Continual Brain Fog post Probiotics

[canyouhearmeaya]

Summary: Took probiotics for the first time ever in 2016, had a very sudden onset of brain fog and disorientation. Stupidly took probiotics MANY times for the years that followed. Evidently have issues with SIBO. H2S seemingly (flatlined 2 breath tests, high sulfur diet = EXTREME fatigue, low sulfur diet = fatigue gone.)

Had an anomolous period in 2019 where I had sudden urgent diarrhea one day, all symptoms gone. I can only assume for some reason, my small intestine cleared - i've never been able to figure out why. Regardless, went from feeling terrible for years, to feeling 100%.

Stupidly took probiotics again a few weeks later (long story), all relapsed. I'd felt for years probiotics were never the root cause, but I suspect they infact maybe (I never had these issues prior to using probiotics. Some gut issues, but none of this extraintestinal stuff)

I've not used probiotics for nearly 9 months, issues remain. Fatigue can be managed with low sulfur diet.

However, I still have persistent brain fog, disorientation and really what I can only describe as anhedonia (feeling just flat, disconnected and unmotivated - this also completely lifted during the remission period.)

I do question if this persistent brain fog may infact be due to excess d-lactate (I tolerated high dose bifido fine as far as i can tell, but when using lactobacillus blends, that seems to be what caused severe worsening.)

I know a low carbohydrate diet is reccomended to reduce d-lactate, which I am now trialling again (my main issue is going low carb + keeping sulfur intake low becomes difficult.)

What i'd like to know is, IF this persistent brain fog is induced by excess D-Lactate, is there anything I can use that will offset symptoms?

OR anything I can try to see if I Can get a temporary lift, which may help identifying if this is the cause? (Outside of a formal test)

I have seen the mention of sodium bicarbonate, would dissolving a sufficient amount of this in water and drinking it theoretically cause a temporary lift in the brain fog if the issue is d-lactate? If so, how much sodium bicarbonate should one use?

Appreciate any ideas.


Edit: just for reference, I tried Rifaximin and had 0 benefit. However, it seems rifaximin actually may enhance lactobacillus, so I Suspect if that issue is an overgrowth of lactobacillus in the small intestine, it may infact be redundant.)

 

[Hip]

Evidently have issues with SIBO. H2S seemingly

Did you take the Trio Smart SIBO breath test for SIBO? Whereas SIBO tests general check hydrogen and methane gases, Trio is the only place I am aware of which also checks hydrogen sulfide gas.



SIBO alone can cause major increases in brain fog and fatigue. So ME/CFS patients with SIBO can improve these symptoms by addressing SIBO.

Since rifaximin failed to help, one possibility is to look into herbal antibacterials, which one study showed can be just as effective as antibiotics.

Herbs used for SIBO include: allicin, neem, berberine, oregano oil, cinnamon, cloves, olive leaf extract and red thyme essential oil. Often several herbs are taken together.

Alternatively, one study found that a physician's elemental diet (to starve the bacteria) for two weeks was highly effective at eradicating SIBO. Ref: 1 More info here. Homemade elemental diet recipe here.

What i'd like to know is, IF this persistent brain fog is induced by excess D-Lactate, is there anything I can use that will offset symptoms?

You will find some suggestions in this post and this post.

 

[canyouhearmeaya]

Would a course of amoxicillin be worth a try? There was a study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006167/ ) in which they indentified a link between probiotics and brain fog onset, in which amoxicillin was used in some patients.. It was also recommended to me to try by somebody else.

I know the study was pulled apart for various reasons / poor design, but the scenario describe is like reading my own experience, which has lead me to the idea of trying another antibiotic.

I'd always been very antibiotic, but like anything I guess they have their place and purpose, and given I did not have these issues prior to probiotics, part of me wonders if a simple course of amoxicillin and permanent abstinence of probiotics in future may do the trick.

I had a lot of anxst around using Rifaximin, to which proved to be in vein (although there was no benefit, I also had 0 side/negative effects also.) I think i've always been apprehensive of medication in general, and yet I wonder if in this case, it might actually be my friend. (I know antibiotics may be the cause of many issues in modern health, but I guess I also have to accept they in the right circumstance, provide great benefit.)

Is one short course of amoxicillin really likely to pose much threat to me?

 

[Wolfcub]

The trouble with probiotics in my opinion is there is very much a "one size fits all" approach to them among health proponents. And they are likely to be bandied around as a panacea for everything nowadays. But I am dubious about that cavalier approach.

I also feel that one doesn't even necessarily have to have SIBO for a certain strain of probiotic to be negative for one's particular digestive system.

We have had -since birth -a unique microbiota set-up. Unique to us as individuals. When we are normal, healthy, young-ish, eat healthy foods etc, don't drink too much, or get too stressed out, there is a homeostasis. It's when there is inappropriate antibiotic (or even herbal) use, excess stress, diet or lifestyle changes for the worse, gut infections, food poisoning, alcohol misuse, viral or bacterial attacks, autoimmune situations, or some imbalance takes place and overloads the natural system.....that things can go haywire.

Taking OTC probiotics, or even those prescribed by someone who doesn't know our individual gut make up is like trying to walk about in someone else's shoes.

I am extremely wary of them -at least as they are widely available to all and sundry, not much understood by doctors, and given star status by most health articles as being the answer to most things!.
For goodness sake! We are messing about with our gut balance!

There is a way to find out what particular strain of probiotic may be more helpful. That would be via a comprehensive stool analysis, say from somewhere like Genova Diagnostics or another reputable Lab. But they do run rather expensive, so it depends how you are fixed financially. Plus you would need a health practitioner to work with you on getting one. But you probably would get a better detailed profile of what is out of balance and what is okay.

 

[JES]

Stupidly took probiotics again a few weeks later (long story), all relapsed. I'd felt for years probiotics were never the root cause, but I suspect they infact maybe (I never had these issues prior to using probiotics. Some gut issues, but none of this extraintestinal stuff)

Which probiotics? Most commercial probiotics like the common lactic acid bacteria are not colonizing the gut. In other words, they enter your gut and leave after around 72 hours. Certain human-sourced probiotics like mutaflor have some evidence behind colonization, but they are rare to come by.

I've had several probiotics cause brain fog, especially ones that are pro-inflammatory, but the effect was always transient. Maybe I was lucky, but even soil-based probiotics that triggered a horrible reaction seemed to eventually leave my gut. What I'm trying to say is, if you experience symptoms long past taking a commercial probiotic, it's most likely from some triggered secondary reaction or bacterial shift perhaps, rather than the probiotic itself.

 

[Judee]

Ken Lassesen talks about this on his website:https://cfsremission.com/2018/08/06/killing-lactobacillus-to-improve-brain-fog/

I've noticed that a lot of commercial combination almost always seem to have lactobacillus. As he notes, most ME/CFSers don't do well on them.

The antibiotic is a good idea but you could try an antibiotic herbal first to see if that helps. He's got a nice chart on this page. (Page down to find it). You can see the fifth column on the chart shows how to reduce lacto.
https://cfsremission.com/treatment/antibacterial-herbs-for-cfs/

Edit: What JES said could be true as well though. It may have killed something else you needed on it's way through your intestinal tract.

 

[canyouhearmeaya]

Which probiotics? Most commercial probiotics like the common lactic acid bacteria are not colonizing the gut. In other words, they enter your gut and leave after around 72 hours. Certain human-sourced probiotics like mutaflor have some evidence behind colonization, but they are rare to come by.

I've had several probiotics cause brain fog, especially ones that are pro-inflammatory, but the effect was always transient. Maybe I was lucky, but even soil-based probiotics that triggered a horrible reaction seemed to eventually leave my gut. What I'm trying to say is, if you experience symptoms long past taking a commercial probiotic, it's most likely from some triggered secondary reaction or bacterial shift perhaps, rather than the probiotic itself.

One was Renew Life's Critical Care 50 Billion, the other was in Australia, can't remember the product but a very similar product with a few more strains.


Well, I guess what I'm saying is, the use of a probiotic seemed to induce a detrimental effect in my gut that isn't reverse in the abstinence of probiotics. So it may not be the literal bacteria from the probiotic that have colonized, but using the probiotic certainly appears to have allow a shift of bacteria (i.e. maybe it's my own lactobacillus that have grown up into the small intestine, but the use of a high CFU probiotic is what allowed this to occur.)

For some people that brain fog seems to lift with cease of use, for others it remains long term. Ofcourse there must already be something skewed in the gut or body for this to likely arise in the first place, but I was certainly not experiencing this prior to the probiotic use, and yet now can't seem to shift it.

I've had GI MAp stool testing done, which showed no infection or anything sinister.

I had elevated Zonulin (i've tried gluten removal etc) which is likely caused by the overgrowth itself, and low Secretory IGA.

As far as normal commensal bacteria, they were all there but E.Coli, which as very low. I do wonder if this caveat my be what determines reactions like this (I.e. a lack of E. Coli allows certain unfavourable shifts in the microbiome post pro-biotic use that otherwise wouldn't happen in the presence of E.Coli in this case, which may counter balanace the situation.)

I have Neem, Oregano Oil, Goldenseal (Berberine) and Enteric Peppermint Oil. I could try running a course of these (i've never ran herbal antiobiotics long enough if I'm honest).

 

[Hip]

Did you take the Trio Smart SIBO breath test for SIBO, @canyouhearmeaya? I am just curious to know where you got your SIBO breath test which tested for H2S.

 

[canyouhearmeaya]

Did you take the Trio Smart SIBO breath test for SIBO, @canyouhearmeaya? I am just curious to know where you got your SIBO breath test which tested for H2S.

No sorry, I didn't. It isn't available in the UK as far as I know at the moment.

I had continual development of severe fatigue and other symptoms with a high sulfur diet, which is what lead me to believe H2S might be the cause (after much trial and error working out what the triggers were.)

So I then took a lactulose breath test, and flatlined the test, which seems to be considered usually indicative of a H2S overgrowth.

I took a second lactulose breath 14 months later, same thing occured (Wanted to make sure the first test was accurate and not an incorrectly done test.)

So symptoms based on dietary reactions + 2 flat line breath tests is my basis for saying that.

 

[Hip]

I had continual development of severe fatigue and other symptoms with a high sulfur diet, which is what lead me to believe H2S might be the cause (after much trial and error working out what the triggers were.)

So I then took a lactulose breath test, and flatlined the test, which seems to be considered usually indicative of a H2S overgrowth.

Ah right. So you are saying that you took a standard hydrogen/methane breath test for SIBO, and did not show any evidence of these two gases in your breath. So the test itself did not find SIBO.

But you feel you have SIBO, so you are assuming that you might have the H2S variety of SIBO, which most breath tests at present cannot detect. As that right?


It's certainly true that SIBO tests generally are not that reliable: the sensitivity of the SIBO breath tests are low: at 55% for the glucose breath test. This leads to many false negatives, as only 55% of people who actually have SIBO will receive a correct positive result on this glucose breath test (the other 45% will receive an incorrect negative result).

So a negative SIBO test does not rule out the possibility that you might have SIBO.


However, the fact that rifaximin did not help your symptoms doesn't support the view that you might have SIBO. Although again, not all people with SIBO improve on rifaximin, especially those with methane-predominant SIBO (which you could be, even with a negative breath test). Methane-predominant SIBO is typically treated with a combination of rifaximin and metronidazole.

This is because methane-predominant SIBO involves not bacteria, but a type of microbe called an archaea. So you need antimicrobials which target these archaea.

In terms of herbs, allicin (from garlic) may be useful for methane-predominant SIBO. Ref: here.

 

[canyouhearmeaya]

Ah right. So you are saying that you took a standard hydrogen/methane breath test for SIBO, and did not show any evidence of these two gases in your breath. So the test itself did not find SIBO.

But you feel you have SIBO, so you are assuming that you might have the H2S variety of SIBO, which most breath tests at present cannot detect. As that right?


It's certainly true that SIBO tests generally are not that reliable: the sensitivity of the SIBO breath tests are low: at 55% for the glucose breath test. This leads to many false negatives, as only 55% of people who actually have SIBO will receive a correct positive result on this glucose breath test (the other 45% will receive an incorrect negative result).

So a negative SIBO test does not rule out the possibility that you might have SIBO.


However, the fact that rifaximin did not help your symptoms doesn't support the view that you might have SIBO. Although again, not all people with SIBO improve on rifaximin, especially those with methane-predominant SIBO (which you could be, even with a negative breath test). Methane-predominant SIBO is typically treated with a combination of rifaximin and metronidazole.

This is because methane-predominant SIBO involves not bacteria, but a type of microbe called an archaea. So you need antimicrobials which target these archaea.

In terms of herbs, allicin (from garlic) may be useful for methane-predominant SIBO. Ref: here.

No, I flatlined the test. This is very different to a negative test. I took a 3-hour lactulose breath test, in which a normal result presents with a spike in hydrogen gases at the time in which the solution releases the large intestine. When there is no spike seen, i.e. no increase in gases ever, this is generally considered to be indicative of H2S (because the Hydrogen is used in the production of H2S, which is therefor no longer present on the test at any point.)

A negative SIBO test would show no/low gases up until the 2 hour mark, and then the spike as seen in a healthy individual. This is also why I took the test twice of the course of 14 months, to ensure it wasn't an incorrect result (both 3 hour lactulose breath tests, two different labs, same result.)

The alternative would likely indicate that I had no normal commensal bacteria producing hydrogen gas in my large bowel, which is evidently not the case as shown by my GI Map test.

Rifaximin is hit or miss, not responding to rifaximin seems to mean quite little IMO. SIBO is talked about like it's one thing, which is ludicrous. All SIBO means is there is an overgrowth of bacteria in the small intestine, is does not specify which type, how many, how much of the small intestine etc. This overarching talk of SIBO IMO is a huge problem and a reason why very few people get resolution.

SIBO is much like depression, it is a symptom that can arised from 100s of different causes, and yet manifest in 100 different ways. Much the same with the treatment for depression, medication response is far from consistent, and ultimately pretty ineffective in the long term. You wouldn't assume that because someone didn't respond to one particular type of anti-depressant, that they in fact are not experiencing depression.

Rifaximin has a eubiotic effect. One of the main purported benefits is that it does not kill but infact promotes Lactobacillus. If you have an overgrowth of lactobacillus in the small intestine, by that logic, I think it would be safe to assume Rifaximin is likely ineffective. Rifaximin is also dependent on the correct activity of bile to exert it effects, without confirmation that an indivuduals bile flow is proper, the potential for Rifaximin to even take effect is uncertain. (Although I do not personally suspect bile is implicated in my own issue, I am infact having a HIDA scan as reccomended by my Gastro next week to rule that out.)

The use of Rifaximin also has very little evidence, even anecdotal, in it's effectiveness in the case of H2S SIBO. It's effectiveness is almost entirely revolved around research on individuals who present with hydrogen dominant SIBO (and even that, it's massively ineffective in both long and short term in many individuals.)

I think the only thing anyone can be sure about with SIBO, is you really can't be sure about anything. The testing is currently inconclusive, the treatment is inconsistent and symptomatic presentation seems to vary wildly.

The microbiome is a complete mystery still.

Even the talk of 2-3 gases is redundant. An incomprehensible number of bacteria produce hydrogen as a biproduct of fermentation. So testing positive for hydrogen, still tells you virtually nothing in reality about what's happening in the small intestine, other than the likelyhood of an overgrowth.

 

[Hip]

When there is no spike seen, i.e. no increase in gases ever, this is generally considered to be indicative of H2S (because the Hydrogen is used in the production of H2S, which is therefor no longer present on the test at any point.)

That's very interesting, did the testing lab report tell you that when there is no increase in gases ever, this is generally considered to be indicative of H2S? Or did you read that elsewhere?

I'd love to get a reference for that, so that I can include it in the SIBO section of my ME/CFS roadmap.

Though if H2S SIBO can be detected in this way, why has there been this interest in developing SIBO tests which detect all three gases (hydrogen, methane and H2S)? I read an article some years ago that there was a drive to develop SIBO tests that could detect H2S, and the Trio test I mentioned above is the only one that I have seen so far which detects H2S.

Rifaximin is also dependent on the correct activity of bile to exert it effects, without confirmation that an indivuduals bile flow is proper, the potential for Rifaximin to even take effect is uncertain.

I appreciate that. I've wondered whether taking bile supplements like TUDCA along with rifaximin might increase its effectiveness? Or alternatively taking herbs which boost bile production (choleretic herbs like milk thistle) as well as herbs which stimulate bile release from the gallbladder (cholagogue herbs).

Even the talk of 2-3 gases is redundant. An incomprehensible number of bacteria produce hydrogen as a biproduct of fermentation. So testing positive for hydrogen, still tells you virtually nothing in reality about what's happening in the small intestine, other than the likelyhood of an overgrowth.

Well, the small intestine is normally close to sterile; it should have almost no bacteria in it. So when bacteria of any species are present in large numbers, that is not good.

But yes, it would be useful to know which particular species of bacteria and archaea were colonizing one's small intestine.

The gold standard for SIBO testing involves endoscopy: sticking an endoscope down your throat, and taking a sample of the bacteria from the small intestine, which is the cultured in a petri dish and identified. Because this is quite an invasive test, the breath test is used in preference.

I would like to find a private clinic in London that does SIBO testing by endoscopy; I'd like to be tested in that way.

 

[canyouhearmeaya]

That's very interesting, did the testing lab report tell you that when there is no increase in gases ever, this is generally considered to be indicative of H2S? Or did you read that elsewhere?

I'd love to get a reference for that, so that I can include it in the SIBO section of my ME/CFS roadmap.

Though if H2S SIBO can be detected in this way, why has there been this interest in developing SIBO tests which detect all three gases (hydrogen, methane and H2S)? I read an article some years ago that there was a drive to develop SIBO tests that could detect H2S, and the Trio test I mentioned above is the only one that I have seen so far which detects H2S.

This if i recall correctly was the observation of I guess what most people would consider to the 'leading experts' with regards to SIBO, I beleive namely Siebecker and the gentlemans name I forget (Ciedar Sinae I believe is his company, who developed the H2S Test itself.)

The first lab considered a flat line a negative test. The second lab considered it a positive test - lol! As with all things SIBO, inconsistency prevails.

The reason for developing the test is because its conclusive. Flatlining a breath INDICATES H2S, but does not confirm H2S. A direct test of H2S therefor is ultimately conclusive. So up until now, flatlining has always been the diagnostic measure used, of course now that H2S testing has finally come out, once it becomes more available that will make things hopefully much easier for people. Although of course practitioners are pairing flat-lining with symptom presentation (i.e. if you flat-line a breath test, but have no advertise reaction to a high sulfur diet, I'd imagine it's safe to assume that a) H2S overproduction wasn't an issue or B) by some means, you weren't experiencing an adverse reaction to excessive H2S production.


I appreciate that. I've wondered whether taking bile supplements like TUDCA along with rifaximin might increase its effectiveness? Or alternatively taking herbs which boost bile production (choleretic herbs like milk thistle) and herbs which stimulate bile release from the gallbladder (cholagogue herbs).


I actually debated trying this myself, but honestly I was hesitant. My logic was this: Bile is secreted after the stomach, at the initiation of the intestine - I worried that taking a bile supplement along with the antibiotic may cause it to become active prior to the small intestine i.e. in the stomach itself, which may ultimately result in undesired effects taking place in the stomach. The use of something to enhance natural bile secretion as you've suggest I think would be more desirable. But to mix it with an actual bile compound itself, I think may be risky (but I don't know enough about any of this to make any kind of conclusion on that, so I just decided to err on the side of caution.)

Well, the small intestine is normally close to sterile; it should have almost no bacteria in it. So when bacteria of any species are present, that not good.

I've actually read conflicting ideas on that. I don't have any links though sadly. But from what I recall, actually a good portion of the small intestine is infact not sterile, but rather just contains much lower amounts of bacteria. I remember reading a piece that stated that Lactobacillus actually had the ability to colonize and live in the small intestine to some extent, and may in fact do in normal individuals. Bifidobacterium supposedly however do not, and only resided in the large bowel. That idea did intrigue me, given that it seems only lactobacillus containing probiotics were associated with a worsening of my symptoms, a huge prolonged dose of exclusively bifidobacterium did not appear to cause any worsening at all, nor does the use of S. Boulardii. I'm not saying Lactobacillus in of itself is bad, ofcourse we know that not to be true. What I do suspect though is that there may be the potential in certain individuals for certain strains of Lactobacillus to cause a shift in the dominance of certain types of Lactobacillus in the gut, which then result in un-regulated amounts of biproduct being produced (e.g. D-Lactic acid) resulting in negative consequence. But that's only my personal speculative idea, and of course if such a thing were to be true, it would invariably rely on there being something else askew to allow this to arise in the first place.

But yes, it would be useful to know which particular species of bacteria and archaea were colonizing one's small intestine.

The gold standard for SIBO testing involves endoscopy: sticking an endoscope down your throat, and taking a sample of the bacteria from the small intestine, which is the cultured in a petri dish and identified. Because this is quite an invasive test, the breath test is used in preference.

I would like to find a private clinic in London that does SIBO testing by endoscopy; I'd like to be tested in that way.

Interesting. I must admit, I've read and listened to endless hours of SIBO related material, and not once have I ever heard of anyone using that method! That certainly seems like it would be the most logical method, because once you can identify particular strains more specifically, the whole game changes. The breath test as I've alluded to before I feel really is far too vague. It tells you at best what might be 10% of a much more complicated picture.

 

[canyouhearmeaya]

Something I think I might try, is using Yakult. Based on:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723183/

Now of course I have 0 confirmation in my case that D-Lactate is an issue, so it's all spectulative. All I know is that it seems that after using Probiotics containing multiple strains of Lactobacillus, for the first time ever I had the onset of these symptoms, which have not reversed with abstinence.

Going back to what I suggested in my last post, I do wonder if it some individuals the issue is ultimately that the probiotics set the stage for an unfavourable balance in Lactobacillus to occur, and the dominance of D-Lactate producers (or whatever the bi-products may be, I'm only using D-Lactate as an example) results in a sustained imbalance which ultimately results in sustained unfavourable symptoms.

So maybe the answer is not to 'kill' per say, but to 're-balance'. I wonder if the introduction of carefully selected strains, may rather result in a reduced dominance of other strains (be it in the small or large bowel) which have otherwise been allowed to take dominance as consquence of the introduction of indiscriminate probiotic use.

Yakult contains Lactobacillus-Casei Shirota, which in this example they are claiming was 1 part of a 3 part 'cocktail' used to seemingly reverse long term this individuals overproduction of D-Lactic acid (ofcourse there are facets of this individual which do not apply to myself, i.e. SBS etc)

But I may try using Yakult alone for now, so as to only change 1 variable, and see if there's any perceivable difference for better or worse.

I suspect that again this may be an integral part of the SIBO/Microbiome picture. Many people with SIBO become fearful of *all* bacteria, when in reality, the answer may lie within bacteria, just the correct ones.

So one probiotic may cause a worsening of symptoms, another may seek to restore balance.

Antibiotics may also work, by just napalming the whole thing, but then you run the risk of taking something away that you don't want to lose, which is why I'm hesistant to go down that avenue.

 

[canyouhearmeaya]

To add to the picture (sorry, i'm enjoying talking about this now and it's fun to flesh out ideas with other people have an interest in these things - as I can assure you my friends and family don't lol!)

The first set of symptoms I experienced post-probiotic use were the ones that seem to be most persistent (brain fog, anhedonia and de-realization.) The H2S symptoms in as much as I can tell, came down the line (after using more and more courses of probiotics... doh.)

I do wonder if one shift, allows the change for another. For example (again, ALL speculative, just bouncing ideas.)

- Individual has incomplete diversity in microbiome (may be from birth, or earlier life antibiotic use.) May be issues free, but potentially a problem waiting to happen.

- Individual indiscriminately introduces broad spectrum probiotics, which allow for a shift to occur in the microbiome which wouldn't of necessarily ever occured in the absence of the introduction of such large amounts of bacteria.

- Because of the pre-existing incomplete diversity, the introduction of the probiotic allows for an unfavorable shift in certain bacteria, which are ultimately able to sustain themselves in this new environment, even in the abstinence of the instigator (probiotics)

- Let's say for example, this shift results in a change in the balance of Lactobacillus, now leaving the individual with excessive D-Lactate producing bacteria. Does this now have it's own consequence? I.e. Could this now excessive production of D-Lactate alter the acidity in an area of the bowel such that it now becomes hospitable to bacteria in which it previously wouldn't have.. e.g. H2S producing bacteria.

- Now you have multiples strains of bacteria, all thriving and residing in a way that they shouldn't be, all triggered by one initial shift in balance.

It seems that bacteria have an ability to alter their environment AFAIK, as a means to provide for their own survival. This may include altering PH etc. As seems to present commonly in nature, each living organism seems to have an innate 'drive to survive'.

To add to this, the other angle is, do other strains overgrow as an adapative mechanism?

My GI map testing showed elevated Zonulin levels, I don't respond to a gluten free diet (no perceivable benefit.) One of the other potential causes of Zonulin is bacteria. Could an excess of certain bacteria, or even their bi-products (e.g. D-Lactate) result in an increase in gut permeability, allowing LPS now to pass into the blood stream and cause inflammatory effects. Could the body then respond to this with an increased production of H2S, as it appears H2S actually seems to help modulate the inflammatory effects induced by LPS.

https://pubmed.ncbi.nlm.nih.gov/15863703/
https://pubmed.ncbi.nlm.nih.gov/16781459/

To me it all seems to be a chain of events, and finding the first domino is the most difficult and possibly most crucial. As consequent events may in fact be adapative and arguably beneficial, even if they result in detrimental effects to the host. Again, the body is concerned with survival, not necessarily well being. It may be in the bodies interest to produce additional H2S to offset potentially more harmful effects of LPS, in spite of the fact of the potential for this to induce great levels of fatigue etc, than allow the inflammation to occur in of itself.

 

[Hip]

Have you looked into doing a leaky gut treatment, @canyouhearmeaya? You can get tested for leaky gut, but it may just be cheaper to try the treatment, and see if that helps.

The best repair supplement for leaky is considered to be glutamine, one of two heaped teaspoons of powder daily on an empty stomach (best to start slowly with lower doses though). Other leaky gut supplements in this post.

The first set of symptoms I experienced post-probiotic use were the ones that seem to be most persistent (brain fog, anhedonia and de-realization.)

Anhedonia was one of the horrible symptoms that hit me after I caught coxsackievirus B4. My guts were never the same after catching that virus; I developed chronic odorless mild flatulence (as did many others who caught my this virus from me). Enterovirus as its name suggests lives in the gut, chronically infecting the gut lining, so it's not going to improve your gut health.


One of the supplements that helped take the edge of my anhedonia was bovine colostrum, at doses of 1 or 2 heaped teaspoons daily. Colostrum contains many types of antibody which will target gut microbes.

Unfortunately my UK source of cheap colostrum is not longer viable: I used to be able to get 500 grams of colostrum (with 30% IgG antibodies) from www.myprotein.com for about £30. But now the price has shot up to over double that for bulk colostrum powder in the UK.

Some other treatments that I found help reduce anhedonia a bit are listed in this post. EGCG (green tea extract) 1000 mg daily is the best, it boosts mood, motivation and mental focus.



@canyouhearmeaya, you might like this 30 second video clip which shows how to quote specific paragraphs of another member's post.

 

[canyouhearmeaya]

Have you looked into doing a leaky gut treatment, @canyouhearmeaya? You can get tested for leaky gut, but it may just be cheaper to try the treatment, and see if that helps.

The best repair supplement for leaky is considered to be glutamine, one of two heaped teaspoons of powder daily on an empty stomach (best to start slowly with lower doses though). Other leaky gut supplements in this post.

Yeah, I spent the last 8 weeks working on that, no avail. Leaky gut diet (AIP style). Glutamine, Colostrum, Collagen, Butyrate, Turmeric, Resveratrol, Liquourice DGL, Mashmallow Root, Slippery Elm, NAG, S. Boulardii etc.. I was super consistent with it. No bueno.

I feel like it's made a reasonable improvement in my 'general' gut health so to speak, so I don't consider it wasted time, and it's all useful as part of process of elimination.

But as usual, I always come back to the true north for it seems, which is bacterial imbalance as suspected cause (but not infection.)

Anhedonia didn't improve at all in those 8 weeks. Historically over the last few years, the periods where I seem to get the lift in Anhedonia, are where I cut my carbs (and go keto basically). This is also what has me wondering about something like D-Lactate.. Onset of symptoms after probiotic use, and carbs persisting symptoms.

The problem with low carb, is when you go keto/low carb and aim to keep sulfur super low, it's pretty limiting lol.

Is using the sodium bicarbonate a good metric/home test for D-Lactate? The last 3 days i've taken 5g dissolved in a big glass of water, and taken it away from meals. Oddly on the first day, it did *potentially* seem to have had some effect, but I didn't control all the variables tightly be sure it was that. Though I can't say I've really seen any obvious benefit the last 2 days.

 

[Hip]

No bueno.

Oh well. Back to the drawing board!

Is using the sodium bicarbonate a good metric/home test for D-Lactate? The last 3 days i've taken 5g dissolved in a big glass of water, and taken it away from meals.

I am not sure, but 5 grams is a pretty hefty dose of bicarb, as this can alkalize the body quite strongly. When I've used bicarb for alkalizing experiments, I took just 1 gram daily, and even then I found the effects quite noticeable (alkalizing always makes be become lightheaded).



Have you looked into vitamin B1 as a possible treatment for D-lactate? See the bottom of this post which I linked to earlier for an explanation.



Generally the possibility that D-lactate can cause symptoms in humans is perplexing, because when D-lactate is experimentally injected into healthy volunteers, they do not notice any adverse effects. Humans have an enzyme D-2-HDH which breaks D-lactate down (detailed in this post).

However, I guess there may be people who are more susceptible to D-lactate. And I wonder if some people might have mutations in the gene which encodes that enzyme, so that the enzyme cannot efficiently detox D-lactate, making them more susceptible?



This study details the case of a child with short bowel syndrome (which predisposes to D-lactate issues) who improved after taking a D-lactate free probiotic. It seems this probiotic pushed out the D-lactate-producing Lactobacillus:

Stool composition of the patient was sequenced regularly over that period. His microbiota profile changed completely in species richness, and a clustering of species according to probiotic usage was seen. Importantly, D-lactate–producing Lactobacillus strains disappeared within a few weeks after probiotic introduction and were no longer detected in the subsequent follow-up specimens.

 

[canyouhearmeaya]

Oh well. Back to the drawing board!

Have you looked into vitamin B1 as a possible treatment for D-lactate? See the bottom of this post which I linked to earlier for an explanation.

This study details the case of a child with short bowel syndrome (which predisposes to D-lactate issues) who improved after taking a D-lactate free probiotic. It seems this probiotic pushed out the D-lactate-producing Lactobacillus:

I've heard of the Thiamine idea, I've taken it at times, probably not consistently enough (wasn't sure if the effect was supposed to be fairly acute.) Certainly haven't noticed anything when I have taken it.

I've seen D-Lactate free probiotics mentioned. I think there's two things that have put me off trying them, cost and just general uncertainity around probiotics because of this whole experience.

I don't know if you recall, but i've made other posts discussing this issue.. Last year, April 2019, I had a very anomolous bout of sudden urgent diarrhea (very out of character for me, never have watery diarrhea, which this was)... and a complete resolution of symptoms.

My best guess is that for whatever reason, by some means by small intestine decided to clear (and the subsequent dump of the bacteria into the large bowel resulted in diarrhea as a means to clear it from the body.)

ALL of the symptoms disappeared that day, sulfur and otherwise (0 anhedonia, 0 brain fog, 0 fatigue etc etc.)

Stupidly I took probiotics AGAIN a few weeks later, and it all relapsed. (Don't ask why I took them again, long story - the result of naivety.)

The week the diarrhea happened, I'd been following a ketogenic/low carb diet for a number of weeks prior, and because I was experimenting with anything and everything at the time (and have been since in many ways lol) I decided to cut my electrolytes (which would generally be a no no on a ketogenic diet due to increased electrolyte loss.)

So for a period of 4-5 days, I basically ate just chicken, olive oil, lettuce, cucumber and green beans. Small portions too, little food, 0 added salt.

I've tried periods of low sodium since, low potassium, and every kind of dietary restriction you can imagine, with nothing similar.

What I haven't tried is throwing myself back into a ketogenic state as I was during that time, and doing the same thing. I think that's also another option I need to consider.

I have 0 idea why it happened, because of the nature of my thought line that week I was taking no supplements at all as far as I recall (I'd gone over in my head 1000 times to try and work out if there was some obscure thing I did or took outside of the diet that might have caused it to happen.)

I know it sounds utterly obsurd, but it happened. I didn't even think anything of the diarrhea at the time, I just assumed it had occured because I'd thrown my electrolyte balance so far off - so I concluded it was a 'failed experiment'...

.. and then later that day noticed suddenly all of the brain fog seemed to have gone.. and over the consequent days noticed ALL of the symptoms had just vanished. No itching, no brain fog, no fatigue, no anhedonia, no nada.

Given that I've experienced no other period like that in the last 4 years, ever being even remotely close to a remission of symptoms, let alone 100%, it's evident to me that whatever happened that day, my gut decided to clear out.

I've tried enemas, laxatives etc, makes 0 difference. It really was the most suddent and urgent diarrhea I have ever experienced in my life, was totally bizarre.

I'd not tried it again because I assumed it must have been chance, and that would not likely repeat.. but who knows?

Maybe in my case there is some weird caveat, where the overgrowth is able to manipulate sodium channels in the small intestine and impair motility in order to prevent itself being removed, and throwing my electrolyte balance off so drastically somehow overrid that and the small bowel kicked in and cleared. I really don't know. I feel like an absolute crazy person everytime I mention this, but all I know is it happened, and it's the one period in 4 years where it resolved.

Taking probiotics indiscriminately was the worst decision I ever made, being stupid and naive enough to take them again after that, was just plain idiocy.

 

[cogent_thought]

Maybe in my case there is some weird caveat, where the overgrowth is able to manipulate sodium channels in the small intestine and impair motility in order to prevent itself being removed, and throwing my electrolyte balance off so drastically somehow overrid that and the small bowel kicked in and cleared. I really don't know. I feel like an absolute crazy person everytime I mention this, but all I know is it happened, and it's the one period in 4 years where it resolved.

I think it's very difficult to kill off a bacteria or miccroorganism via lack of feeding. The work of Dr Valter Longo suggests that even humans benefit from some periods of fasting and for bacteria it may be their natural state.

I am considering doing elemental diet into an anti-biotic / probiotic protocol, awaiting results from https://app.thryveinside.com/ + http://microbiomeprescription.com/ to ensure I''m not doing something stupid.

I'm currently on low fodmap keto and couldn't resist trying one of the mutaflor that arrived. I felt an immediate reaction, so hoping it's clearing up something pathogenic in my upper intestine.