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Dr. Zorba Paster: Probiotics might ease anxiety and depression

UPDATED: Thu., Oct. 15, 2020

Organically grown Spanish Roja garlic is photographed at Sunshine Farm on Green Bluff on Thursday, Aug. 16, 2018. Garlic is a natural prebiotic.  (Kathy Plonka/The Spokesman-Review)
Organically grown Spanish Roja garlic is photographed at Sunshine Farm on Green Bluff on Thursday, Aug. 16, 2018. Garlic is a natural prebiotic. (Kathy Plonka/The Spokesman-Review)
By Dr. Zorba Paster For The Spokesman-Review

Bottom line first in this column: Probiotics might help your depression.

Surprised? I sure was when I reviewed a recent study. We’ll dig into the data, but first a few definitions.

Microbiome refers to the full array of microorganisms (the microbiota) that live on and in us. We’re just discovering how useful the “natural and living” bacteria in us help us live and, when disrupted, cause disease.

Many people with irritable bowel syndrome suffer from an imbalance in their gut, which contributes to their discomfort. We’ve just started to do gut – poop – transplants for people with intractable IBS and other bowel problems. And it works.

Next in the vocabulary lesson are probiotics, foods containing bacteria that positively influence the gastrointestinal microbiome. Prebiotics are chemical compounds that promote the flourishing of these good bacteria.

Now, here was the provocative question in the recent study, published in the British Medical Journal: Does the microbiome play a role in depression and anxiety?

The study showed that possibly taking probiotics, especially supplemented with prebiotics, just might ease depression and anxiety.

Here’s the data. In the U.K., there is one insurance company – it’s called the government. It has one database, which tracks pretty much everybody in the country. In 2016, 1.5 million people were referred for mental health issues. Half of them had anxiety and one-third had depression.

Researchers theorized about a two-way relationship existing between the brain and digestive tract, known as the gut-brain axis. They considered the possibility that the microbiome – the range and number of bacteria, the good guys residing in the gut – might help treat mental health issues.

This was not the first time this relationship had been postulated. It’s been kicked around for years.

So relevant studies published in English between 2003 and 2019 were looked at, examining the potential therapeutic contribution of pre- and probiotics in adults with depression or anxiety disorders.

Of an initial haul of 71 studies, just seven met all the criteria for inclusion. All seven investigated at least one probiotic strain, with four looking at the effect of combinations of multiple strains.

In all, 12 probiotic strains were featured in the selected studies, primarily Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidium. One study looked at combined pre- and probiotic treatment, while one looked at prebiotic therapy by itself.

The studies varied considerably in their design, but all used standard methods, questionnaires with scoring, to see if depression and anxiety improved.

All of them concluded that probiotic supplements, either alone or especially in combination with prebiotics, was linked to measurable reductions in depression. Every study showed a significant improvement in depression and anxiety.

The theory is that probiotics might help reduce the production of inflammatory chemicals – such as cytokines, as is the case in inflammatory bowel disease – that might influence other chemicals such as tryptophan, a chemical thought to be important in the gut-brain axis in psychiatric disorders.

Natural prebiotics include onions, garlic, bananas, leeks and chicory root, popular for its coffee-like flavor. Dandelion greens also are often a great source of fiber. Just Google it, and you’ll find more of them.

Natural probiotics include yogurt, kefir, sauerkraut, tempeh, kimchi, miso, kombucha, pickles, buttermilk and some cheeses.

My spin: None of the studies lasted very long, many of the studies were small, and the number of participants in each was not large. So the conclusions have to be tempered.

But if you suffer from depression and anxiety, you might want to try probiotics and prebiotics to see if it helps you. There is no harm. And it might work.

I would start with Mother Nature, the foods I mentioned and others you can find on the internet, not with industrialized products. Food first, pills second. Stay well.

Dr. Zorba Paster is a family physician and host of the public radio program “Zorba Paster on Your Health.” He can be reached at askzorba@doctorzorba.com.

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