01/02/2019
Anna Resurreccion posts an article from the Institute of Food Technologists Newsletter on BRAIN FOGGINESS or IMPAIRED COGNITION IS FOUND RELATED TO PROBIOTICS.
New research associates probiotics with brain fogginess A team of health professionals at the Medical College of Georgia at Augusta University has published research that documents a link between brain fogginess and probiotic use. What happens, explains Dr. Satish S. C. Rao, professor of medicine and director of the Digestive Health Clinical Research Center at the college, is that taking probiotics can lead to an overgrowth of bacteria in the small intestine, and the bacteria produce high levels of D-lactic acid, which has been associated with impaired cognition (i.e., brain fogginess).
In a study that tracked his patients’ experiences, Rao found that among a group of 38 patients, the 30 who reported problems with concentration and confusion were all taking at least one kind of probiotic. After discontinuing probiotic use and receiving treatment with bacteria-targeting antibiotics, 85% of the patients said they no longer suffered from brain fogginess. An article detailing the researchers’ findings appeared in the journal Clinical and Translational Gastroenterology.
“What we now know,” says Rao, “is that probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid. So if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing D-lactic acidosis and brain fogginess.”
Such inadvertent colonization may be occurring if someone takes a probiotic and it breaks down in the small intestine, releasing live bacteria before it reaches the large intestine (colon), where they are supposed to work. “There is a high likelihood that the bacteria may just latch itself onto the small bowel and then linger there forever,” Rao says. “If that were to happen, then when we consume foods like carbohydrate foods, when those carbohydrates are exposed to the probiotics, the probiotics will ferment the carbohydrate foods, leading to the D-lactic acid production.”
While probiotics can be beneficial in a variety of instances (after a course of antibiotics diminishes normal gut bacteria, for example), Rao believes that the increasingly frequent complaints of brain fogginess that he’s seeing in his medical practice are related to the surge in popularity of probiotics and the fact that many people self-prescribe them. “Probiotics should be taken with caution under medical direction,” Rao counsels. “Don’t take probiotics like you would take a multivitamin pill.”
Rao further notes that probiotic use can be particularly problematic for individuals with reduced gut motility, which can slow the transit of probiotics to the large intestine. Drugs and medications including antidepressants, opioids, and proton pump inhibitors (prescribed to help relieve heartburn and reflux) can either slow gut motility or facilitate colonization of bacteria.
Rao says that the Medical College of Georgia research team has plans in place for rigorous follow-up research, which would start by establishing a definition for brain fogginess based on patient input using a validated questionnaire. Then, he continues, “Once we’ve identified that a patient that has brain fogginess has bacterial overgrowth … we want to then remove probiotics and give them antibiotics and then re-administer all these questionnaires and tests one more time. We want to show that they no longer produce D-lactic acid [in the small intestine] coinciding with symptom improvement.”
Correspondence submitted to the journal and a statement posted on the International Scientific Association for Probiotics and Prebiotics website titled “‘Brain Fogginess’ and D-Lactic Acidosis: Probiotics Are Not the Cause” takes issue with the Rao research findings, noting that “the misleading paper title suggests an intention to indict probiotics even in the absence of evidence.” The Clinical and Translational Gastroenterology publication by Rao and his team is titled “Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis.”