Looking for a primer on gut health with ABX

[kimballot]

Hi -

 

Lots of interesting posts recently about probiotics and gut health, and, with the help of some posts from ThinkGutBacteria and others, I am moving toward learning more about gut health and probiotics. I am sure that my ds15's gut health is a huge part of his condition. He started on antibiotics at 4 months of age and was not able to come off until age 7 - and that entire time we never even considered using a probiotic. I am sure that only added to his already depleted immune system and I KNOW he had major yeast problems. Around age 7 we learned about leaky gut, the "yeast connection" and fungal sinusitis and realized (somewhat) what we had been doing, and then spent the next few years avoiding antibiotics at all costs and promoting gut health - only to get hit with simultaneous H1N1, sinus cyst, and bartonella 3 years ago, and we are working now on recovery from that. He currently is on a gluten-free / dairy-free diet and we use Sacchyromyces twide daily. I throw in some acidophilus when I can but, honestly, do not do that regularly because I have a hard time remembering to give it to him 2 hours before/after ABX. I can give sacchy at the same time, so we just go with that. He is not on an antifungal at the present time, and I wonder if that is a mistake.

 

So - I am wondering if there are some good gut- health sites or references that folks would recommend to help me to understand this better. Thanks so much!

[LNN]

I'm sure there are better sites, but here's one I have bookmarked:

http://www.medicalinsider.com/bacterial.html#top

 

Halfway down this table of contents, you'll see a section on probiotics. I think learning about gut bacteria is fascinating. But reading that a certain strain of probiotic is beneficial and finding that strain in a capsule I can buy have been two different things. Consuming fermented foods isn't going to happen in my house. So we've been limited in what we can find and mostly shoot for blends.

 

As for the 2 hr window away from abx, we've been able to do it by giving abx at dinner and then probiotics at bedtime. That sends the probiotics into the stomach when the stomach is less active/lower acid and lets the probiotics sit in the intestines overnight, hopefully helping with digestion and having a few hours to do some good.

[ThinkGutBacteria]

Are you looking for something technical from somebody like Sarkis Mazmainian or are you looking for starter info that's suitable for smart lay-readers like this article in the New Yorker?

 

http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter

[kimballot]

Are you looking for something technical from somebody like Sarkis Mazmainian or are you looking for starter info that's suitable for smart lay-readers like this article in the New Yorker?

 

http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter

 

Thank you so much for this article. It was very good but... unfortunately, leaves me with the impression that:

 

1. My son (who started on antibiotics at 4 months of age and has been on them most of his life) had a complete upset of his microbiome early on.

 

2. Replacing the lost bacteria is a great idea, but we have no idea exactly what type of bacteria needs to be replaced nor in what amount.

 

3. The effects of antibiotics are systemic, but bacteria replacement through oral probiotics will likely not replace the bacteria in, say, his ears or sinuses (though the comment in the article about transferring ear wax from the non-infected ear to the infected ear is very intresting!).

 

4. Mulitple strains of probiotics are not necessarily better than singe strains, since we have no idea what is missing and we don't know if the multiple strains work in concert or if they could have some sort of negative interactive effect.

 

 

Now - I recognize that the article was fairly conservative as it was written in the New Yorker, so I am sure they would not go out on a limb to promote anything that could not be backed up 100% by evidence. So, my question is... given the scientific evidence we have now... what is the best thing I can do for my immune-deficient, PANDAS-prone 15 year old son probiotically, as he is on 3 antibiotics now and may very well be on at least one antibiotic for the rest of his life. He does take probiotics, but I feel like I am guessing at this more than anything.

 

Thanks so much for your insights - I really enjoy your posts.

[sf_mom]

Metamedrix Comprehensive Stool Analysis will provide the level of good bacteria in the gut indicating what is needed to help re-establish specific strains of bacteria with probiotics. Here is a PDF of their result page. The 'good' bacteria is considered predominate bacteria and listed in the first section. There are only about 8 or 9 listed but its a good indication of where you come up short and potentially how to focus your choice of probiotics. We tend to rotate brands now but initially used Custom Probiotics - 11 strain powder in high doses. We are now using Natren 'Healthy Trinity' which is dairy free and has better absorption.

 

http://www.metametrix.com/files/test-menu/sample-reports/GI-Effects-GI-Function-SR.pdf

 

Additionally, you will have difficulties correcting leaky gut if the digestive enzymes are off, if there is proliferation of yeast and/or have a heavy metals issues. The stool analysis will provide you with the level of yeast 'hopefully'. Unfortunately, yeast isn't always picked up in stool analysis. Yeast will form biofilms and can be very difficult to treat and usually needs to be addressed in some way 'ongoing' while on long term antibiotics. Regular nystatin doses did not do it for our children but we also have heavy metals issues of Lead and potentially Mercury. The stool results will also provide what digestive enzymes are missing if any. We give digestive enzymes and a high dose 'compounded' nystatin together before meals to deal with yeast biofilms/lack of enzymes/gut issues. We used our initial stool analysis as a baseline and have re-ran the analysis about once a year to check status. The probiotics over the years have definitely helped even while on antibiotics (we have done mega doses) especially when it comes to Prevotella sp, Streptomyces sp., Mycoplasma sp. strains. We still need better coverage for Lactobacillus sp and Bifidobacter sp. but I think we've had a tough time with re-establishing gut bacteria due to heavy metals.

 

There are lotions, ear sprays and nasal sprays with probiotics in them. We use a probiotic cream called Magoroku as we are dealing with a ton of rashes due to yeast/fungal issues.

 

Hope that helps. Typically a 'good' DAN is well versed in all of these issues heavy metals, yeast, digestive enzymes, leaky gut. We see an LLMD plus a Pediatrician that specializes in treating autism biomedically... For some reason our Pediatrician does not specifically refer to herself a DAN.

Edited February 24, 2013 by SF Mom

[ThinkGutBacteria]

Are you looking for something technical from somebody like Sarkis Mazmainian or are you looking for starter info that's suitable for smart lay-readers like this article in the New Yorker?

 

http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter

 

Thank you so much for this article. It was very good but... unfortunately, leaves me with the impression that:

 

1. My son (who started on antibiotics at 4 months of age and has been on them most of his life) had a complete upset of his microbiome early on.

 

2. Replacing the lost bacteria is a great idea, but we have no idea exactly what type of bacteria needs to be replaced nor in what amount.

 

3. The effects of antibiotics are systemic, but bacteria replacement through oral probiotics will likely not replace the bacteria in, say, his ears or sinuses (though the comment in the article about transferring ear wax from the non-infected ear to the infected ear is very intresting!).

 

4. Mulitple strains of probiotics are not necessarily better than singe strains, since we have no idea what is missing and we don't know if the multiple strains work in concert or if they could have some sort of negative interactive effect.

 

 

Now - I recognize that the article was fairly conservative as it was written in the New Yorker, so I am sure they would not go out on a limb to promote anything that could not be backed up 100% by evidence. So, my question is... given the scientific evidence we have now... what is the best thing I can do for my immune-deficient, PANDAS-prone 15 year old son probiotically, as he is on 3 antibiotics now and may very well be on at least one antibiotic for the rest of his life. He does take probiotics, but I feel like I am guessing at this more than anything.

 

Thanks so much for your insights - I really enjoy your posts.

 

Oh boy, it's frustrating as heck trying to turn all of these tiny scraps and hints into anything useful for our kids! The only other avenues to explore, or at least know about, include helminthic therapy, fecal transplant (also called bacteriotherapy), and prebiotics. Do you know about those already?

 

The best book I read on the topic of gut health and chronic disease is by Moises Velasquez-Manoff called "An Epidemic of Absence" Here's a review of it in the NY Times: http://www.nytimes.com/2012/09/11/science/an-epidemic-of-absence-review-seeing-hygiene-as-driver-of-disease.html?_r=0

 

An interesting source of prebiotic is a kind of beneficial-bacteria-promoting fiber sold by King Arthur (http://www.kingarthurflour.com/shop/items/hi-maize-fiber-12-oz) They also sell the fiber pre-blended with white flour.

 

An interesting website on an interesting class of prebiotic is here

http://en.wikipedia.org/wiki/Mannan_Oligosaccharide_based_nutritional_supplements_(MOS)

 

You should also know about the "poopy lab" of Dr. Emma Allen-Vercoe

http://www.uoguelph.ca/theportico/bacteria/

 

More later. I have to be productive in another facet of my life...

[LNN]

I found this article by Yasko and Mullen today that might give you an overview of things to think about. A bit dry and technical, but I know you're up to the task

http://www.psychiatryburbankca.com/wp-content/uploads/2012/10/Gastrointestinal_Balance_and_Neurotransmitter_Formation.pdf

[ThinkGutBacteria]

I found this article by Yasko and Mullen today that might give you an overview of things to think about. A bit dry and technical, but I know you're up to the task

http://www.psychiatryburbankca.com/wp-content/uploads/2012/10/Gastrointestinal_Balance_and_Neurotransmitter_Formation.pdf

 

Neat, thanks! I find it utterly fascinating that bacteria a few inches behind your belly button can make you happy, sad, anxious, etc. Amazing. Truth really is stranger than fiction (maybe that's why politicians don't go near the stuff )

[Mayzoo]

I'm sure there are better sites, but here's one I have bookmarked:

http://www.medicalinsider.com/bacterial.html#top

 

Halfway down this table of contents, you'll see a section on probiotics. I think learning about gut bacteria is fascinating. But reading that a certain strain of probiotic is beneficial and finding that strain in a capsule I can buy have been two different things. Consuming fermented foods isn't going to happen in my house. So we've been limited in what we can find and mostly shoot for blends.

 

As for the 2 hr window away from abx, we've been able to do it by giving abx at dinner and then probiotics at bedtime. That sends the probiotics into the stomach when the stomach is less active/lower acid and lets the probiotics sit in the intestines overnight, hopefully helping with digestion and having a few hours to do some good.

 

Just curious, but which strain can you not find in capsule?

[LNN]

I wasn't referring to any strains listed on the link. A few years ago, I read a book on the specific attributes of various probiotics strains. I wrote down the names of the ones the author singled out for immune support (L. Reuteri) and other issues that seemed relevant to the things we were struggling with. I then went online and into the health food stores and of the half dozen strains I was looking for, L. Reuteri was the only one I could find, and it was in a low dose - something like 5-8 billion CFUs.

 

I now just use a variety of strains and rotate brands. My only point was that there's "ideal" and then there's "real life" and sometimes those are two different things.