5 ms·

Probiotics are mostly useless and can actually hurt you

35 points by jv22222 8y ago

jv22222 8y ago
> Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way. However, the researchers were surprised to find that this prevented the return of the person’s normal microbiome for up to six months. “The probiotics very potently and persistently prevented the original microbiome returning to its original situation,” says Elinav. “This was very surprising and alarming to us. This adverse effect has not been described to date.” That was the part I found interesting.
- hnzix 8y ago
  Disrupting the gut microbiome can be a desirable outcome. There is a link between the biome and mental health[0], with experiments even transplanting faeces to introduce "healthier" flora.[1] Shrinks are sometimes prescribing probiotics for anxiety conditions. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ [1] https://www.psychologytoday.com/au/blog/reading-between-the-headlines/201309/gut-bacteria-transplant-new-treatment-anxiety https://www.psychologytoday.com/au/blog/reading-between-the-...
  - jmpz 8y ago
    I think you meant to say psychologists.
    - apendleton 8y ago
      I'm not sure what you were getting at with this correction, but at least in most states in the US, psychologists don't prescribe -- they're not MDs. I suppose probiotics are available over the counter so psychologists could recommend that a patient take them, but if it's "prescribing" in the sense of "writing a prescription," psychiatrists would be the ones to do it.
      - jmpz 8y ago
        I was meaning shrink is derogatory for a mental health professional.
        hnzix 8y ago
        Shrink is not derogatory, it's colloquial. Eg "I'm going to see my shrink today". Like calling a general practitioner "doc", as opposed to quack. I use it because I can never remember the difference between psychologists and psychiatrists.
    - ifoundthetao 8y ago
      I think you meant to say psychiatrists.
- darkpicnic 8y ago
  Interesting indeed. The article's assumption is that an individual's current microbiome is the optimal state and that preventing it from returning to that state is "potentially harmful". I think this is where I take issue. The last ten years of data shows that the Western diet has completely reconfigured our gut bacteria and that most people's stomachs are probably out of whack to some degree. Preventing it from returning to that state is probably a good thing. That being said, I do find it interesting that probiotics use is more or a less an unquantifiable shot in the dark. What's the right amount to take of each kind of bacteria? Do some people need more of a certain kind, less of another? I feel like we treat it like a panacea when it obviously is not.
coldcode 8y ago
The research is on a small sample however. The interesting part it that measuring at the output end is not the same as measuring in the gut.
rectang 8y ago
What I take away from this article is that once antibiotics disturb the gut biome, restoring it to the original condition is nontrivial.
- ricardobeat 8y ago
  And here I thought that was the whole point. If your microbiome is in such great shape, then why would you be taking probiotics?
  - rectang 8y ago
    Say that your microbiome was in fine shape before you went on antibiotics for some completely unrelated reason, such as to address an infected finger. Yes, you would want your old microbiome back. Well, from this study we see that probiotics aren't a way to cancel out that side effect of antibiotics. To my mind that suggests refocusing on the microbiome-disturbing effects of antibiotics.
jonbarker 8y ago
This research needs to be conducted in conjunction with the effects of prebiotics (ie certain fibrous foods). From what I understand, populating your gut with bacteria but failing to provide those bacteria with the right food is likely to fail.
- pixl97 8y ago
  Eating fiber, that's un-American! It really is horrible how much fiber is processed out of our food and fed back to animals.
- WalterSear 8y ago
  "Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way."
delbel 8y ago
Taking probiotics with fiber was a complete game changer for me, and greatly the benefited my health, both digestive and other reasons.
- ConceptJunkie 8y ago
  My wife has been giving me probiotics for years, and I assume it helps, but starting fiber abotu a year ago made a big difference for me. Psyllium husk FTW!
skookum 8y ago
Among other potential caveats, it's worth keeping in mind that this study is of probiotic supplements and not of foods containing probiotics. Seems reminiscent of the studies on antioxidants concluding they are useless and/or harmful while studying isolated high-dose supplementation.
gdubs 8y ago
Wow, what a headline. We're completely at the beginning of our understanding of the gut biome – it seems outrageous to claim that it can 'actually hurt you' when, in fact, we have no idea what's going on. For me, the biggest question is – how healthy was a person's biome before the antibiotics? Research seems to indicate that the quality and health of a given person's gut bacteria is highly variable. What's to say that the colonization of the new bacteria is 'bad', just because it's 'different' than before? The answer is, we don't know. Way too early to say.
- seanmcdirmid 8y ago
  > it seems outrageous to claim that it can 'actually hurt you' when, in fact, we have no idea what's going on. Uhm, wait isn’t that exactly how the lack of knowledge actually works?
  - gdubs 8y ago
    I'm not sure I understand your question. My point was that this study doesn't seem to support the claim that probiotics are potentially harmful, or useless. I question the conclusions they've drawn, and find it problematic that the headline borders on prescriptive without compelling evidence to support the claims. Good science welcomes intense criticism and skepticism.
    - seanmcdirmid 8y ago
      Can doesn’t mean does. The fact that we don’t know that they are harmful means that they could be. Maybe we are disagreeing on the meaning of “can” here?
      - gdubs 8y ago
        I see. Well yea, 'could' is significantly different than 'can'. The latter implies probiotics have the capacity to be harmful. The former says, 'hey, we don't know – maybe they're harmful?'. "Useless and can actually hurt you" isn't really supported by the evidence. More accurate would be, "probiotics role is still a mystery, requires further study."
nabla9 8y ago
> The opposite effect was observed with the patients given a dose of their own pre-antibiotic microbiome via FMT. Their native gut microbiome returned to normal within days. Maybe in the future people have 'shit banks' similar to blood banks. You make a deposit before you take antibiotics. Then you take a transplant after using the antibiotics. It seems like FMT can be done in pill form as well. You eat a capsule that travels past stomach before it dissolves.
- matthewwiese 8y ago
  On the T here in Boston there is an ad that asks for donating your poop! After a simple Google search, I was able to find something indeed quite similar to what you thought up: https://www.openbiome.org/ https://www.openbiome.org/ -- a "stool" bank is close enough I'd say :)
saudioger 8y ago
I'm seeing the information where probiotics can significantly delay antibiotic recovery to a normal gut state, but how long does the process take without additional probiotics? Also the probiotics are rabidly repopulating the gut... would it potentially be better for some gut repopulation to happen faster at the expense of a longer recovery otherwise? Are these questions that require follow-up research?
darkerside 8y ago
The original study might be great, but the article's interpretation is full of FUD
sctb 8y ago
Previously: https://news.ycombinator.com/item?id=17927802 https://news.ycombinator.com/item?id=17927802.
wolco 8y ago
This is a very interesting article. I came to a similiar conclusion after trying to repopulate my gut after cipro. Probiotics were making me sicker so I tried single strains trying to find the right one. Months of this I decided to stop everything and in short order things started to improve. Most strains in the gut are not available in probiotic form and food is the best/only way to repopulate those strains (aside from fme).

35 points by jv22222 8y ago

> Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way. However, the researchers were surprised to find that this prevented the return of the person’s normal microbiome for up to six months. “The probiotics very potently and persistently prevented the original microbiome returning to its original situation,” says Elinav. “This was very surprising and alarming to us. This adverse effect has not been described to date.” That was the part I found interesting.

hnzix 8y ago
Disrupting the gut microbiome can be a desirable outcome. There is a link between the biome and mental health[0], with experiments even transplanting faeces to introduce "healthier" flora.[1] Shrinks are sometimes prescribing probiotics for anxiety conditions. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ [1] https://www.psychologytoday.com/au/blog/reading-between-the-headlines/201309/gut-bacteria-transplant-new-treatment-anxiety https://www.psychologytoday.com/au/blog/reading-between-the-...
- jmpz 8y ago
  I think you meant to say psychologists.
  - apendleton 8y ago
    I'm not sure what you were getting at with this correction, but at least in most states in the US, psychologists don't prescribe -- they're not MDs. I suppose probiotics are available over the counter so psychologists could recommend that a patient take them, but if it's "prescribing" in the sense of "writing a prescription," psychiatrists would be the ones to do it.
    - jmpz 8y ago
      I was meaning shrink is derogatory for a mental health professional.
      - hnzix 8y ago
        Shrink is not derogatory, it's colloquial. Eg "I'm going to see my shrink today". Like calling a general practitioner "doc", as opposed to quack. I use it because I can never remember the difference between psychologists and psychiatrists.
  - ifoundthetao 8y ago
    I think you meant to say psychiatrists.
darkpicnic 8y ago
Interesting indeed. The article's assumption is that an individual's current microbiome is the optimal state and that preventing it from returning to that state is "potentially harmful". I think this is where I take issue. The last ten years of data shows that the Western diet has completely reconfigured our gut bacteria and that most people's stomachs are probably out of whack to some degree. Preventing it from returning to that state is probably a good thing. That being said, I do find it interesting that probiotics use is more or a less an unquantifiable shot in the dark. What's the right amount to take of each kind of bacteria? Do some people need more of a certain kind, less of another? I feel like we treat it like a panacea when it obviously is not.

coldcode 8y ago

The research is on a small sample however. The interesting part it that measuring at the output end is not the same as measuring in the gut.

rectang 8y ago

What I take away from this article is that once antibiotics disturb the gut biome, restoring it to the original condition is nontrivial.

ricardobeat 8y ago
And here I thought that was the whole point. If your microbiome is in such great shape, then why would you be taking probiotics?
- rectang 8y ago
  Say that your microbiome was in fine shape before you went on antibiotics for some completely unrelated reason, such as to address an infected finger. Yes, you would want your old microbiome back. Well, from this study we see that probiotics aren't a way to cancel out that side effect of antibiotics. To my mind that suggests refocusing on the microbiome-disturbing effects of antibiotics.

jonbarker 8y ago

This research needs to be conducted in conjunction with the effects of prebiotics (ie certain fibrous foods). From what I understand, populating your gut with bacteria but failing to provide those bacteria with the right food is likely to fail.

pixl97 8y ago
Eating fiber, that's un-American! It really is horrible how much fiber is processed out of our food and fed back to animals.
WalterSear 8y ago
"Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way."

delbel 8y ago

Taking probiotics with fiber was a complete game changer for me, and greatly the benefited my health, both digestive and other reasons.

ConceptJunkie 8y ago
My wife has been giving me probiotics for years, and I assume it helps, but starting fiber abotu a year ago made a big difference for me. Psyllium husk FTW!

skookum 8y ago

Among other potential caveats, it's worth keeping in mind that this study is of probiotic supplements and not of foods containing probiotics. Seems reminiscent of the studies on antioxidants concluding they are useless and/or harmful while studying isolated high-dose supplementation.

gdubs 8y ago

Wow, what a headline. We're completely at the beginning of our understanding of the gut biome – it seems outrageous to claim that it can 'actually hurt you' when, in fact, we have no idea what's going on. For me, the biggest question is – how healthy was a person's biome before the antibiotics? Research seems to indicate that the quality and health of a given person's gut bacteria is highly variable. What's to say that the colonization of the new bacteria is 'bad', just because it's 'different' than before? The answer is, we don't know. Way too early to say.

seanmcdirmid 8y ago
> it seems outrageous to claim that it can 'actually hurt you' when, in fact, we have no idea what's going on. Uhm, wait isn’t that exactly how the lack of knowledge actually works?
- gdubs 8y ago
  I'm not sure I understand your question. My point was that this study doesn't seem to support the claim that probiotics are potentially harmful, or useless. I question the conclusions they've drawn, and find it problematic that the headline borders on prescriptive without compelling evidence to support the claims. Good science welcomes intense criticism and skepticism.
  - seanmcdirmid 8y ago
    Can doesn’t mean does. The fact that we don’t know that they are harmful means that they could be. Maybe we are disagreeing on the meaning of “can” here?
    - gdubs 8y ago
      I see. Well yea, 'could' is significantly different than 'can'. The latter implies probiotics have the capacity to be harmful. The former says, 'hey, we don't know – maybe they're harmful?'. "Useless and can actually hurt you" isn't really supported by the evidence. More accurate would be, "probiotics role is still a mystery, requires further study."

nabla9 8y ago

> The opposite effect was observed with the patients given a dose of their own pre-antibiotic microbiome via FMT. Their native gut microbiome returned to normal within days. Maybe in the future people have 'shit banks' similar to blood banks. You make a deposit before you take antibiotics. Then you take a transplant after using the antibiotics. It seems like FMT can be done in pill form as well. You eat a capsule that travels past stomach before it dissolves.

matthewwiese 8y ago
On the T here in Boston there is an ad that asks for donating your poop! After a simple Google search, I was able to find something indeed quite similar to what you thought up: https://www.openbiome.org/ https://www.openbiome.org/ -- a "stool" bank is close enough I'd say :)

saudioger 8y ago

I'm seeing the information where probiotics can significantly delay antibiotic recovery to a normal gut state, but how long does the process take without additional probiotics? Also the probiotics are rabidly repopulating the gut... would it potentially be better for some gut repopulation to happen faster at the expense of a longer recovery otherwise? Are these questions that require follow-up research?

darkerside 8y ago

The original study might be great, but the article's interpretation is full of FUD

sctb 8y ago

Previously: https://news.ycombinator.com/item?id=17927802 https://news.ycombinator.com/item?id=17927802.

wolco 8y ago

This is a very interesting article. I came to a similiar conclusion after trying to repopulate my gut after cipro. Probiotics were making me sicker so I tried single strains trying to find the right one. Months of this I decided to stop everything and in short order things started to improve. Most strains in the gut are not available in probiotic form and food is the best/only way to repopulate those strains (aside from fme).