Rethinking Probiotics.

Ema

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Yesterday an email popped up in my inbox regarding probiotics and histamine. Since I've been taking abx for a while now for Lyme, I've always been very pro-probiotics. But I've also had issues with abdominal bloating especially after mealtimes and multiple chemical sensitivity due to high histamine.

So this article says that some strains of probiotics are histamine producing...and some are histamine degrading. And it apparently can really make a difference for some people in terms of weight, bloating and histamine reactions if they overconsume the histamine producing variety. PubMed has articles on this topic as well and there are blog posts galore when you search for probiotics and histamine. I don't know how I missed this for so long!
Yogurt falls into the histamine producing category as well and it is also insulinemic which is no good for those of us with insulin resistance.

The good news is that there are probiotics available that do not contain the histamine producing strains of probiotics.

So, sorry VSL #3. I'm switching to Xymogen...

From Chris Kresser:
One of my patients that has histamine intolerance discovered, I guess, a German study that was translated and posted in a Facebook group that talks about these issues, a fecal bacteria therapy group. And this study apparently looked at various microbial strains and broke them into three categories: one category that’s histamine producing; another category, which seems to be sort of neither histamine producing, nor histamine degrading; and then the third category would be histamine degrading. And so obviously 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 (Ema added it may produce tyramine though), 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. It’s been interesting, though, to observe that, that the soil-based organisms are better. And in fact, pretty soon here I’m going to write an article about one of the products that I’m using a lot in my practice called Prescript-Assist that I really like. I’m using it actually myself personally and having some really good results, and I’ve been using it with my patients with good results, so stay tuned for an article about that.

(This is not a complete list unfortunately. I want to try to put a better list together from all the articles I've read.)

Below from http://thelowhistaminechef.com/these-probiotic-strains-lower-histamine-rather-than-raising-it/:

SO I’M LOOKING FOR A PROBIOTIC SUPPLEMENT WITH INFLAMMATION LOWERING…

(read the article below to understand the logic)
Bifidobacterium infantis
Bifidobacterium longum
Lactobacillus reuteri (raises histamine in the short term but elevates anti inflammatory cAMP levels)
But also Lactobacillus plantarum (lowers/inhibits tyramine and putrescine) (Ema added conflicting reports on this one. Study shows it actually produces tyramine which is also a biological amine that those on low histamine diets may want to avoid.)

POTENTIALLY…

Saccharomyces-Boulardii: I found a number of studies on its effectiveness in treating gastroenteritis, which some researchers have linked to high histamine/mast cell issues.

NEUTRAL STRAINS…

Lactobacillus acidophilus, Lactobacillus Lactis, Lactococcus Lactis, and Lactobacillus plant arum which do not have any effect on biogenic amines like histamine and tyramine.

BUT NOT…

Lactobacillus casei (produces histamine and tyramine)
Lactobacillus Bulgaricus (increases histamine alone)

http://www.bulletproofexec.com/why-yogurt-and-probiotics-make-you-fat-and-foggy/?utm_medium=email&utm_campaign=Beyond+Organic+Probiotic+Post&utm_content=Beyond+Organic+Probiotic+Post+CID_ef03d869b8ce71fa7ef52e8c50448368&utm_source=Campaign%20Monitor%20Mailing&utm_term=Click%20here%20to%20read%20the%20entire%20article
(I wouldn't buy an MLM product if I can help it but the info is good regardless).
Ema
 
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camas

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Ema,

Thanks so much for this. I've struggled with various probiotics, but seemed to be okay with Align which is a Bifidobacterium infantis. Florastor, a Saccharomyces-Boulardii, made my throat swell. I thought it might be because it's yeast based and I was just allergic, but now I wonder? Very interesting.
 
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Thanks, some good info. I have a difficult time with probiotics in general, including soil based. I think the worse for me is the bifodo lactis.

I am thinking this is refererng to histamine produced in gut, which I am guessing is similar to that which is ingested via food. I wonder how this differs from histamine reaction, allergy reaction.

Also, I am wondering how histamine intolerance is detected/diagnosed, and how it is in fact different from allgery. I think there is a test for serum histamine, though it is difficult to come by. I think there is a related test, diamine oxidase (DAO), but again, I think it is difficult to come by.
 

Little Bluestem

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Yogurt falls into the histamine producing category as well and it is also insulinemic which is no good for those of us with insulin resistance.
Is all yogurt insulinemic or just the flavored ones that have tons of sugar added?
 

Lala

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Very interesting, Ema, thank you. I have been reading about different probiotics for a long time, but this is completely new to me.
 

Thinktank

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I just read a piece of Dave Asprey about probiotics and the effects on histamine.
http://www.bulletproofexec.com/why-yogurt-and-probiotics-make-you-fat-and-foggy/

I don't know if it's allowed to copy-paste a whole article but here it is. Just ignore the self-promotion for his coffee product.

Yes, you read the title of this post correctly. You’re about to read how yogurt and some probiotics negatively affect our gut bacteria, which is an unknown culprit in making people fat and foggy headed.
For the past 30 years, obesity and autoimmune disease rates have been on a steady rise. At the same time, a little-known condition called histamine intolerance has become much more common. It’s a challenge to figure out the root causes and common denominators for these three seemingly unrelated health trends.
Lots of research shows that an unhealthy gut contributes to obesity, diabetes, rheumatoid arthritis, autism, depression, and chronic fatigue. The gut biome (intestinal bacteria), your diet, and the gut lining determine gut health. Modern lifestyle factors like the overuse of antibiotics, and diets high in processed, preserved, and histamine producing foods (i.e. most conventional yogurt), all contribute to an unhealthy gut biome. To repair an unhealthy gut and decrease histamine intolerance you need to eat an anti-inflammation diet, minimizing histamine producing bacteria and maximizing histamine degrading bacteria.
This isn’t just science to me – it’s personal. My history of 15 years of heavy antibiotic use for chronic sinus infections as a young man set me up to have a histamine intolerance. Biohacking that problem helped me to discover the histamine connection years ago, but the link to the gut biome was quite elusive.
Why Your Gut Biome has Changed and Why Probiotics Have Become So Important

The human gut biome (microbiome) consists of about 100 trillion bacteria cells – more than 10 times more than there are human cells in your body. You could even start to think of your gut biome as a significant organ in your body, so keeping it healthy and balanced is essential to reduce disease and optimize performance. As we learn more about the makeup of good and bad bacteria in the gut biome, researchers are also doing cutting edge DNA microbiome sequencing to show how people’s gut biomes are changing on a population level.
Gut biomes are becoming imbalanced because there are less good bacteria and more bad bacteria available in modern lifestyles and the standard American diet. When microbiota balance is out of whack, your body develops chronic inflammation, which can become autoimmune disease or other serious health problems. New research even suggests that diabetes may be an autoimmune disease triggered by poor gut health.1
By now, most people know that one contributor to a broken microbiome is overuse of antibiotics. Antibiotics may wipe out whatever bad bacteria you were hoping they would, but they can also clear your system of the really good bacteria that promote a healthy gut. A number of studies show that even a single course of antibiotics can permanently alter the gut flora.2,3
Aside from antibiotics overuse, poor diets and environmental toxins also wreak havoc on the gut by wearing down the protective barriers of the intestinal walls, eventually creating a leaky gut. As I’ve written previously, foods that are heavily processed, preserved, and filled with chemicals and toxins, damage gut health. Common types of these gut-damaging foods include: gluten, processed meats, sugar, most alcohol, mold toxins from coffee and chocolate, and more. These foods increase histamine levels, which in part is due to bad bacteria. I will go into more detail about histamine inducing bacteria in foods later in this post.
One of the reasons I’m such a fan of fresh, organic, local meat and vegetables is that our gut bacteria ultimately are related to our soil bacteria. Soil bacteria are the microbiome of the planet. Industrial agriculture has permanently modified soil organisms – molds and bacteria – so that they produce more toxins than ever before in history. The genes that form those toxins get shared with the bacteria growing in your gut.
Since the advent of antibiotics, scientists have been all over fighting bad bacteria. Now they are beginning to understand the importance of good bacteria and microorganisms in our guts. This “good bacteria” theory led to taking supplemental probiotics as the go-to way to help re-populate our guts after courses of antibiotics or other stressors. Although some probiotics are good for you, sadly (for yogurt companies especially), most manufactured probiotics are only minimally effective at re-populating the gut biome. It is becoming apparent that not all strains of probiotics interact with the gut in the same way.
Histamine Intolerance and Which Bacteria to Avoid

Disturbance in gut biome also plays a significant role in creating the recent rise in histamine intolerance. Histamine intolerance is the result of an imbalance between the breakdown of histamine and its buildup in the gut. This is generally caused by a deficiency in the DAO enzymes (found in intestinal mucosa) that helps metabolize and breakdown dietary sources of histamine.
A histamine overload leads to increased inflammation and many other symptoms including: skin irritation, hives, throat tightening, increased heart rate, nasal congestion, migraines, fatigue, heartburn, reflux, and weight gain.4 Unlike other food allergies and sensitivities, the response from histamine intolerance is cumulative and not always immediate, so it is harder to pin point right away. 5,6
This is personal – I’m histamine intolerant but have been able to reduce my intolerance dramatically following the advice I’m sharing in this post.
**Sneak peak into a future post: Histamine is not the only bioactive substance that can lead to histamine intolerance. Biogenic amines also interact with DAO enzymes in the gut.**
Although there are some genetic causes for a decrease in the production of DAO enzymes, the change in people’s gut biome is also responsible for histamine intolerance. Even if someone has a normal production of DAO enzymes, the levels may still be insufficient when placed against high concentrations of histamine-rich foods and histamine producing bacteria.
Many of the histamine-rich foods are found in the red (toxic) areas of the Bulletproof Diet infographic, but some common sources of histamine-producing foods are surprising. The following foods often have higher histamine contents or help release stored histamine:
  • Matured or fermented foods (depending on the bacteria and yeasts that are involved in the process): Sauerkraut, Kombucha, pickles, fermented SOY products, soy sauce, fish sauce, fermented coffee (Upgraded Coffee is safe). Some fermented foods are acceptable as long as it doe not cause a negative reaction.
  • Microbiologically produced foods: Most yogurt, buttermilk, kefir, mature cheese, sauerkraut, wine (especially reds)
  • Processed, smoked, and fermented meats: Lunchmeat, crappy bacon, sausage, pepperoni, salami, etc.
  • Alcohol: Red wine, white wine, champagne, beer
  • Yeasty Foods: breads made with yeast
  • Certain Vegetables, Fruit, and Nuts: tomato, canned vegetables, strawberries, kiwi, pineapple, peanuts, cashews, walnuts, and more.
Different types of bacteria and probiotics also play a part in histamine regulation. Some probiotics are necessary for proper gut function (where histamine lowering enzymes DAO form), but some strains actually raise histamine levels. The different strains of studied probiotics are categorized as (1) histamine producing bacteria, (2) neutral bacteria, or (3) histamine degrading bacteria.7-1
  1. Histamine producing bacteria: Lactobacillus casei, Lactobacillus reuteri, and Lactobacillus bulgaricus (Found in most yogurts and fermented foods).
  2. Neutral bacteria: Streptococcus thermophiles (also in yogurt) and Lactobacillus rhamnosus (shown to down regulate histamine receptors and up-regulate anti-inflammatory agents)
  3. Histamine degrading bacteria: Bifidobacterium infantis (found in breast milk), Bifidobacterium longum, Lactobacillus plantarum, and some soil-based organisms.
Some of these bacteria form histamine when they break down protein in foods, even vegetables, whether the food is in your gut or fermenting in your kitchen. Now you know why I’m skeptical about throwing a bunch of cabbage into a bucket to let it ferment. You just don’t know what you’re getting.
The Probiotic Bulletproof Coffee Failed Experiment

Four months ago, I had a brilliant idea. I’d add a prebiotic (food for probiotics) called fructooligosaccharide to my Bulletproof coffee in the morning, and take a probiotic with it. Over the last decade, I estimate I’ve spent upwards of $25,000 on various strains of probiotics to fix my gut, including the time I took pig whipworm eggs. Anyway, I took an “acidophilus pearl” capsule because those were convenient and I was out of my normal probiotic. The one I took had lactobacillus casei, a histamine producing bacteria in it.
The result? I gained 10 pounds in seven days, with a noticeable inflammation in the gut. I stopped the probiotics and it took 7 days to lose the weight.
Probiotic supplementation is a catch-22 and you should not just grab whatever has the best label on the shelf. If you have histamine intolerance, or you want to avoid developing it, experiment with avoiding histamine producing bacteria and focus on histamine degrading or neutral bacteria.
So just toss out the Lactobaccillus casei from your cupboards and fill your refrigerator with Bifidobacterium longum, right?! Uh… yeah… The good news is there are protocols, diets, and product already developed to help you reduce histamine-rich foods, avoid histamine producing bacteria, and consume more histamine degrading bacteria.
3 Ways to a Healthy Gut Biome and Reduce Histamine Intolerance

#1) Follow the Bulletproof Diet to heal your gut:

Eat a low histamine, anti-inflammatory diet like the Bulletproof® Diet as the primary way to protect your gut and reduce histamine intolerance. Eating prebiotic foods that selectively stimulate the growth of good bacteria in your gut is also helpful. Prebiotic foods in the ‘green portions’ of the Bulletproof diet include: Jerusalem artichoke, avocados, and vegetables high in soluble fiber like sweet potatoes, Brussels sprouts, asparagus, and turnips. Onions are in the yellow zone because of what they do to alpha brain waves, but they also have prebiotics in them.
Self-tracking tools like the Bulletproof Food Sense App help to detect physiological responses to foods you are sensitive too that may be due to excess histamine concentration. Although histamine intolerance can be difficult to diagnose, one of the common symptoms is an elevated heart rate. Using the Food Sense App after meals (as instructed) will use the iPhone’s camera sensor to measure your heart rate and compare it to your baseline heart rate. If there was an increase of more than 16 beats per minute, then this signifies a food sensitivity and helps you zoom in on gut wrecking or histamine-rich foods.
#2) Reduce histamine producing bacteria

Avoid histamine producing bacteria like Lactobacillus casei, Lactobacillus reuteri, and Lactobacillus bulgaricus that are mostly commonly found in the majority of yogurts and fermented foods, especially when they are not balanced by other species. Rampant unbalanced focus on lactobacillus in yogurt has led to this problem.
#3) Increase histamine degrading bacteria

Finding ways to get more histamine degrading bacteria into your diet can be difficult, but is great for gut health and key to reducing histamine intolerance. High phenol foods like blueberries, coffee, and chocolate can feed a type of gut bacteria called firmacutes.
My favorite (best tasting) source of balanced bacteria is a yogurt-like product, called Amasi, that contains 30 carefully controlled strains of bacteria. Traditionally, Amasi is the renowned drink of the Masai warrior tribes in Northern Tanzania and Kenya and is known for its rich variety of beneficial bacteria and highly bioavailable nutrients.
As you might have heard on podcast episode #47 with Jordan Rubin, founder of Beyond Organic and creator of Amasi, he replicated the Masai tribes’ production system to produce Amasi from grass fed, antibiotic free, cow’s milk. Rubin even went to the extent to make sure he used the same genetic breed of the Masai’s cows to assure they have non-inflammatory kind of casein (Beta casein A2).
The fermentation of the Amasi is influenced by key histamine degrading bacteria: Lactobacillus plantarum, Bifdocaterium lactis, and Bifidobacterium longum.13,14 These particular strains not only lower histamine levels, reduce inflammation, and improve digestion, but Amasi as a whole food helps improve absorption of specific nutrients such as vitamin B6, B2, and K, folic acid, niacon, and zinc.
MLM alert – Beyond Organic, the creator of Amasi, is a multilevel marketing company. I despise that business model because it usually victimizes needy people, and it leads to low quality or high prices. Long discussions with Jordan and an evaluation of his standards and pricing lead me to believe that Beyond Organic is not out to victimize people and is charging a fair price for impossibly high quality dairy. I did not decide to mention a MLM company lightly and did so after great diligence. If you don’t like it that I’ve made this decision, I invite you either accept it or unsubscribe. It is a decision made with integrity.
Beyond Organic has gone to great lengths to do everything right in creating a truly transformative dairy product. I have never seen anything like it and Amasi is the only yogurt-like food my body has been able to digest flawlessly, and it tastes great! Amasi is a great way to allow a little bit of yogurt into your life and still feel perfectly normal afterwards.
This is why I worked with Beyond Organic to create customized Bulletproof packs at a special discounted rate for the Bulletproof Community to try these incredible products yourselves. The Bulletproof® Packs were personally crafted to include an assortment of Bulletproof approved foods and beverages that will help upgrade your gut health and mental performance, including: Amasi, Omega powder, grass-fed low histamine beef jerky, almonds, and herbs.
 

undcvr

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I have come to the same conclusion myself and I now only consume B strain probiotics. They actually produce not only the DAO enzyme but other amine oxidases as well that break down other nitrosamines. Another thing to note of is that the DAO produced in the gut is completely Cu dependent. If you don't get it from your diet you cannot make the enzyme. The poduction also requires B6 in its P5P form to go through. Worth nothing if buying Histame as a supplement is expensive, make sure you are supplementing with Copper and P5P first.
 

triffid113

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I'll have to give this some thought - it's an interesting hypothesis. But I LOVE yogurt. I might avoid it during allergy season Only and see. I am now taking Spirulina which is an anti-histamine. It does work. Now that allergy season is over I have fallen back to a dose of 2g/day as this works after 3 months. I was taking 10.5g during the season. idk if I needed that much, but since I was not taking it in advance maybe I did.
 

undcvr

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Spirulina is also a th1 cytokine booster and helps to balance your th1 and th2, that is the reason why it works as an antihistamine, it works indirectly.
 
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Anyone know of a histamine degrading (or neutral) probiotic, that is also free of d-lactate (or at least non d-lactate producing)?

Also, is lactobacillus coagulant histamine producing or degrading?
 

ahmo

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@Tara, Top of the thread has the info compiled by the low histamine chef, Yasmina. She is using Ben Lynch's probiotic, not good for me as it contains prebiotics, which also feed the SIBO. You can find this linked to her site.
I switched mine, to the first 2 in the iherb list, also using PrescriptAssist, soil-based. I now alternate these.

I've also taken her recommendation re nigella (black cumin)oil, adding it to my skin creams. It seems to be hydrating, my skin loves it.

BELOW IHERB LISTINGS FOLLOW 2-3 HOURS RESEARCHING IHERB AND OTHERS MENTIONED ABOVE. THE REST HAVE UNWANTED PROBIOTICS OR OTHER INGREDIENTS. DEC 2 2013]

http://www.iherb.com/Nature-s-Way-Primadophilus-Reuteri-Pearls-60-Pearls/14704
1 Billion CFU Lactobacillus acidophilus; Bifidobacterium longum; Lactobacillus reuteri; Lactobacillus rhamnosus)

* http://www.iherb.com/Ortho-Molecular-Products-Ortho-Biotic-Gastrointestinal-Health-60-Capsules/20798#p=2&oos=1&disc=0&lc=en-US&w=lactobacillus plantarum&rc=184&sr=null&ic=47
Proprietary Blend
20 Billion CFU++
Lactobacillus acidophilus, Lactobacillus paracasei,
Bifidobacterium bifidum,
Bifidobacterium lactis
Lactobacillus plantarum
Lactobacillus rhamnosus
Saccharomyces Boulardii

http://www.iherb.com/Solgar-Advanced-Multi-Billion-Dophilus-60-Veggie-Caps/14215#p=1&oos=1&disc=0&lc=en-US&w=l. paracasei&rc=36&sr=null&ic=3
L. acidophilus, LA-5
B. lactis, BB-12
L. paracasei, L. CASEI 431
L. rhamnosus GG, LGG

http://www.iherb.com/Solgar-Advanced-40-Acidophilus-120-Veggie-Caps/8751#p=1&oos=1&disc=0&lc=en-US&w=l. paracasei&rc=36&sr=null&ic=6
Advanced 40+ Acidophilus Complex providing
L. acidophilus, LA-5
L. rhamnosus GG, LGG
L. paracasei, L CASEI 431
B. lactis, BB-12
S. thermophilus, TH-4
 
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ahmo

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@maryb, I'll go for that! I wanted to modify my post re brands to add that one of my criteria was not needing ice for shipping, but there's no edit prompt showing. oh well.:aghhh:..i like these little guys.
 

Critterina

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@maryb, I wanted to modify my post re brands to add that one of my criteria was not needing ice for shipping, but there's no edit prompt showing. oh well.:aghhh:..i like these little guys.
I was reading the labels on your links, @ahmo , and both the Solgar products said "refrigeration optional". The Reuteri Pearls said "No refrigeration needed".

My pulmonologist is willing to order DAO activity tests if we can only find somewhere (preferably in the US) that does the test. Any clues?

Oh, and I wanted to post my research on tests:
http://lsialab.com/gb/Histamine_Intolerance_Test

http://www.purehealthshop.co.uk/shop/article_22/Histamine-DAO-Enzyme-Test-(blood).html?sessid=hkB6QKFTGubAErWfK9nChk00QDYU3jAxMeXNiCKNeQcX6iWah00OiQhKCjOhegw7&shop_param=cid%3D1%26aid%3D22%26 (Note: I wrote to find what kind of test)

http://www.sciotec.at/uploads/media/dao_rea_en.pdf

...and on HI/DAO Articles:
http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1998.tb11141.x/full
In the gut H catabolism is preferentially performed by diamine oxidase (DAO) and H-N-methyltransferase (HNMT), present in epithelial cells of the small and large bowel. 5 Because the rate of H degradation might influence the occurrence and severity of allergic symptoms, this study investigated the distribution of DAO activity in the gut of patients suffering from FA and healthy subjects. (Note: See references 5, 16, and 17)

http://www.ncbi.nlm.nih.gov/pubmed/6416024
Studies were performed on the distribution and properties of intestinal diamine oxidase (DAO) previously called histaminase. DAO activity is high in the gastrointestinal tract of all investigated species. The highest values are in the aboral part of the small intestine: where DAO is localized in the mucosa, predominantly in the top villus region. A high reaction velocity of human intestinal DAO is observed with putrescine, methylhistamine and histamine. H2 receptor antagonists and an agonist (impromidine) inhibit intestinal DAO. The physiological and pathophysiological significance of intestinal DAO in the regulation of histamine and putrescine levels is described, as is the possibility that DAO may act as a growth retardant.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.1990.tb02791.x/abstract

http://www.researchgate.net/publica...nd_supporting_treatment_for_chronic_headaches
This one was discouraging...I want my tomatoes back!!!!
 

ahmo

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@Critterina, yes, that's what I was trying to add to my post. These are the ones that don't need refrigeration, which is necessary for me in Aus. So, there could have been some others there which I didn't list, as they weren't suitable for me.

I'll look through your links tomorrow. Thanks very much. ;)
 

Critterina

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@ahmo
I noticed the first in your list has L. reuteri, which increases histamine, at least in the short run. Being one to be laid low by a slice of tomato, I'm not going to risk that one. Oh, and I have been chastised professionally for not italicizing the genus and species consistently, so watch me now!