coincidental, but I discontinued the supplement for the time being.
I don't have a blood glucose problem particularly, but I am hoping to reduce inflammation. The manufacturer offers several probiotic supplements, and Sugar Shift seems to be the most comprehensive.
About 90% of serotonin is made in the gut [1]. This is one of those things that helps us with being happy and an unhealthy gut produces less. So, this makes sense.
Seratonin is produced in multiple places in the body (not just the brain, and apparently, most of the seratonin in your body is not produced in the brain), but doesn't appear to cross the blood-brain barrier.
I'm not a doctor but I think what that means is "seratonin in your gut probably doesn't make it's way to the brain; but, the rest of the body is already awash in seratonin, so additional production in the gut can help increase those levels, which may have some sort of yet-to-be-understood action that has an impact on depression"
There is no serotonin in pills. SSRI stands for selective serotonin reuptake inhibitor. It is a chemical that modifies how certain cells reabsorb serotonin.
The problem is that you have to take them often to colonize your gut, so it becomes a bit expensive, and it won't work on everyone, depending on their gut (since scientists know too little about the gut).
My hypothesis is that probiotics also need to be paired with the right diet. Bacteria needs to be fed, and needs to compete with the existing gut flora. If conditions aren't right, then they may never get a foothold.
Yeah and honestly I don't think there is a "right diet", because that might be highly dependent on the person, his/her food history, medical past, antibiotics, genetics, physical activity, the "initial gut bacteria" at birth, breast fed or not, etc.
Of course one can expect the usual "less sugar and fat, more macro nutrient", but unless there's proof and proper cause-effect relationships, it's going to be complex to draw conclusions. I'm not really sure that sugar causes a bad balance in the gut bacteria.
Not to mention all the chemicals in food and the environment that makes it almost impossible to track what could work and what would not.
I've heard that most of a probiotic dies in the stomach. That what you need is probiotics: foods that make the gut more friendly to the right types of bacteria, which basically amounts to 'a range of vegetables'.
My wife as been on SSRIs for years. Anecdotally, a few years ago, she noticed when she forgets to order her probiotics she slides into a malaise after a few days. For both of our benefit, I now make sure we never run out.
https://www.amazon.com/Probiotics-Billion-CFU-Prebiotics-Aci...
they were using the HAM-D instrument to measure impact. The probiotics group appears to have initial +2 HAM-D (19 vs 17), and have -1 at follow-up (7 vs 8).
This is for relatively small N (21 completed probiotics course, 26 placebo), and the fact that the difference is smaller at the end vs at the beginning says 'within the noise' to me.
results section also notes probiotic group had twice the drop-out rate of the placebo group (30% vs 13%)
I've also had anecdotal experience in agreement with this. There have been many studies on this but most of them have a similar small sample size. Wonder why it hasn't been conducted with a larger sample size yet, or maybe it has but didn't find anything so it's not being posted on HN ¯\_(ツ)_/¯
The original study [1] uses Vivomixx in about double dose.
According to them it's because it is easily accessible and has multiple strains of bacteria in it (they were not trying to go for one strain in particular).
I don't know much this topic, but if you are looking for supplements make sure they are refrigerated. Yogurt is probably the easiest/best way to ingest them though instead of specific pills.
Almost as if the gut microbiome (and by extension, the food we eat) has massive influence over our mood, health and autonomy. Crazy how that's a novel concept to people still.
Probiotics are a cheap and low-risk. If you have any general inflammation type issues that don't seem to have a cause, it might be worthwhile to just try probiotics.
My Dr. told me to try them for a digestive issue - and they sort of helped that.
But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable, and my skin really cleared up. I had red, flaky skin on my face for 20 years and suddenly it's gone within 48 hours of starting probiotics.
Yeah... post hoc ergo propter hoc, but it's a cheap and harmless shot in the dark.
Worst case scenario, it doesn't work and you're out $10.
Edited to say "low risk" instead of "risk free".