Should probiotics be regulated? The potential dangers of unregulated micro-organisms

Unregulated probiotics, good or bad?

Probiotics are known to alter the function of the human microbiome. Not a lot is known about what the microbiome does or what it can do but it is suspected by the latest studies that the gut is actually part of the brain. The gut-brain axis as medical professionals call it is a part of the body which can regulate mood and effect behavior as much as the brain inside the skull. It has been shown that micro organisms can cause anxiety, depression, cardiovascular disease and many other possible health alterations. At the same time these organisms have been shown to treat anxiety, depression, and cardiovascular disease in ways which scientists don't fully understand.

The ability to create designer micro-organisms exists now and is relatively simple. The problem is that these designer micro-organisms really have unknown properties because humans do not have hundreds or thousands of years of co-evolution with these new organisms.

On the topic of depression the typical theory of the cause of depression is some sort of neurotransmitter or brain chemistry imbalance. At the same time there is no specific blood test which I'm aware of which is capable of materially proving that there is a neurotransmitter imbalance nor can we have strong certainty that neurotransmitters are beneficially altered by treatments such as SSRI. What we have is behaviors which change in response to the treatment. It is possible that a lot of treatments can alter behavior or effect the same brain chemistry and some theories say imbalances in the gut are the actual cause of depression and anxiety. It is possible to test for different micro organisms in the gut which seems to be an advantage vs the brain where I am not aware of any way to detect what exactly the chemistry is.

Serotonin Deficiency? What is the cause, if it even exists?

• Seratonin can be checked by a blood test but it's not capable of detecting brain levels.
• Serotonin levels can for sure by altered by gut micro organisms. This is confirmed in my opinion by the fact that most (estimated 90%) of seratonin is created in the digestive track. So it may be true that serotonin deficiency can cause the symptoms associated with depression but it has not been proven at all that the condition of depression originates from the brain.
• Gut-Brain axis shows that these things are a lot more complex and that while some people may be helped by a pill it does not mean that all people with depression or anxiety can be helped by the same pill. SSRIs may in fact be over prescribed, but typically are the first choice because probiotics and other more experimental treatments have not been sufficiently studied.

Regulation of probiotics would be quite difficult. Anyone can grow micro-organisms and they can evolve or be evolved into different strains .The problems occur when amateurs who don't know what they are doing attempt to grow micro-organisms. How safe for example is Kefir? It really would depend on who grows it and how. How safe is s boulardii? It's possibly safe if the user does not have a compromised immune system and if it's grown in a safe way but the supplement industry offers no clear standards which means how can the buyer be 100% sure they are buying exactly the micro organisms in the precise dose they need?

If it does need to be regulated how would it be regulated without being over restrictive? I would guess some sort of controls to make sure that supplement companies actually contain the probiotics they claim and nothing else. In addition, designer probiotics need to be carefully studied. In my opinion the ultimate treatment for depression and anxiety likely will be some sort of designer probiotic treatment but in my opinion it will have to be individualized to the specific gut profile of the patient and likely not going to be something people can buy in some standardized packaged way. If a person is experiencing anxiety, depression, or other symptoms, because of some micro organisms imbalance, we would likely have to get a unique profile of the patient to have an idea of what they need.

References

Kelesidis, T., & Pothoulakis, C. (2012). Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therapeutic advances in gastroenterology, 5(2), 111-125.

BMJ. (2019, May 20). Anxiety might be alleviated by regulating gut bacteria: Review of studies suggests a potentially useful link between gut bacteria and mental disorders. ScienceDaily. Retrieved September 15, 2019 from www.sciencedaily.com/releases/2019/05/190520190110.htm
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Herbrecht, R., & Nivoix, Y. (2005). Saccharomyces cerevisiae Fungemia: An Adverse Effect of Saccharomyces boulardii Probiotic Administration. Clinical Infectious Diseases, 40, 1635-7.

Benjamin Offei, Paul Vandecruys, Stijn De Graeve, María R. Foulquié-Moreno, Johan M. Thevelein. Unique genetic basis of the distinct antibiotic potency of high acetic acid production in the probiotic yeast Saccharomyces cerevisiae var. boulardii. Genome Research, 2019; DOI: 10.1101/gr.243147.118

American Heart Association. (2012, November 5). Daily doses of a new probiotic reduces 'bad' and total cholesterol. ScienceDaily. Retrieved September 15, 2019 from www.sciencedaily.com/releases/2012/11/121105114620.htm