Teaser Excerpt from The Paleo Approach: Probiotic Supplements

February 18, 2013 in Categories: , , , by

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The Paleo Approach by Sarah BallantyneLast week I posted a teaser excerpt from The Paleo Approach about the importance of including probiotics (while the book is written from the perspective of autoimmune disease, the benefits of probiotics extend to all health conditions and human health in general).  However, there are many people who don’t do well with fermented foods (reasons might include a yeast sensitivity, which is common in people with gluten intolerance, or a histamine sensitivity) or who just plain old don’t like them.  So, it’s no surprise that that post prompted a series of questions about probiotic supplements.  I have decided to share another excerpt from the book with you to help answer the question of probiotic supplements.

I should probably mention that both of the specific brands of probiotics mentioned in this section are ones that I take myself (and chose after a great deal of research).  I’ve been taking these for 4 or 5 months and really like both of them.  I also heard Chris Kresser rave about Prescript-Assist in his most recent podcast (just in case you were looking for a second opinion!).

This excerpt is from Chapter 8 (the supplements chapter).

As mentioned in Chapter 6,different strains of probiotics confer different effects on your body.  However, from the vast array of different probiotic bacteria (approximately 35,000 species), only a handful have been characterized.

As previously mentioned, probiotic supplementation was shown to be beneficial for the management of every autoimmune disease in which it has been tested, including: inflammatory bowel disease, autoimmune myasthenia gravis, celiac disease, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroid disease.  However, it is important to note that there is also some conflicting information.  In fact, there is convincing evidence that both bifidobacterium and lactobacillus probiotic bacteria (the two most common bacterial genera in probiotic supplements) are a source of autoantibody formation through molecular mimicry in autoimmune thyroid disease (discussed in Chapter 2).  Furthermore, there have been reports of severe eosinophilic syndrome—a condition characterized by elevated eosinophils (a type of white blood cell important for the innate immune system) in the blood with damage to cardiovascular system, nervous system, and/or bone marrow—directly attributable to the use of probiotics (both in people with a history of autoimmune disease but also in completely healthy individuals).

What does this mean?  If you do not tolerate fermented foods, probiotics are definitely worth trying.  The majority of the evidence in the scientific literature supports their potential benefits; however, some caution is advisable.  Just as in the case of fermented foods, probiotic supplements can be added after following The Paleo Approach for several weeks (at least 3) in the case of people with severe gastrointestinal symptoms or known bacterial overgrowth.

Which probiotics should you take? Probiotic supplements fall into two categories:

kirkman bio goldLactobacillus/Bifidus:  Lactobacillus and bifidobacterium are the two most heavily studied genera of probiotic bacteria.  They are also the most commonly found in supplement form.  It is important to note that even though the majority of scientific studies show health benefits of these strains, these are also the strains that may contribute to autoantibody formation and to severe eosinophilic syndrome in some people.

If you choose to take a lactobacillus and bifidobacterium supplement, look for a brand with as many different strains as possible (for greater probiotic diversity).  However, be cautious:  dairy ingredients are common in these types of supplements.  Look for a bottle that specifically brands itself as dairy-free, gluten-free, soy-free, corn-free, wheat-free, egg-free, peanut-free, and tree nut-free.  Also look for one that is yeast-free if the reason you are taking a probiotic supplement instead of eating fermented foods is yeast sensitivity concerns.  One high-quality brand to look for is Kirkman.

Start with a low dose, even breaking open a capsule and sprinkling a small amount in your food or in a small cup of water.  Alternatively, you can take your probiotic supplement every 2 or 3 days.  Over the course of several weeks, work your way up to the suggested dose on the bottle, taken daily.  Some probiotic supplements recommend taking with food while other recommend taking them on an empty stomach.  It is typically best to follow the specific recommendation of the brand you are using.  If your probiotic supplement does not have directions regarding whether or not to take it with food, first try taking it on an empty stomach.  After several weeks, switch to taking with food and see if you notice any improvement.

prescript-assist-probiotic-largeSoil-Based Organisms:  While not as extensively studied as probiotics from the lactobacillus and bifidobacterium genera, soil-based organisms hold extreme promise for modulating the immune system and correcting gut dysbiosis.  They have been shown to have extreme therapeutic potential in Irritable Bowel Syndrome and provide probiotic organisms that are routinely missing from our modern, over-hygienic lifestyles yet are normal residents of a healthy gut.

One brand to look for is Prescript-Assist which contains 29 different strains of soil-based organisms and is also dairy-free, gluten-free, soy-free, corn-free, wheat-free, egg-free, peanut-free, tree nut-free and yeast-free (also none of the strains included in Prescript-Assist come from the lactobacillus or bifidobacterium genera, or indeed any of the strains typically found in fermented foods).  Prescript-Assist has one of the best diversity of any probiotic supplements available.  Soil-based organisms seem to be better tolerated than lactobacillus and bifidobacterium, although extensive comparisons have not been made.

It is typically recommended to take two capsules daily (divided into two doses) for thirty days, followed by one capsule once or twice per week as a maintenance dose.  Because the strains in soil-based organism probiotics are different from the probiotic strains typically found in fermented foods, it is worth strongly considering taking a soil-based probiotic even if you are eating fermented food or taking a lactobacillus and bifidobacterium-based probiotic supplement.


Interested in learning even more about The Paleo Approach? This video from my YouTube Channel is just a quick tour (the book is so big that giving you a broad overview takes 13 minutes!) but you get to see just how comprehensive and detailed this book is.

Bittner AC, Croffut RM & Stranahan MC, Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study, Clin Ther. 2005 Jun;27(6):755-61.

Bittner AC, et al., Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial, Clin Ther. 2007 Jun;29(6):1153-60

Jirillo E, Jirillo F & Magrone T, Healthy effects exerted by prebiotics, probiotics, and symbiotics with special reference to their impact on the immune system, Int J Vitam Nutr Res. 2012 Jun;82(3):200-8

Kiseleva EP, et al., The role of components of Bifidobacterium and Lactobacillus in pathogenesis and serologic diagnosis of autoimmune thyroid diseases, Benef Microbes. 2011 Jun;2(2):139-54.

Klaenhammer TR, et al., The impact of probiotics and prebiotics on the immune system, Nat Rev Immunol. 2012 Oct;12(10):728-34

Kverka M & Tlaskalova-Hogenova H, Two faces of microbiota in inflammatory and autoimmune diseases: triggers and drugs, APMIS. 2012 Oct 24.

Mendoza FA, et al., Severe eosinophilic syndrome associated with the use of probiotic supplements: a new entity?, Case Report Rheumatol. 2012;2012:934324

Veerappan GR, Betteridge J &Young PE., Probiotics for the treatment of inflammatory bowel disease, Curr Gastroenterol Rep. 2012 Aug;14(4):324-33.

Vyas U & Ranganathan N., Probiotics, prebiotics, and synbiotics: gut and beyond, Gastroenterol Res Pract. 2012;2012:872716.

 

Comments

Do you have any brand recommendations for people in Europe? Prescript Assist will not be shipped to Germany, neither does (tried to order it some weeks ago) e.g. Syontix Probiotics. I guess it is a question of package insert or so.

It’s now available in the Netherlands! I just found out, which is why I’m on the internet looking for more info than the distributor can give me ;-) You’ll be able to order it through a couple of Dutch webshops and I’m leaning more and more towards prescribing and selling it myself (I’m an intestinal flora therapist) :-)

I have crohns disease and am very sensitive to just about everything new I try (whether it be a new food or Rx). A doctor at a CCFA seminar told us to use just regular yogurt for a probiotic. I cannot tolerate yogurt at all for some reason. Even when I am in remission with my crohns two tsp of yogurt will set off my stomach. So if I am reading your post correctly I should try the soil-based and see how that goes? Why do you think I respond so badly to yogurt when so many others with crohns swear it works for them? Thanks for any info.

Dairy proteins have very similar effects to gluten in the gut and diary intolerance is extremely common in autoimmune disease. So, it might just be the fact that it’s yogurt made from cow milk (which is what I’m assuming). Either way though, yes, I think soil-based would be a good thing to try.

Hi! I was wondering about bifidobacterium and lactobacillus being “a source of autoantibody formation through molecular mimicry in autoimmune thyroid disease”. I have ai thyroid disease and I take a probiotic with those two strains (BioKult) but I’ve only just starting taking the probiotic (4 weeks now) and I’ve had ai thyroid disease for at least 6 years. I didn’t take any probiotics before this. Well, some yoghurt on occasion but that’s it. I’m just wondering if the probiotic only causes the molecular mimicry or if it also continues it. I’m following a cross section of GAPS/AI Paleo right now, hence the BioKult. I’m googling now for more information but if you have any links to studies, I’d love to see them. Thanks! Jen

The study is in the references. All the study was able to say was that the antibodies formed in autoimmune thyroid disease also bind to proteins specific to those bacteria. So, basically, if you have a leaky gut and you have those bacteria in it (either from probiotics or normally), proteins from those bacteria are a source of autoantibody formation. But, taking those probiotics shouldn’t on their own perpetuate autoantibody formation–that’s more about having a leaky gut and eating foods that stimulate inflammation or rev up the immune system.

Thanks! and Duh! I just skimmed over the references without reading them – bad Jen. Just read the abstract and that is very interesting. I may have to reassess my probiotics. I’ve only been taking them for a month but I’ve been consuming ferments for about 6.

One more Q: Do you know specific these strains are? For example, BioKult has Bifidobacterium bifidum PXN 23 while the study references Bifidobacterium bifidum 791. Do the numbers make much of a difference or would the whole family be part of the molecular mimicry phenomenon? That’s just one example, all of the strains they mention (except Bifidobacterium adolescentis) are in BioKult but none of the numbers at the end match up.

Thanks again, can’t wait for the book!

When it comes to molecular mimicry, there will be an incredible similarity between those strains that it likely doesn’t make a difference, but at the same time, the only hard conclusions can be drawn from the stains studied.

Hi, firstly congratulations and thank you for all this excellent free content. I’m looking forward to the book.

I’m wondering what your thoughts are on the safety of soil-based organisms. A quick search reveals lots of articles suggesting that propagation via spores can be dangerously effective. Could Prescript-Assist start a colony of bacteria that grows out of control?

I know I’m allergic to some (if not all) mould. Is it possible I will also have a problem with soil-based organisms?

The issue of possible overgrowth is not at all limited to SBOs. It’s possible for any bacteria to overgrow if you aren’t eating the right foods, aren’t sleeping well and aren’t managing stress. But, I think what you are referring to is that early SBO formulations contained the strain Bacillus licheniformis which has since shown to be pathogenic/toxic. Prescript-Assist does not contain that strain (actually, I think that most if not all manufacturers have removed that strain from their formulations). Prescript-Assist is the only SBO to publish a peer-reviewed longer-term study on its use, so I do feel comfortable recommending it.

I’m curious about your comment that bacillus licheniformis has been proven to be pathenogenic.

It’s still sold in SBOs like Body Biotics (formerly Nature’s Biotics), and wasn’t that the one that Jordan Rubin used to heal/recover from a severe case of Crohn’s disease?

Thanks,

Kelly

I clicked on the link for Prescript Assist because I would like to try it but the picture on amazon that comes up is different than the one on you post? Are they different? Is the one that is linked OK to order from? PS I can’t wait for your book.

Some people have very dramatic reactions to probiotis. Plus, if you have a severe overgrowth, they can actually make the problem worse, which is why I advise adding them in after a few weeks.

Hi Sarah (this is a continuation of Melissa’s question above) – I’ve been on probiotics for years now but still having gut problems (I’ve commented on the AI post and the SIBO posts…). My question has to do with treating SIBO and/or dysbiosis in general (too much bad bacteria) – while I’m “proactively” treating this, should I HOLD OFF on ALL gut repair and reinoculating steps? This would be stopping the l-glutamine, quercitin, zinc and DGL (I’m also considering colostrum as well), as well as ALL probiotics?? I’ve been taking the l-glutamine and probiotics for a while now (a couple of years). My out-of-state ND wants me to try a combo of SIBO treatments: neomycin, berberine complex and oregeno oil, plus a low fodmaps diet (I’m also going to do maybe a combo of your SIBO/fodmaps protocols? I tried the treatment as prescribed for a few days (drugs and pills) but think I had a pretty severe allergic reaction, so I’m actually hesitant to try those again and would prefer to kill off the bad guys with diet only and perhaps some caprylic acid/lauricidin supplements. I think, if I’m reading your post on probiotics correctly, that you DO advise to NOT take probiotics for 2-3 weeks while initially treating SIBO or any form or gut dysbiosis to ensure any overgrowth (good or bad) is killed, right? Thanks in advance!

For some people, taking probiotics can actually make overgrowths worse, depending on the probiotic. You might not need to stop (although that’s still a good option to consider for a couple of weeks), but might find that switching brands, especially switching to a soil based probiotic, might be very helpful. You’ll also get much more diversity in microorganisms from fermented foods, so that’s another way to go. Also, quercitin and DGL are immune stimulators, so depending on exactly what’s going on in your body, they might not be helping (they only stimulate certain cell types which is thy they can be useful is some situations; colostrum is similar). You might have had a severe die-off reaction as opposed to an allergic reaction (they can be similar, rashes and diarrhea being the most common symptoms of diet-off). It can really help to support liver function while going through die-off, which means lots of organ meat, fish, and cruciferous veggies (sticking with the ones that are also low FODMAP–I do think that makes sense).

Hi Sarah, thank you for this information! Honestly, I don’t know EXACTLY what is going on (it’s been chronic for years and years…), so it’s been a trial and error process. I like your idea of switching to a soil based probiotic (which is one thing I have not tried). It could have been die-off, but it started literally within 24 hrs of the treatment (that said, the rash, swelling – all around my eyes – last for a couple of weeks and JUST went away hence my reluctance to go back to such a harsh approach). I really want to tackle any overgrowth, so I’m going to move forward, probably removing quercitin, dgl, colostrum etc initially and start off more slowly with the antibacterial meds and continue to take milk thistle for liver support (which I’ve been taking daily for a couple of months). Thanks again for all of your support and information – it’s pretty scary and intimidating trying to figure out and tackle all of this on my own – your site, balanced bites, chris kesser, et al have all been wonderful sources of information! Have a great weekend, and I will be on the lookout for your book – can’t wait!

What are your opinions on probiotic supplements while pregnant? I’ve taken various probiotics on and off through the years. Do you feel that either of your recommendations are safe to add while pregnant? What other things can I do to improve my gut flora before giving birth?

Yes, I feel that both would be safe during pregnancy. But, I will say that you will get greater probiotic diversity from lactobacillus and bifidobacter type strains with fermented vegetables. The other thing you can do to improve your gut flora is to eat tons of vegetables (non-starchy and starchy) and to be very mindful of your omega-3 intake (specifically, the ratio with omega-6) and I’m assuming you are already eating a paleo diet. Insoluble fiber and omega-3 fats are the two biggest influences of the numbers and types of bacteria growing in your gut once you remove the factor of excess sugars that are difficult to digest (basically, one you stop eating grains and legumes).

Do you know if there is any change to the protocol if you are starting in pregnancy? I currently follow a GAPS/AIP hybrid, and just had gotten Prescript Assist and was about to start it. The found out I’m newly pregnant :). I know you want to avoid excessive change and die off with pregnancy so hence the question if there is literature available on modifying the protocol for prescript assist.

I have been dealing with leaky gut and Candida all my life and now,thanksto you, understand the roleauto-immunity plays. I have taking SBO Bacillus Coagulans from Thorne for about 1 month and Prescript Asssist for about 2 weeks. What an amazing difference!!! I can now eat fruit as well as paleo friendly starches like root veggies and plantains in moderation without the candida coming back!!! Doing the AIP, I progressed in a month what I hadn’t in 2 years. I started incorporating back in what I eliminated and have fond I am not ready. I am so grateful your website and information. I can’t thank you enough. Btw I have tried some of your recipies like the mofongo. Awesomeness!!

Hi there Sarah. I just pre-ordered your book. I find your information on the autoimmune protocol invaluable. I have a disease called mastocytosis (as well as urticaria pigmentosa) and though it is not technically an autoimmune disease, I feel strongly that the autoimmune protocol can be of great benefit to my health. I have a question about eating fermented food with a histamine disease when it is so high in histamines. What do you think? I so want my health back! Thank you so much.

Good question. I guess you don’t really know until you try, but I would suggest delaying trying for a little while. There’s a difference between foods that stimulate histamine release and foods high in histamine, but both might be an issue for you, at least initially. In terms of being able to eat high histamine foods, the goal is to heal the gut so that there is sufficient deamine oxidase being produced. In terms of histamine release by mast cells and basophils, the goal is to regulate the immune system. I think I would recommend the AIP without fermented foods initially to try and get that healing and immune regulation going first.

Thanks Sarah! I have been unwell for so long, so I understand that it will take some time before I can get better. I have done a lot of research into what is required to facilitate healing. Doctors only know how to treat the symptoms of mastocytosis, plus most doctors I have seen needed to be educated by me about it because they had not heard of the disease. Finding your blog has been a Goddess-send. You have so much information that is easily understood by the laymen like me and (the most important thing) you can back up your data with scientific proof. I am very grateful to you and the work you are doing and am telling anyone I know who needs you and your information about your blog and book. I can’t wait until your book comes out! Thank you so much and keep up the good work. Here’s to good health for us all!

I have been using Blue Rock Holistic’s Super Shield Probiotic, it is mainly a lactobacillus and bifidobacteria probiotic. How does this measure up in terms of repopulation and yeast reduction? Do you think that it is an acceptable product or should I consider trying out other probiotics? Thanks for all of your help!!

Cannot wait for the books release! I have mine pre-ordered. I have been thinking of a probiotic for awhile. I have tried several over the years with no noticeable change. I have been thinking of Prescript Assist – So THANKS! for this post!

Research is not actually clear on whether colostrum is beneficial for a leaky gut, and as a source of probiotics, I think that would be more useful if you were drinking human colostrum (since the intestinal bacteria of cows is pretty different from our own).

Hi I have crohns and severe RA. I have been on many meds and diets. I just recently decided to look into the paleo lifestyle as I have found I do much better without flour and sugar and dairy. Raw fruits and vegetables are a problem as well. I also just started a probiotic the pharmacist recommended, Culturelle, but am wondering if I should switch to the one you recommended. Can I buy that in the store or do I need to order online? Also, what is the difference between probiotics and prebiotics?

Thank you!
Lisa

Probiotics are bacteria and yeast. Prebiotics are food for bacteria and yeast. Prescript-Assist might be available in some specialty stores, but easier to find online. They’re actually different classes of bacteria so you can take both.

Would it be to my body’s benefit to use both or just one or the other? My goal is to slow my bowel movements and rid my body of some pain as well as the belly swelling.

It really depends on exactly what’s going on inside your digestive tract, but generally both can be beneficial. I also recommend getting fermented foods into your diet since these have far, far, far more variety of organisms than supplements.

HELP!!! I’m SO confused right now! I have been following AIP for over 3 months now, I just read the body ecology diet book b/c I have a yeast overgrowth I’d like to tame. She highly recommends “cultured vegetables” which are fermented foods….. should I be eating them with my overgrowth or not? i was just finding out that i can tolerate them and was hoping to cut out my pro-biotic… HELP! :) Thank you for ALL of your knowledge, I’ve appreciated it since the day I was diagnosed with Hashi’s!!!!
Hope

I have been following a very strict diet for three weeks. i have IBS (possible SIBO) and Candida issues. I have only been eating some veggies, grass fed beef a little chicken, and salmon. My digestive issues are better (got worse at first but I stuck with it). My candida got worse last week. I had a very bad yeast infection and my tinea versicolor acted up really bad. Both are a little better. I want to start adding supplements slowly back. Do you recommend taking both of the supplements above? (I would start one at a time).

They are both good supplements with completely different strains. I’m also a huge fan of fermented foods which would have far more diversity of lactobacillus and bifidobacteria strains that any supplement in pill form.

Thanks for all the detailed information. I am on the Paleo AIP and want to switch over to these probiotics. (IBS/Auto-immune issues) In my reading, I see that the Prescript Assist recommendation seems to be to take 1 pill 2x/day for 30 days, then to go down to two pills a week. How and when would you recommend adding in the Kirkman Pro-Bio Gold? Take the Kirkman every day from the beginning or only add it in once the Prescript Assist is down to the twice a week stage? And then continue with Kirkman daily and Prescript Assist twice a week for the long haul? I feel like I finally have found what I’d like to try, now I just need some clarity on how to do it. Thanks.

There’s no guidance from the scientific literature on the best way to do this, so I think whatever you decide will be fine. But, I do like the idea of adding in only one at a time just in case you react negatively to one or the other. After my recent bout of antibiotics, I was taking Prescript-Assist with breakfast and dinner and taking Kirkman Biogold with lunch and that seemed to work well for me. Now, I take Prescript-Assist once per day and Biogold about once per week (but I eat a lot of fermented foods too).

Hi Sarah, thanks for your informative post about probiotics, i purchased your book recently and i feel that its a really good book. I had been taking the probiotics for the last 2 weeks at every 2 days. Recently this week i ate it daily and i have been feeling nauseous recently. I’m not sure if this is due to the frequency in taking probiotics or me implementing the aip paleo diet this week. I used to have bloating but now since i have been on this diet, my stomach doesn’t hurt from the gas. But the nausea really bothers me.

It could be the probiotics or the diet change. I would try lowering the probiotic dose (or removing them entirely) to see if that helps. If it persists, you may want to speak to your healthcare provider. – Christina, Sarah’s assistant

Been taking Prescript Assist for a while now. I have continued to experience multiple digestive issues along with other systemic issues that lead me to believe I may have a parasitic infection. What is the best approach to testing and elimination of parasites? Can a test be done prior to or even separate from working with alt med physician?

Any doctor can order the proper tests to diagnose you. The metamatrix panel is a popular one, if you prefer to order your own. Treatment will vary depending on what you’re diagnosed with, but usually, it will be some kind of antibiotic/anti-fungal and a low-FODMAP diet. – Christina, Sarah’s assistant

Ok, thank you! I am looking for the cost efficient and quickest way to find out the problem and take care of accordingly. Any tips would be helpful!

Just wondering where you got the dosing recommendation for Perscript Assist? The bottle says “1-2 a day” and you state that the recommendation is: “It is typically recommended to take two capsules daily (divided into two doses) for thirty days, followed by one capsule once or twice per week as a maintenance dose.” Thanks in advance. Sara

That’s kind of the standard recommendation for any probiotic if you are trying to first repopulate the gut and then maintain that population. Your needs may differ. – Christina, Sarah’s assistant

Hi Petra,

I also have Graves. I use Bio-Kult for probiotics since I follow a combo of Paleo AIP and GAPS diets. You can get Bio-Kult in Australia from this site: http://gapsaustralia.com.au/bio-kult/ I know it’s not on Sarah’s list but it’s also a quality probiotic that my doctor recommended and I’ve been getting great results with it. I’m planning to try Prescript Assist at some point though as I’ve heard so many good things about it and have read it’s good to switch up your probiotics. You can also make fermented foods to get your good bacteria. For what it’s worth, my Graves related digestive issues went away after removing dairy and consuming lots of probiotics. It took a few months though so hang in there. After a year I can now consume very small amounts of dairy with no issues. Good luck to you!

Jen

How does water kefir fit into this discussion? Is it considered probiotic? I do not like fermented vegetables at this point, and am just learning what I can…I have been drinking water kefir, is this adequate?

Dear Sarah and her assistants, here is some scientifically referenced information about the organisms in prescript assist:
http://fixyourgut.com/hso-probiotics-part-3-prescript-assist/
It lists 16 organisms that are not considered normal human flora or have non-existent human interaction research in Prescript Assist. It also lists 4 other documented opportunistic organisms in Prescript Assist with 8 scentific references:
http://www.ncbi.nlm.nih.gov/pubmed/846390
http://www.ncbi.nlm.nih.gov/pubmed/362918
http://link.springer.com/article/10.1007%2FBF01643394#page-1
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC172888/
http://fixyourgut.com/hso-probiotics-part-2-danger-supplementing-bacillus-subtilis/
http://onlinelibrary.wiley.com/doi/10.1002/rcr2.31/abstract
http://www.gutpathogens.com/content/2/1/16
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC133002/
And it says “Pseudomonas fluorescens has even been implicated as the cause of Crohn’s disease (I believe that it is a coinfection instead of being the direct cause).” Pseudomonas fluorescens references are the last 2, the latter of which is about Crohn’s disease.

I think about using Prescript Assist also after I reduced the overgrown bacteria of my SIBO, but want to read your response to these information. Also, would it be better to start using Prescript Assist sooner instead of reducing the overgrown bacteria of SIBO ?

Thank you very much

Hi! I am curious about your thoughts on the links that Fan posted about the possible risks associated with soil bacteria. I have been reading similar articles and feel conflicted about what probiotic I should take as I start GAPS soon. Thanks for any input you have!

Same here,I’m quite concerned as well,I’ ve just bought PA and not sure if start taking it since there’s so much information warning about possible dangers of getting sicker.Please,Sarah,tell us what you as an expert think.Thanks

Can you please tell us what you think about the concerning scientific links Fan posted that question prescript assist safety?I still don’t know if it’s dangerous taking them. Thanks

I really appreciate your commitment to providing scientific support for your recommendations. I’m intrigued by soil-based organisms, but I have concerns about the science behind the Prescript-Assist formula and the current manufacturer. The published studies mention a company called Safer Medical, Inc., which appears to be out of business. Prescript-Assist is now sold by a company called LL Magnetic Clay. The staff bios on their website don’t give me much confidence in their scientific credentials: http://www.magneticclay.com/staffbio.php

Maybe Magnetic Clay is just the distributor? I’m not sure. But even if if the original formula was extensively studied, how do we know that this new company didn’t just buy the name? Have there been any recent studies done based on the current formula and manufacturer?

Thanks. Best of luck with the book.

Thanks so much for this information! Very helpful! Wondering what your recommendations for children and teens might be. My 13 yr old son eats fermented food with no problems (pickles, saurkraut, kombucha) but I wonder if it’s enough. I had him on a probiotic that seemed to help and then the reformulated and added rice, of which he is highly allergic to. He still has trouble swallowing (sensory issues) any kind of capsule/tablet. What are your thoughts on giving him a lower dose of the the PA in his food?

Thanks for any advice/help you can offer!

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