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I don't know that it's "necessary". We do it for two reasons - the Truflora is especially good against yeast but you don't need to take it every day. Even their website suggests twice a week. Both Truflora and Theralac are pricey, especially with 3 family members taking them. So we use each one twice a week and the other three days, we use 1-2 Sacc B because that one is much cheaper. So my first reason for rotating is financial.


The second reason is that it probably isn't a bad idea to rotate to give the gut a variety of bacteria. I got a book out of the library on probiotics and it alked about the various benefits of different strains. So the rotating is also to give variety. But I haven't ever been told it's absolutely required.

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You might want to think about adding goat milk kefir. We all take it here and feel actually better. The kefir is a super excellent source of probiotics and is even a greater source of good bacteria. I use about 1/4 cup per person each day in a smoothie with pineapple juice, coconut oil and as much of the rest of the supps I can get in there without messing up the taste. I buy the redwood farms brand. Check out their website for more info on the benefits of kefir.

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Do probiotics need to be rotated LLM? Do you know?

We don't rotate our probiotics because I'm afraid of rocking the boat, per se, but I was at a meeting last week where an integrative doctor spoke of the importance of rotating them - especially if you are on abx.


Custom Probiotics sells an 11 strain powder probiotic. A little goes a long way.

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Here are the ones we use. I look for high quality, high count, and I don't use any on dd with the strep strain, but do for myself, strep strain doesn't affect me.

Custom probiotics 11 strain (powder- I blast a syringe with heapings of this every morning 2+ hours away from her antibiotics)

Culterelle - I hear it is good to combat c. diff., and because she seems to react to sacc. B (florastar) I use this instead,

and then later in the day, either Theralac or Klaire Detox probiotic.

I blast my dd with them- as she is on antibiotics 2x a day, and we have had gut issues before.


Me, I take VSL capsules (strep strain, but super high count) and some of the above.

I have also used some Kirkman probiotics that I liked and were good quality (not Kirkland, the Costco brand.)

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Here's a pretty good site I just stumbled on



This was particularly interesting:


Streptococcus thermophilus also lacks genes which contain surface proteins. This is important because harmful bacteria use these surface proteins to attach to mucosal tissues and hide from the body’s defensive actions.


I have always been under the impression that the M proteins of strep are the ones that make autoimmunity a problem in our kids and it's the similarity in M proteins in certain strains of strep (particularly the dozen that cause scarlet fever) and the M proteins in the lyme spirochete that can make lyme a trigger for Pandas symptoms (that these M proteins look similar to the proteins found on the surface of heart and basal ganglia cells). I have total respect for those who feel that strep strains of probiotics are bad for their kids, but aside from Dr T's cautionary - maybe better to avoid it - advice a few years back, I can't recall seeing any research that suggests S. Thermophilus in probiotics is problematic. Particularly if this above quote is true and it has no surface proteins. Does anyone have any research to support the need to avoid S thermophilus in probiotics?


Also interesting is this:


One of Streptococcus thermophilus’ unique abilities is that it can break down casein, the protein in dairy products like cheese. It reduces them into small peptides and amino acids


The process behind this yogurt production is beneficial to digestive health in a couple of ways. The good bacteria ferment the sugar in the milk, also known as lactose. The lactose is transformed into lactic acid, which is highly effective in preventing lactose intolerance. The production of the lactic acid reduces pH and results in the milk curdling and turning tart. This also prevents the growth of bacteria that causes food poisoning



In addition to the natural ability of Streptococcus thermophilus to prevent transformation of nitrates into cancer-causing nitrites, the bacterium has other exciting cancer-related applications. One strain which is undergoing exciting research is Streptococcus thermophilus TH-4. Chemotheraphy often causes intestinal mucositis, severe inflammation of primarily the small intestines which can be fatal. Although there are a variety of treatments for this condition, they often do not work.


A 2009 study in Adelaide, Australia has shown very positive results when Streptococcus thermophilus TH-4 was used to treat rats with mucositis caused by chemotherapy drugs. Rats responded to the treatment by showing a normalization of healthy cell function in the affected areas and a significant reduction of distress to the tissue of the intestines.


I would hate to avoid a strain based on name only if there is no actual similarity between the strep we fear and S thermophilus.

Edited by LLM
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I think this is one area where you may need to play around a little to see what will or will not work. You need to start out small and slowly increase to avoid possible gastro symptoms. You also may see a small increase in other symptoms for a few days that should subside within a week. I tried Theralac and my daughter reacted with an increase of symptoms, so I stopped. This was before I knew about herxing so I probably didn't give it enough time. But the herxing was minimal and it subsided when I stopped the probiotic. I tried VSL #3 on dd and all h@ll broke out - so I won't be using that again (it does have the strep strain- so who knows)- it took more than a week for symptoms to subside. If I recall, I tried it again with the same results. I also think you can be more sensitive to products/supplements at times when your infection load may be higher or immune system is not working properly. I notice when my daughter is doing somewhat better, she can tolerate more stuff going into her little body.

Edited by philamom
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I totally agree that it is individual (strep strain reactions.)


Before this whole PANDAS/PANS/Lyme thing started, I was feeding dd (4 years old at the time) coconut yogurts with the strep strain probiotic-

and I certainly did see an uptick.

Now, I feed her yogurt and I don't see it.

But I am not prepared to give her probiotics with the strep strain.

Honestly, I don't know where she is with strep- never high titers, no positive culture in 4 years-

Was it a co-infection? Does it sit somewhere in the body, lurking? Because I know it was there.

Whatever, I am afraid to provoke. Could just be my own paranoia.

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