'The Gut-Brain Axis: How our gut bacteria influence our mental health' sponsored by OptiBac

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Questions and Answers:

• You mentioned anti-inflammatories, do we know if antioxidants have effects on depression, anxiety, obesity, etc.?
  I am not familiar with the research on antioxidants you are referring to, however we know that they protect our bodies from free radicals and inflammation, so with any condition where this is a contributing factor, antioxidants may be worth including.
  Several studies show that polyphenols can have a positive effect on brain health. Here are a couple of examples:
  Gomez-Pinilla F, et al (2012) Natural mood foods: The actions of polyphenols against psychiatric and cognitive disorders. Nutritional Neuroscience.;15(3):127-133.
  Figueira, I et al (2017) Polyphenols journey through blood-brain barrier towards neuronal protection Scientific Reports volume 7, Article number: 11456

• Any studies showing the effects of prebiotics on mental health?
  We know that prebiotics are soluble fibres that feed the bacteria we have in our gut, and are important for the health and diversity of the microbiome. In this webinar I discussed how important a balanced microbiota is for the bi-directional communication that takes place between the gut and brain. There are studies on prebiotics and mental health such as Kirstin Schmidt et al., (2015) which conclude that taking prebiotics can help reduce the stress response in volunteers, but we need to take into account the microbial balance as part of this.
  You may also remember that there was recently a BBC documentary on the affect of prebiotics and gut bacteria on sleep. You might be interested in our blog post on this BBC documentary discusses how gut bacteria may affect our sleep
  Kirstin Schmidt et al., (2015) Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers Psychopharmacology May 2015, Volume 232

• Could LPS alone account for very high CRP levels when all other factors are taken into account?
  No. CRP is an indicator for other factors that could be at play here ranging from infection to cancer as well as inflamed arteries.
• Are allergies directly helped with probiotics?
  A lot of the research around probiotics are on their impact on allergies. As always specific strains of probiotics have been shown to be particularly implicated in allergies for example Lactobacillus acidophilus NCFM® which has been shown in a study by Ouwehand et al 2009 to alleviate allergies to pollen.
  Probiotics have been shown to reduce allergies by stimulating the immune system. However we also know that often allergies are caused by intestinal permeability and consequently a heighted, and inappropriate immune response. Therefore a gut health protocol often results in a reduction in the incidence of allergies or the intensity of the allergic reaction.
  We have lots of information on this on our website including the FAQ and Blogposts below:
  Could live cultures help with allergies?
  Gut bacteria, allergies and probiotics on the BBC’s Horizon
  Could probiotics be the answer to a peanut allergy
  Ouwehand, A.C. et al., (2009). ‘Specific probiotics alleviate allergic rhinitis during the birch pollen season’. World Journal of Gastronenterology. 15(26): 3261-3268.

• Is there a lower incidence of depression in Mediterranean populations that follow a Mediterranean diet?
  I’m not aware of the actual statistics on depression in the Mediterranean versus the UK. However, as mentioned in the webinar a recent clinical review ‘’shows that there is observational evidence to suggest that both adhering to a healthy diet, in particular a traditional Mediterranean diet, and avoiding a pro-inflammatory diet is associated with reduced risk of depressive symptoms or clinical depression’’. Therefore we would assume that the incidence of depression in the Mediterranean may be lower than here.
  Lassale C et al (2018) Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry

• I didn’t think that serotonin could cross the BBB?
  Serotonin taken orally does not pass into the serotonergic pathways of the central nervous system, because it does not cross the blood–brain barrier. Serotonin produced in the gut influences the brain via immune-neuro messaging using the enteric nervous system. However, tryptophan and its metabolite 5-hydroxytryptophan (5-HTP), from which serotonin is synthesized, does cross the blood–brain barrier.
• What strains would you recommend for a peri-menopausal woman?
  This depends on which symptoms of the peri-menopause you are wanting to address. If it is low mood and anxiety then the strains (Lactobacillus acidophilus Rosell-52 and Bifidobacterium longum Rosell-175 or Lactobacillus casei shirota) and protocol discussed in this webinar may be suitable. However, if you are wanting to address intimate health issues such as cystitis, thrush or vaginal dryness then a probiotic formulated for a women’s intimate area would be advisable. OptiBac Probiotics ‘For women’ is a formula that contains 2 strains of bacteria (Lactobacillus reuteri RC-14 and Lactobacillus rhamnosus GR-1) that have been shown in clinical trials to help reduce urinary tract infections, bacterial vaginosis and thrush. Anecdotally it has also appeared to have helped some women with reducing the symptoms of vaginal dryness.
• What specific foods can be helpful for depression and anxiety?
  There are no specific foods that I am aware of that can on their own reduce depression and anxiety. However as discussed in the webinar recent research suggests that a Mediterranean style diet of fruit, vegetables, nuts and seeds, olive oil with not too much meat and dairy, enhanced mood in the participants. I’d suggest that this diet is essentially one that highlights antioxidants, healthy brain fats, gut friendly and anti-inflammatory food groups, which are all thought to be beneficial for those with low mood.
• Can you take OptiBac Probiotics while taking Enbrel?
  We recommend that anyone on an immunosuppressant check with their consultant before using probiotics. As their practitioner you will also be well placed to decide how that person is functioning on the immunosuppressant. If you feel that it is not affecting their overall health, then taking probiotics may be applicable, safe and helpful. However, if the individual has a faltering immune system due to the medication, and is not well on them, then we would suggest that maybe probiotics would not be helpful to them. However, there is very little research on this area.
• How do psychiatric drugs interact with microbiome?
  We know that SSRIs for example can affect overall gut health as they are sometimes prescribed for gut conditions such as IBS. There is also reason to believe that drugs such as SSRIs may damage the microbiome (Macedo et al 2017) but there is not much research specifically on how they interact with the gut microbes.
  Interestingly, a recent study found that non antibiotic drugs promoted antibiotic resistance. 40 of the most common strains of gut bacteria were grown in anaerobic conditions. Those cultures were then exposed to hundreds of drugs for a range of ailments, at the sorts of concentrations that might be encountered in the human intestine. The study, published in Nature, has revealed an unexpected avenue by which gut bacteria can become resistant to antibiotics: exposure to drugs that were designed to act on human cells rather than microbial ones. Of the drugs in the study, 156 were antibacterials but a further 835, such as painkillers and blood-pressure pills, were not intended to harm bacteria. Yet almost a quarter (203) did (Maier et al 2018).
  Macedo, Danielle et al. (2017) Antidepressants, antimicrobials or both? Gut microbiota dysbiosis in depression and possible implications of the antimicrobial effects of antidepressant drugs for antidepressant effectiveness. Journal of Affective Disorders, Volume 208, 22 – 32
  Lisa Maier et al., (2018) Extensive impact of non-antibiotic drugs on human gut bacteria Nature vol 555, pages 623–628

• Anything to add for Alzheimer’s treatment?
  Although depression is a symptom of Alzheimer’s, Alzheimer’s is a different condition to that of a mental health disorder. And therefore would require a whole webinar to itself. However, some of the aspects of how the microbiome affects brain health that I touched on in this webinar, such as the effect of lipopolysaccharides on brain health, is similar in Alzheimer’s.