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Health Check: should you take probiotics when you’re on antibiotics?

Health Check: should you take probiotics when you’re on antibiotics?

Following on from the Israeli research that Probiotics are mostly useless and can actually hurt you: healthunlocked.com/cllsuppo... , a recent The Conversation article notes that "This research exposes a perhaps unexpected truth: we still don’t know what types of bacteria are truly beneficial or even what constitutes a healthy microbiome.

The answer is unlikely to be that individual bacterial strains are particularly helpful.

It’s more likely a diverse community of thousands of different types of microbes working together can provide health benefits. This microbial community is as individual as each one of us, meaning there is not just one configuration that will result in health or illness.

So, it’s unlikely that the addition of one or even 11 strains of bacteria in a probiotic could somehow balance this complex system.

A more effective (but less palatable) alternative?

The Israeli study also explored an alternative approach to microbiome restoration.

One group of participants had their own stool collected and frozen prior to antibiotic treatment. It was then re-instilled into their gut at the end of the antibiotic therapy.

This treatment, known as autologous faecal transplantation, was able to restore the microbiome to original levels after just eight days. The other group took 21 days to recover."

Full article by Lito Papanicolas, Infectious diseases specialist and PhD candidate and Geraint Rogers, Professor; Director, Microbiome Research, South Australian Health & Medical Research Institute: theconversation.com/health-...

In an 'appendix' to this post, we are finally recognising that our appendix provides a safe harbour for our microbiome, so that our gut can be repopulated with healthy bacteria after diarrhoea. From WebMD: webmd.com/digestive-disorde...

Full paper The immunology of the vermiform appendix: a review of the literature: ncbi.nlm.nih.gov/pmc/articl...

Plus it has been discovered that our appendix is an important part of our immune system up until our 60's. From Scientific American: scientificamerican.com/arti...

Among adult humans, the appendix is now thought to be involved primarily in immune functions. Lymphoid tissue begins to accumulate in the appendix shortly after birth and reaches a peak between the second and third decades of life, decreasing rapidly thereafter and practically disappearing after the age of 60. During the early years of development, however, the appendix has been shown to function as a lymphoid organ, assisting with the maturation of B lymphocytes (one variety of white blood cell) and in the production of the class of antibodies known as immunoglobulin A (IgA) antibodies. Researchers have also shown that the appendix is involved in the production of molecules that help to direct the movement of lymphocytes to various other locations in the body.

"In this context, the function of the appendix appears to be to expose white blood cells to the wide variety of antigens, or foreign substances, present in the gastrointestinal tract. Thus, the appendix probably helps to suppress potentially destructive humoral (blood- and lymph-borne) antibody responses while promoting local immunity."

So much for the long held belief that our appendix is a vestigial organ with no purpose!

Neil

Photo: It's Bottlebrush season!

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My doctors did not recommend probiotics when I was having chemo. Can interfere. I am in remission but will wait 6 more months to start taking it again. Chemo is still working.

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I always used to take probiotics half a day after each antibiotic pill. Will never do that again...

I wonder if major universities will be opening autologous faecal transplantation research centers. "Pediatric Stool & Flora AFT"

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What about prebiotics, Neil. They have been around fir a while- touted by a Dr. Gudry.

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Prebiotics (food ingredients that induce the growth or activity of beneficial microorganisms in our digestive tract and which can change the composition of our microbiome), is worthy of a post in itself. Again, we are only just beginning to understand how what we eat influences the health of our microbiome and its makeup. I suspect that what we think we know now will (probably quickly) be rewritten as we do more research along the lines of the Israeli research mentioned above. It should be interesting to see how the positions of high profile advocates for probiotics change their stance as new discoveries are made.

I think it is becoming obvious that society's shift to processed foods and a reduction in roughage/fibre in our diet isn't doing us any favours. Eating a wide range of fruit and vegetables that we prepare ourselves (raw if our immunity permits it), along with nuts and grains (again being careful about bacterial risk), seems to be wise. It's not something I see as having as much influence over our path with CLL, provided we are obtaining sufficient nutrients, with the importance of exercise generally overlooked. That includes reducing the amount of exercise our digestive systems get if we juice and blend our food rather than chewing it!

Neil

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Oh AussieNeil… If only I could go back in time to before my first exposure to antibiotics (age 5, hospital admission for three weeks, injected Penicillin every day) so that someone could have collected a stool sample...

Anyway, dealing with the real world which so far doesn't include a time machine, I shall continue with my Kefir experiment. (Reporting soon!).

John

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Great photo Neil

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Hi Neil very interesting research. Thank you for sharing it. I am on Flair trial ibrutinib. I have used a prescribed probiotic for IBS for many years. My CLL specialist is happy for me to continue, 9 months now. Should I be worried? Should I try to stop? Should I continue until further research confirms this one?

Ann

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Hi Ann,

What helps with IBS can be hard to determine - it varies so much from patient to patient. I don't know if you have been able to conclusively work out whether your prescribed probiotic has helped or not. The research wasn't about probiotic use in those with IBS in any case, but it would be interesting to know what research was behind your doctor's suggestion in prescribing it for you.

Neil

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Thanks for the reply Aussie. It was recommended by a gastroenterologist many years ago who had IBS himself and found it helped.

It is not based on research as far as I know.

My GP was kind enough to prescribe for me.

I think what it did for me was to allow me to tolerate roughage something that helps IBS.

I have been thinking of weening myself off to see if my bowel has adjusted on its own now.

I also use inulin a roughage which has also helped.

Regards

Ann

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Wonderful photo Neil... 😉

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Never took probiotics!

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