Archive for the ‘Gut Health’ Category

Cochrane Review – Probiotics Reduce C-diff By 70% in High Risk Patients Taking Antibiotics

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006095.pub4/abstract

Probiotics for the prevention of Clostridium difficile‐associated diarrhea in adults and children

Abstract

Background

Antibiotics can disturb gastrointestinal microbiota which may lead to reduced resistance to pathogens such as Clostridium difficile (C. difficile). Probiotics are live microbial preparations that, when administered in adequate amounts, may confer a health benefit to the host, and are a potential C. difficile prevention strategy. Recent clinical practice guidelines do not recommend probiotic prophylaxis, even though probiotics have the highest quality evidence among cited prophylactic therapies.

Objectives

To assess the efficacy and safety of probiotics for preventing C.difficile‐associated diarrhea (CDAD) in adults and children.

Search methods

We searched PubMed, EMBASE, CENTRAL, and the Cochrane IBD Group Specialized Register from inception to 21 March 2017. Additionally, we conducted an extensive grey literature search.

Selection criteria

Randomized controlled (placebo, alternative prophylaxis, or no treatment control) trials investigating probiotics (any strain, any dose) for prevention of CDAD, or C. difficile infection were considered for inclusion.

Data collection and analysis

Two authors (independently and in duplicate) extracted data and assessed risk of bias. The primary outcome was the incidence of CDAD. Secondary outcomes included detection of C. difficile infection in stool, adverse events, antibiotic‐associated diarrhea (AAD) and length of hospital stay. Dichotomous outcomes (e.g. incidence of CDAD) were pooled using a random‐effects model to calculate the risk ratio (RR) and corresponding 95% confidence interval (95% CI). We calculated the number needed to treat for an additional beneficial outcome (NNTB) where appropriate. Continuous outcomes (e.g. length of hospital stay) were pooled using a random‐effects model to calculate the mean difference and corresponding 95% CI. Sensitivity analyses were conducted to explore the impact of missing data on efficacy and safety outcomes. For the sensitivity analyses, we assumed that the event rate for those participants in the control group who had missing data was the same as the event rate for those participants in the control group who were successfully followed. For the probiotic group, we calculated effects using the following assumed ratios of event rates in those with missing data in comparison to those successfully followed: 1.5:1, 2:1, 3:1, and 5:1. To explore possible explanations for heterogeneity, a priori subgroup analyses were conducted on probiotic species, dose, adult versus pediatric population, and risk of bias as well as a post hoc subgroup analysis on baseline risk of CDAD (low 0% to 2%; moderate 3% to 5%; high > 5%). The overall quality of the evidence supporting each outcome was independently assessed using the GRADE criteria.

Main results

Thirty‐nine studies (9955 participants) met the eligibility requirements for our review. Overall, 27 studies were rated as either high or unclear risk of bias. A complete case analysis (i.e. participants who completed the study) among trials investigating CDAD (31 trials, 8672 participants) suggests that probiotics reduce the risk of CDAD by 60%. The incidence of CDAD was 1.5% (70/4525) in the probiotic group compared to 4.0% (164/4147) in the placebo or no treatment control group (RR 0.40, 95% CI 0.30 to 0.52; GRADE = moderate). Twenty‐two of 31 trials had missing CDAD data ranging from 2% to 45%. Our complete case CDAD results proved robust to sensitivity analyses of plausible and worst‐plausible assumptions regarding missing outcome data and results were similar whether considering subgroups of trials in adults versus children, inpatients versus outpatients, different probiotic species, lower versus higher doses of probiotics, or studies at high versus low risk of bias. However, in a post hoc analysis, we did observe a subgroup effect with respect to baseline risk of developing CDAD. Trials with a baseline CDAD risk of 0% to 2% and 3% to 5% did not show any difference in risk but trials enrolling participants with a baseline risk of > 5% for developing CDAD demonstrated a large 70% risk reduction (interaction P value = 0.01). Among studies with a baseline risk > 5%, the incidence of CDAD in the probiotic group was 3.1% (43/1370) compared to 11.6% (126/1084) in the control group (13 trials, 2454 participants; RR 0.30, 95% CI 0.21 to 0.42; GRADE = moderate). With respect to detection of C. difficile in the stool pooled complete case results from 15 trials (1214 participants) did not show a reduction in infection rates. C. difficile infection was 15.5% (98/633) in the probiotics group compared to 17.0% (99/581) in the placebo or no treatment control group (RR 0.86, 95% CI 0.67 to 1.10; GRADE = moderate). Adverse events were assessed in 32 studies (8305 participants) and our pooled complete case analysis indicates probiotics reduce the risk of adverse events by 17% (RR 0.83, 95% CI 0.71 to 0.97; GRADE = very low). In both treatment and control groups the most common adverse events included abdominal cramping, nausea, fever, soft stools, flatulence, and taste disturbance.

Authors’ conclusions

Based on this systematic review and meta‐analysis of 31 randomized controlled trials including 8672 patients, moderate certainty evidence suggests that probiotics are effective for preventing CDAD (NNTB = 42 patients, 95% CI 32 to 58). Our post hoc subgroup analyses to explore heterogeneity indicated that probiotics are effective among trials with a CDAD baseline risk >5% (NNTB = 12; moderate certainty evidence), but not among trials with a baseline risk ≤5% (low to moderate certainty evidence). Although adverse effects were reported among 32 included trials, there were more adverse events among patients in the control groups. The short‐term use of probiotics appears to be safe and effective when used along with antibiotics in patients who are not immunocompromised or severely debilitated. Despite the need for further research, hospitalized patients, particularly those at high risk of CDAD, should be informed of the potential benefits and harms of probiotics.

 

What is Clostridium difficile‐associated diarrhea?

Antibiotics are among the most prescribed medications worldwide. Antibiotic treatment may disturb the balance of organisms that normally populate the gut. This can result in a range of symptoms, most notably, diarrhea. Clostridium difficile (C. difficile) is a particularly dangerous organism that may colonize the gut if the normal healthy balance has been disturbed. Clostridium difficile‐related disease varies from asymptomatic infection, diarrhea, colitis, and pseudo‐membranous colitis to toxic megacolon and death. The cost of treatment is expensive and the financial burden on the medical system is substantial.

What are probiotics?

Probiotics are live organisms (bacteria or yeast) thought to improve the balance of organisms that populate the gut, counteracting potential disturbances to the gut microbial balance that are associated with antibiotic use, and reducing the risk of colonization by pathogenic bacteria. Probiotics can be found in dietary supplements or yogurts and are becoming increasingly available as capsules sold in health food stores and supermarkets. As ‘functional food’ or ‘good bacteria’, probiotics have been suggested as a means of both preventing and treating C. difficile‐associated diarrhea (CDAD).

What did the researchers investigate?

The researchers investigated whether probiotics prevent CDAD in adults and children receiving antibiotic therapy and whether probiotics causes any harms (side effects). The researchers searched the medical literature extensively up to 21 March 2017.

What did the researchers find?

This review includes 39 randomized trials with a total of 9955 participants. Thirty‐one studies (8672 participants) assessed the effectiveness of probiotics for preventing CDAD among participants taking antibiotics. Our results suggest that when probiotics are given with antibiotics the risk of developing CDAD is reduced by 60% on average. Among trials enrolling participants at high risk of developing CDAD (> 5%), the potential benefit of probiotics is more pronounced with a 70% risk reduction on average. Side effects were assessed in 32 studies (8305 participants) and our results suggest that taking probiotics does not increase the risk of developing side effects. The most common side effects reported in these studies include abdominal cramping, nausea, fever, soft stools, flatulence, and taste disturbance. The short‐term use of probiotics appears to be safe and effective when used along with antibiotics in patients who are not immunocompromised or severely debilitated. Despite the need for further research, hospitalized patients, particularly those at high risk of CDAD, should be informed of the potential benefits and harms of probiotics.

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2019-03-08T18-05-38.002Z_d9cf3bb3-63ee-4954-844b-df8809dc8984_group_cover_photo

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What Does it Mean to Herx?

https://globallymealliance.org/what-does-it-mean-to-herx/?

MyLymeLife_2-4

by Jennifer Crystal

Sometimes when I’m describing tick-borne illness, I feel like I’m speaking a foreign language.

Most people have heard of Lyme disease—though too many mistakenly call it “Lyme’s” when there is actually no possessive form. I often get blank stares when I use words like babesia, ehrlichia, and bartonella. Another term that confuses people, even those who have been diagnosed with Lyme, is Jarisch-Herxheimer reaction, more commonly referred to as a “Herx”.

A what? Bear with me.

Discovered by dermatologists Adolf Jarisch and Karl Herxheimer in their studies of syphilis—another illness like Lyme whose bacterium is a spirochete, meaning having a spiral shape—a Jarisch-Herxheimer reaction is an adverse response to toxins released by bacteria killed by antibiotics. In the case of Lyme disease, antibiotics sometimes kill spirochetes faster than the body can eliminate them. This means the patient is stuck with a backlog of dead bacteria which takes time to expel. The buildup of this toxic waste can make the patient feel much worse before it makes them feel better; their symptoms increase until their bodies can expel the dead spirochetes.

That’s one explanation of a Herxheimer reaction, but what does it feel like to actually have one?

When I started taking intravenous antibiotics, the first six weeks were awful. I’d expected the medicine to slowly clear up my symptoms the way antibiotics work, for example, on a sinus infection or simple bronchitis. But within a week of beginning treatment, I started feeling worse than I ever had before. My fatigue was as intense as it was when I first took ill. I felt a pulling sensation in my limbs stronger than I’d ever had before. I couldn’t find a comfortable position in bed because of all the the pains in my joints. Usually easy tasks like brushing my hair and washing dishes felt like workouts. My sleep became so heavy that my blood stopped circulating properly, and my limbs felt weighted. I wondered how I could still be alive when my body seemed so lifeless.

“This is great news,” my doctor said, paradoxically. “It means the medicine is working. Stay the course.”

My doctor said I was Herxing, meaning that the antibiotics were doing exactly what they were supposed to do.

“Once your body gets rid of that build up of dead bacteria, you’ll start to feel better.”

You may wonder how the bacteria gets eliminated. Some of it, especially the toxins from the parasitic tick-borne co-infection babesia, is sweated out. I’d wake two or three times a night completely soaked from head to toe, as if I’d just showered. The sweat felt slimy on my body, like a lotion or oil. I often had to change pajamas and sometimes even the sheets of my bed in the middle of the night.

But most dead spirochetes are eliminated as you might imagine: through the stool. I’d sit up in bed and suddenly feel a great urge for the bathroom. Once there, I’d barely get my nightgown raised and underwear down before my bowels exploded. The release came with the rush of diarrhea but the consistency was of foam noodles snaking out of me in long tubes. The toilet filled so quickly that I had to flush before continuing to go. The toilet steamed with hot dung the color of dead, hardened manure. The smell made me gag.

During my most intense Herxes, I ran to the bathroom upwards of ten times a day. I had to make sure to drink lots of electrolyte-enhanced water, to combat the dehydration brought on by night sweats and frequent elimination. I ate bananas to keep up my potassium levels. I spent a lot of time sleeping, or trying to sleep. During these periods my neurological symptoms would also worsen, because dead spirochetes were piling in my central nervous system, which for me meant insomnia or even hallucinatory nightmares.

The span of a Herx differs by patient. It depends on how you respond to treatment. How much bacteria do you have in your body to start with? Moreover,  how quickly can your body detox? For me, a Herx could last anywhere from a couple days to a couple weeks. Then, I’d get a reprieve for a week or two, and then the cycle would start all over. Each time, the Herxheimer reaction was a little less intense, but shorter. You might feel like you’re dying when you’re having one, but in fact it’s actually the bacteria that is dying, and that’s really a good thing.

You can’t control how well your body will respond to antibiotics, but you can help the detox process. There are many theories on how to do so. Some Lyme Literate Medical Doctors (LLMDs) use actual detox protocols. What helped me the most was electrolyte- augmented water, decaffeinated green tea, and lemon juice. Talk to your LLMD about how you can best support your body during a detox, so that your Herxes aren’t so bad. And when you do have a Herx and someone asks, “What’s that?” just show them this article.


jennifer crystal

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. She has written a memoir about her journey with chronic tick borne illness, for which she is seeking representation. Contact her at: 

lymewarriorjennifercrystal@gmail.com. 

_________________

**Comment**

One of the hardest things to understand about this complex disease(es) is that you feel a whole lot worse before you feel better and this can take considerable time.  Managing the herx is a challenging job.  Many find sauna’s to be of great help.  I also found drinking lemon water, green tea, MSM, and taking enzymes helpful.  As Dr. Burrascano says, “Now is the time for pristine health habits.”

For more:  https://madisonarealymesupportgroup.com/2015/08/15/herxheimer-die-off-reaction-explained/

https://www.lymedisease.org/lymesci-herxing/

https://madisonarealymesupportgroup.com/2019/01/26/lyme-herxheimer-reactions-dr-rawls/

https://madisonarealymesupportgroup.com/2015/12/06/tips-for-newbies/

Enzymes:  https://madisonarealymesupportgroup.com/2016/04/22/systemic-enzymes/

https://madisonarealymesupportgroup.com/2018/03/05/how-proteolytic-enzymes-may-help-lyme-msids/

https://madisonarealymesupportgroup.com/2018/10/24/herbs-habits-to-revive-your-gut/

MSM – another detoxifier, gut support, & inflammation & pain reducer:  https://madisonarealymesupportgroup.com/2018/03/02/dmso-msm-for-lyme-msids/

 

Food Allergies Got You Down? Your Essential Guide to Allergy-Friendly Alternatives

https://www.linkedin.com/pulse/food-allergies-got-you-down-heres-your-essential-jill-c-carnahan-md/

Food Allergies Got You Down? Here’s Your Essential Guide to Allergy-Friendly Alternatives

Jill C. Carnahan, MD
Living with food allergies can sometimes feel like a curse. Allergies require constant vigilance and lots of explaining. It can almost make eating seem like a chore. And it can be a bummer to explain that you can’t dig into that pizza at the Super Bowl party. It can also feel pretty lonely.
But it doesn’t have to be this way.
No one should be defined by their allergies. And going out with your friends shouldn’t have to be a stressful experience. So it’s time to get creative! I’ll show you how you or your loved one can enjoy mealtime again with tips on how to avoid the most common allergy-triggering foods and what you can replace them with.

Most Common Food Allergies

In the U.S., about 4% of adults and 8% of children suffer from food allergies, costing about $25 billion every year. And the numbers keep growing. There are over 170 known allergy-triggering food substances (also known as allergens), but scientists have found that only eight of them cause 90% of food-allergy reactions.

We’ll go into more detail about each of the eight most common allergens and the alternatives you can use to make safe (and still delicious) dishes. Below you’ll find a cheat sheet of my favorite allergy substitutions followed by a more detailed look into each:

Instead of This…Use This Cow’s Milk Rice, Almond, Coconut, or homemade nut milk Homemade nut milk recipe:

Blend ½ cup of raw nuts or seeds with 1 cup of water until smooth

EggsEner-G Egg Replacer, mashed banana, unsweetened applesauce, or ground flaxseedsPeanutsTree nuts like almonds, hazelnuts, cashews, and pecans (maybe), pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seedsTree NutsPeanuts (maybe), pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seedsSoyBeans, lentils, quinoa, almond milk, coconut milk, green peas, soy-free vegan butter and yogurt, other legumes and grainsWheatGluten-free flours and grains, such as flours made with: coconut, almond, oat, rice, quinoa, amaranth, millet, teff, arrowroot, tapioca bean, and nuts and seedsFish (Finned)Shellfish, eggs, dairy, other types of meat, high-protein vegetables and legumes like lentils, beans, and broccoliFish oil alternatives: flaxseed oil, walnut oil, soy oil, canola oil

Shellfish Finned fish, mollusks, eggs, dairy, other types of meat, high-protein vegetables and legumes like lentils, beans, and broccoliFish oil alternatives: flaxseed oil, walnut oil, soy oil, canola oil

Milk

Cow milk allergy is the most common type of allergy among young children and infants, affecting between 2 and 7.5% of them. Fortunately, most tend to outgrow it. The likelihood of a child outgrowing milk allergy depends on the level of cow’s milk antibodies in the child’s blood – the higher the antibody levels, the more likely it is for the allergy to continue into adulthood.

To replace milk, you can use dairy-free alternatives, such as rice, almond, coconut, or homemade nut milk. Homemade nut milk can be made by blending ½ cup of raw nuts or seeds with 1 cup of water. Many of these options taste great, are affordable, and are easy to find!

Eggs

Eggs are so commonly used in our foods that it can be a challenge to avoid them. It is the second most common food allergy in children after milk, affecting 0.5 to 2.5% of children.

And avoiding eggs is not an easy task. People with egg allergy can be accidentally exposed to them, especially at restaurants or bakeries where an egg-free item can easily come into contact with another item that contains eggs.

But being allergic to eggs doesn’t mean you have to settle for tasteless muffins or other baked goods! While you may not be able to eat egg-focused dishes, there are plenty of egg substitutes, like Ener-G Egg Replacer, mashed banana, ground flaxseeds, and unsweetened applesauce.

Peanuts

Have you noticed that schools near you are banning peanut products?

Peanut allergy deserves special attention because it accounts for a majority of severe food-related allergic reactions, including death. Not only is peanut allergy a growing problem, you can’t outgrow it, and even tiny amounts of peanuts can trigger a reaction in highly sensitive people.

Despite its name, peanuts are actually legumes, not nuts. So even if you can’t enjoy peanut butter, there are many options made of other types of nuts that’ll make your sandwich taste almost as good, like almond, hazelnut, walnut, cashew, and pecan butter.

Tree Nuts

Unfortunately for some of you with peanut allergy, you could also be allergic to tree nuts. In one large study examining peanut allergy, 86% of individuals with peanut allergy were also sensitive to tree nuts, and 34% of them had documented tree nut allergy. It turns out that this “cross-reactivity” occurs because peanuts and some tree nuts share similar allergenic proteins!

So what are tree nuts? Tree nuts include:

  • Almonds
  • Cashews
  • Macadamia nuts
  • Walnut
  • Brazil nuts
  • Hazelnut
  • Pecans
  • Pistachios
  • Shea nuts

As with peanuts, you can swap tree nuts for pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seeds. Many of these are especially good if you lightly toast them first.

Soy

Soy is a product of soybeans, a legume that is commonly used in Asian cuisines. It is rich in nutrients, including vitamin B, fiber, potassium, and magnesium.

While more research needs to be done about soy’s effects on human health, what’s clear is that soy allergy is becoming more common, affecting 0.4% of children. Fortunately, allergic reactions to soy tend to be mild and approximately 50% of children with soy allergy outgrow their allergy by the age of 7, and most will by the age of 10.

However, everyone is different, and it’s advised that those with soy allergy avoid foods with soy. Instead, you can substitute soy products with beans, almond milk, coconut milk, green peas, soy-free vegan butter and yogurt, among many others.

Wheat

As one of the most widely grown crops worldwide, wheat is used in many foods and drinks, such as sweets, breads, pasta, pizza, ketchup, and beer. It is even used in hot dogs!

Wheat allergy is often confused with gluten sensitivity or intolerance, but they are not the same thing. Gluten is just one of 27 allergens found in wheat, meaning not everyone with wheat allergy is allergic to the same part of the plant.

Although many children outgrow wheat allergy, some people can still have life-threatening reactions, and should opt for wheat-free products. For example, instead of flour made with wheat, look for the following types of flours:

  • Rice
  • Coconut
  • Almond
  • Oat
  • Spelt
  • Quinoa
  • Amaranth
  • Millet
  • Teff
  • Arrowroot
  • Tapioca bean
  • Nuts and seeds

You can use a blend of these flours to replace the full amount of wheat flour.

Even if you don’t have wheat allergy, I would still highly recommend that you avoid it as much as possible. In fact, this lifestyle change could end up saving your life. Eating wheat can increase your exposure to glyphosate, a toxic chemical found in the popular herbicide Roundup. I’ve written about the health-related dangers of glyphosate several times (most recently here), and I feel that the information we know now is just the tip of the iceberg.

Remember, it’s much easier to be proactive than reactive, especially when it comes to your health.

Fish

Fish consumption has increased worldwide, and so have reports of fish allergy, affecting between 0.5 and 5% of the population. Although fish allergy often develops during childhood, 40% of people experience their first allergic reactionto fish as adults.

The most common fish species people have reported being allergic to include salmon, tuna, and halibut. Many people who are allergic to one type of fish are also allergic to other types of fish, so avoiding all fish and fish products is essential, including fish oil.

As an alternative to fish, you can try eating shellfish. Since finned fish and shellfish are not related, you can still consume one while being allergic to the other. For fish oil alternatives, you can check out oil from plant sources, such as flaxseed oil, walnut oil, soy oil, and canola oil.

Shellfish

Like fish, shellfish allergy is a lifelong problem, and 60% of people with this allergy experience their first adverse reaction as adults.

There are two groups of shellfish, crustaceans and mollusks. Examples of each include:

  • Crustaceans: crabs, lobsters, shrimp, and krill
  • Mollusks: mussels, octopuses, clams, oysters, and snails

Typically, it is the crustacean group that causes the greatest number of allergic reactions. Some people with shellfish allergy have been known to be able to tolerate mollusks.

People with shellfish allergy may not be allergic to finned fish. However, if you happen to be allergic to both, you can still get your protein by consuming eggs, dairy, and other meat products (assuming you’re not allergic to any of them). If you’re a vegetarian, you can replace fish and shellfish with high-protein vegetables and legumes, such as lentils, beans, and broccoli.

Heal Your Gut With An Elimination Diet

If you suspect that you or a loved one has food allergies, it is important to identify the allergens, which may not be as easy as it sounds. The best way to do so is with an elimination diet.

According to The Institute for Functional Medicine (IFM), an elimination diet can help not only clear your body of the allergens, but it can also help restore balance to your gut microbiome. There is a growing body of evidence that says changes to your gut microbiome play a role in the development of food allergies. In fact, the lack of certain types of bacteria like Lactobacilli have already been linked to a higher risk of developing allergies in children. Are you surprised?

An elimination diet is typically a short-term program that first requires the participants to remove certain foods and food types from their diet. This gives the body an opportunity to heal, reducing oxidative stress and inflammation. After the initial elimination period, the foods are then slowly reintroduced one at a time, over 2 to 3 days, to see which ones trigger a negative reaction. When the allergen is identified, you can remove it from your diet. The entire process usually takes around 5 to 6 weeks.

IFM recommends that you attempt to reintroduce foods that provoke symptoms after 3 to 6 months, which gives your gut sufficient time to heal. Once your gut microbiome is more balanced, you may find that you can reintroduce those foods without symptoms.

Reintroduction can safely be done at home. However, for people with severe allergic reactions, this part should only occur in the presence of a doctor or another healthcare professional. Elimination diets for children should always be done under the supervision of a doctor.

Do You Have A Food Allergy?

Food allergies can present a daily challenge, but we now have more options than ever to substitute common allergens with safe and delicious alternatives.

Now I want to hear from you. Do you have a food allergy? Have you tried an elimination diet? What strategies or substitutes have you found useful? Share your experiences and thoughts in the comments!

References:

https://www.ncbi.nlm.nih.gov/pubmed/24388012?dopt=Abstract

https://www.ncbi.nlm.nih.gov/pubmed/20836734

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069662/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC154188/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962743/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548240/

https://www.hsph.harvard.edu/nutritionsource/soy/

https://www.ncbi.nlm.nih.gov/pubmed/20226303

https://www.foodallergy.org/common-allergens/soy-allergy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295079/

https://www.ncbi.nlm.nih.gov/pubmed/15241360

https://www.webmd.com/allergies/food-substitutes-for-fish-and-shellfish

https://www.foodallergy.org/common-allergens/shellfish-allergy

https://acaai.org/allergies/types/food-allergies/types-food-allergy/shellfish-allergy

https://www.ifm.org/news-insights/heal-microbiome-ifm-elimination-diet/

https://www.ncbi.nlm.nih.gov/pubmed/25157157

https://www.ncbi.nlm.nih.gov/pubmed/10202341/

https://www.ncbi.nlm.nih.gov/pubmed/25827065

https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/inflammatory-disease-processes-and-interactions-with-nutrition/8B6E145706102090539C4CE52A58F35E

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For more:  https://madisonarealymesupportgroup.com/2018/04/19/what-to-eat-when-youre-allergic-to-everything/

https://madisonarealymesupportgroup.com/2018/03/13/mcas-lyme-msids/

https://madisonarealymesupportgroup.com/2018/04/04/more-about-healing-from-mcas/

https://madisonarealymesupportgroup.com/2018/12/29/mcas-triggers-symptoms-how-to-cope/

https://madisonarealymesupportgroup.com/2018/06/26/study-links-food-allergy-to-autism-spectrum-disorder-in-children/

A new study from the University of Iowa finds that children with autism spectrum disorder (ASD) are more than twice as likely to suffer from a food allergy than children who do not have ASD.

Germs in Your Gut Are Talking to Your Brain. Scientists Want to Know What They’re Saying.

https://www.nytimes.com/2019/01/28/health/microbiome-brain-behavior-dementia.html?smid=fb-nytimes&smtyp=cur

The body’s microbial community may influence the brain and behavior, perhaps even playing a role in dementia, autism and other disorders.

Credit Sean McSorley

In 2014 John Cryan, a professor at University College Cork in Ireland, attended a meeting in California about Alzheimer’s disease. He wasn’t an expert on dementia. Instead, he studied the microbiome, the trillions of microbes inside the healthy human body.

Dr. Cryan and other scientists were beginning to find hints that these microbes could influence the brain and behavior. Perhaps, he told the scientific gathering, the microbiome has a role in the development of Alzheimer’s disease.

The idea was not well received.

“I’ve never given a talk to so many people who didn’t believe what I was saying,” Dr. Cryan recalled.

A lot has changed since then: Research continues to turn up remarkable links between the microbiome and the brain. Scientists are finding evidence that microbiome may play a role not just in Alzheimer’s disease, but Parkinson’s disease, depression, schizophrenia, autism and other conditions.

For some neuroscientists, new studies have changed the way they think about the brain.

One of the skeptics at that Alzheimer’s meeting was Sangram Sisodia, a neurobiologist at the University of Chicago. He wasn’t swayed by Dr. Cryan’s talk, but later he decided to put the idea to a simple test.

“It was just on a lark,” said Dr. Sisodia. “We had no idea how it would turn out.”

He and his colleagues gave antibiotics to mice prone to develop a version of Alzheimer’s disease, in order to kill off much of the gut bacteria in the mice. Later, when the scientists inspected the animals’ brains, they found far fewer of the protein clumps linked to dementia.

Just a little disruption of the microbiome was enough to produce this effect. Young mice given antibiotics for a week had fewer clumps in their brains when they grew old, too.

“I never imagined it would be such a striking result,” Dr. Sisodia said. “For someone with a background in molecular biology and neuroscience, this is like going into outer space.”

Following a string of similar experiments, he now suspects that just a few species in the gut — perhaps even one — influence the course of Alzheimer’s disease, perhaps by releasing chemical that alters how immune cells work in the brain.

He hasn’t found those microbes, let alone that chemical. But “there’s something’s in there,” he said. “And we have to figure out what it is.”

Scientists have long known that microbes live inside us. In 1683, the Dutch scientist Antonie van Leeuwenhoek put plaque from his teeth under a microscope and discovered tiny creatures swimming about.

But the microbiome has stubbornly resisted scientific discovery. For generations, microbiologists only studied the species that they could grow in the lab. Most of our interior occupants can’t survive in petri dishes.

In the early 2000s, however, the science of the microbiome took a sudden leap forward when researchers figured out how to sequence DNA from these microbes. Researchers initially used this new technology to examine how the microbiome influences parts of our bodies rife with bacteria, such as the gut and the skin.

Few of them gave much thought to the brain — there didn’t seem to be much point. The brain is shielded from microbial invasion by the so-called blood-brain barrier. Normally, only small molecules pass through.

“As recently as 2011, it was considered crazy to look for associations between the microbiome and behavior,” said Rob Knight, a microbiologist at the University of California, San Diego.

He and his colleagues discovered some of the earliest hints of these links. Investigators took stool from mice with a genetic mutation that caused them to eat a lot and put on weight. They transferred the stool to mice that had been raised germ-free — that is, entirely without gut microbiomes — since birth.

After receiving this so-called fecal transplant, the germ-free mice got hungry, too, and put on weight.

Altering appetite isn’t the only thing that the microbiome can do to the brain, it turns out. Dr. Cryan and his colleagues, for example, have found that mice without microbiomes become loners, preferring to stay away from fellow rodents.

The scientists eventually discovered changes in the brains of these antisocial mice. One region, called the amygdala, is important for processing social emotions. In germ-free mice, the neurons in the amygdala make unusual sets of proteins, changing the connections they make with other cells.

Studies of humans revealed some surprising patterns, too. Children with autism have unusual patterns of microbial species in their stool. Differences in the gut bacteria of people with a host of other brain-based conditions also have been reported.

But none of these associations proves cause and effect. Finding an unusual microbiome in people with Alzheimer’s doesn’t mean that the bacteria drive the disease. It could be the reverse: People with Alzheimer’s disease often change their eating habits, for example, and that switch might favor different species of gut microbes.

Fecal transplants can help pin down these links. In his research on Alzheimer’s, Dr. Sisodia and his colleagues transferred stool from ordinary mice into the mice they had treated with antibiotics. Once their microbiomes were restored, the antibiotic-treated mice started developing protein clumps again.

“We’re extremely confident that it’s the bacteria that’s driving this,” he said.

Other researchers have taken these experiments a step further by using human fecal transplants.

If you hold a mouse by its tail, it normally wriggles in an effort to escape. If you give it a fecal transplant from humans with major depression, you get a completely different result: The mice give up sooner, simply hanging motionless.

As intriguing as this sort of research can be, it has a major limitation. Because researchers are transferring hundreds of bacterial species at once, the experiments can’t reveal which in particular are responsible for changing the brain.

Now researchers are pinpointing individual strains that seem to have an effect.

To study autism, Dr. Mauro Costa-Mattioli and his colleagues at the Baylor College of Medicine in Houston investigated different kinds of mice, each of which display some symptoms of autism. A mutation in a gene called SHANK3 can cause mice to groom themselves repetitively and avoid contact with other mice, for example.

In another mouse strain, Dr. Costa-Mattioli found that feeding mothers a high-fat diet makes it more likely their pups will behave this way.

When the researchers investigated the microbiomes of these mice, they found the animals lacked a common species called Lactobacillus reuteri. When they added a strain of that bacteria to the diet, the animals became social again.

Dr. Costa-Mattioli found evidence that L. reuteri releases compounds that send a signal to nerve endings in the intestines. The vagus nerve sends these signals from the gut to the brain, where they alter production of a hormone called oxytocin that promotes social bonds.

Other microbial species also send signals along the vagus nerve, it turns out. Still others communicate with the brain via the bloodstream.

It’s likely that this influence begins before birth, as a pregnant mother’s microbiome releases molecules that make their way into the fetal brain.

Mothers seed their babies with microbes during childbirth and breast feeding. During the first few years of life, both the brain and the microbiome rapidly mature.

To understand the microbiome’s influence on the developing brain, Rebecca Knickmeyer, a neuroscientist at Michigan State University, is studying fMRI scans of infants.

In her first study, published in January, she focused on the amygdala, the emotion-processing region of the brain that Dr. Cryan and others have found to be altered in germ-free mice.

Dr. Knickmeyer and her colleagues measured the strength of the connections between the amygdala and other regions of the brain. Babies with a lower diversity of species in their guts have stronger connections, the researchers found.

Does that mean a low-diversity microbiome makes babies more fearful of others? It’s not possible to say yet — but Dr. Knickmeyer hopes to find out by running more studies on babies.

Credit Sean McSorley

As researchers better understand how the microbiome influences the brain, they hope doctors will be able to use it to treat psychiatric and neurological conditions.

It’s possible they’ve been doing it for a long time — without knowing.

In the early 1900s, neurologists found that putting people with epilepsy on a diet low in carbohydrates and high in protein and fat sometimes reduced their seizures.

Epileptic mice experience the same protection from a so-called ketogenic diet. But no one could say why. Elaine Hsiao, a microbiologist at the University of California, Los Angeles, suspected that the microbiome was the reason.

To test the microbiome’s importance, Dr. Hsiao and her colleagues raised mice free of microbes. When they put the germ-free epileptic mice on a ketogenic diet, they found that the animals got no protection from seizures.

But if they gave the germ-free animals stool from mice on a ketogenic diet, seizures were reduced.

Dr. Hsiao found that two types of gut bacteria in particular thrive in mice on a ketogenic diet. They may provide their hosts with building blocks for neurotransmitters that put a brake on electrical activity in the brain.

It’s conceivable that people with epilepsy wouldn’t need to go on a ketogenic diet to get its benefits — one day, they may just take a pill containing the bacteria that do well on the diet.

Sarkis Mazmanian, a microbiologist at Caltech, and his colleagues have identified a single strain of bacteria that triggers symptoms of Parkinson’s disease in mice. He has started a company that is testing a compound that may block signals that the microbe sends to the vagus nerve.

Dr. Mazmanian and other researchers now must manage a tricky balancing act. On one hand, their experiments have proven remarkably encouraging; on the other, scientists don’t want to encourage the notion that microbiome-based cures for diseases like Parkinson’s are around the corner.

That’s not easy when people can buy probiotics without a prescription, and when some companies are willing to use preliminary research to peddle microbes to treat conditions like depression.

“The science can get mixed up with what the pseudoscientists are doing,” said Dr. Hsiao.

Dr. Costa-Mattioli hopes that L. reuteri some day will help some people with autism, but he warns parents against treating their children with store-bought probiotics. Some strains of L. reuteri alter the behavior of mice, he’s found, and others don’t.

Dr. Costa-Mattioli and his colleagues are still searching for the most effective strain and figuring out the right dose to try on people.

“You want to go into a clinical trial with the best weapon, and I’m not sure we have it,” he said.

Katarzyna B. Hooks, a computational biologist at the University of Bordeaux in France, warned that studies like Dr. Costa-Mattioli’s are still unusual. Most of these findings come from research with fecal transplants or germ-free mice — experiments in which it’s especially hard to pinpoint the causes of changes in behavior.

“We have the edges of the puzzle, and we’re now trying to figure out what’s in the picture itself,” she said.