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Popular Probiotic May Cause Neurotoxicity

Affiliate Disclosure | in Health | by | with 156 Comments

 Popular Probiotic May Cause Neurotoxicity

It’s Strange But True . . .

Tipping at a restaurant in Iceland is considered an insult, camels have three eyelids, and what we thought we knew about L-acidophilus just might be all wrong.

Okay, not ALL wrong, but what if certain probiotic strains sometimes make autism worse, exacerbate chronic fatigue syndrome and other autoimmune disorders, and create brain fog, confusion and depression? I’m not talking about “die-off” or a healing crisis, where an individual gets worse before they get better. In this post, I’m going to share research that has caused me to conclude that sometimes the probiotics themselves may the problem. Let’s jump in with a little Probiotic 101, shall we?

pro·bi·ot·ic (noun)

Screen Shot 2013-02-18 at 5.38.30 PM.png

[Warning: This section contains a fair amount of geek speak, but we’ll move as quickly as possible to the Belly Button Biodiversity Project. Ready, Set, READ!]

The two most common types of probiotics come from lactic-acid producing bacteria (LAB’s) and bifidobacteria. Of the LAB’s there are two categories:

  • those that primarily produce L-lactic acid/L-lactate
  • those that primarily produce D-lactic acid/D-lactate.

L-Lactate, which is usually predominant in the body, is easily metabolized. For most people D-Lactate is not a problem, either, but in large amounts it may be difficult for those with impaired digestion to break down. This is especially true for those who have difficulty digesting carbohydrates.

Certain probiotics – especially L. acidophilus – are sometimes taken in huge quantities because they’re considered “safe in any amount.” However, L. acidophilus mainly produces D-lactic acid, and for those who cannot easily break this could create unintended consequences.

D-lactic acidosis (or a sub-clinical form of the same) occurs when the body is unable to rid itself of D-lactic acid. Diet – especially a diet rich in carbs if an individual cannot digest them well – is considered by some to be the main factor behind acidosis. As we’ll discuss later on, though, there are studies which indicate probiotic use can also induce this condition.

Here’s what happens at a cellular level: D-lactate buildup causes cellular metabolism of glucose to switch from an aerobic (oxygen-rich) process to an anaerobic (oxygen-deprived) process. In this oxygen-starved environment cells are unable to produce adequate amounts of adenosine triphosphate (ATP), which is needed for the “synthesis, degradation and ‘firing’ of neurotransmitter molecules.” (source)

Low ATP can affect cognitive function, create feelings of fatigue and impair coordination among other things. More generally, symptoms of D-Lactic acidosis include fatigue, confusion, impaired central nervous system function, impaired coordination, depression, nausea, vomiting, anxiety, anemia, headaches and in extreme cases encephalopathy. (source 1, source 2)

Hmmm . . . fatigue and brain fog? Does this sound familiar to you?

Is It Really “Die-Off”?

If you’ve come across the GAPS or SCD protocol before, you already know that re-balancing damaged gut flora can involve some pretty unpleasant experiences. Tops on that list is the Herxheimer reaction (aka “die off”), which is a term that “was coined to describe what Karl Herxheimer saw when he administrated drugs to patients. The reaction is thought to happen when toxins from dying pathogens (viruses, bacteria, parasites, candida, etc.) overwhelm the body’s abilities to clear them out.” (source)

Basically, the idea is that it’s normal for some people to temporarily feel bad when introducing probiotics – the body working hard to clear a lot of junk out all at once! But what if that’s not what’s happening? Acidosis and die-off can have very similar symptoms so they could be easily confused. “Die-off” typically lasts 3-7 days according to some experts, so if it’s lasting longer than that it might be worth considering acidosis or another factor.

What The Studies Say

Taking a closer look at D-Lactate

Unless they’re taking megadoses, it appears that most people with good digestion will be able to clear excess D-lactate. Unfortunately, the individuals most likely to experience side effects from D-lactate are those who are taking probiotics therapeutically for conditions such as:

  • autism
  • ADD
  • chronic fatigue syndrome
  • leaky gut syndrome
  • compromised immune system (In this study all 14 people whose invasive infection was attributed to probiotics were immune compromised)

Since the side effects can be the same as the original symptoms it’s hard to figure out what’s going on without a lab test, but we do know in general that abnormally high levels of D-lactic acid have been observed in some individuals with chronic fatigue and autism. (source) According to this study:

Coleman and Blass in [41] were the first to link to bioenergy metabolism disturbances with ASD [autism spectrum disorder]. They reported lactic acidosis in four children with autism. Later, Laszlo et al. [42] reported increased serotonin, lactic acid and pyruvate levels in children with autism. Lombard [43] then proposed that mitochondrial oxidative phosphorylation defects could cause abnormal brain metabolism in children with autism, leading to lactic acidosis and decreased serum carnitine levels.

Probiotics & Antibiotics Both Implicated


Ironically, both probiotics AND antibiotics are implicated in D-lactate acidosis. This study found that invasive infection from probiotic strains is rare but possible, though some actual infection rates may be under-reported due to misdiagnosis as “die-off.” In this study set, a little girl who had been given acidophilus from 4 months to 18 months began exhibiting “nervous shuddering, ticks, and OCD tendencies with greatly increased amounts of flatulence.” Lab tests indicated an overgrowth of L. acidophilus as the possible culprit.

On the flipside, some D-lactic acid producing bacteria appear to be antibiotic resistant, which means they could survive a course of antibiotics which killed everything else. With the competition eliminated, D-lactate producing bacteria could gain a stronger hold.

D-Lactate Acidosis and Neurotoxicity

This is simple math, really:

Studies indicating probiotic induced acidosis + studies confirming neurotoxicity from D-Lactic acidosis = popular probiotic strains may induce neurotoxicity.

Now just to tie up a few loose ends!

Why I’m Not Giving Up Probiotics

I imagine some of you are wondering whether it’s worth it to continue taking probiotics. I’m not an expert, but I personally think they’re beneficial in many circumstances. The benefits of lactic acid producing bacteria (LAB’s) have been thoroughly documented, and research indicates that trying to eliminate them completely can negatively affect our inner-ecology in different ways. Should we rethink megadoses of L. acidophilus and monitor individuals with compromised digestion for signs of acidosis? I think so, especially in cases where people are working hard to heal and not seeing the results they expect.

For me, the important thing to understand is that certain species of lactobacillus may be more compatible with our biology than others. Just about everyone easily clears L-lactate, so I buy probiotics that focus on strains which primarily produce this acid instead of D-lactate.

What About Fermented Foods?


If you don’t mind, I’ll respond to this question with a question: Have you ever heard of the Belly Button Biodiversity Project? Oh yes, it’s a real endeavor pioneered by scientists at North Carolina State University. Apparently, they’ve found 1,400 different distinct bacterial strains that live in the belly buttons of random volunteers – half of which have never been identified before!

In a similar way, the diversity of beneficial bacteria that can be found in fermented foods is stunning. Some D-lactate may be present, but I wouldn’t miss out on all the other amazing strains they have to offer by worrying about it.


That was A LOT of info! Please imagine me standing in my bathrobe, loudly applauding you for making it to the end of this post! Any questions?


Photo Credit: alles-schlumpfPRINCESS THEATER – Raising the Curtain, and kern.justin

Disclaimer: These statements have not been evaluated by the FDA and cannot diagnose, treat, or cure any disease. Please see my full disclaimer here.

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156 Responses to Popular Probiotic May Cause Neurotoxicity

  1. Jason says:

    Any suggestions or help welcome. I suffer CFS with gut problems, including overgrowth of D-lactacte producing bacteria with associated neurological symptoms. I have been on probiotics for a long time with little or no help and feel they possibly made my neurological symptoms worse. Have tried kefir but body can’t tolerate it – get muscle and joint pain, clicking and stiff joints, headaches, acidic gut and neurological symptoms worsen. It seems kefir is normally very well tolerated and beneficial for people in similar circumstance to me – but not helpful for me. I have tried just about every supplements, natural medicine and some medicines under the sun with little benefit, no benefit or worsening. I am tolerating less and less foods and my body is literally wasting away. I have seen numerous doctors, integrative doctors, naturopaths, and nutritionists and I am always consider as an extreme case and never respond to therapy or treatment in a normal or predictable manner.

    • Jason says:

      Please can anybody give me any help or suggestion? I am so desperate. I realise that I need to get the good bacteria into my gut to improve my health but I simply can not tolerate probiotics or fermented foods. They make my health worse, my neurological / nervous system worse, severe anxiety and gut pain, joint and muscle pain and general health worse.

      • Karyn says:

        Hi Jason:
        My first suggestion is seeing a Naturopathic Doctor. See the website of Dr. Timothy Gerstmar. Die off can cause anxiety and depression symptoms as well as joint pain. I went through it myself. Many times you will get worse before you get better. Also you may have an overgrowth of intestinal yeast. I am currently being treated for both, an overgrowth of bad bacteria and yeast. A comprehensive stool test will detect both but you must go through an ND or an MD who treats causes and not symptoms. Check out Dr. Gerstmar’s website. If you are out of the area, he does consulting over the phone.

        • Jason says:

          Thankyou for the reply!
          I currently see a Naturopathic Doctor. I have had the full gamut of testing including comprehensive stool tests. Over the past 5 years of solidly devoting my entire life, money and resources into trying to improve health I have gone from bad, to worse to extremely sick. I follow strict diet and have tried just about every supplement, food based supplement and some medicines under the sun to find they either outright make things worse or improve one thing and make something else very much worse. I have tried commercial and homemade probiotics – D-lactate free, single strain, multi strain, food based powder/liquid, milk kefir, water kefir, sauerkraut and they make my health worse. It isn’t just a short term effect either. After taking any probiotics I need to kill them off with herbs or alkalise my gut with bicarb to get some relief from the gut pain, extreme neurological and nervous system symptoms, joint muscle pain and complete loss of energy and strength. I understand about die off reactions but this is becoming increasingly worse over the past 5 years – not better. My tests are coming back worse each time despite following very strict protocols.

          • Karyn says:

            Hi Jason:
            If I were you, I would consult with Dr. Gerstmar. Ask for an introductory consultation. Usually it’s 15 minutes and free-of-charge but confirm that with his office. You can send him your current test results. He may have a different interpretation of your test results. He will save you a lot of time and money! I went through much of the same thing you are going through, emotionally, physically, and financially. I saw many doctors who did nothing except charge a lot of money. He is no non-sense and will get to the bottom of your illness. Don’t think there isn’t a solution, there is. You just need someone to help you identify it. Dr. Gerstmar will do that! As you can see, I am a very satisfied patient!

          • Sue says:

            I just went over your posts and I have very very similar symptoms. I was wondering if you have resolved your health problems and what is your situation now. Sue

          • Jason says:

            Hi Sue (and everyone who has replied to my comment.)

            I am really sorry it has taken me so long to respond. I have been very unwell. I was put on antibiotics a year ago (as a desperate last option) which I reacted to very severely and my health is an even worse mess since. I am not tolerating any supplements and most food as well. In some ways I am better off for not taking the supplements, many which were making my digestion worse – but my health is very poor. Having said that… the one supplement I do take is digestive enzymes – the improvement is very very minimal and seems to be wearing off as time goes by. Symptoms and health in general have a cycle of slightly better times and worse times, but it does not take much at all to make things worse.
            I am house bound and dependent on others to provide my everyday needs. I’m really doing nothing at all towards my health other than trying to rest, as my body simply is not tolerating anything which I swallow natural or otherwise. I feel that the antibiotics has broken the last straw in my body.

            I am really sorry to not be able to share happy news or suggestions. There are people who have had their health improved or recovered… unfortunately I have not been so lucky. I think the only thing left for me is a miracle.
            The only advice I can give you is to listen to your body and find what works best for it. Always keep trying to learn.
            All the very best for your health and recovery.

          • Tess says:

            Hello Jason,
            Wow. You have been through some travails with your health, to say the least! And it sure seems that you’ve exhausted most options. I have a suggestion for you to consider, if you would. First, a quick backstory …. I have a sister-in-law who had terrible symptoms and CFS, like you. To be honest, not as advanced as you but pretty close. She had to have care also and tried all the different things you are trying as well. But she found something that started to cure her and today (it’s been a process) she is almost completely healthy. What she found was something called NAET, which stands for Nambudripad’s Allergy Elimination Techniques. It turned out that her body was turning against her in so many ways and that allergies were the root of every single problem. After she started going through this process, she started seeing small improvements and today she is like a 20 year old (she’s about 60). It’s been amazing to witness and I’m a huge skeptic of stuff like this. But the results with her are undeniable. Anyway … I just thought I might throw this in the proverbial hat of things for you to consider. :)

      • Mo says:

        Jason – Please do post back here if you get good results as I can relate to you exactly. I thought probiotics would sort me out, but now I am without hope again. Good luck.

      • Kristie says:

        I was wondering if you had considered histamine intolerance? A low histamine diet might help you. Here is some information on my blog about histamines: and here: I have more histamine related posts under the label low histamine. My histamine pinterest board might help as well- Here is part of my story: I know this was posted some time ago, and I hope you are already doing better.

        • Kristie says:

          I thought of one more thing. Your symptoms could be from glutamate toxicity. Here is something that might interest you- She also has a list of free glutamate containing ingredients on that page. Basically avoiding glutamate cured her daughter’s autism.

      • Haley says:

        Hi Jason, I’m similar to you. I had to stop all probiotics and fermented foods for 6 months then slowly started taking d-lactate free probiotics called Gut-Pro and finally feeling better. Wishing you well

      • amy says:

        jason-have you tried D-lactate Free Probiotic Powder by Custom Probiotics? It addresses the specific issue of people with high d-lactate.

    • Penny says:

      As you are desperate, you might consider the possibility that you have Lyme – check out Steven Buhner Healing Lyme – he has a web site – he has listed some herbs that you can take – like Japanese Knotwood (resveratrol), cats claw, Andrographis – also, if you have a cat, the likelihood of having Bartonella goes up astonomically – everyone I know with MS has a cat… Dr. Klinghardt has some great lectures on Lyme – he says anyone with chronic fatigue is infected with Lyme – I would really urge you to check them both out – Buhner is an amazing herbalist – has written quite a few books – Lyme is very difficult to diagnose but the herbs aren’t expensive and they are like most herbs you would find in a parasite formula, so what do you have to lose by trying a few? Naturally, I’m not a doctor, so run it by him first:-)

    • E says:

      Hey I realize this is a very old post but have you tried d-lactate free probiotics? It’s expensive but Custom Probiotics has a d-lactate free version that you can try. I’ve used them and I find them to be pretty good.

  2. matt says:

    have you looked into yeast / fungas overgrowth? Have you been able to find a doctor to give you fluconizole? If not, try it. I twitching, cramps, pain, fatigue, vision issues, rashes, GI issues, joint pain, sinus pain, food intolerance and more. 30 days on the anit fungal took most of the symptoms away and reduced the symptoms of all of them. unfortunatly, i was taken offtoo early andstill deal with symptoms. I am looking for a doctor to try the anti fungal treatment again and stay on it for 30-90 days.

    • Lynndi says:

      let me know if you have any luck getting a doctor to prescribe this to you, most wont. I would like to know how to get the Diflucon or Nystatin for this. I hear they can kill the yeast/fungus. Thanks!

  3. Mo says:

    Just reposting as I didn’t tick the box for notifications!

  4. Superfoods says:

    Interesting post :).

    A favorite probiotic/prebiotic supplement of mine is Prescript-Assist which is a soil based probiotic formula. I found it very effective for supporting my digestion.

  5. Brian says:

    Something like this has happened to me after taking raw probiotics. First in the pill form and then the week long cleanse which had 400 billion per dose, 34 diff strains. I have ADD, anxiety/depression, mild ocd type symptoms, chronic fatigue issues etc. etc.. This brand seemed to give me tons of gas and made me very irritable and depressed. I’m not usually an angry person. I thought it may be “die off” but I think its lasted too long with no benefits. It took me a while to finish the first bottle as I wasn’t disciplined about taking them. I finished the cleanse in a week. I went through a couple bottles of mercolas probiotics last year and took acidophilus many years ago briefly(with no side effects and no noticeable benefits). My diet isn’t always ideal but I try to not make too many bad choices. The best Ive ever felt was on a paleo diet but I find it too difficult to maintain. As I don’t like to cook much or spend a lot of time on food prep plus it’s expensive and I’m exhausted all the time. Plus i’m a student again now so I find it nearly impossible. I just try to stay as gluten free as possible now since that seems to give me a lot of gastro distress as well….. Anyway, this was interesting to see. Thank you.

  6. Kalle says:

    Americans seems to be the most worried and most sick in the world. Soon science will come to the conclusion thay body and mind and possibly spirit is connected. If we worry body creates chemicals which is bad for us. Mind affect us , now some wont agree but 80% or more is subconscious and unless you can open that up you cant say for 100% mind is not affecting us. American mega dosages actually makes you more sick. So you need more pills to balance and later you become like gmo food. Mn thought he can create better food for profit but your body does not know what it is, like gmo rice your body is hungry after an hour instead of full all day. Because man think he can create better than the creator. If you think you lack so will be. Never wonder how some can survive cancer when doctor said they will die for sure? Because their mind didnt give up, thats the power of our mind.

  7. Hannah Crum says:

    Great article, Heather! This is a prime example of the fallacy of nutritionism. When we focus on the ONE thing that is going to solve x,y or z issue instead of considering the complexity of our organism, we lose out. We are designed to consume several strains of bacteria & yeast at a time i.e. in our naturally fermented foods. This is due to isopathy (like controls like) i.e. healthy bacteria keep pathogenic bacteria in check. We barely know anything about how our bodies work and the more we know, the less we know! By that I mean, we are incredibly complex! Science is a process of observation in order to explain that which already IS. We evolved consuming fermented foods. When we remove them from our diet and couple it with toxic overload (pollution – air, water, food), we suffer. Fermented foods deliver a variety of bacterial and yeast strains in quantities our bodies have evolved to utilize. When we try to “fool nature” by over dosing on a singular probiotic strain or a singular chemicalized vitamin, we often put our health in jeopardy. Here is our article about nutritionism if you are curious to read more–>
    Thanks again for an insightful article!

  8. Jo says:

    My son can’t cope with many probiotics or fermented foods. I’ve tried and tried but it doesn’t matter how I keep them up, his behaviour and mood just deteriorate on them. I’ve spent so much money on various types of probiotics and eventually I came to the conclusion a while back that it was a d-lactate problem. The kids who have a d-lactate problem also tend to do badly on starchy foods and my son has the same response to eating potatoes or grains as to having probiotics containing acidophilus. I’ve given up on fermented foods for him and only give him Saccromyces Bourlliardi, GutPro and sometimes Prescript Assist. Sac B is my fave as it has lots of studies supporting its effectiveness and he seems to do well on it.

  9. Review: GutPro Probiotics And Enzymes | The MommypotamusThe Mommypotamus | says:

    […] those of you who might be wondering about the D-lactate issue I wrote about earlier this week, here’s something worth mentioning:  My research on the subject was sparked by a […]

  10. Marilyn says:

    Thank you for this post. I am currently being treated for a yeast infection and have never had the experience before. The corners of my mouth split and my lips peeled. Being ignorant about all of this and after wondering how I got it, it struck me that I am on my second box of Probiotics and thought there may be a connection – now to read all this. Am I correct to question if it is the culprit? It does have Lactobacillus acidophilus and I have a Graves Disease and a leaky Gut which I am working on with a Paleo diet. Thank you for your info.

  11. Cate says:

    Hi Heather,

    Would you you mind telling me which probiotic you give to your little ones? Prescript Assist? Gut Pro? Another brand?

    Thank you SOOO much!

    • Heather says:

      Hi Cate, I give them about a quarter of a Prescript Assist capsule, and sometimes GutPro if we are not eating a lot of fermented foods at the moment.

  12. Cate says:

    Hi Heather!

    Thank you so much for getting back to me:) Do you give the same amount to your little guy? My kids are similar ages to yours 5, 3 and 9 months. Did you start out with less than that and work up or do you feel that a quarter capsule is a good place to start? Did they have any die off when you introduced it?

    • Cate says:

      Hi Heather,

      I know you are incredibly busy. I have no idea how you do it, actually:) I hope you won’t mind helping me out for a second, though. I can’t seem to find an answer anywhere. My baby is having constipation issues and I’m planning to start him on prescript assist. He’s was exclusively breastfed until solids and now eats a strict whole foods diet with FCLO. Never had any antibiotic, meds, etc, but is still having eczema and constipation issues, which I know indicates gut issue. I’m nervouse about die off reactions even though his toxic load should be low since we work so hard to avoid them. Just wondering if you give it to your little man and how much you started out with? Did he have any reaction at first?

      • Lisa says:

        I realize you posted this a year ago, but I’m hoping you can tell me what you ended up doing as far as probiotics? …or for that matter, at all? You describe my situation to a “T.” We’re giving my 9 month old the Rosita Cod Liver Oil instead of fermented, but other than that, everything you say is true for us. I cannot rid his eczema for anything! He’s also having major constipation issues now that we have started solids. Your help, or anyone else’s, would be GREATLY appreciated! We’re desperate! :)

  13. Casey says:

    Do you think taking probiotics during pregnancy is safe? I know my gut flora is messed up. I’ve been taking probiotics but I think they may be the cause of a skin rash I have. My main concern is my little one. My doctors don’t know enough about probiotics to offer any advice. Thanks so much for any advice you may have!

  14. sean says:

    Hi there. I have been suffering from left abdomen pain, nausea everyday, dizziness, confusion, fatigue, and inability to concentrate for the past 3-4 months. It has gradually gotten worse by the day, to the point where I can almost not go to work anymore. I had a colonoscopy/endoscopy and they said everything was fine except for a bit of acid reflux. I was left lost and searching for any possible answers to what is doing this to me when I found this article.

    I have been taking Custom Probiotics ever since around the time this all started happening. I recently switched to VSL3 last week and it seems to all have gotten worse. I never knew about Lactate and the fact it could be harming me. I’m almost positive this is what is effecting me.

    My question is, what do I do if I have it? I stopped taking the Probiotic today. Is that enough? Is there anything else I can do? Please help.

    • Mia says:

      Did you feel better after you stopped taking the probiotics? I am taking custom probiotics and like you described.

  15. Jenny says:

    Im curious now. My kids take therbiotic infant formula probiotics. They don’t seem to have any issues with them. Is that supposed to be a good brand?

  16. Randa says:

    So I gathered that GutPro is the brand to go with from the conversations in the comments while my baby sleeps (lol). Is this something you would give a 15 months old or is it for adults only. I used HMF natogen on him when he was a baby and he was fine actually his gas seemed to get better on it and I use garden of life with on an off symptoms I cannot tell if its from it but I would like to give a great brand a try and also check with my naturopath on it.. she likes to learn stuff as well from me :) or her patients.

  17. Sher Lin says:

    I believe that if all commercial and OTC probiotics are not working well for you, you should go for practitioner grade probiotic blend such as MicrobioMax Yogurt Blend.
    I am giving it to my son with Autism too and my close ones are taking them to counter 1st stage cancer.

    It contains over 40 strains of probiotic and at 80 billion CFU
    (the highest in the world) and the best part is expect NO manufacturing errors…because you basically ferment your own probiotic yogurt, these are live dehydrated bacteria we are talking about and should be well kept in suitable temperature at all times. I always believe Probiotics are sensitive supplements and should NOT be seafreight (the heat will kill all things good) by manufacturers which many does that, causing the efficiacy level to drop almost by 80% leaving you with contaminated probiotic capsules which does not work and in return, you get more side effects!

    Fast Absorption when taken fresh and it only last a week and make a new batch every week! I am lactose intolerant so this is perfect for me where i get to sieve out the casein from the fermenting process so i don’t get bloating tummy or vomiting.

    Give MicrobioMax Immune Blend a try!

  18. 6 Probiotic Myths Everyone Should Know | Diet Wellbeing says:

    […] to consider probiotics that are low on, or contain no d-lactate producing strains of bacteria. See Heather’s post for more information on this. There are several brands in my favorite category that fit this […]

  19. Dario says:

    Hello Heather

    I know this is an old post but I wanted to personally thank you for it. I’ve been on and off probiotics for the last couple of years. Medical and natural health professionals kept advising me that I needed to take them. However I constantly struggled with taking them and always experienced headaches, irritability, and moodiness. I tried a variety of products to no avail. I had no clue why I experienced the side effects that I did (and neither did the professionals). I stumbled onto you article and eventually tried a probiotic which is lactase free. Needless to say the side effects are gone – no more irritability or headaches. Had it not been for your article I would have tried to suffer through on probiotics or given up entirely. Once again, thank you, because you have made it possible for me to continue supplementation without the suffering while allowing me to reap the benefits.

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