Lactic Acidosis from Probiotics

[dannybex]

I dunno. I found some papers saying that Bifida is really important for digesting food. Different strains digest different types of sugars. It seemed to help me - no more FODMAP problems. I can even eat dairy. Haven't tried gluten, don't want to get crazy..

Hi Mimi --

Wondering if you're still taking bifidus? And if your digestion is still improved?

Thanks in advance,

Dan

 

[aimossy]

WOW! Hi I am new here, this info on probiotics is really interesting.i feel like if I can get my gut under more control I will get my cfs under more control.i have been thinking this for a few years now. I feel like I need help with it. have just made myself relapse on lactobacillus rhamnosus lgg and bifidobacterium animalis bb-12. I also feel awful if I have greek yoghurt.i have noticed that it affects my brain and gut and breathing and muscles and tension gets worse.its nuts! and the heavy arms and legs thing! gets real severe.i am so gutted that I cant tolerate probiotics.but this has showed me that this has a big relation with me somehow.im not sure where to start. I am in new Zealand. looks like I might have too much lactic acid thing maybe.im sure I have gastritis,weaning off coffee.i do fodmaps and last time I reduced coffee right down I discovered it was what was keeping my gut moving.mental. I really don't want to be back on omeprazole, seems to just make me worse.i better do the introduce section.have align bifantis but Im a bit nervous to fiddle with more things in this state!

 

[Mogwai]

Bugger...

Well I think this explains why my gut has gone berserk the last few days. Decided to try some probiotics that my brother takes for IBS, with good success. I was doing fine for a couple of weeks, but the last few days have been rough.

It has to be the probiotics - nothing else has changed. Ah well...

 

[aimossy]

Bugger...

Well I think this explains why my gut has gone berserk the last few days. Decided to try some probiotics that my brother takes for IBS, with good success. I was doing fine for a couple of weeks, but the last few days have been rough.

It has to be the probiotics - nothing else has changed. Ah well...

it is a bugger ay!!! what sort and strains were they?

 

[Mogwai]

it is a bugger ay!!! what sort and strains were they?

Just the two, as I didn't want to push my luck - BAH!

Lactobacillus acidophilus and Bifidobacterium lactis.

Then I read this thread and do some more digging:

http://www.mecfsassist.org/1/post/2...t-d-lactate-probioticsfiber-use-in-mecfs.html

If I understand you correctly its possible that strains of Lactobaccilus bacteria that are frequently found in probiotic preparations could exacerbate lactic acid production. Apparently Lactobaccillus acidophilus turns sugars into lactic acid.

Yes, but not all Lactobacillus strains produce the undesirable D-Lactate (for example, the well-researched Lactobacillus GG does not produce D-Lactate, but most strains of Lactobacillus have not been investigated for D-Lactate production. Its time to map that out properly).

It’s generally true that L.acidophilus does turn sugars into lactic acid, but not all Lactobacillus strains produce the D-Lactate; the L-Lactate can be cleared with a fair amount of ease by most.

Do you recommend staying away from the traditional formulations (L acidophilus)?
Most probiotics marketed under the umbrella term “acidophilus” have not been researched for health outcomes (let alone stability!) and we have no idea of their D-Lactate potential. It is known from studies in short bowel syndrome that unspecified strains of L. acidophilus can be major promoters of D-Lactate.

 

[aimossy]

I got myself into trouble with lactobaccilus GG and animalis combo. whatever happened with this it was powerful.dont know if it was a die off I couldn't handle but it was like allergic. I think some people do really well and some don't. I think I might go ok on bifantis but will have to up the fibre if I do cos that one felt quite diff the one tablet I took the other day.a little hesitant cos of my level of sensitivity also I know how powerful these can be now.i want to know more about it all now.

 

[Christopher]

aimossy,

I got a severe allergic reaction just from the Lacto GG in Culturelle, and from then on the Jarrow Acidopholous. Have you tried just bifido?

 

[xks201]

Hate to burst your bubbles guys but D-Lactate and L-Lactate interconvert to each other. lol

 

[Peyt]

First thank you for this post, you may have given me a great clue on my path to recovery from SIBO.
2nd I wanted to ask those who tried Probiotics with Bifido, have you tried both of these:

http://kirkmanlabs.com/ProductKirkman/333/1/BifidoComplexandAdvancedFormula-Hypoallergenic/
and
http://www.customprobiotics.com/custom-probiotics-b-lactis.htm

and which one do you recommend?
Thanks

 

[finalgates]

baking soda isnt good for this?

 

[Peyt]

baking soda isnt good for this?

Not at all! (I tried it , it made me feel worst!)

 

[WNM]

Some of my thoughts on the matter.

In the gut lactate is usually rapidly metabolised to butyrate. An imbalance of lactate producing versus utilising bacteria may promote lactate accumulation; as may an excessively low pH. This classically occurs in short bowel syndrome where Lactobacilli and Leuconostoc are increased, and others such as Clostridium and Bacteriodetes decreased. Common bacteria in probiotics which can produce D-lactate include lactobacillus acidophilus, plantarum and bulgarius.

In CFS research the Sheedy culture-based study found increased levels of D-lactate producing Streptococcus and Enteroccoccus. The most recent gut microbiota study using updated methodology (16s rRNA gene sequencing) found Strep levels were usually below 5% of total bacteria, but up to 15-60% in a few patients. These results may suggest an increased potential to generate D-lactate in some with CFS.

I think increased gut lactate production in some with CFS may relate to SIBO. This would allow bacteria increased access to dietary carbohydrate which can be metabolised to L/D-lactate. There was one study ages ago which found SIBO in 77% of CFS patients (31), and its eradication led to symptom improvement. Gut bacteria involved in SIBO were identified in one study although the overall lactate metabolism is not clear. The main risk factors for SIBO are low stomach acid (HCl) and slowed intestinal motility or constipation. Anecdotally many people with CFS feel they have low HCL. Gastric emptying is also slow in CFS which might also imply upper intestinal motility is too in some people.

There is still no study directly measuring D-lactate levels in ME/CFS. Other studies finding increased lactate levels in muscles upon exertion are consistent with impaired oxidative energy metabolism and a shift toward anaerobic metabolism. This may similarly explain the increased brain lactate in CFS. Hence in these studies the lactate is not likely of gut origin. However some people with CFS may have increased D-lactate levels; although probably not severely high.

I think removing SIBO is probably key (improve HCl and digestion?). You could avoid most lactic acid bacteria (LAB) probiotics and FOS which may promote more lactate accumulation. However some pre and probiotics may be able to improve D-lactate acidosis; perhaps mainly by boosting Bifidobacteria. Carbs could be removed initially then you could boost butyrate-producing bacteria (e.g. Roseburia, Feacalibacterium and Blautia coccoides) by consuming lots of vegetables, fruit, fibre and resistant starch.

It is worth remembering that whilst current probiotics are typically based around lactate-producing Lactobacilli bacteria, this genus should be a very minor component of the normal gut microbiota. Like with many things in science what we first learn to appreciate attracts most research attention and becomes a bias exploited by mass marketing.

 

[Glynis Steele]

There is still no study directly measuring D-lactate levels in ME/CFS. Other studies finding increased lactate levels in muscles upon exertion are consistent with impaired oxidative energy metabolism and a shift toward anaerobic metabolism. This may similarly explain the increased brain lactate in CFS. Hence in these studies the lactate is not likely of gut origin. However some people with CFS may have increased D-lactate levels; although probably not severely high.

.

I found this study a while back being carried in Australia. It is a follow up study on the Sheedy paper, which found higher than normal levels of d-lactate producing bacteria in the stools of CFS patients. They are looking at d-lactate in blood, stool and urine samples, in CFS patients.

http://sacfs.asn.au/download/Lactic acid study 2008 - Ethics Application.pdf

 

[Peyt]

Some of my thoughts on the matter.

In the gut lactate is usually rapidly metabolised to butyrate. An imbalance of lactate producing versus utilising bacteria may promote lactate accumulation; as may an excessively low pH. This classically occurs in short bowel syndrome where Lactobacilli and Leuconostoc are increased, and others such as Clostridium and Bacteriodetes decreased. Common bacteria in probiotics which can produce D-lactate include lactobacillus acidophilus, plantarum and bulgarius.

In CFS research the Sheedy culture-based study found increased levels of D-lactate producing Streptococcus and Enteroccoccus. The most recent gut microbiota study using updated methodology (16s rRNA gene sequencing) found Strep levels were usually below 5% of total bacteria, but up to 15-60% in a few patients. These results may suggest an increased potential to generate D-lactate in some with CFS.

I think increased gut lactate production in some with CFS may relate to SIBO. This would allow bacteria increased access to dietary carbohydrate which can be metabolised to L/D-lactate. There was one study ages ago which found SIBO in 77% of CFS patients (31), and its eradication led to symptom improvement. Gut bacteria involved in SIBO were identified in one study although the overall lactate metabolism is not clear. The main risk factors for SIBO are low stomach acid (HCl) and slowed intestinal motility or constipation. Anecdotally many people with CFS feel they have low HCL. Gastric emptying is also slow in CFS which might also imply upper intestinal motility is too in some people.

There is still no study directly measuring D-lactate levels in ME/CFS. Other studies finding increased lactate levels in muscles upon exertion are consistent with impaired oxidative energy metabolism and a shift toward anaerobic metabolism. This may similarly explain the increased brain lactate in CFS. Hence in these studies the lactate is not likely of gut origin. However some people with CFS may have increased D-lactate levels; although probably not severely high.

I think removing SIBO is probably key (improve HCl and digestion?). You could avoid most lactic acid bacteria (LAB) probiotics and FOS which may promote more lactate accumulation. However some pre and probiotics may be able to improve D-lactate acidosis; perhaps mainly by boosting Bifidobacteria. Carbs could be removed initially then you could boost butyrate-producing bacteria (e.g. Roseburia, Feacalibacterium and Blautia coccoides) by consuming lots of vegetables, fruit, fibre and resistant starch.

It is worth remembering that whilst current probiotics are typically based around lactate-producing Lactobacilli bacteria, this genus should be a very minor component of the normal gut microbiota. Like with many things in science what we first learn to appreciate attracts most research attention and becomes a bias exploited by mass marketing.

Thanks for your reply,
You are spot on as far as Low stomach acid and slow motility being a common symptom on SIBO patients. As I mentioned before, I have SIBO, and I take HCL for low stomach and get help from certain foods, magnesium, and Prescript-Assist(another Probiotic) for slow motility. And although this combination has been very helpful, I am still looking to improve further.

I did purchase the Bifido Complex from Kirkman .. today is my 2nd day on it... so far I have not had any side effects
but no improvements either. I will report back in a couple of weeks if i see any actual improvements.

Interestingly enough, about 3 weeks ago, I started on another probiotic called "Cardioviva", which has been very helpful. I initially purchased this probiotic to help with my high cholesterol and low vitamin D because that's what this product is advertised for.., but after I started taking it, I noticed after about 4 days that the mouth thrush i always have reduced to half and much lighter and also my body felt lighter and I seem to be able to move around and exercise. anyways, here is that probiotic:
http://www.amazon.com/Cardioviva-Vegetable-Capsules-90-Count/dp/B00CFIO7EK

When I looked at the ingredient of Cardioviva, it says all it has is 1 strain of bacteria which is: L. Reuteri
Anyways, whatever it has, it's working for me, so this one is definitely a keeper... as far as Bifido Complex, I need more time to assess it.
Good luck to all.

 

[Ripley]

FYI. Those who have trouble with D-Lactate-producing species almost always do better on an SBO (soil based organism) probiotic.

Probiotics are actually a mixed bag with SIBO because SIBO often involves an overgrowth of D-lactate-producing probiotic species, and that causes a buildup of D-lactate in the gut, and a lot of the symptoms associated with SIBO are caused by that. So, you want to avoid in many cases taking any probiotics that have D-lactate-forming species like Lactobacillus acidophilus, which is, of course, one of the most common probiotics that people take. There’s a D-lactate-free product sold by Custom Probiotics that’s helpful.

I’ve also found soil-based organisms to be helpful when SIBO is present, and the one that I like the most right now is called Prescript-Assist...I’ve actually had a lot of success with it myself and with my patients in my practice....A few months ago, I started doing some research about it. There’s one study that was double-blind, placebo-controlled that lasted for quite a long time, especially for probiotics. A lot of the studies are pretty short in duration. And essentially the theory behind it is that we evolved in an environment where we were continually exposed to these soil-based organisms. Our ancestors were not scrubbing their vegetables and fruits before they ate them. They were taking them out of the ground and maybe wiping them off a little bit and eating them. They weren’t buying them in the store after they had been scrubbed, and they weren’t scrubbing them themselves. And the other thing is that the soil diversity and quality has changed a lot since the industrialization of agriculture, and so we’re just not exposed to the same number and types of soil-based organisms to the same extent that we probably were for most of our evolutionary history. And as we’re going to discuss in a lot more detail in a later question, there’s a lot of evidence that these soil-based organisms have profound immunoregulatory effects. In other words, we evolved with them over a long period of time, and our immune systems have a symbiotic relationship with them and function much better in their presence. And so the soil-based organisms are a different approach than the lactic acid-forming types of probiotics, and I’ve found that they’re better tolerated in people with SIBO. As a fairly unrelated side note, they tend to work better for constipation than a lot of other probiotics. Oftentimes, probiotics can make constipation worse, so the soil-based organisms and Prescript-Assist, I think, is a really good choice for people with SIBO.

And then another probiotic that can be helpful with SIBO is Saccharomyces boulardii, which is a beneficial strain of yeast, and I’ve had some success with that as well. [LINK]

Soil-based organisms do not produce significant amounts of D-lactic acid, and are a better choice for this reason.[LINK]

I'm really using mostly soil-based organisms like bacillus species because I find that first of all in the literature, they have stronger antimicrobial effects than a lot of lactic acid kinds of probiotics. They’re endospore formers. So what that means is they can survive the harsh acidic environment of the stomach and make it through to the colon where they’re supposed to get to completely intact. That’s because bacillus species bacteria are wild type adopted for the human gut. They’ve been surviving that passage for a very long time. We’ve been exposed to them through soil and untreated water for a long, long time, you know, hundreds and hundreds of thousands of years so we have this kind of symbiotic relationship with that.

The last reason is that in order to really significantly change the levels of gut bacteria and have a really significant impact, you have to take more than what exists in the gut already. So as I said before, lactobacilli and bifido bacteria if you supplement with them, there are a few problems. One is that they’re not wild type adopted for the gut so they’re very susceptible to the stomach acid. They're killed by the stomach acid. Number two, because they exist in concentrations of twenty trillion in the gut, you have to take an enormous amount of them to influence the population because otherwise it's kind of like just emptying a cup of water in the ocean. Right?

The bacillus species are only present in concentrations of hundreds of millions. So if you take capsules with two to four billion, you're really dramatically affecting the population...That’s really great and really effective and the good news about these, both of these that I’m going to mention are that they’re safe to take when you have SIBO.

The other problem with bifido bacteria and lactobacillus is that when you have small intestinal bacterial overgrowth, it usually involves an overgrowth of lactic acid forming species like Lactobacillus acidophilus, and of course guess what is in most probiotics...

...So those can actually make people worse that have SIBO and...a lot patients are like oh, I don’t do well with probiotics. You know, they make my symptoms worse. I get really constipated when I take them and that’s exactly what’s happening. So that kind of patient who doesn’t do well with probiotics or fermented foods they typically do really well with Prescript-Assist or the other soil-based organisms and I will always use those in those situations. [LINK]

If you do your research on SBO's, you'll come across some fear-mongering by people who have a stake in dairy-based probiotics claiming that SBO's will run rampant in your gut. It's not true. SBOs are extremely safe. Those false rumors were covered here.

 

[Peyt]

FYI. Those who have trouble with D-Lactate-producing species almost always do better on an SBO (soil based organism) probiotic.







If you do your research on SBO's, you'll come across some fear-mongering by people who have a stake in dairy-based probiotics claiming that SBO's will run rampant in your gut. It's not true. SBOs are extremely safe. Those false rumors were covered here.

Yes, as I mentioned I am taking Prescript-assist... that's the soil based probiotic Chris Kresser is talking about. (I am very familiar with his work and podcasts) ... It's helpful, in the sense of motility, but does nothing as far as degrading histamine which is the root of the problem which slows down bowel movement. I am looking to lower my histamine producing bacteria, and increase my histamine degrading ones...

 

[Ripley]

Yes, as I mentioned I am taking Prescript-assist... that's the soil based probiotic Chris Kresser is talking about. (I am very familiar with his work and podcasts) ... It's helpful, in the sense of motility, but does nothing as far as degrading histamine which is the root of the problem which slows down bowel movement. I am looking to lower my histamine producing bacteria, and increase my histamine degrading ones...

Well, according to Kresser...

...Obviously [if] you have histamine intolerance, you’d want to focus on the ones that are histamine degrading, and you’d want to avoid the ones that are histamine producing. And the histamine-producing category is Lactobacillus casei, Lactobacillus reuteri, Lactobacillus plantarum, and Lactococcus lactis, Enterococcus faecalis, and various types of E. coli. And then the ones that seem to degrade histamine and be beneficial are lots of bifidobacteria species, but particularly Bifidobacterium infantis and then Lactobacillus rhamnosus and salivarius and sporogenes and Lactobacillus gasser.

This is the tip of the iceberg because there are a lot more species, obviously, of probiotics out there, and I personally wonder about soil-based organisms. I just anecdotally in my practice have observed that soil-based organisms are much better tolerated by people with histamine intolerance and people with SIBO, so my suspicion is that those are not histamine builders and may even be histamine degraders, but I don’t have any evidence to back that up.[LINK]

Also prebiotics, particularly Resistant Starch, are known to help bloom bifido populations in the gut better than probiotics can.

 

[Peyt]

Well, according to Kresser...
Chris Kresser said:
...Obviously [if] you have histamine intolerance, you’d want to focus on the ones that are histamine degrading, and you’d want to avoid the ones that are histamine producing. And the histamine-producing category is Lactobacillus casei, Lactobacillus reuteri, Lactobacillus plantarum, and Lactococcus lactis, Enterococcus faecalis, and various types of E. coli. And then the ones that seem to degrade histamine and be beneficial are lots of bifidobacteria species, but particularly Bifidobacterium infantis and then Lactobacillus rhamnosus and salivarius and sporogenesand Lactobacillus gasser.

This is the tip of the iceberg because there are a lot more species, obviously, of probiotics out there, and I personally wonder about soil-based organisms. I just anecdotally in my practice have observed that soil-based organisms are much better tolerated by people with histamine intolerance and people with SIBO, so my suspicion is that those are not histamine builders and may even be histamine degraders, but I don’t have any evidence to back that up.[LINK]



Also prebiotics, particularly Resistant Starch, are known to help bloom bifido populations in the gut better than probiotics can.

Yes, that's exactly why I started experimenting with Probiotics again after leaving them alone for about a year. The thing I don't understand is that he names L. reuteri as a histamine producing one, but when I take the product I mentioned earlier "Cardioviva" which has only single strain of L. reuteri my mouth thrush reduces, my sinus congestion reduces and i feel so much lighter... i still have not figured that one out yet... but because of this, I feel even Chris Kresser (and the whole medical community for that matter) is in the early stages of learning about Histamine degrading vs. producing bacterias... I have a feeling as more research will come out we will know alot more stuff that actually can be applied in real life.

BTW, today is my 4th day on that Bifido Complex from Kirkman, and instead of reducing my histamine I can feel/tell it's going the wrong direction! My nose was stuffy this morning when I woke up and mouth thrush covered my tong again! .... I am gonna take it for a few more days. I do feel my food is somewhat digesting better... so i have a feeling there is a strain in the formula that is helping and perhaps others that are not.... I am also learning that I am having more success with single strain products because once i take them i am clear as to if this strain is helping or not, but when i take probiotics that have bunch of strains in them, i feel like some things improve and some don't which now makes total sense to me... I have Gut Dysbiosis, and since there is not a test that can tell me exactly which bacterias I have too much of and which ones I have not enough of , I am (like the rest of the people with Gut Dysbosis) are shooting in the dark and trying different ones hoping I get lucky and find the ones that I am low on....

Gut Dysbiosis is a very complicated thing when there is not a test for it that can accurately measure all the strains of bacteria in the gut. I guess this is why what works for me may not work for another person, because I may be low on 1 strain and someone else on another. But our condition is both classified under Gut Dysbiosis.

 

[adreno]

@Peyt

Take a look at the Rethinking Probiotics thread, it's about histamine.

 

[Peyt]

Just wanted to give an update, I have stopped the Bifido Complex by Kirkman , it was clearly not working for me. Later I discovered that one of the strains in that Bifido formula does not do well for people that have fat malabsorption(it's the Bifido Bifidum). Since then, I called Custom Probiotics and bought some pure B. Longum which according to this study helps digest Fructose:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249088/

Ever since I started taking a small amount of B. Longum with each meal, I no longer have gas. But my bloating still remains. So still looking for more answers. I am tempted to try that "Probio Defense" which is mentioned in the "Rethinking Probiotics" thread. It has the B. Longum that works for me without the B. Bifidum.