Probiotics for Anxiety Lactobacillus Rhamnosus

Gut bacteria can change the neurotransmitters (brain chemicals) in the body, because certain gut bacteria thermselves manufacture certain neurotransmitters. Some probiotics have a great effect in reducing anxiety. Another way gut bacteria works to reduce anxiety is by sercreting certain chemical messengers called cytokines that change the immune system/nervous system response. This is called psychoneuroimmunology. Photo Credit Niaid

Lactobacillus Rhamnosus and GABA

GABA is a great neurotransmitter. It is the OFF switch of the nervous system and patients with anxiety often do not have enough GABA, or they have too much other excitatory neurotransmitters. GABA helps a person settle down, feel calm, feel safe and stop the fight and flight response. Certain prescription medications that affect the GABA pathway include Klonopin, Xanax, Valium, and Gabapentin. But these medications are often addictive and have unwanted side effects. It’s best that your body makes it’s own GABA. The probiotic Lactobacillus rhamnosus makes GABA. L rhamnosus can be a GABA making machine in the body if a patient has enough of this strain in their gut. 

An animal study shows that treatment with L rhamnosus decreased activity in the hippocampus, amygdala and local coeruleus.

1. The hypocampus is associated with long term memory, spacial relationship, and behavioral inhibition. Excessively active activity such as over firing in the hypocampus or inflammation can affect the above

2. The amygdala associates the 5 senses with emotions. Overactive function may ingrain more traumas such as in PTSD or excessive negative emotional associations with events, smells, sights, people etc.

3. The local coeruleus  is the part of brain involved in stress and panic. It Secretes adrenaline. 

Lactobacillus rhamnosus also reduced the stress response associated with cortisol. Therefore supplementation with L. rhamnosus is promising for supporting the body in making more GABA via the bacteria producing it. 

Lactobacillus rhamnosus and Inflammation

Too much inflammation in the brain is not good and can contribute to anxiety. We are not referring to the type of inflammation like a concussion, but chronic oxidative stress to the nervous system. Patients with higher levels of inflammation in the body such as those with autoimmune diseases, allergies, aches and pains are more likely to also have more inflammation in their nervous system. Anxiety, depression, and memory loss are definite symptoms that indicate an increased inflammatory response in the brain. 

Think of increased inflammation in the brain as increased firing of neurons. Think of an electric cord with too much electricity going through it that it blows the fuse. GABA helps to slow down this rapid firing and regulate it back down to normal. 

A study shows that Lactobacillus rhamnosus inhibits the inflammatory response by increasing IL-10 levels. IL-10 is an anti-inflammatory cytokine and helps to shut down the T cell response after infections or stressors. If there is not enough IL-10, inflammation can extend long after it is needed, resulting in chronic inflammation. L. rhamnosus probiotic can help support healthy levels of IL-10.

Psychobiotics

Lactobacillus Rhamnosus is a psychobiotic. A psychobiotic is a live organism (probiotic) that when ingested in a certain amount produces a health benefit in patients suffering from psychological disorders. How does this work? The gut bacteria influence the vagus nerve which communicates with the brain. The vagus nerve is the longest cranial nerve, exiting the brain and reaching all the way to the intestinal tract. This nerve channels the communication between the brain and the gut. I use a product, Ultra Flora Women's by Metagenics with my patients which contains L. Rhamnosus. 

How do you know the quality of your supplements?

The answer is sometimes an enigma. Two bottles may seem to have similar ingredients but one is clinically effective and the other not. For those that are not clinically effective, it can be a costly mistake.

My microbiology professor in medical school ran an experiment on probiotic supplements, culturing many different brands. Of the several brands she tested, unfortunately only three brands matched the advertized label. All the other probiotics did not meet label claims, for example, if the bottle claims 10 billion lactbaccilus accidophilus per servings, only about 4 billion were present indicating the product was not manufactured to be shelf stable. Even more shocking she found that some brands contained unwanted bacterial contaminants.

This is why I take the time to research supplements I use for my patients to ensure that they recieve the quality that they pay for and that they do not inadvertently get pesticides, heavy metals, PCBs, unwanted microbes in their products. I may not be able to tell if a certain product found on the internet is of good quality, because it is not possible to put hours of research to investigate the quality control protocols of the many companies that are out there.  I am however careful to choose products in my practice i can be confident that are of the highest quality.

When you purchase supplements, ensure that they are GMP (Good Manufacturing Practice) certified. For example, Metagenics, a company I use in my practice is certified by three third party GMP organizations, one of which is an Australian agency, TGA (Therapeutic Goods Administration) who's standards are 10 times  stricter than the FDA in the United States. Metagenics is the only company to achieve GMP certification from 3 leading external quality control agencies. That is not to say that there are not many other wonderful companies who manufacture products that are effacacious, environmentally friendly, and pure.

The shocking video below shows how supplements can be manufactured in people's home kitchen, and illustrates that nutritional supplements vary in quality. It is important to do your research or consult a health professional who is knowledgeable in this field. However, this article is not intended to create paranoia about supplements but to empower you to choose sources that are manufactured properly, meet label claims, and give you what you pay for. The graph (right) shows how safe nutritional supplements are compared to medications even if some were not manufactured in "Cadillac" quality facilities. In 2008, the US had 48,700% more AERs (Adverse Event Reports) for prescription drugs compared to supplements. According to the FDA, an AER is anything from a concern that a supplement isn’t working, to a serious illness that follows the consumption of said supplement. In conclusion, using a natural product is still more safe, produces less side effects, and is less invasive than prescription drugs.