1636 replies to this topic

[ForLyla]

Hey FH I've been trying to cram as much research as possible on this. I need to do a gi map test and find our what my pathogenic strains are and the good ones I'm lacking. Certain strains like bifido, bacillus and s boulardii are supposed to the the best. However, I need to consider that many probiotics cause histamine release so need to find ones that dont.

[fishinghat]

Got it. Will add that to my to do list. There are around 40 strains of bacteria that are considered "good" for the digestive tract. Each has their own purpose. Some help digest sugars or starches, some help with oil and grease digestion other in controlling inflammation, etc etc. A gut map would be a wise idea. I would not wait to start a probiotic before getting the gut map done however. Right now the population of bad bacteria is low and the need to get the good bacteria a head start is immediate.

[fishinghat]

Some information on probiotics and histamine production/effects. One of the things that surprised me is that nearly all species of probiotics can produce antihistamines or act as an H1 receptor agonist. It should be noted that there are dozens of strains of each probiotic species. For example Bifidobacterium longum has genetic strains that produce no histamines, some that do and others that are only direct agonists of H1 receptors or even have no direct interaction with any aspect of histamine production or receptors. This would make your quest to find probiotics that are not involved with the histamine system nearly impossible.



https://www.ncbi.nlm...les/PMC6213508/
Probiotics in Autoimmune and Inflammatory Disorders
Probiotics and other nicrobial agents activation of the intestinal histamine-2 receptor.
Histamine produced by L. reuteri 6475 interacts with H2 presented on intestinal epithelial cells and macrophages to reduce levels of proinflammatory cytokines (TNF-α, MCP-1, and IL-12).
Histamine signaling. The tolerogenic effects of lactobacilli are very strain- and metabolite-dependent. For example, a L. rhamnosus strain that secretes low levels of histamine is immunosuppressive, whereas a L. saerimneri strain secreting high histamine levels induces gut inflammation. In a series of studies, L. reuteri ATCC PTA 6475 (L. reuteri 6475) was found to differ from the sister strain L. reuteri 17938, in that L. reuteri 6475 makes histamine. Histamine is produced by L. reuteri 6475 via the action of histidine decarboxylase (HDC). Its production of histamine suppresses TNF-α synthesis in vitro . Gao et al. showed that L. reuteri 6475 has anti-inflammatory effects in the trinitrobenzoate (TNBS) model of colitis via a mechanism dependent on intestinal histamine-2 receptor signaling. A mutant L. reuteri 6475 strain lacking HDC did not suppress TNBS-induced colitis in mice; furthermore, the anti-inflammatory effect of L. reuteri 6475 was dependent on the histamine H-2 receptor on intestinal cells [111]. This HDC-dependent gene effect may be of relevance to colorectal carcinoma, which, interestingly, is more prevalent in humans deficient in HDC. As a proof of concept, L. reuteri 6475, when administered in a Hdc−/− mouse model of colon cancer, suppressed tumor size and number, presumably by its synthesis of histamine.

https://www.ncbi.nlm...les/PMC5809336/
Gut Microbe–Mediated Suppression of Inflammation-Associated Colon Carcinogenesis by Luminal Histamine Production
Administration of hdc+Lactobacillus reuteri in the gut resulted in luminal hdc gene expression and histamine production in the intestines of Hdc−/− mice.

Note - There is a number of research papers showing similar results for this species of probiotic.

https://www.ncbi.nlm...pubmed/29153882
Identification of probiotic effector molecules: present state and future perspectives.
We show examples of well-documented probiotic effector molecules in Lactobacillus and Bifidobacterium strains, including surface-located molecules such as specific pili, S-layer proteins, exopolysaccharides, muropeptides, as well as more widely produced metabolites such as tryptophan-related and histamine-related metabolites, CpG-rich DNA, and various enzymes such as lactase and bile salt hydrolases.

https://www.ncbi.nlm...les/PMC6656559/
Probiotics in Disease Prevention and Treatment
Different strains of the same species of Probiotics produce different levels of histamine production or even no histamine production. They may not even effect histamine but may be a H1 receptor agonist.

[fishinghat]

Prokinetics

Prokinetics activates of a wide range of serotonin receptors which results in enhanced gastrointestinal motility.

 

Animal research has found that supplementation with the probiotics Lactobacillus rhamnosus and Bifidobacterium lactis enhances the speed and strength of phase III of the migrating motor complex in the small intestine resulting in reduced small intestinal bacterial overgrowth and bacterial translocation.[10]

 

Research in rats has found that supplementation with Lactobacillus acidophilus and Bifidobacterium bifidum increases small intestinal motility with a measurable decrease in the duration of migrating motor complex cycles. A further study found that in rats supplemented with a diet of Lactobacillus rhamnosus and Bifidobacterium lactis, the number and velocity of phase iii of the migrating motor complex increased. These effects make the small intestine more effective at propelling food, bacteria and luminal secretions into the colon.[10] Bifidobacterium bifidum in combination with Lactobacillus acidophilus accelerated small intestine transit in rats.[11]

 

Research into the prokinetic effects of probiotics on the gastrointestinal tract has also been conducted in humans. Lactobacillus reuteri in infants and Lactobacillus casei and Bifidobacterium breve in children have been found to be effective in the treatment of constipation. Lactobacillus plantarum, in adults has been found to increase defecation frequency.[12]

Wiki
 

[fishinghat]

This is the only article I could find dealing with the relationship of prokinetics to sibo.
FH

 

FH - Prokinetics is a very popular item in the treatment of sibo but is backed by very little research. Prokinetics are little more than bacteria that act as laxatives to increase the movement of material through the digestive tract.

https://www.ncbi.nlm...pubmed/30483563
Risk of small intestinal bacterial overgrowth in patients receiving proton pump inhibitors versus proton pump inhibitors plus prokinetics.
The use of prokinetics in patients on PPI may reduce the risk of SIBO by enhancing intestinal motility and may reduce SIBO risk associated with long-term PPI use.
Prokinetics are a group of drugs that propel food and bacteria through the stagnant colon and may assist with the clinical improvement of patients with SIBO. (increases the movement of material through the GI tract).

 

[ForLyla]

Everything I take seems to greatly exasperate my cymbalta withdrawal symptoms. I feel absolutely dreadful- like full blown acute withdrawal but worse. My vision has never been this bad. On top of that, I have throat burning and ear pain all day every day. I think this really is the end for me. Theres no winning in all of this. Before I die though I'm going to jump off the cymbalta. I'm not going down with this poison in me.

[fishinghat]

Did you get some probiotics in you yet. It should really help with the throat burning and some of the withdrawal symptoms by improving your digestion and reducing inflammation.

[ForLyla]

Ya I did. The probiotics make me feel terrible otherwise though. Histamine intolerance from cymbalta and benzo withdrawal and gut dysbiosis. All these meds and supplements change the effect of cymbalta. My vision is probably one of my scariest symptoms. The only thing that makes me feel better is staying away from EVERYTHING and just taking cymbalta but if I do that then I'm not treating the sibo. 

[ForLyla]

I dropped my dose by 1 point today from .132 to .131. I might just do a rapid taper soon. I can't deal with cymbalta anymore. I just want off because at least then I can work on my other health issues and I'll know that there's an end in sight. Cymbalta actually blocks DAO so it's what's causing my histamine issues on top of SIBO. They both cause histamine intolerance. I can't fix my stomach without affecting cymbalta so there's no point even being on it anymore. 

[fishinghat]

It will take the probiotics about a week at 1 a day to really kick in. After that one every 2 or 3 days for about a week and you should be good to go. After that I agree. Just stay on your current dose of Cymbalta until you see where you settle at. Hopefully during the next 2 weeks the gerd will settle down. It should but who the heck knows with you Lyla.  lol

 

At that point If things are not showing improvement I would consider just stopping the Cymbalta and getting it out of your system. I don't know what else to try.

[ForLyla]

I really doubt the probiotics will do anything but make me worse.

So, when I go off how should I go about it? Will send me into seizures or something? What can I expect from someone that is as sensitive as me? I have a daughter to think about otherwise I'd just end it now. I'm at the end of my rope. No one has luck like me.

[fishinghat]

I was really thinking the sibo may have been the key issue in not being able to wean. I was suspicious that it had been in the back ground for a long time. Certainly the sibo good very much account for the sensitivity to med changes that you have exhibited. It would effect the absorption of nearly all meds as well as causing your GERD issues.

 

If I remember right you are on 28 beads right now, is that correct?  How long have you been at that level?

[ForLyla]

More like 120 beads. It works out to about 25.5mg. I've been at that level since Feb 2019. Every time I start feeling better I've taken a ppi or some garbage that throws me right back into it. It's not as simple as saying that I'm a weird case that I'm just not healing. Minus the reflux, I was feeling fine last September and I would have fully recovered then and there. But this issue keep setting me back and theres just no treating it and keeping my cymbalta intact at the same time. I need literally many many months of complete homeostasis before I can begin to tamper with my dose and it not affect me. Every supplement and every medication I take tampers with that. So I either live with sibo or live with withdrawal now. I would feel fine mentally and physically with sibo minus the constant throat pain and inflammation.

[fishinghat]

You think sibo is still an issue? The antibiotic should have taken care of that. Follow your instincts is about all I can say at this point.

[ForLyla]

Sibo is far more complicated than that. Its pretty rare one round of antibiotics gets rid of more severe cases that are methane dominant. It's very difficult to cure. I dont think the antibiotics did anything for me but send me back into the throws of severe cymbalta withdrawal. The probiotics make me feel terrible because of the histamine release. The last two days have been terrible especially. I need to stop treating it and maybe just do an all liquid diet for a long time.

[fishinghat]

If things have gotten worse since starting the probiotics then I agree. The probiotics would/should cause a slow steady improvement. I guess you are right,  it is time to take other approaches like the liquid diet to see if it helps.

 

I will dig into the medical journal articles to see if there are any jewels of wisdom I can find. It may take a couple of days though.

[ForLyla]

I think it's all too late for me. I'm losing weight like crazy. This seems like the end. Would be surprised if I don't have cancer or something like that from all of this. 

[fishinghat]

Sibo., liquid diets, antibiotics, stress... I wonder why you are losing weight?  lol

[invalidusername]

Blimey - if I wasn't already doing a PhD, there would be a thesis in this thread alone!!!

 

Trying to keep up with it all, and Lyla, there will be an end to this all. This that are broken can be unbroken - it is just a case of finding the right things to switch on and off. You probably don't have the time to be delving into other fields, but the SENS Foundation and Dr Aubrey De Grey have done some incredible work in the molecular/cell damage through disease and aging. It is incredible stuff. Dr De Grey looks a bit of an odd-ball... well he is... be he is one of the brightest bulbs on the planet at this moment.

 

Well worth a look as and when. Meanwhile, I will try to keep up here and I really wish you all the best. So glad that you found Hat as you seem to have been destined to work together on this... I feel bad for not being able to contribute, but this is not my field...

[ForLyla]

I really appreciate the help guys but sibo is far more complicated than you think. It's a very serious disease that is very hard to treat in many cases. Just doing a round of antibiotics doesnt do much. The antibiotics made me way worse actually. I'm now having rapid weight loss and extreme acute cymbalta symptoms. I'm not going to last much longer. I'm already writing my will out for my daughter.

I have an appointment tomorrow with a specialist in Australia. They are supposed to be the best in the world at treating sibo. Maybe they can help me but I highly doubt it because of the cymbalta.FH what was the name of that med for heart pounding? I'm going to probably rapid taper the cymbalta as a last ditch effort and I need something for my heart.

[invalidusername]

Please try not to think all or nothing under the circumstances... following your post I have had a look at the information through journals and so forth and whilst sibo can indeed be quite nasty and can be difficult to treat, evidence does not point to it being fatal. Finding the underlying root cause is the determining factor, and whilst it may reoccur, working with specialists will be the way forward.

[fishinghat]

I believe you are referring to atenolol. Another hood one is clonidine that not only helps with the heart pounding but also anxiety,

[ForLyla]

My doctor recommended getting on Prozac and doing a rapid taper off cymbalta. What do you guys think?

[fishinghat]

Many have had success with that method and for many it did not work. I was one of those where it had no effect.

[ForLyla]

FH what do you mean it had no effect? So it would have been the same had you just cold turkeyed rather than cross taper?

[ForLyla]

Also, I wonder if probiotics have a negative effect on Cymbalta absorption. 

[fishinghat]

I was totally off the Cymbalta for about 5 months before trying the prozac.  I was on it for nearly 3 months and it was of absolutely no help. Went on to Lexapro and after that Olanzipine and neither of them helped at all. Next was Zoloft and it finally did the trick. Sometimes they work and sometimes they don't.  Flip a coin.

 

As far as probiotics are concerned the effects on Cymbalta absorption it depends on what strains of bacteria are present, pH of the stomach, your motility time, antacids, moisture in the stomach and intestines, and especially the types of food in your diet. A very complicated system. Some bacteria release histamines, some don't, some effect dopamine, some don't, m ost effect serotonin but there are some strains that do not effecty Serotonin. No way to tell which way to turn.

[invalidusername]

I worry that you will be replacing one poison with another...

[ForLyla]

Well my main reason to get off cymbalta would be so I can treat sibo and its symptoms, however, I'm assuming ppi's and all that stuff would also interact with zoloft? From my understanding though, SNRI's are far more difficult to get off of?

[fishinghat]

Correct on both accounts. Zoloft easier but has more stomach issues during withdrawal because it effects serotonin more than Cymbalta.