Side Effects Of Probiotics
- Interactions with antibiotics and autoimmune drugs
- Small intestinal bacterial overgrowth
- Increased risk of death during pancreatitis
- Unknown safety during pregnancy
- Unknown safety while breastfeeding
The first three listed, the digestive problems, are by far the most common adverse reactions one might encounter. Fortunately, they often occur during the first few days of starting a probiotic regimen and will dissipate over time. If they dont, you should discontinue use.
Whether probiotics will make you gain weight or lose weight is not black and white.
In horses, pigs, and livestock, there are certain strains associated with weight gain and are given for that very purpose. Human data is limited, as only Lactobacillus reuteri has been associated with obesity. The opposite has been seen with Lactobacillus rhamnosus.
can be a life-threatening response by your body to fight an infection. Its basically your immune system going into overdrive.
In immunodeficient mice, the side effect of sepsis was seen with human isolates of L. reuteri, L. acidophilus, and Bifidobacterium animalis or LGG. There were deaths reported with neonatal mice, which would make sense since their immune systems are less developed than the adults.
The same holds true for neonatal human babies, as they are more susceptible to infection.
If they are leading to an overstimulation of the immune system, probiotics might interfere with medications for autoimmune diseases.
Ethos Ho Bsc Pharm Candidate
How Safe are Probiotics Really?
In last weeks article, we discussed that while the use of probiotics is generally safe for most patients, caution is advised in individuals who areimmunocompromised or have a severely damagedgastrointestinaltract. Today, were going to delve deeper on the safety of probiotics in immunocompromised individuals, particularly those who received transplants.
This article was inspired by a real-life case at work, where a patient in the nephrology clinic inquired about the potential effects of probiotics on her transplanted kidney. Although the pharmacist and I were unsure about the evidence supporting its use, the theory of probiotics potentially boosting the immune system to cause transplant failure and the importance of maintaining a state of immunosuppression formed the basis of the recommendation.
Lets look at the evidence surrounding probiotic use in transplant patients.
What Does the Evidence Say?
A quick look at the available studies did not yield many results on the topic. One article that evaluated the current evidence on the safety of probiotics found that the main side-effects found were . Individuals who were at an increased risk for these complications included:1
- Critically ill in intensive care units
- Critically sick infants
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Probiotics For Kidneys: Is The Extra Pill Worth It
Probiotics for kidneys? Are they good? Are they bad? Do they actually help with anything? Or are they just another pill or supplement added in desperation to keep the kidneys stronger longer?
Disclosure: This post is sponsored by Kibow Biotech, the producer of Renadyl, a probiotic for kidney health. As always, all opinions are my own.
My answer probiotics for kidneys are something we should definitely consider with kidney health. Why? Because gut health is a big part of supporting optimal renal function. To quote, one of my favorite scientific reviews on the topic, The recent explosion of knowledge on the metabolic potential of gut microbiomehas led the nephrologist to refocus on the gut as a potential cause of CKD-related complications Ill add here this means not just the nephrologist should be looking at the gut-kidney connection, but all nephrology professionals and every patient looking to support their kidney health.
The recent explosion of knowledge on the metabolic potential of gut microbiomehas led the nephrologist to refocus on the gut as a potential cause of CKD-related complications
The Gut Microbiome, Kidney Disease, and Targeted Intervention. Ramezani A and Raj S. JASN April 2014, 25 657-670.
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Search For Literature And Selection Of Studies
The search for literature was carried out from December of 2016 to May of 2017 onthe following databases: Scientific Electronic Library Online , MEDLINE, Clinical Trials, and Cochrane Library. A search for morerecent papers published since May of 2017 was made on June of 2017. Anadditional search was made on Google Scholar to make sure no relevant paper wasmissed. The searches were carried out using the following terms: OR OR OR AND OR OR OR. All terms were used in the searches without using quotation marks.
Theres No Doubt That The Microbiome Is Vital But Probiotic Supplementation Is Not Yet A Fully Understood Science
The theory behind probiotic supplementation is that by adding some more friendly microorganisms to the mix, we can amplify the benefits of the microbes already there. But its not that simple.
Still in question are whether or not that works, when it works, and which types of microorganisms are a good fit for your cats gut.
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Mr Bacteria Please Eat Some Uremic Toxins
Give me some of that uremic-toxin eating bacteria! you say. Yes, that is possible! Let me tell you what that really means as far as what you do. Also consider that we are not just concerned about a strain of bacteria but also must always consider overall gut health because of how it impacts inflammation.
Gut health and kidney disease is not just about uremic toxins. Theres a lot more. There hasnt been one huge study, perfectly randomized, placebo-controlled study that shows the relationship between gut health and CKD progression. But theres been plenty of smaller studies focusing on correcting gut bacterial balance with reported findings of delaying kidney progression, reducing inflammation, and improving iron status .
There is also some interesting data showing that probiotics may help improve the health, strength, and overall condition of the gut barrier . The gut barrier is an absolutely essential point to understand when looking at the connection between gut health and inflammation.
The gut barrier is pretty important since it houses 70% or so of our immune system . It also is supposed to be a semi-permeable barrier meaning it lets some little things through and some big things out . If the gut barrier becomes more permeable, aka leaky, then unwelcome things pass into the blood that shouldnt.
When your guts epithelial tight junctions start to loosen up, some ugly things that should stay in your gut and be metabolized by bacteria begin toenter the bloodstream.
Does It Matter Which Probiotic I Use
Multiple probiotics have been studied with a specific focus on kidney disease. Bacillus pasteurii, Sporlac, Lactobacillus acidophilus, Escherichia coli-DH5, and others . There are many researchers in a variety of universities that study probiotics and prebiotics with kidney disease. Kibow Biotech, who produces Renadyl, is the only company that specifically studied probiotics for kidneys. Their probiotic consists of (S thermophilus-KB19, L acidophilus-KB27, and B longum-KB3 in a dosage of about 90 billion organisms. Dr. Ranganathan, the founder of Kibow Biotech, and one of the primary researchers has been studying this formula for 20+ years.
Current studies with Renadyl show that especially in later stages of CKD that uremic toxins were able to be broken down and excreted with help of their probiotic strains. Plus, remember I just mentioned bacterial production of ammonia and ammonium hydroxide from breaking down uremic toxins? There is some interesting data that Renadyl can help reduce that as well . Each of the different strains of bacteria has been chosen for a specific purpose. For example, per their report S. thermophils-KB19 breaks down urea, uric acid and creatinine, while B. longum-KB31 helps reduce levels of protein bound uremic toxins like p-cresol and indoles .
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Assessment Of Risk Of Bias
The coefficient of two reviewers was 0.899 . The bias of included trials was assessed according to the Cochrane Collaborations tool for assessing the risk of bias . Blinding of outcome assessment had the lowest low risk of 25%, while incomplete outcome data and other bias had the highest risk of 87.5% . Borges studies was graded as highest quality, while Pavans study was graded as low quality .
Risk of bias graph and summary. In Fig. 2a, low risk of random sequence generation was 62.5%, and low risk of allocation concealment was 37.5%. Blinding of patients had the low risk of 62.5%, while blinding of outcome assessment had the low risk of 25%. Completeness of outcome data and other bias were with the highest rate of low risk of 87.5%. Selective reporting with the low risk of 75%. In Fig. 2b, color green represents low risk, while red represents high risk. The yellow circle represents unclear risk, which means that no evidence was found. Borges study was estimated as low risks in all assessments. And Pavans research was estimated as high risk in three assessments.
Effect Of A Probiotic Combination In An Experimental Mouse Model And Clinical Patients With Chronic Kidney Disease: A Pilot Study
- 1Division of Nephrology, China Medical University Hospital, Taichung, Taiwan
- 2Department of Internal Medicine, China Medical University College of Medicine, Taichung, Taiwan
- 3Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan
- 4Department of Internal Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- 5Glac Biotech Co., Ltd., Tainan, Taiwan
- 6Biotools Co., Ltd., New Taipei City, Taiwan
- 7Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan
- 8Graduate Institute of Biological Science, China Medical University College of Medicine, Taichung, Taiwan
- 9Division of Neonatology, China Medical University Children’s Hospital, China Medical University, Taichung, Taiwan
- 10School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- 11Asia University Hospital, Asia University, Taichung, Taiwan
- 12Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
- 13Children’s Hospital, China Medical University, Taichung, Taiwan
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Inclusion And Exclusion Criteria
This systematic review included studies published between 2012 and 2016 in theEnglish and Portuguese languages, designed as randomized clinical trials enrolling humans to examine the effect of probiotic supplements, independentclinical trials phases I, II, III, IV enrolling patients with CKD, aged 18 yearsor older of both sexes, on hemodialysis or not. Review papers, systematic,narrative and integrative reviews, editorials, book chapters and abstracts,experimental trials with animals, and abstracts published in meeting proceedingswere excluded.
Chronic Kidney Disease & The Gut Microbiome
The kidneys play a vital role in maintaining the overall health of animals and people. They regulate hydration and act as a filter to aid in the removal of waste from the bloodstream. In this context waste refers to the breakdown of substances such as food, old cells, and medication. This waste is filtered through the kidneys and excreted via the urine. The kidneys also aid in the regulation of blood pressure, production of red blood cells, calcium homeostasis, and many other crucial functions.
Chronic Kidney Disease:
So how does CKD affect the gut microbiome?
When kidney function is impaired, the kidneys can no longer filter out waste normally. Failure to eliminate excess waste results in an accumulation of waste in the bloodstream which is known as uremia. When this buildup of waste circulates in the bloodstream it can cause an imbalance of bacteria in the gut microbiome resulting in an increased production of toxins by the gut . This disruption of the gastrointestinal flora, also known as dysbiosis, can cause an increase in permeability of the intestinal lining, promote inflammation, and negatively affect the overall immune system . Increased permeability of the intestinal lining allows further translocation of these toxins into circulation which can enhance the progression of kidney disease.
How Can Probiotics Help?
Visbiome Vet is a high potency probiotic that supports normal inflammatory responses in the gastrointestinal health. tract and helps maintain gut health.
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Sample Size Study Duration Intervention Characteristics
Sample size ranged between 18 and 101 patients with CKD, and study durationvaried from four to 24 weeks. Probiotic agent dosages ranged from 2.0 x 1012 to 16 x 109 CFU and 15g dosages did not follow a specific standard. The formof presentation of the probiotic agents varied significantly some wereadministered in bags/envelopes to be dissolved in water, while others had to beadded to yogurt and a few were given in capsules. In all studies, groups ofpatients were prescribed probiotics in different presentations – capsules, bags,etc. – and times in relation to meals -right after or while eating.
Some Ingredients May Cause Adverse Reactions
People with allergies or intolerances should read the labels of probiotic supplements carefully, since they might contain ingredients they could react to.
For example, some of the supplements contain allergens such as dairy, egg or soy.
These ingredients should be avoided by anyone who is allergic, as they may trigger an allergic reaction. If necessary, read labels carefully to avoid these ingredients .
Similarly, yeast-based probiotics should not be taken by those with yeast allergies. Instead, a bacteria-based probiotic should be used .
Milk sugar, or lactose, is also used in many probiotic supplements .
While studies suggest that most people with lactose intolerance can tolerate up to 400 mg of lactose in medications or supplements, there have been case reports of adverse effects from probiotics (
Some people experience gas and bloating when consuming synbiotics. Those who experience these side effects may want to select a supplement that does not contain prebiotics .
Probiotic supplements can contain allergens, lactose or prebiotic fibers that may cause adverse reactions in some people. These ingredients can be avoided by reading labels.
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Possible Side Effects Of Probiotics
Probiotics are living bacteria and yeasts that provide health benefits when consumed in large amounts.
They can be taken as supplements or consumed naturally through fermented foods like yogurt, kefir, sauerkraut, kimchi and kombucha .
The health benefits of probiotic supplements and foods have been well documented, including a lower risk of infections, improved digestion and even a reduced risk for some chronic diseases .
While there are many health benefits linked to taking probiotics, there can also be side effects. Most of these are minor and only affect a small percentage of the population.
However, some people with serious illnesses or compromised immune systems may experience more severe complications.
This article reviews the most common side effects of probiotics and how to reduce them.
Adverse Effects Because Of Low
Additives can cause a reaction in people who are sensitive. Even healthy individuals can get adverse reactions from unhealthy additives present in many low-quality supplements.
However, traces of these substances are usually harmless:
Some manufacturers add synthetic, diary-based, or gene modified ingredients. For example, some supplements are treated with a polymer of acrylic acid, a synthetic chemical sprayed onto the capsule. This can cause adverse reactions.
Probiotics are not the problem, only poor manufacturing principles causing side effects.
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Soprobiotics For Kidneys Do They Support Kidney Health
So will it help? The research is not absolutely conclusive on probiotics and slowing kidney disease progression. Though there have been some studies showing a stabilization of eGFR in patients taking specific types of probiotics . But, I find the research and studies compelling as far as potential for probiotics supporting kidney health.
In addition, I absolutely believe gut health and kidney care are intertwined so it makes sense to put a renal-specific probiotic on board to support the gut and thus the kidneys as much as possible. I frequently recommend Renadyl for my clients. While my clients work to switch to a plant-based diet I think Renadyl is a great support for gut health and thus kidney health.
One other important side-note here. Probiotics are not like seeds Some people think that is you take a bunch of probiotics, you will have a permanent increase of these bacteria in your gut and get to a new level of gut bacteria Zen. This not the case.
Open Access License / Drug Dosage / Disclaimer
This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License . Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Some Strains Can Increase Histamine Levels
Some bacterial strains used in probiotic supplements can produce histamine inside the digestive tract of humans .
Histamine is a molecule that is normally produced by your immune system when it detects a threat.
When histamine levels rise, blood vessels dilate to bring more blood to the affected area. The vessels also become more permeable so that immune cells can easily get into the relevant tissue to combat any pathogens .
This process creates redness and swelling in the affected area, and can also trigger allergy symptoms such as itching, watery eyes, runny nose or trouble breathing.
Normally, histamine that is produced in your digestive tract is naturally degraded by an enzyme called diamine oxidase . This enzyme inhibits histamine levels from rising enough to cause symptoms .
However, some people with histamine intolerance have trouble properly breaking down the histamine in their bodies, seeing as they do not produce enough DAO .
The excess histamine is then absorbed through the lining of the intestinal tract and into the bloodstream, causing symptoms similar to an allergic reaction (
Theoretically, they may want to select probiotic supplements that do not contain histamine-producing bacteria, but to date, there has been no research on this specific area.
Some histamine-producing probiotic strains include Lactobacillus buchneri, Lactobacillus helveticus, Lactobacillus hilgardii and Streptococcus thermophilus .