Probiotics have many health benefits. They are generally very safe as they are beneficial microorganisms normally found living in the gut and on the human body. However, there are documented instances where probiotics may be dangerous or unsafe. We will discuss these cases further below.
Probiotics for Acute Pancreatitis
The pancreas is where many of your digestive enzymes are produced. Acute pancreatitis is an instance where the pancreas gets irritated and inflamed and releases its enzymes into the surrounding tissues instead of into the digestive tract. It is a very painful condition and is associated with chronic alcoholism.
A study found that a certain combination of probiotics consisting of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus salivarius, Lactococcus lactis, Bifidobacterium bifidum, and Bifidobacterium lactis (previously classified as Bifidobacterium infantis) actually increased the mortality rate in patients with acute pancreatitis. 16% of patients in this study treated with probiotics died compared to 9% in placebo controlled patients.1
Probiotic use with Central Venous Cathethers
Central venous catheters are devices inserted into a main vein to make easier to administer medications and draw blood. There have been documented cases in which unsanitary administration of Saccharomyces boulardii probiotic resulted in the introduction of probiotics into the blood of 4 patients via the central venous catheter which resulted in infections. These patients were in the Intensive Care Unit and their infections were successfully treated with antifungals.2
Probiotic Use in Immunocompromised Individuals
People with a weakened immune system such as individuals with untreated HIV, transplant recipients taking immune-suppressing drugs, or those born with an immune system deficiency will have difficulty fighting microorganisms that normal individuals don’t have a problem with.
S. boulardii is a commonly used probiotic fungus. It normally does not take up residence in the GI tract but helps to normalize bowel movements in those with diarrhea. In one documented case a woman receiving immune-suppressing drugs for a organ transplant developed S. boulardii fungemia (fungal growth in the blood) after taking S. boulardii probiotic for C diff. In another case a HIV+ individual developed S. boulardii fungemia after taking the probiotic for diarrhea. Both cases were treated successfully with antifungal drugs.3
Most probiotics are bacteria and not fungi but bacteremia (bacteria in the blood) can happen in immunocompromised individuals as well. One case has been reported in which an elderly patient with chronic lymphocytic leukemia (CLL) taking Bacillus subtilis probiotic developed a blood infection and did not recover.4
Conclusion
In summary, there are several situations in which probiotics may be dangerous. Those include persons with acute pancreatitis, those with central venous catheters, and those that are immunocompromised. People who have acute pancreatitis are usually have severe, debilitating pain. People who have central venous catheters are usually hospitalized in the intensive care unit. Anyone who is immunocompromised should consult a physician before using probiotics.
Next article in our series on probiotics: Benefits of Probiotics
Sources:
- http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.546.1932&rep=rep1&type=pdf
- https://jcm.asm.org/content/jcm/41/11/5340.full.pdf
- https://journals.lww.com/jcge/Fulltext/2003/01000/Saccharomyces_cerevisiae_Fungemia_After.13.aspx
- https://jcm.asm.org/content/36/1/325.short
About the Author:
Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.