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Probiotics can support the effect of antidepressants

208 points by NickRandom 4y ago

NickRandom 4y ago
Note to mods: I 'editorialised' submission title slightly (Original is "Good bacteria to tackle depression") which seemed a bit click-baity
- deleted 4y ago
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- josiahpeters 4y ago
  I appreciate your editorial take. Thanks for saying no to click-bait titles!
amelius 4y ago
Also: https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-long-covid-recovery/ https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-lon...
__alexs 4y ago
I noticed when reading the Amazon reviews of probiotics recently that a lot of people claim they improved their mood a lot too.
- raverbashing 4y ago
  I suppose there's also an inverse correlation with, let's say, "bathroom frequency"
mfer 4y ago
About 90% of serotonin is made in the gut [1]. This is one of those things that helps us with being happy and an unhealthy gut produces less. So, this makes sense. [1] https://my.clevelandclinic.org/health/articles/22572-serotonin https://my.clevelandclinic.org/health/articles/22572-seroton...
- zymun 4y ago
  Does this serotonin make its way to the brain?
  - jasongill 4y ago
    Seratonin is produced in multiple places in the body (not just the brain, and apparently, most of the seratonin in your body is not produced in the brain), but doesn't appear to cross the blood-brain barrier. I'm not a doctor but I think what that means is "seratonin in your gut probably doesn't make it's way to the brain; but, the rest of the body is already awash in seratonin, so additional production in the gut can help increase those levels, which may have some sort of yet-to-be-understood action that has an impact on depression"
    - amelius 4y ago
      How does serotonin in a pill reach the brain then? :) Is there some special delivery mechanism behind it?
      - kayodelycaon 4y ago
        There is no serotonin in pills. SSRI stands for selective serotonin reuptake inhibitor. It is a chemical that modifies how certain cells reabsorb serotonin. https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
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- PragmaticPulp 4y ago
  The serotonin in your brain doesn’t come from the gut. Serotonin isn’t just a “happy chemical”. The body uses it in different places for different functions.
kache_ 4y ago
n=40, seems a bit small. But this fits into a lot of anecdotal accounts I've heard. Gut flora is very complex and not well understood.
- Kakashi4 4y ago
  I've also had anecdotal experience in agreement with this. There have been many studies on this but most of them have a similar small sample size. Wonder why it hasn't been conducted with a larger sample size yet, or maybe it has but didn't find anything so it's not being posted on HN ¯\_(ツ)_/¯
- marginalia_nu 4y ago
  What is an adequate sample size depends entirely on the effect size.
  - kache_ 4y ago
    Yep. I wouldn't eat a mushroom that killed someone, sample size being 1
woliveirajr 4y ago
> Probiotics maintained microbial diversity and increased the abundance of the genus Lactobacillus, indicating the effectivity of the probiotics to increase specific taxa. The increase of the Lactobacillus was associated with decreased depressive symptoms in the probiotics group. [0] So, yogurt everybody ? [1] [2] [0] https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z [1] https://en.wikipedia.org/wiki/Yogurt#Health_research https://en.wikipedia.org/wiki/Yogurt#Health_research [2] https://en.wikipedia.org/wiki/Probiotic https://en.wikipedia.org/wiki/Probiotic
- 0daystock 4y ago
  As long as it's not cow's milk yogurt, sure. https://pubmed.ncbi.nlm.nih.gov/20389060/ https://pubmed.ncbi.nlm.nih.gov/20389060/ https://pubmed.ncbi.nlm.nih.gov/23415826/ https://pubmed.ncbi.nlm.nih.gov/23415826/ Also, the citations in the wikipedia article are hilariously biased. > Presented at the satellite symposium “First Global Summit on the Health Effects of Yogurt." The conference was organized by the ASN, the Nutrition Society, Danone Institute International, and the Dairy Research Institute Another paper was straight up one paid consultant writing an industry-funded article. Here's who edited and reviewed it: > Editorial assistance was provided by Chill Pill Media LLP, which was contracted and funded by Danone Institute International. It's hilarious how desperate the dairy industry is to cook science.
  - blindmute 4y ago
    Somehow I remain skeptical that the dairy (and meat) that humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns. I think it's a wee bit more likely that when you're morbidly obese with diabetes, like in that study, and you feel better after eating a controlled, healthy, low-calorie diet, it can be attributed to factors more relevant than veganism.
    - 0daystock 4y ago
      > humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns They literally haven't eaten meat, dairy and eggs 3-5x per day. This is a new phenomenon in the last half-century. And to go back even further, our biochemistry is millions of years old, and is frugivorous in nature. We have no physical adaptations to eating meat. We only started doing it recently as a means of survival when humans left their tropical niche. > a controlled, healthy, low-calorie diet Plant-based foods are naturally low in fat, which is calorie dense, so such a diet is in fact ideal for weight loss.
AmateurLeader 4y ago
Probiotics can (potentially) be very beneficial, but are also often seen as something that "couldn't hurt, so why not try it?". Just wanted to share this article to let people know they are not always harmless, and in some very specific cases, could lead to death. [0] [0] https://pubmed.ncbi.nlm.nih.gov/18279948/ https://pubmed.ncbi.nlm.nih.gov/18279948/
jokoon 4y ago
The problem is that you have to take them often to colonize your gut, so it becomes a bit expensive, and it won't work on everyone, depending on their gut (since scientists know too little about the gut).
- goda90 4y ago
  My hypothesis is that probiotics also need to be paired with the right diet. Bacteria needs to be fed, and needs to compete with the existing gut flora. If conditions aren't right, then they may never get a foothold.
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  - jokoon 4y ago
    Yeah and honestly I don't think there is a "right diet", because that might be highly dependent on the person, his/her food history, medical past, antibiotics, genetics, physical activity, the "initial gut bacteria" at birth, breast fed or not, etc. Of course one can expect the usual "less sugar and fat, more macro nutrient", but unless there's proof and proper cause-effect relationships, it's going to be complex to draw conclusions. I'm not really sure that sugar causes a bad balance in the gut bacteria. Not to mention all the chemicals in food and the environment that makes it almost impossible to track what could work and what would not.
  - stephen_g 4y ago
    Yeah, it requires types of dietary fibre classed as ‘prebiotic’ [1]. 1. https://www.monash.edu/medicine/ccs/gastroenterology/prebiotic/faq https://www.monash.edu/medicine/ccs/gastroenterology/prebiot...
  - markdown 4y ago
    Of course the manufacturer will never tell you how to feed your pet bacteria, because they want them to die within a month so they can sell you more.
- pbhjpbhj 4y ago
mrfusion 4y ago
How to find the best probiotics?
- UI_at_80x24 4y ago
  I don't know much this topic, but if you are looking for supplements make sure they are refrigerated. Yogurt is probably the easiest/best way to ingest them though instead of specific pills.
- MezzoDelCammin 4y ago
  The original study [1] uses Vivomixx in about double dose. According to them it's because it is easily accessible and has multiple strains of bacteria in it (they were not trying to go for one strain in particular). 1 : chapter "Study intervention" of https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z
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Ozzie_osman 4y ago
I read this take somewhere that we are basically a vessel for our microbiome / gut Flora. Our moods, what food we crave, how social we are might all be impacted by them, in which case they do have some sort of control over not just how we feel, but how we behave. For instance if you eat a lot of sugar, you will crave more sugar, and the argument would be that it's the bacteria that have developed in your gut that are causing you to crave that sugar because that is what they consume (vs the more human-focused evolutionary argument of "sugar was rare and so humans have evolved to crave as much of it as they can get"). Reality is probably a mix of both (ie we are a complex system with wants/needs influenced by both our own body and the Flora that live within it).
- 0daystock 4y ago
  The literature couldn't be more clear in support of what you wrote. It's actually a fairly well researched topic in nutritional science. https://nutritionfacts.org/video/microbiome-we-are-what-they-eat/#transcript https://nutritionfacts.org/video/microbiome-we-are-what-they...
PaulHoule 4y ago
When I think of probiotics I think of this song https://www.youtube.com/watch?v=pnJM_jC7j_4 https://www.youtube.com/watch?v=pnJM_jC7j_4 because probiotics are the "ones that mother gives you [that] don't do anything at all" (Right up there with Vitamin D supplements. Everything good, like low blood pressure and your team winning the Superbowl seems to be associated with high vitamin D in the population and everything bad is associated with low vitamin D... But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl.)
- Alex3917 4y ago
  > But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl Because you need UVA to convert the vitamin D to nitric oxide, and if you're getting enough UVA to do that then you're also more likely to already be getting enough UVB to create sufficient vitamin D in the first place.[1] Not super complicated. Taking vitamin D supplements is probably still better than not taking them if you're deficient, but if you understand the mechanism of action then it should be obvious as to why the science is always equivocal. [1] Or, more precisely, vitamin D regulates nitric oxide synthesis.
- wutbrodo 4y ago
  You're commenting on a post about an RCT that does show probiotics having an effect...? And AIUI, there's plenty of other evidence of a) their efficacy for changing the gut biome and b) the gut biome's causal effect on a variety of health issues.
  - PaulHoule 4y ago
    An rct with n=40 is better than the junk non-controlled studies that inexplicably get funded and accepted by journals but probably meaningless for something involving something as subjective as mental health.
- PKop 4y ago
  You need to get it from sunlight. Modern man has way too little sun exposure, and the meme of everyone being afraid of sun and using sunscreen obsessively exacerbates the problem.
SaintGhurka 4y ago
Sample size of 1 here, but just hear me out. Probiotics are a cheap and low-risk. If you have any general inflammation type issues that don't seem to have a cause, it might be worthwhile to just try probiotics. My Dr. told me to try them for a digestive issue - and they sort of helped that. But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable, and my skin really cleared up. I had red, flaky skin on my face for 20 years and suddenly it's gone within 48 hours of starting probiotics. Yeah... post hoc ergo propter hoc, but it's a cheap and harmless shot in the dark. Worst case scenario, it doesn't work and you're out $10. Edited to say "low risk" instead of "risk free".
- giancarlostoro 4y ago
  > But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable What are you even buying if you don't mind me asking? I don't get acid reflux often, but I definitely want to prevent it happening so often, because it continues for days when I do get it. There's all sorts of things that say they have / are probiotics, including a few different sodas out there.
  - SaintGhurka 4y ago
    Culturelle. Just their basic "Digestive Daily Probiotic". It's a single strain Lactobacillus rhamnosus. My Dr. suggested either that or Align. The first thing I tried worked so I haven't tried anything else. A friend of mine had the same problem and he buys generic bulk acidophilus from amazon and he says it works for him. I didn't expect it to work, but I didn't want to wonder if it failed because I cheaped out, so I went for the expensive stuff.
    - philliphaydon 4y ago
      Definitely going to try this too. I go though periods of acid reflux and it wakes me up. I sleep with 2 pillows so raise my head and shoulders to prevent it waking me which helps most of the time. But will give the probiotics a try. Thanks.
ianstormtaylor 4y ago
Anyone have recommendations for which probiotics are the best ones to buy? I always get confused while looking at all the various options, and this seems like a good place to find someone who’s done a lot of research.
- wtk 4y ago
  I think the market is flooded with supplements, while you can help your gut bacteria with natural products like kefir (kind of buttermilk), kombucha, kimchi like products. I happen to love all those mentioned.
  - 0daystock 4y ago
    Those are all very bad recommendations. Buttermilk is loaded with cholesterol and saturated fat, kombucha with sugar, and fermented vegetables like kimchi have shown to increase prostate adenocarcinoma. You want to regulate your gut flora with a variety of whole plant-based foods, not quick fixes like pills and a jar of stinky cabbage.
    - enviclash 4y ago
      You are telling me milk kefir is the cause of health issues? I would suggest limiting it to a few spoons a few times per week, then.
      - glogla 4y ago
        How would you make that practical? How long can you keep a bottle of kefir open before it goes bad?
        enviclash 4y ago
        I have half glass of milk with kefir cultures, only, and I keep in the fridge. I use it also ad sauce, because the cultures get big and it gets concentrated and strong.
    - 4y ago
sealthedeal 4y ago
Kombucha is the way
cpncrunch 4y ago
Hmmm not very impressive. See figure 1. Placebo and treatment group have identical depression scores post intervention, and the small difference at followup is the same amount as the difference between groups.
PragmaticPulp 4y ago
Full paper here: https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z Skip down to Figure 1 to see the chart. Note that the response to placebo is normally extremely strong in depression studies, so it’s normal to see both groups improve drastically like this. The only thing that jumps out to me is that the probiotic group started with HAM-D depression inventory scores that were notably higher. When measuring absolute reduction of HAM-D scores, this actually leaves the more depressed patients with more room to improve and can therefore inflate the perceived effectiveness of their response, placebo or otherwise. And indeed, both groups had basically identical scores at the end of the trial. They only really diverged at follow-up where the probiotic group had improved slightly more than placebo. I’ve seen enough probiotic stories that failed to pan out later that I’d take this one with a huge grain of salt. Trying probiotics might be worthwhile if you can afford them, but the probiotic-depression link never seems to actually play out from online anecdotes of people taking them. Note that we’ve been seeing small studies about this exact topic for a long, long time.
- cpncrunch 4y ago
  HN users seem to have a habit of posting crap science wrapped up in impressive sounding news stories, and it's kind of annoying. This is meant to be a group of intelligent people who should have the ability to click on the link to the article and look at the actual results.
  - guerrilla 4y ago
    The community has grown a lot. A ton of junk is posted (a ton, browse new for a while) but the real deal here is that sometimes enough people upvote the junk to frontpage it. I don't know why but I think sometimes some people just want certain things to be true.
    - encryptluks2 4y ago
      I'm speaking from anecdotal evidence here but I have seen a lot of research that indicate the digestive tract is basically the primary storage of serotonin. And whenever I get chronically depressed I also get chronically constipated. I don't necessarily think probiotics are a magical cure but I think anything that aids with digestion and moving things through the digestive tract can help.
0daystock 4y ago
Almost as if the gut microbiome (and by extension, the food we eat) has massive influence over our mood, health and autonomy. Crazy how that's a novel concept to people still.
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negroni 4y ago
My wife as been on SSRIs for years. Anecdotally, a few years ago, she noticed when she forgets to order her probiotics she slides into a malaise after a few days. For both of our benefit, I now make sure we never run out. https://www.amazon.com/Probiotics-Billion-CFU-Prebiotics-Acidophilus/dp/B09GLGC9DG/ https://www.amazon.com/Probiotics-Billion-CFU-Prebiotics-Aci...
awinter-py 4y ago
actual results are in figure 1 of the linked article https://www.nature.com/articles/s41398-022-01977-z/figures/1 https://www.nature.com/articles/s41398-022-01977-z/figures/1 they were using the HAM-D instrument to measure impact. The probiotics group appears to have initial +2 HAM-D (19 vs 17), and have -1 at follow-up (7 vs 8). This is for relatively small N (21 completed probiotics course, 26 placebo), and the fact that the difference is smaller at the end vs at the beginning says 'within the noise' to me. results section also notes probiotic group had twice the drop-out rate of the placebo group (30% vs 13%)
kudzoo 4y ago
A healthy gut microbiome has a diversity of bacteria. You want to have a healthy gut microbiome because it has an incredible number of interactions with your nervous system, which can impact mood, energy, and brain function. Below is a quick rundown of the essential tools for feeding one's gut microbiome. - Prebiotics: Carbohydrates and fiber that our body can't digest but act as food for the bacteria in our gut. - Active culture foods: Yogurt, sauerkraut, kimchi, etc that contain active bacteria which support the growth of other bacteria. - Probiotics supplements: contain live active cultures. If you have a depleted gut microbiome due to stress, disease or recent usage of antibiotics, probiotics are useful to restart the gut microbiome but probably aren't needed for maintenance. Instead, you may be better off eating a diet that contains a healthy amount of prebiotics (fiber, complex carbs) and fermented foods.
- midislack 4y ago
  This is a GPT post, right?
  - jb1991 4y ago
    I was thinking something similar -- says a lot without saying much.
    - midislack 4y ago
      Looks like it was just lifted from some article somewhere.
harigov 4y ago
I have always had a significant mood boost from taking probiotics - either from food or as supplements. Some forms of probiotics make me overly happy to the point that it is detrimental to my life. Recently I started taking these probiotics - seed.com - and find them reasonably balanced. You will see improved mood and sleep for a few days but then not much - not sure why it doesn't persist. I am still continuing with these because they seem to be helping with other digestive issues. I also notice way more mood improvement when eating Sauerkraut so try to eat a couple of tablespoons of it everyday. I have experimented enough with microbiome related stuff that I am fully convinced they play a major role in ones health (including mood and energy). That said, there is way more to it than simply the species of bacteria. Where those bacteria are located in the gut (small or large intestine or colon), what other species are there, your genetics, your diet, lifestyle, your psyche, etc., all play a part in their functioning. I wish there was a more "big-data" approach to figuring out things than researching one species at a time.
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InfiniteRand 4y ago
One thing with depression is that every ache and discomfort gets amplified and seems endless and indicative of the terrible nature of existence. So taking care of yourself in numerous ways is helpful. Not sure if that’s all that’s going on with the probiotic link but it’s a factor. Unfortunately, depression saps your will to care for yourself so eating better, exercising, sleeping better are all easier said than done
Cenk 4y ago
Here’s a direct link to a PDF of the study: https://oa.mg/pdf/s41398-022-01977-z.pdf https://oa.mg/pdf/s41398-022-01977-z.pdf
cess11 4y ago
Leonid Schneider has some interesting background on Lang and Schmidt. https://forbetterscience.com/2022/06/17/schneider-shorts-17-06-2022-once-again-macchiarini-walks-out-free-2/#lang https://forbetterscience.com/2022/06/17/schneider-shorts-17-...
getpost 4y ago
I'm doing a trial of Sugar Shift[0][1], inspired by William Davis[2]. There may be a small improvement in my mood, but not enough to say with certainty. I'm not doing any tests to monitor for the other possible benefits of the supplement. Two weeks into the trial, I have a mouth sore, which is rare for me (less than one occurrence per year). This may be coincidental, but I discontinued the supplement for the time being. I don't have a blood glucose problem particularly, but I am hoping to reduce inflammation. The manufacturer offers several probiotic supplements, and Sugar Shift seems to be the most comprehensive. [0] https://biotiquest.com/pages/sugar-shift https://biotiquest.com/pages/sugar-shift [1] https://biotiquest.com/blogs/blog/sugar-shift-challenge-the-results-are-in https://biotiquest.com/blogs/blog/sugar-shift-challenge-the-... [2] https://drdavisinfinitehealth.com/ https://drdavisinfinitehealth.com/
nope96 4y ago
This study scared me away from trying Probiotics: Probiotics linked to brain fog, severe abdominal bloating https://www.healio.com/news/gastroenterology/20180808/probiotics-linked-to-brain-fog-severe-abdominal-bloating https://www.healio.com/news/gastroenterology/20180808/probio... “What we now know is that probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid,” he said in the press release. “So, if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing lactic acidosis and brain fogginess.”
- bwat48 4y ago
  probiotics 'colonizing' at all is very rare, they are generally transient
justsocrateasin 4y ago
Sample size of 1 here, but hopefully worth the read. I got food poisoning while abroad shortly after college, and took some shitty OTC antibiotics. I was low-grade sick for ~1 month, and when I came home I started developing IBS which got progressively worse over the next few years. FODMAP saved me, but at the detriment of needing to eliminate a lot of foods that I loved eating. Recently I started eating 2tbps of chia seeds with some lemon juice and water daily. Chia seeds are incredibly fibrous. Over the next month, my stomach seemed to get permanently better - I can now eat larger quantities of some of those "problem" foods without debilitating side effects. The bacteria in your gut affect a whole lot of things. And there are competing cultures, all of which like to eat different things. My hunch is that I coaxed the fiber-loving ones back to health, and they in turn did me the favor of repressing the cultures that liked fermenting beans and cruciferous vegetables. There's a lot we don't know about our gut microbiome, but my guess is that eating high-fiber, high-diversity diets is a much better solution than taking a pill.
- cpeterso 4y ago
  I’m glad you were able to recover. What prompted you to try chia seeds, in particular?
zackmorris 4y ago
I finally beat my digestive issues and chronic fatigue (physical depression) which lasted 3+ years from 2019-2021. Without getting too far into it, here's the stuff that finally worked, weighted by immediacy on a scale of 10: - 10: Eating a serving of Brussels sprouts, preferably daily - 10: Taking about 3 psyllium husk capsules occasionally with FODMAP and spicy meals - 10: Taking a digestive enzyme occasionally with FODMAP and spicy meals (Digest Basic, no affiliation) - 10: Taking a "stress" B complex with 100% daily, instead of 1000% weekly (Nature Made, no affiliation) - 10: Avoiding all beans, unaged dairy, whole-grain wheat and most tree nuts for a few months - 8: Drinking at least twice as much water as I feel that I need, from one big container over the course of the day - 8: Eating plain giant salads with dressing, preferably spinach-greens mix, several times per week - 8: Drinking Kefir daily - 6: Trying several different brands of probiotics occasionally in no particular order - 6: Eating 1-4 eggs per day, preferably on post-workout days - 6: Taking an iodine supplement initially, a few times per week until the bottle was gone I think what kicked this all off was dabbling with keto 5 years ago which might have cost me most of my tolerance to milk, and prolonged dehydration from intense workouts and large servings of protein without proactive hydration. When I lost my gut health, I may have picked up bad bacteria or parasites from food poisoning or raw seafood. I was also under debilitating stress during the last few years at my previous job, so began every morning on an empty tank spiritually. I never listened to my body until my health failed and it made the decision to stop for me. The biggest change has been that being tired feels ordinary and rare, with no emotional component. Instead of the crushing "universe is against me" sense of being attacked, alone and hopeless knowing there was no end of it in sight, which I endured for many years before my physical health's deterioration finally caught up.
- jstx1 4y ago
  So difficult to pick out which part of this had what effect though.
  - smt88 4y ago
    Or none of it had any effect, and something psychological or undiagnosed was resolved. It's a completely meaningless list for us and (possibly) for OP.
mensetmanusman 4y ago
I had to go on a probiotic diet due to medication once. My favorite dish (that I still eat!) was simply mixing powdered baking chocolate with Greek yogurt.
- markdown 4y ago
  Did the powdered baking chocolate add anything more than flavour?
  - Sunspark 4y ago
    It contains caffeine.
  - mensetmanusman 4y ago
    https://en.m.wikipedia.org/wiki/Flavonoid https://en.m.wikipedia.org/wiki/Flavonoid
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2OEH8eoCRo0 4y ago
Garbage in, garbage out. Everybody wants a pill or supplement rather than adopting healthy eating habits. My "chronic" acid reflux disappeared by simply doing what I already knew I should be doing: Eat fruits and vegetables. Fish > chicken > beef > pork. Don't buy snacks or sugary drinks. You aren't hungry, you're bored. I wish doctors would treat the whole person rather than prescribing a pill. I wish my doctor told me to do these things before prescribing me omeprazole when I had an issue.
DoreenMichele 4y ago
However, the level of these health-promoting gut bacteria decreased again over the following four weeks. “It may be that four weeks of treatment is not long enough and that it takes longer for the new composition of the intestinal flora to stabilize,” explains Anna-Chiara Schaub, one of the lead authors of the study. Or maybe it's a moving target and people eat every day and their eating habits are part of why their gut is a mess to begin with.
anotherevan 4y ago
These two episodes of the Huberman Lab podcast went into a lot of details about the gut and its effects on our mood and behaviour: https://hubermanlab.com/how-to-enhance-your-gut-microbiome-for-brain-and-overall-health/ https://hubermanlab.com/how-to-enhance-your-gut-microbiome-f... https://hubermanlab.com/dr-justin-sonnenburg-how-to-build-maintain-and-repair-gut-health/ https://hubermanlab.com/dr-justin-sonnenburg-how-to-build-ma... I found them quite interesting.

208 points by NickRandom 4y ago

Note to mods: I 'editorialised' submission title slightly (Original is "Good bacteria to tackle depression") which seemed a bit click-baity

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josiahpeters 4y ago
I appreciate your editorial take. Thanks for saying no to click-bait titles!

amelius 4y ago

Also: https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-long-covid-recovery/ https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-lon...

__alexs 4y ago

I noticed when reading the Amazon reviews of probiotics recently that a lot of people claim they improved their mood a lot too.

raverbashing 4y ago
I suppose there's also an inverse correlation with, let's say, "bathroom frequency"

mfer 4y ago

About 90% of serotonin is made in the gut [1]. This is one of those things that helps us with being happy and an unhealthy gut produces less. So, this makes sense. [1] https://my.clevelandclinic.org/health/articles/22572-serotonin https://my.clevelandclinic.org/health/articles/22572-seroton...

zymun 4y ago
Does this serotonin make its way to the brain?
- jasongill 4y ago
  Seratonin is produced in multiple places in the body (not just the brain, and apparently, most of the seratonin in your body is not produced in the brain), but doesn't appear to cross the blood-brain barrier. I'm not a doctor but I think what that means is "seratonin in your gut probably doesn't make it's way to the brain; but, the rest of the body is already awash in seratonin, so additional production in the gut can help increase those levels, which may have some sort of yet-to-be-understood action that has an impact on depression"
  - amelius 4y ago
    How does serotonin in a pill reach the brain then? :) Is there some special delivery mechanism behind it?
    - kayodelycaon 4y ago
      There is no serotonin in pills. SSRI stands for selective serotonin reuptake inhibitor. It is a chemical that modifies how certain cells reabsorb serotonin. https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_i...
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PragmaticPulp 4y ago
The serotonin in your brain doesn’t come from the gut. Serotonin isn’t just a “happy chemical”. The body uses it in different places for different functions.

kache_ 4y ago

n=40, seems a bit small. But this fits into a lot of anecdotal accounts I've heard. Gut flora is very complex and not well understood.

Kakashi4 4y ago
I've also had anecdotal experience in agreement with this. There have been many studies on this but most of them have a similar small sample size. Wonder why it hasn't been conducted with a larger sample size yet, or maybe it has but didn't find anything so it's not being posted on HN ¯\_(ツ)_/¯
marginalia_nu 4y ago
What is an adequate sample size depends entirely on the effect size.
- kache_ 4y ago
  Yep. I wouldn't eat a mushroom that killed someone, sample size being 1

woliveirajr 4y ago

> Probiotics maintained microbial diversity and increased the abundance of the genus Lactobacillus, indicating the effectivity of the probiotics to increase specific taxa. The increase of the Lactobacillus was associated with decreased depressive symptoms in the probiotics group. [0] So, yogurt everybody ? [1] [2] [0] https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z [1] https://en.wikipedia.org/wiki/Yogurt#Health_research https://en.wikipedia.org/wiki/Yogurt#Health_research [2] https://en.wikipedia.org/wiki/Probiotic https://en.wikipedia.org/wiki/Probiotic

0daystock 4y ago
As long as it's not cow's milk yogurt, sure. https://pubmed.ncbi.nlm.nih.gov/20389060/ https://pubmed.ncbi.nlm.nih.gov/20389060/ https://pubmed.ncbi.nlm.nih.gov/23415826/ https://pubmed.ncbi.nlm.nih.gov/23415826/ Also, the citations in the wikipedia article are hilariously biased. > Presented at the satellite symposium “First Global Summit on the Health Effects of Yogurt." The conference was organized by the ASN, the Nutrition Society, Danone Institute International, and the Dairy Research Institute Another paper was straight up one paid consultant writing an industry-funded article. Here's who edited and reviewed it: > Editorial assistance was provided by Chill Pill Media LLP, which was contracted and funded by Danone Institute International. It's hilarious how desperate the dairy industry is to cook science.
- blindmute 4y ago
  Somehow I remain skeptical that the dairy (and meat) that humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns. I think it's a wee bit more likely that when you're morbidly obese with diabetes, like in that study, and you feel better after eating a controlled, healthy, low-calorie diet, it can be attributed to factors more relevant than veganism.
  - 0daystock 4y ago
    > humans have been eating for literally tens of thousands of years is causing depression and widespread health concerns They literally haven't eaten meat, dairy and eggs 3-5x per day. This is a new phenomenon in the last half-century. And to go back even further, our biochemistry is millions of years old, and is frugivorous in nature. We have no physical adaptations to eating meat. We only started doing it recently as a means of survival when humans left their tropical niche. > a controlled, healthy, low-calorie diet Plant-based foods are naturally low in fat, which is calorie dense, so such a diet is in fact ideal for weight loss.

AmateurLeader 4y ago

Probiotics can (potentially) be very beneficial, but are also often seen as something that "couldn't hurt, so why not try it?". Just wanted to share this article to let people know they are not always harmless, and in some very specific cases, could lead to death. [0] [0] https://pubmed.ncbi.nlm.nih.gov/18279948/ https://pubmed.ncbi.nlm.nih.gov/18279948/

jokoon 4y ago

The problem is that you have to take them often to colonize your gut, so it becomes a bit expensive, and it won't work on everyone, depending on their gut (since scientists know too little about the gut).

goda90 4y ago
My hypothesis is that probiotics also need to be paired with the right diet. Bacteria needs to be fed, and needs to compete with the existing gut flora. If conditions aren't right, then they may never get a foothold.
- deleted 4y ago
  [deleted]
- jokoon 4y ago
  Yeah and honestly I don't think there is a "right diet", because that might be highly dependent on the person, his/her food history, medical past, antibiotics, genetics, physical activity, the "initial gut bacteria" at birth, breast fed or not, etc. Of course one can expect the usual "less sugar and fat, more macro nutrient", but unless there's proof and proper cause-effect relationships, it's going to be complex to draw conclusions. I'm not really sure that sugar causes a bad balance in the gut bacteria. Not to mention all the chemicals in food and the environment that makes it almost impossible to track what could work and what would not.
- stephen_g 4y ago
  Yeah, it requires types of dietary fibre classed as ‘prebiotic’ [1]. 1. https://www.monash.edu/medicine/ccs/gastroenterology/prebiotic/faq https://www.monash.edu/medicine/ccs/gastroenterology/prebiot...
- markdown 4y ago
  Of course the manufacturer will never tell you how to feed your pet bacteria, because they want them to die within a month so they can sell you more.
pbhjpbhj 4y ago

mrfusion 4y ago

How to find the best probiotics?

UI_at_80x24 4y ago
I don't know much this topic, but if you are looking for supplements make sure they are refrigerated. Yogurt is probably the easiest/best way to ingest them though instead of specific pills.
MezzoDelCammin 4y ago
The original study [1] uses Vivomixx in about double dose. According to them it's because it is easily accessible and has multiple strains of bacteria in it (they were not trying to go for one strain in particular). 1 : chapter "Study intervention" of https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z
- deleted 4y ago
  [deleted]

Ozzie_osman 4y ago

I read this take somewhere that we are basically a vessel for our microbiome / gut Flora. Our moods, what food we crave, how social we are might all be impacted by them, in which case they do have some sort of control over not just how we feel, but how we behave. For instance if you eat a lot of sugar, you will crave more sugar, and the argument would be that it's the bacteria that have developed in your gut that are causing you to crave that sugar because that is what they consume (vs the more human-focused evolutionary argument of "sugar was rare and so humans have evolved to crave as much of it as they can get"). Reality is probably a mix of both (ie we are a complex system with wants/needs influenced by both our own body and the Flora that live within it).

0daystock 4y ago
The literature couldn't be more clear in support of what you wrote. It's actually a fairly well researched topic in nutritional science. https://nutritionfacts.org/video/microbiome-we-are-what-they-eat/#transcript https://nutritionfacts.org/video/microbiome-we-are-what-they...

PaulHoule 4y ago

When I think of probiotics I think of this song https://www.youtube.com/watch?v=pnJM_jC7j_4 https://www.youtube.com/watch?v=pnJM_jC7j_4 because probiotics are the "ones that mother gives you [that] don't do anything at all" (Right up there with Vitamin D supplements. Everything good, like low blood pressure and your team winning the Superbowl seems to be associated with high vitamin D in the population and everything bad is associated with low vitamin D... But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl.)

Alex3917 4y ago
> But when you supplement Vitamin D seems to lower your blood pressure as much as it makes your team win the Superbowl Because you need UVA to convert the vitamin D to nitric oxide, and if you're getting enough UVA to do that then you're also more likely to already be getting enough UVB to create sufficient vitamin D in the first place.[1] Not super complicated. Taking vitamin D supplements is probably still better than not taking them if you're deficient, but if you understand the mechanism of action then it should be obvious as to why the science is always equivocal. [1] Or, more precisely, vitamin D regulates nitric oxide synthesis.
wutbrodo 4y ago
You're commenting on a post about an RCT that does show probiotics having an effect...? And AIUI, there's plenty of other evidence of a) their efficacy for changing the gut biome and b) the gut biome's causal effect on a variety of health issues.
- PaulHoule 4y ago
  An rct with n=40 is better than the junk non-controlled studies that inexplicably get funded and accepted by journals but probably meaningless for something involving something as subjective as mental health.
PKop 4y ago
You need to get it from sunlight. Modern man has way too little sun exposure, and the meme of everyone being afraid of sun and using sunscreen obsessively exacerbates the problem.

SaintGhurka 4y ago

Sample size of 1 here, but just hear me out. Probiotics are a cheap and low-risk. If you have any general inflammation type issues that don't seem to have a cause, it might be worthwhile to just try probiotics. My Dr. told me to try them for a digestive issue - and they sort of helped that. But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable, and my skin really cleared up. I had red, flaky skin on my face for 20 years and suddenly it's gone within 48 hours of starting probiotics. Yeah... post hoc ergo propter hoc, but it's a cheap and harmless shot in the dark. Worst case scenario, it doesn't work and you're out $10. Edited to say "low risk" instead of "risk free".

giancarlostoro 4y ago
> But a handful of other things unexpectedly improved. Acid reflux went from really bad to barely noticeable What are you even buying if you don't mind me asking? I don't get acid reflux often, but I definitely want to prevent it happening so often, because it continues for days when I do get it. There's all sorts of things that say they have / are probiotics, including a few different sodas out there.
- SaintGhurka 4y ago
  Culturelle. Just their basic "Digestive Daily Probiotic". It's a single strain Lactobacillus rhamnosus. My Dr. suggested either that or Align. The first thing I tried worked so I haven't tried anything else. A friend of mine had the same problem and he buys generic bulk acidophilus from amazon and he says it works for him. I didn't expect it to work, but I didn't want to wonder if it failed because I cheaped out, so I went for the expensive stuff.
  - philliphaydon 4y ago
    Definitely going to try this too. I go though periods of acid reflux and it wakes me up. I sleep with 2 pillows so raise my head and shoulders to prevent it waking me which helps most of the time. But will give the probiotics a try. Thanks.

ianstormtaylor 4y ago

Anyone have recommendations for which probiotics are the best ones to buy? I always get confused while looking at all the various options, and this seems like a good place to find someone who’s done a lot of research.

wtk 4y ago
I think the market is flooded with supplements, while you can help your gut bacteria with natural products like kefir (kind of buttermilk), kombucha, kimchi like products. I happen to love all those mentioned.
- 0daystock 4y ago
  Those are all very bad recommendations. Buttermilk is loaded with cholesterol and saturated fat, kombucha with sugar, and fermented vegetables like kimchi have shown to increase prostate adenocarcinoma. You want to regulate your gut flora with a variety of whole plant-based foods, not quick fixes like pills and a jar of stinky cabbage.
  - enviclash 4y ago
    You are telling me milk kefir is the cause of health issues? I would suggest limiting it to a few spoons a few times per week, then.
    - glogla 4y ago
      How would you make that practical? How long can you keep a bottle of kefir open before it goes bad?
      - enviclash 4y ago
        I have half glass of milk with kefir cultures, only, and I keep in the fridge. I use it also ad sauce, because the cultures get big and it gets concentrated and strong.
  - 4y ago

sealthedeal 4y ago

Kombucha is the way

cpncrunch 4y ago

Hmmm not very impressive. See figure 1. Placebo and treatment group have identical depression scores post intervention, and the small difference at followup is the same amount as the difference between groups.

PragmaticPulp 4y ago

Full paper here: https://www.nature.com/articles/s41398-022-01977-z https://www.nature.com/articles/s41398-022-01977-z Skip down to Figure 1 to see the chart. Note that the response to placebo is normally extremely strong in depression studies, so it’s normal to see both groups improve drastically like this. The only thing that jumps out to me is that the probiotic group started with HAM-D depression inventory scores that were notably higher. When measuring absolute reduction of HAM-D scores, this actually leaves the more depressed patients with more room to improve and can therefore inflate the perceived effectiveness of their response, placebo or otherwise. And indeed, both groups had basically identical scores at the end of the trial. They only really diverged at follow-up where the probiotic group had improved slightly more than placebo. I’ve seen enough probiotic stories that failed to pan out later that I’d take this one with a huge grain of salt. Trying probiotics might be worthwhile if you can afford them, but the probiotic-depression link never seems to actually play out from online anecdotes of people taking them. Note that we’ve been seeing small studies about this exact topic for a long, long time.

cpncrunch 4y ago
HN users seem to have a habit of posting crap science wrapped up in impressive sounding news stories, and it's kind of annoying. This is meant to be a group of intelligent people who should have the ability to click on the link to the article and look at the actual results.
- guerrilla 4y ago
  The community has grown a lot. A ton of junk is posted (a ton, browse new for a while) but the real deal here is that sometimes enough people upvote the junk to frontpage it. I don't know why but I think sometimes some people just want certain things to be true.
  - encryptluks2 4y ago
    I'm speaking from anecdotal evidence here but I have seen a lot of research that indicate the digestive tract is basically the primary storage of serotonin. And whenever I get chronically depressed I also get chronically constipated. I don't necessarily think probiotics are a magical cure but I think anything that aids with digestion and moving things through the digestive tract can help.

0daystock 4y ago

Almost as if the gut microbiome (and by extension, the food we eat) has massive influence over our mood, health and autonomy. Crazy how that's a novel concept to people still.

deleted 4y ago

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negroni 4y ago

My wife as been on SSRIs for years. Anecdotally, a few years ago, she noticed when she forgets to order her probiotics she slides into a malaise after a few days. For both of our benefit, I now make sure we never run out. https://www.amazon.com/Probiotics-Billion-CFU-Prebiotics-Acidophilus/dp/B09GLGC9DG/ https://www.amazon.com/Probiotics-Billion-CFU-Prebiotics-Aci...

awinter-py 4y ago

actual results are in figure 1 of the linked article https://www.nature.com/articles/s41398-022-01977-z/figures/1 https://www.nature.com/articles/s41398-022-01977-z/figures/1 they were using the HAM-D instrument to measure impact. The probiotics group appears to have initial +2 HAM-D (19 vs 17), and have -1 at follow-up (7 vs 8). This is for relatively small N (21 completed probiotics course, 26 placebo), and the fact that the difference is smaller at the end vs at the beginning says 'within the noise' to me. results section also notes probiotic group had twice the drop-out rate of the placebo group (30% vs 13%)

kudzoo 4y ago

A healthy gut microbiome has a diversity of bacteria. You want to have a healthy gut microbiome because it has an incredible number of interactions with your nervous system, which can impact mood, energy, and brain function. Below is a quick rundown of the essential tools for feeding one's gut microbiome. - Prebiotics: Carbohydrates and fiber that our body can't digest but act as food for the bacteria in our gut. - Active culture foods: Yogurt, sauerkraut, kimchi, etc that contain active bacteria which support the growth of other bacteria. - Probiotics supplements: contain live active cultures. If you have a depleted gut microbiome due to stress, disease or recent usage of antibiotics, probiotics are useful to restart the gut microbiome but probably aren't needed for maintenance. Instead, you may be better off eating a diet that contains a healthy amount of prebiotics (fiber, complex carbs) and fermented foods.

midislack 4y ago
This is a GPT post, right?
- jb1991 4y ago
  I was thinking something similar -- says a lot without saying much.
  - midislack 4y ago
    Looks like it was just lifted from some article somewhere.

harigov 4y ago

I have always had a significant mood boost from taking probiotics - either from food or as supplements. Some forms of probiotics make me overly happy to the point that it is detrimental to my life. Recently I started taking these probiotics - seed.com - and find them reasonably balanced. You will see improved mood and sleep for a few days but then not much - not sure why it doesn't persist. I am still continuing with these because they seem to be helping with other digestive issues. I also notice way more mood improvement when eating Sauerkraut so try to eat a couple of tablespoons of it everyday. I have experimented enough with microbiome related stuff that I am fully convinced they play a major role in ones health (including mood and energy). That said, there is way more to it than simply the species of bacteria. Where those bacteria are located in the gut (small or large intestine or colon), what other species are there, your genetics, your diet, lifestyle, your psyche, etc., all play a part in their functioning. I wish there was a more "big-data" approach to figuring out things than researching one species at a time.

deleted 4y ago
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InfiniteRand 4y ago

One thing with depression is that every ache and discomfort gets amplified and seems endless and indicative of the terrible nature of existence. So taking care of yourself in numerous ways is helpful. Not sure if that’s all that’s going on with the probiotic link but it’s a factor. Unfortunately, depression saps your will to care for yourself so eating better, exercising, sleeping better are all easier said than done

Cenk 4y ago

Here’s a direct link to a PDF of the study: https://oa.mg/pdf/s41398-022-01977-z.pdf https://oa.mg/pdf/s41398-022-01977-z.pdf

cess11 4y ago

Leonid Schneider has some interesting background on Lang and Schmidt. https://forbetterscience.com/2022/06/17/schneider-shorts-17-06-2022-once-again-macchiarini-walks-out-free-2/#lang https://forbetterscience.com/2022/06/17/schneider-shorts-17-...

getpost 4y ago

I'm doing a trial of Sugar Shift[0][1], inspired by William Davis[2]. There may be a small improvement in my mood, but not enough to say with certainty. I'm not doing any tests to monitor for the other possible benefits of the supplement. Two weeks into the trial, I have a mouth sore, which is rare for me (less than one occurrence per year). This may be coincidental, but I discontinued the supplement for the time being. I don't have a blood glucose problem particularly, but I am hoping to reduce inflammation. The manufacturer offers several probiotic supplements, and Sugar Shift seems to be the most comprehensive. [0] https://biotiquest.com/pages/sugar-shift https://biotiquest.com/pages/sugar-shift [1] https://biotiquest.com/blogs/blog/sugar-shift-challenge-the-results-are-in https://biotiquest.com/blogs/blog/sugar-shift-challenge-the-... [2] https://drdavisinfinitehealth.com/ https://drdavisinfinitehealth.com/

nope96 4y ago

This study scared me away from trying Probiotics: Probiotics linked to brain fog, severe abdominal bloating https://www.healio.com/news/gastroenterology/20180808/probiotics-linked-to-brain-fog-severe-abdominal-bloating https://www.healio.com/news/gastroenterology/20180808/probio... “What we now know is that probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid,” he said in the press release. “So, if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing lactic acidosis and brain fogginess.”

bwat48 4y ago
probiotics 'colonizing' at all is very rare, they are generally transient

justsocrateasin 4y ago

Sample size of 1 here, but hopefully worth the read. I got food poisoning while abroad shortly after college, and took some shitty OTC antibiotics. I was low-grade sick for ~1 month, and when I came home I started developing IBS which got progressively worse over the next few years. FODMAP saved me, but at the detriment of needing to eliminate a lot of foods that I loved eating. Recently I started eating 2tbps of chia seeds with some lemon juice and water daily. Chia seeds are incredibly fibrous. Over the next month, my stomach seemed to get permanently better - I can now eat larger quantities of some of those "problem" foods without debilitating side effects. The bacteria in your gut affect a whole lot of things. And there are competing cultures, all of which like to eat different things. My hunch is that I coaxed the fiber-loving ones back to health, and they in turn did me the favor of repressing the cultures that liked fermenting beans and cruciferous vegetables. There's a lot we don't know about our gut microbiome, but my guess is that eating high-fiber, high-diversity diets is a much better solution than taking a pill.

cpeterso 4y ago
I’m glad you were able to recover. What prompted you to try chia seeds, in particular?

zackmorris 4y ago

I finally beat my digestive issues and chronic fatigue (physical depression) which lasted 3+ years from 2019-2021. Without getting too far into it, here's the stuff that finally worked, weighted by immediacy on a scale of 10: - 10: Eating a serving of Brussels sprouts, preferably daily - 10: Taking about 3 psyllium husk capsules occasionally with FODMAP and spicy meals - 10: Taking a digestive enzyme occasionally with FODMAP and spicy meals (Digest Basic, no affiliation) - 10: Taking a "stress" B complex with 100% daily, instead of 1000% weekly (Nature Made, no affiliation) - 10: Avoiding all beans, unaged dairy, whole-grain wheat and most tree nuts for a few months - 8: Drinking at least twice as much water as I feel that I need, from one big container over the course of the day - 8: Eating plain giant salads with dressing, preferably spinach-greens mix, several times per week - 8: Drinking Kefir daily - 6: Trying several different brands of probiotics occasionally in no particular order - 6: Eating 1-4 eggs per day, preferably on post-workout days - 6: Taking an iodine supplement initially, a few times per week until the bottle was gone I think what kicked this all off was dabbling with keto 5 years ago which might have cost me most of my tolerance to milk, and prolonged dehydration from intense workouts and large servings of protein without proactive hydration. When I lost my gut health, I may have picked up bad bacteria or parasites from food poisoning or raw seafood. I was also under debilitating stress during the last few years at my previous job, so began every morning on an empty tank spiritually. I never listened to my body until my health failed and it made the decision to stop for me. The biggest change has been that being tired feels ordinary and rare, with no emotional component. Instead of the crushing "universe is against me" sense of being attacked, alone and hopeless knowing there was no end of it in sight, which I endured for many years before my physical health's deterioration finally caught up.

jstx1 4y ago
So difficult to pick out which part of this had what effect though.
- smt88 4y ago
  Or none of it had any effect, and something psychological or undiagnosed was resolved. It's a completely meaningless list for us and (possibly) for OP.

mensetmanusman 4y ago

I had to go on a probiotic diet due to medication once. My favorite dish (that I still eat!) was simply mixing powdered baking chocolate with Greek yogurt.

markdown 4y ago
Did the powdered baking chocolate add anything more than flavour?
- Sunspark 4y ago
  It contains caffeine.
- mensetmanusman 4y ago
  https://en.m.wikipedia.org/wiki/Flavonoid https://en.m.wikipedia.org/wiki/Flavonoid

deleted 4y ago

[deleted]

2OEH8eoCRo0 4y ago

Garbage in, garbage out. Everybody wants a pill or supplement rather than adopting healthy eating habits. My "chronic" acid reflux disappeared by simply doing what I already knew I should be doing: Eat fruits and vegetables. Fish > chicken > beef > pork. Don't buy snacks or sugary drinks. You aren't hungry, you're bored. I wish doctors would treat the whole person rather than prescribing a pill. I wish my doctor told me to do these things before prescribing me omeprazole when I had an issue.

DoreenMichele 4y ago

However, the level of these health-promoting gut bacteria decreased again over the following four weeks. “It may be that four weeks of treatment is not long enough and that it takes longer for the new composition of the intestinal flora to stabilize,” explains Anna-Chiara Schaub, one of the lead authors of the study. Or maybe it's a moving target and people eat every day and their eating habits are part of why their gut is a mess to begin with.

anotherevan 4y ago

These two episodes of the Huberman Lab podcast went into a lot of details about the gut and its effects on our mood and behaviour: https://hubermanlab.com/how-to-enhance-your-gut-microbiome-for-brain-and-overall-health/ https://hubermanlab.com/how-to-enhance-your-gut-microbiome-f... https://hubermanlab.com/dr-justin-sonnenburg-how-to-build-maintain-and-repair-gut-health/ https://hubermanlab.com/dr-justin-sonnenburg-how-to-build-ma... I found them quite interesting.