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Lactobacillus And Anxiety: Whats The Link
Amy Loughman and MARY NEYLAN
How our gut microbiome could help reduce anxiety and its potential effects on the most common antidepressant and anti-anxiety medication.
Interactions between the gut and anxiety
Oftentimes, when were nervous or worried we feel it in our belly. We may feel nauseous or need to run for the bathroom. Am I right in thinking youve felt something like this before?
Theres a growing body of evidence out there about a bidirectional connection between the gut and the brain, the gut-brain axis. Gastrointestinal disorders and mental illness often occur hand in hand. It has been found that the rate of irritable bowel syndrome and other functional gastrointestinal disorders was four times higher in people with anxiety than those who dont have anxiety. The rate of anxiety was also five times higher in people with IBS than without.
Supplements comprising other bacterial species have been found to reduce these behaviours in both mice and humans. Theres growing evidence that particular gut bacteria including Lactobacillus, Bifidobacterium, andBacteroides may be related to anxiety symptoms.
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Psychobiotic Interventions Could Benefit From Existing Cultural Practises
One advantage of psychobiotics in the treatment and prevention of youth anxiety that may have been as yet overlooked is the existing cross-cultural prevalence of fermented food sources containing psychobiotics. For instance, anxiolytic strains of lactobacilli have been found in traditional fermented doughs from the Congo and Burkina Faso, Japanese fermented fish, dairy and pickles from China and Mongolia, and eastern European kefir fermented milk. This means that the general public might be responsive to a behavioural nudge, as part of a public health campaign for increasing the anxiolytic psychobiotics consumption for example, given that these products exist widely in many cultures and therefore potentially present fewer cultural barriers to use.
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Probiotics For Depression & Anxiety
There are numerous studies that have been conducted investigating the therapeutic efficacy of probiotics for the treatment of depression and anxiety. While most research is limited to animal models, a few studies have shown promising results in humans. Included below are some important scientific articles that you should read if you are interested.
Perhaps the most thorough explanation comes from a 3-part series written by Alison Bested et al. entitled Intestinal microbiota, probiotics, and mental health. Part 1 eloquently summarizes the historical application of gut bacteria for the treatment of various medical conditions, Part 2 addresses how the gut influences physiology, and Part 3 discusses trials of bacteria for the treatment of neuropsychiatric conditions. Below is a synopsis of the most relevant Part 3, as well as other informative research.
2015: Systematic review of evidence to support the theory of psychobiotics.
A systematic review of evidence conducted by Romijn and Rucklidge investigated the efficacy of psychobiotics, or using probiotics for the treatment of neuropsychiatric disorders. Though many human and animal studies had been published documenting the effects of probiotics as interventions for neuropsychiatric conditions, no researchers had reviewed the literature. Researchers collected studies dating through July 2014 from numerous sources including: Cochrane, Medline, and PubMed to name a few.
Eat Prebiotics To Nourish Probiotic Bacteria
So, youve upped your probiotic intake, but to reap all their health benefits, you need to keep them nourished. Just like you, your gut bacteria need food to keep them sustained, energised, and thriving. Thats where prebiotics come in.
Prebiotics are substances found in plant-based foods which maintain beneficial gut bacteria. Prebiotic fibres, polyphenols, and resistant starches all nourish gut bacteria which in turn transform them into good things like SCFAs and vitamins.
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How Does The Gut Impact Anxiety
With trillions of both good and bad bacteria and yeast living in our gut, maintaining a natural balance can be important to our overall well being.
Research carried out at APC Microbiome Ireland in UCC has found that when there is a disruption in the balance of the bacteria in our gut, this bacteria can influence molecules called MicroRNA in the part of the brain that deals with anxiety and fear-related behaviour , causing us to feel anxious or stressed.
This research found that anxiety and stress can be triggered by a changing balance of bacteria in the gut, and balancing this bacteria can help to minimise stress and anxiety.
Research has also shown that experiencing stress or anxiety can lead to problems in your gut, highlighting the link between gut health and the mental wellbeing.
People suffering from Irritable Bowel Syndrome have also been known to suffer from anxiety and depression as a result of the condition.
How Can I Try Probiotics For Depression
If youre considering trying probiotic supplements for depression, you may want to talk to your healthcare provider first. Probiotics are considered safe to use, but its generally a good idea to get their advice before trying any new supplement or medication.
In clinical trials, Lactobacillus and Bifidobacterium bacteria appeared to be most helpful for mental health. You can purchase probiotic blends on Amazon, like this one, that combine strains of both of these.
You can also try adding more probiotic foods to your diet, such as:
If you decide to take a supplement, follow the manufacturers recommendation for dosage. Theres no evidence that taking more than the recommended amount offers any extra benefits.
Probiotics may be helpful, but they dont replace therapy, medication, or other depression treatments. You might notice an improvement in your symptoms after you start taking probiotics, but its important to still keep up with any other treatments.
This is especially true if you take antidepressants. Abruptly stopping these medications can have potentially serious psychological and physical effects.
Instead, work with your healthcare provider to come up with a plan that will allow you to slowly taper off your medication, if thats something youre interested in doing.
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Dealing With Stress And Anxiety In A Covid
In todays world, anxiety and stress levels are high. Were adjusting to a new normal and facing much uncertainty and unknown. As discussed, the gut is especially sensitive to anxiety-induced stress and many good bacteria in the gut die off during stressful times.
Changes to the gut microbiome negatively impact brain function in many ways, and are linked to changes in mood, ability to focus and concentrate, as well as memory. More than ever, restoring and maintaining a strong, healthy gut microbiome is essential for overall mental and physical wellness.
How Are Your Gut And Your Brain Connected
Your brain and central nervous system control much of your body. But your gut also has its own brain, called the enteric nervous system .
The ENS is the largest collection of nerve cells outside the brain. Its physically connected to your brain and can communicate with it.
The communication between your brain and your ENS is a two-way street what happens in your brain can affect your gut, and what happens in your gut can affect your brain. Your gut microbiome plays an important role in many of these communications.
Scientists studying rats and mice have found that bacteria in their gut can influence the development of areas in the brain related to pain, stress, and emotional behavior. In turn, signals from the brain can alter the composition of the gut microbiome.
Although more research is needed to understand how this works in people, there are three main ways that your gut microbiome influences communication between your gut and your brain:
The gut contains two-thirds of the bodys immune cells. These fight microbes that cause disease but allow your gut bacteria to send signals to the brain without attacking them.
Your gut is connected directly to your brain by the vagus nerve. Through this route, substances produced by your gut microbiome can affect brain functions.
Your Active Ingredients Review Better Gut Microbiome
Our research group was interested in how psychobiotics can be used by young people to improve anxiety. Liu and colleagues review shows that there is clinical relevance for these specific dietary supplements, so we set out to find whether this is also true for young people, and how using dietary supplements and gut microbiome research is perceived by youth with lived experience of anxiety .
We carried out a systematic review on the effect of psychobiotics on stress and anxiety in young people aged 10-24 years. We used the same methodology as Liu and colleagues and found 14 studies reporting on either anxiety or stress outcomes following pre- and/or probiotic interventions.
We found mixed evidence for the efficacy of probiotics and prebiotics, which was most likely due to the high risk of bias present in all but one of the studies we found. Therefore, we cannot be certain at this stage that probiotics and prebiotics are useful in treating stress and anxiety in young people. However, we suggest that this is because of too much variance in how the research studies available have been carried out .
We agree and would suggest to better support mental wellbeing in young people we need to consider individual circumstances and the day-to-day experience of youth. Research studies must also reflect this, and we suggest using multidisciplinary approaches in randomised controlled trials to better test the effects of psychobiotics on mental health in young people.
So Can Taking Probiotics Help With Anxiety
While the studies above suggest probiotics can have a positive effect on managing stress, John Hopkins University says the jury is still out and cautions against using them as a replacement for any prescribed mood-managing medication.
But if taking one a day for a month at least helps ease your gut issues, the university adds, when it comes to probiotics for anxiety and depression that alone might make you feel a little bit more up.
Everyone’s gut microbiome is unique and so the best way to answer do probiotics help with anxiety? is to try them for yourself.
To get the most out of your new probiotic regimen, consider taking your probiotics every morning with a meal, ideally one that contains prebiotics and/or fibre. You can also pair your probiotics for anxiety with vitamins for anxiety.
You should avoid taking probiotics when youre on a round of antibiotics, but commence taking your probiotics as soon as your antibiotics are finished.
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Inflammation Gut Bacteria And Depression
To support your health, your gut microbiome needs to be diverse, and diversity helps keep it balanced. However, if it is not balanced – something called dysbiosis – opportunistic microbes can take advantage and proliferate, resulting in inflammation.
Thats because your body doesnt want opportunistic bacteria, so your immune system is alerted, resulting in inflammation. Interestingly, inflammation can contribute to depression, and depression can cause inflammation. But a diverse microbiome can prevent inflammation.
So, controlling inflammation can help to improve both mood and anxiety levels. Diet is one way to increase the abundance of diverse microbes and reduce inflammation. Beneficial gut bacteria thrive on a natural, plant-based diet because fiber is an important source of energy for them.
A Primer On Probiotics
As we mentioned, your gut is filled with strains of bacteria like, really filled with it. There are trillions of probiotic bacteria living there. Some of these are good, or healthy bacteria and some are bad but even these are necessary. In truth, both types can be considered beneficial bacteria when theyre balanced, since having a balance of good bacteria and bad bacteria keeps your intestinal tract in check and functioning properly. If you dont have this delicate balance, probiotics can help restore it.
Its thought that the beneficial effects of probiotics include aiding your gastrointestinal tract and digestive health, boosting immune health and easing gas and bloating. And while research isnt conclusive, they may help manage symptoms of irritable bowel syndrome and some forms of inflammatory bowel disease , such as ulcerative colitis.
You can get probiotics through foods like yogurt, kombucha, pickles, sauerkraut, miso and more. Another option is taking a probiotic supplement. Different supplements contain different strains of probiotics, so it may take you some trial and error to figure out one that addresses your particular gut issues.
But what about the effects of probiotics on non-gut problems? In addition to the above benefits, some say that probiotics can help ease mental health issues like the symptoms of anxiety and depression.
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Probiotics Alone Or Combined With Prebiotics May Help Ease Depression
But possible contribution to lessening anxiety not yet clear, evidence review suggests
Probiotics either taken by themselves or when combined with prebiotics, may help to ease depression, suggests a review of the available evidence, published in BMJ Nutrition Prevention & Health.
But as to whether they might help to lessen anxiety isnt yet clear, say the researchers.
Foods that broaden the profile of helpful bacteria in the gut are collectively known as probiotics, while prebiotics are compounds that help these bacteria to flourish.
In the UK in 2016-17, 1.4 million people were referred with mental health issues, over half of them had anxiety or stress related disorders, while a third had depression.
A two-way relationship exists between the brain and digestive tract, known as the gut-brain axis. And the possibility that the microbiome–the range and number of bacteria resident in the gut–might help treat mental ill health has become a focus of interest in recent years.
To explore this further, the researchers searched for relevant studies published in English between 2003 and 2019, which looked at the potential therapeutic contribution of pre-and probiotics in adults with depression and/or anxiety disorders.
Out of an initial haul of 71 studies, just 7 met all the criteria for inclusion. All 7 investigated at least 1 probiotic strain 4 looked at the effect of combinations of multiple strains.
The Effects Of Probiotics On Patients With Depression Or Anxiety And Participants Under Stress
Seven studies include depression scales with 204 subjects in the probiotics group and 200 subjects in the placebo group. Due to the heterogeneity of the included studies , the random-effects model was applied. The meta-analysis showed significant differences in the relief of depression scores between the probiotics and placebo groups . The results showed that probiotics have obvious effects on positive changes in depressive symptomatology related scores. The forest plots of the meta-analysis are shown in Figure 2A.
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Ways To Incorporate Psychobiotics Into Your Life
If you want to incorporate psychobiotics into your life, there are a few ways to go about it, including probiotic supplements and incorporating fermented foods into your diet, according to Dr. Naidoo. Having yogurt high in certain beneficial probiotics for breakfast or in a smoothie, using tempeh as a protein in savory meals, flavoring food with miso and adding kimchi or sauerkraut to sandwiches, salads or burgers are a few easy ways to increase daily probiotic intake, she says.
Can Probiotics Treat Chronic Conditions
If, in theory, bacteria have a role in these chronic conditions, perhaps changing the intestinal bacteria by adding probiotics might help treat chronic illnesses. Probiotics have been utilized widely in countries like China and Japan for decades, primarily in the form of fermented milk. In addition, there are a number of animal studies that suggest probiotics may be helpful for conditions like diarrhea or colitis. Unfortunately, probiotics have not yet been shown to treat much human disease.
A recent article in Annals of General Psychiatry reviewed the currently available medical literature on using probiotics to treat anxiety and depression. The doctors identified 10 studies that were well done , and looked at each study in depth. All of these studies had relatively small numbers of patients, ranging as from as few as 42 to as many as 124. The results of these studies were mixed some suggested that there may be mild benefits of taking probiotics if you have anxiety or depression while other studies showed no benefit. Overall, the authors concluded the clinical effects of probiotics on mental health have yet to be studied comprehensively.
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Have You Tried Probiotics For Your Depression Anxiety Or Mental Health
If youve tried probiotics for your depression, anxiety, or brain health, have you noticed any significant benefits? To help others get a better understanding of your particular situation, mention the specific probiotic product that youre taking, as well as the specific strains of bacteria within that product, and the total CFU . Assuming your probiotic has had no effect on your overall health, have you considered that the particular product youre taking isnt actually delivering the bacteria to your gut?
Many probiotic products are hypothesized to deliver the beneficial bacteria to your gut, completely unadulterated. The problem is that many times the product will have spoiled and/or the bacteria will die off well before they can proliferate within your gut. If you believe that a particular probiotic is working well for you, have you considered a possible placebo effect and/or been able to dismiss such an effect?
Since there is a bidirectional relationship between the brain and the gut, perhaps even if there is a placebo effect it could yield benefit for your gut health via CNS-to-ENS signaling. That said, if you want to rule out a placebo effect, you could pursue a gut assay via a kit that involves mailing in a stool sample. The stool sample is analyzed and a microbial profile is created for your particular gut to highlight pathogenic bacteria, fungi, and parasites.