Reason to take L.reuteri?

[Zizzle]

I've been having good success taking probiotics Megasporebiotic and Culturelle (L. rhamnosus). I wonder if I should add L. reuteri?

Histamine H2 Receptor-Mediated Suppression of Intestinal Inflammation by Probiotic Lactobacillus reuteri

http://mbio.asm.org/content/6/6/e01358-15

[tex]

That's interesting research in view of the fact that the American Gastroenterological Association Institute published new guidelines in December for the medical management of microscopic colitis that expressly recommends against the use of probiotics when attempting to obtain clinical remission of MC symptoms (scroll down page to last news item at the link below).

http://www.microscopiccolitisfoundation ... s-new.html

It would be nice to see some similar compelling research on human gut response to that probiotic. But to answer your question — there's only one way to find out.

I note that the list of references for that article lists a number of articles supposedly praising the benefits of that probiotic strain for reducing inflammation in rodent guts, and even in human guts. But apparently it must not work very well in the real world, otherwise why would the American Gastroenterological Association Institute change their guidelines to discourage the use of probiotics for treating MC?

But if you want to use H2 receptor function to suppress inflammation, the most logical and effective way to do that is with the use of an H2 blocker (H2 antihistamine), rather than a probiotic.

Thanks for the link.

Tex

[tex]

Zizzle,

The biggest problem I have with this research is found in this statement:

However, the mechanisms of probiosis are not clear. Our current studies suggest that supplementation with hdc+ L. reuteri, which can convert l-histidine to histamine in the gut, resulted in suppression of colonic inflammation.

Not clear? So what did the research accomplish? What did they actually prove (if anything)? L-histidine is a precurser to histamine. IOW, histamine is produced by the body from L-histidine. So how did increasing histamine production in the intestines suppress inflammation? IMO they need to answer that question before the research will have any clear value. The problem with their claim is that most MC patients seem to already have too much histamine (it comes with the territory) — we don't need more histamine. For someone who happens to be low on histamine though, then taking Lactobacillus reuteri might help.

For someone diagnosed with dermatomyositis though, I would view that as a risky venture. But of course I could be all wet.

Or am I looking at this research wrong?

Tex

[Zizzle]

Tex,
I don't understand the whole histamine/H2 connection. It seemed odd to me that producing more histamine in the gut would be a good thing. Maybe unconverted hustidine is a problem?? I don't have major histamine issues that I'm aware of. I can eat fermented veggies, kombucha, leftovers, etc without incident. However, a meal of fish, spinach, vinegar and wine will promptly send me to the loo with D (meaning insane histamine overload, IMO).

I recently read a non-peer reviewed article about H2 blockers revving up the immune system and increasing white blood cell counts. I don't understand how they can do that, but I'm intrigued, as I'm seeing a top-doc hematologist next Monday for my worsening WBCs (2.2 at last check, normal is 3.8-10.8, and I have lymphopenia and now neutropenia). I have no idea whether he'll tell me it's part and parcel of having a lupus-related AI disease and send me on my way, or whether he'll take interest in my unusual case (atypical DM presentation, no real lupus markers other than ANA, parents with neutropenia, etc).

Regarding probiotics, I've always been very sensitive to them, promptly rejecting all the milk-based ones like acidophilus and bifidus, and having mind-boggling changes in the D from Prescript Assist, Megaspore, and now Culturelle. Incidentally, I tried Culturelle early on when the D was bad, and I noticed no effect.
But now, just one pill is enough to change most of my symptoms overnight. Even my legume allergic daughter is reporting fewer belly aches and general GI calmness overall on Culturelle. I'm sold!

I just found a Swanson brand L. rhamnosus at a fraction of the price of Culturelle ($13 for 60 pills on Amazon), instead of $1/pill. So I alternate...Megaspore one day, Culturelle the next. Occasionally I throw in a Prescript Assist, even though it makes me gassy.

Sadly, although the MC is improving, the DM rash continues to advance again. A glutening in early November got the ball rolling on my hip, and it has spread down my thigh, up my back, and to my other buttock. It almost seems like my 2 diseases function in opposition to each other. D improves/rash gets worse. I still believe the DM is virus related (EBV) and my doc seems to agree. Anytime viruses are making the rounds in my house or nearby I never get sick, but my rash goes crazy.

I give up.

[tex]

Maybe I'm looking at this wrong. In the stomach, activating H2 receptors results in the increased production of gastric acid. But in other organs, H2 receptor activation tends to relax smooth muscle tissue (such as intestines), and it's claimed to inhibit the production of antibodies, T cells, and cytokines. So presumably this last response (inhibition of pro-inflammatory mediators) is what they are attempting to elicit.

But this still leaves the histamine problem that many of us have, and without knowing how/why the process actually inhibits those mediators, there are a lot of questions, and the answers may matter.

Sorry about the DM rash. Are you sure that all the fermented stuff doesn't fan the flames (or perpetuate it) once a rash becomes active? Consider this connection (and I'm guessing that this probably applies to you, also):

Normally I can take a warm/hot shower with no problems. But if I happen to have a histamine-induced rash (that is, a rash due to too much histamine in my diet), I may not even notice it until I take a shower (and it usually isn't even visible). But I'll sure notice it after the warm/hot water hits it. It will be clearly visible as an angry red rash, and it will begin to itch like mad, and it will remain visible (and extremely itchy) for a day or 3, depending on whether or not I take an antihistamine, and how well I respond if I take one. IOW, the shower is a secondary trigger/enhancer to a histamine-induced rash, and it tends to perpetuate the symptoms. Without a shower, the rash is a minor issue. A shower supercharges it, and subsequent showers will boost it again. The fermented foods could be doing the same thing. The probiotics might possibly be having an adverse effect on the DM, also. Or maybe not.

Tex

[Zizzle]

Yes, hot showers definitely supercharge my rash, but only for a few minutes. DM is a vascular disease, and I've assumed the hot water just brings lots of blood to the surface of the skin. Never thought about a histamine connection, other than the observation that alcohol turns the rash on, but perhaps due to vascular reasons too? The alcohol redness and itch doesn't last long either.

Regarding fermented foods, I haven't had any in a while, now that I've found targeted probiotics that do a better job for me.

What type of antihistamine do you take for the rash? H1 or H2? Or both? I hate how H1s make me feel (dry and foggy), and they barely help the itching, but I haven't tried an H2 yet. Worth an experiment? I haven't tried Histame either.

[tex]

I use Allegra because it doesn't cause me to have dry mouth or any other noticeable side effects. Chlor-Trimeton is more effective, but causes dry mouth, and has anti-cholinergic effects (that can contribute to dementia risk, as you are probably aware). But I will agree that while Allegra helps, it doesn't immediately kick the problem to the curb. I tried Claritin a couple of years ago, for pollen allergy, but it didn't seem to have much effect. I've never used more than 1 Allegra at a time, though (which is surely an option). And I've never tried an H2 antihistamine.

If those secondary triggers (hot water, alcohol, etc.) only cause short-duration effects on the rash, then you're probably correct that histamine may not be a major problem for you.

Tex

[Zizzle]

Well my 8-yo daughter is home vomiting every 30-40 mins since 5:00 am. Some unamed GI illness is making the rounds in our city, many guess it's norovirus, but might be an enterovirus. Not sure how to protect myself other that hygeine, C, D and extra probiotics. If I catch it, the rash will flare 10-fold. Ugh!

[tex]

Mothers have the toughest, most demanding job in the world. It goes on 24x7 with no provisions for opting out.

I hope that you can manage to avoid catching it.

Tex