Aug 26 2013

Probiotics for Mental Health?

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12 Responses to “Probiotics for Mental Health?”

  1. evhantheinfidelon 26 Aug 2013 at 1:26 pm

    My mother buys me Kefir to help with gut problems that are probably the effects of anxiety. I told her that the probiotics probably didn’t help my gut, but I like the taste of the stuff anyway. It would be nice to think that the probiotics could help with me anxiety, but alas, it seems it isn’t so. I have a question, Dr. Novella. What state is our knowledge in in regards to the cultures in our body that are important, and many they number? Does it vary from person to person?

  2. daviddb1on 26 Aug 2013 at 1:28 pm

    I was thinking about emailing this story to you. I just read it yesterday myself. I love the Verge, but this article really bugged me. My favorite part of the article, which you mentioned as well, was: “besides psychotherapy and medication, Greenblatt also prescribed Mary a twice-daily dose of probiotics,”. HA! Besides real therapy, we also….. Anyway, glad to see you found it and made a point to address it. I hope you don’t mind if I add a link to this blog post on the comments of the article. There is too much BS being spread in those comments.

  3. denisexon 26 Aug 2013 at 7:51 pm

    From my own negative experience I’m wondering if there’s even good evidence that probiotics help with digestive problems as widely claimed.

    I’m on my fourth bottle of increasingly more expensive pills trying to recover from antibiotics taken almost a year ago.

    It struck me to wonder when I first saw the Activia commercials why they would recommend that you eat this stuff every day; once the bacteria have colonized your gut, why should you need to keep taking it? I went looking to see if they might have engineered these bacteria not to reproduce. I didn’t see anything like that, but I did see that there’s a lot of uncertainty about whether probiotics taken orally even survive the trip down to the gut at all. Maybe that would explain why none of these pills has helped me.

  4. tmac57on 26 Aug 2013 at 8:58 pm

    denisex- I’m no expert about this,but I am going to go out on a limb and say that bacteria will indeed survive the trip down to the gut because otherwise we would never have any problem from dangerous strains of e coli (and others) that regularly cause dangerous outbreaks of food borne illnesses (it’s always the organic bean sprouts ;) ) .
    My understanding of the state of probiotics is that they have identified a handful of gut flora that are common to most people,and posit that replenishing those specific types may help recolonize missing bacteria (if indeed they are missing). And that may be true,but that is no substitute for the specific gut flora that is likely to be unique to the individual,due to whatever factors have come to shape their personal microbiome.

  5. Cow_Cookieon 26 Aug 2013 at 9:26 pm

    Novella wrote: “The article begins, as is unfortunately often the case, with an emotional anecdote. Journalists are taught to find a human angle to draw the reader in, and I get this. But this style is better suited to fluff pieces than serious science journalism.”

    Don’t confuse bad use of a structure with a perfectly fine structure. A good journalist could use this format with someone who accurately reflects the evidence and achieve remarkable results.

    You still need the human angle to grab readers who wouldn’t otherwise read it (sad but true). The key is finding a subject who is representative of the whole rather than just individually compelling.

    Good nonfiction of any kind is about the transition from anecdotal to global. The average reader just isn’t going to relate to pure stats and numbers. Instead, you use the anecdotal narratives to support and illuminate the larger truth. There’s nothing inherently wrong or “fluffy” about this as long as the anecdotes support the evidence.

    Rick Atkinson’s “The Guns at Last Light” is an excellent example of this. It’s a history of the invasion of Western Europe. In one paragraph, he quotes intensely personal letters from soldiers who died in the campaigns. In the next, he cites mind-boggling statistics about the amount of supplies used. From that dialogue between the tactical and the strategic, the reader gains a larger understanding of what the war was about. And without either of those parts, the book wouldn’t have the emotional or intellectual heft that it does.

    Good science journalism works the same way.

  6. BillyJoe7on 27 Aug 2013 at 12:27 am

    “the species of bacteria that make your GI system their home exist in a stable ecosystem”

    I seem to remember an article here or at SBM that said the opposite – that our biomes are ever changing.

  7. ccbowerson 27 Aug 2013 at 9:57 pm

    tmac57-

    The pH of the stomach is 1-2, so assuming normal function (no reason for reduced acid secretion like a PPI) most bacteria will be killed, unless they can tolerate very low pH like encapulated forms. Diarrheal symptoms like those caused by some strains of E coli you mentioned are the result of enterotoxins produced by the bacteria. It is not necessary for the bacteria to survive to cause illness, because the toxins themselves are causing symptoms.

    Now, there are ways to make sure that bacteria survive by using delayed release formulations, such as enteric coatings. For example, putting the bateria in a capule that remains intact at low pH (stomach), but dissolve in higher pH settings like the small intestine and beyond. Of course, very few probiotics have been shown to have any major effects for many reasons (discussed above and elsewhere). The one exception appears to be fecal transplantation for C diff, which can be given orally (as delayed release), but is usually given by enema infusion for obvious reasons.

  8. lindyblueon 30 Aug 2013 at 5:27 pm

    I seem to remember hearing a story about this on Radio Lab a while back. They mentioned something about stimulating the vagus nerve, I think? Anyhow, if I recall correctly, their reporting was more balanced and did talk about how there’s still much more researched required though did seem a little hyped but nothing close to this. It’s been a while since I’ve listened to it though, and I may have to go back and relisten.

  9. lindyblueon 30 Aug 2013 at 5:28 pm

    *research, not researched

  10. dcardanion 05 Sep 2013 at 6:32 pm

    I had an issue that was helped by probiotics, and I have to say that I think this comment you made in the article is spot on:

    “Some of the results may be as simple as animals being in a bad mood when their tummy aches”

    It goes way further than that! Having a digestive issue 24/7 means constantly being vigilant about how close you are to a bathroom at all times, losing sleep because it wakes you up several times a night, not feeling like going out, or eating, or being with people, or being around loved ones. It’s kind of like torture. Taking a pill that clears that one problem up can surely go a long way towards fixing depression, though probably not because it directly affects the brain!

  11. Tro10on 13 Sep 2013 at 6:41 pm

    I just came across your blog because I think that the research on probiotics is intriguing, but like all new research things will get blown out of proportion by journalists driven by the faddish dictates of the market rather than the slow paced demands of scientific integrity. That said, I was speaking with a friend who has a terrible time with antibiotics — both he and his mother goes through a pretty bad depression for several days when they take them. Of course, there are a myriad number of possible explanations, but after hearing about Greenblatt’s research, I couldn’t help but wonder if there was a connection between the dead critters in his gut and his depression…

  12. brotherjohnon 24 Sep 2013 at 2:21 pm

    Wow, you think THIS story was bad, take a look at the subsequent ABC News Story (from Sept 12th): http://abcnews.go.com/Health/anxiety-head-gut/story?id=20229136

    Maybe this has since been discussed here or on SGU. But this story went further, saying “A study published in Nutritional Neuroscience from The Great Plains Laboratory, has shown that HPHPA levels are much higher in the urine of autistic children.” They also cover the same case study and “miracle cure”, and the same Dr. James Greenblatt saying “”I don’t know why this test isn’t done on every psychiatric patient… I question that every day.”

    As the father of an autistic boy, such a strongly worded statement genuinely interested me. What about this study; is there anything to it? Who is James Greenblatt, who keeps popping up in these stories? What is the Great Plains Laboratory (GPL form here on)? Being a PhD in zoology and a science writer/editor, I’d never heard of this facility. Is it akin to the Cleveland Clinic, the Mayo… what is it? So I did a little digging.

    The key study discussed here, Shaw 2010, is by William Shaw, PhD, of the GPL(http://www.greatplainslaboratory.com/home/eng/home.asp). It concludes that HPHPA levels are markedly higher in autistic children, and treatment with antifungals or other gut flora modifications can greatly benefit these children. The methods and statistics are somewhat dubious, and have never been repeated as far as I can tell. The paper comes off more like an opinion piece than a piece of science. But it certainly isn’t the first time that a journal has published an article with shaky results.

    As for GPL? Well, they’re a testing lab that conduct their own non-standard tests to detect a variety of things that, according to them, are related to many difficult-to-treat illnesses such as fibromyalgia, chronic fatigue syndrome, autism, etc. Shaw not only is based out of GPL, he is its founder and Director. I’ve read that certain doctors (I assume Dr. Greenblatt among them) send their labs to GPL, saying only GPL can detect what they’re looking for.

    Of course, it’s a problem that such minimal (possibly questionable) research is being used to drive treatment of autistic children. But a bigger problem with Drs. Shaw and Greenblatt is they’re behind a cottage industry promoting unproven treatments on a large scale, and involving serious conflicts of interest. Dr. Shaw is not only founder of GPL, but is also the founder and head of New Beginnings Nutritionals, a company that sells you the supplements that will cure all these ills! According to them. (http://www.nbnus.com/about-us.html)

    A little more digging told me that James Greenblatt, is a Defeat Autism Now! (DAN!) provider (http://wholehealthamerica.com/designs/bp.php?idnum=97&zt=article&articleid=30463&categoryid=43&display=article)… as I’m sure you know, DAN! promotes chelation and other harmful, unproven therapies for autism, and still promotes the idea that vaccines cause autism (http://en.wikipedia.org/wiki/Autism_Research_Institute). But worse, in light of his promotion of probiotics for mental health, Dr. Greenblatt is connected with GPL He not only promotes their ideas on his website (http://www.integrativepsychmd.com/freewebinar2.html), but he “serves as Medical Consultant for Mental Heath Disorders for New Beginnings Nutritionals” (http://www.greatplainslaboratory.com/home/eng/manual/Introduction_Zeebra_Formulations.pdf).

    Dr. James Greenblatt and Dr. William Shaw run a racket. And it seems like they’ve got a pretty good PR machine in place, and ABC News (among others) are the last people who are going to question it.

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