Evidence to Support the Clinical Use of Probiotics in Depression - Magaziner Center

Evidence to Support the Clinical Use of Probiotics in Depression

The Magaziner Center for Wellness has long been recognized for our clinical advances in the treatment of mental health and neurological disorders. We have pioneered various alternative, natural, and complementary care options in helping patients with these challenges. Rather than using medication to mask symptoms, we take an holistic approach for each patient, offering extensive testing to help determine all causes and contributing factors to their challenges.

While medications generally work by suppressing, blocking or disabling normal reactions in the body, our therapies work by facilitating, enabling, and assisting normal physiologic reactions to occur. We create a unique and personalized treatment plan for every patient, based on their individual triggers, detoxification pathways, immunologic factors, nutritional status, lifestyle, lab work results, and more. As a result, our patients can experience excellent clinical outcomes and fewer side effects. In short, our treatments work in concert with the body rather than attempting to battle it.

In this article we will focus on one aspect of concern we see in our patients. A condition of inflamed gut and its impact on mental health.

The new science of gut-brain interaction and its implication in mental illness. Garbled communications.

We are going to follow four years of research which will bring us here into 2021.

A June 2016 study in The International Journal of Neuropsychopharmacology, (1) tells its fellow neuropsychologists: “The potential role of gut microbiota in influencing brain function, behavior, and mental health has attracted the attention of neuroscientists and psychiatrists.” Furthermore, “the communication of gut microbiota with the brain, through what is referred to as the microbiota-gut-brain axis, represents a new biological axis by which novel diet-based therapies can be designed to influence brain function and behavior.”

Recent advances have shown that the gut microbiota (the collective name for the bacteria that lives in the digestive/intestinal tract) and its interaction with the brain, has an influence on behavior and mental health and it breaks down when messages between the gut and the brain do not get through or are garbled.

In a 2018 study in the Journal of Microbiology (2) scientists described this gut-brain relation.

“It is increasingly evident that bidirectional interactions exist among the gastrointestinal tract, the enteric nervous system (that part of the nervous system that governs the function of the gastrointestinal tract) and the central nervous system.Recent preclinical and clinical trials have shown that gut microbiota plays an important role in these gut-brain interactions. Furthermore, alterations in gut microbiota composition may be associated with pathogenesis of various neurological disorders, including stress, autism, depression, Parkinson’s disease, and Alzheimer’s disease. Therefore, the concepts of the microbiota-gut-brain axis is emerging.”


When gut-brain communications block bad thoughts and when they can’t

In the opening paragraph of a study published in the journal Psychosomatic Medicine (3) investigators keyed on the communication aspect of how the gut and the brain send messages to each other:

“The brain-gut-microbiota axis has been put forward as a new paradigm in neuroscience, which may be of relevance to mental illness. The mechanisms of signal transmission in the brain-gut-microbiota axis are complex and involve bidirectional communications which enables gut microbes to communicate with the brain, and the brain to communicate with the microbes.”

While this indicates a positive relationship between brain and gut, inflammation can open a gate that allows negative communication through

In the journal Trends in Neurosciences, (4) investigators from Oxford University suggested that pro-inflammatory cytokine concentrations (the inflammation that makes a disease worse) are capable of increasing the permeability of the blood–brain barrier permitting access to the potentially physically and mentally pathogenic entities. In simplistic terms – the makers of bad and altered thoughts get through – because they can alter and lower levels of serotonin, dopamine, and glutamate (an amino acid involved in mental health) that would typically block them.

The new consensus in the medical community is that when the gut and brain talk to each other, inflammation is the most important topic

Returning to the doctors at Oxford research, here is a summary of their fascinating findings on how the gut and brain talk to each other.

Gut bacteria produce a range of neurotransmitters through the metabolism of indigestible fibers. These include the following with a very simple and general explanation of its influence

Dopamine (reward and pleasure)

Noradrenalin (alertness and sexual arousal)

GABA Gamma-Aminobutyric acid (low levels linked to anxiety and issues of chronic pain)

Serotonin (low levels implicated in depression)

Acetylcholine (reward and arousal)

The gut produces the neurotransmitters, the neurotransmitters talk to the brain.

The gut talks to the brain through the metabolization of dietary fiber which produces short-chain fatty acids (SCFAs) – a communication link that may control inflammation related to depression.

A high fiber diet can produce short-chain fatty acids than can reduce low-grade inflammation.

A high fat diet can produce short-chain fatty acids than can increase inflammation and its negative effects on depression.

A great amount of research from the medical community is now centering on helping the gut reduce inflammation through amino acids and probiotics

Connecting nutritional deficiency to impaired communications via inflammation and oxidative stress

As we have seen in the research above, the complexity of the gut-brain information highway requires many recommendations to supplement and alter diets.

A March 2020 study in the journal and aptly named for this article Mediators of inflammation, (5) found that a deficiency in serine, an essential amino acid found in foods such as soybeans, peanuts, almonds, walnuts, eggs, chickpeas or garbanzo bean, lentils, shellfish and meat, as well as in supplement form, reduced the gut’s antioxidant and anti-inflammatory defense system.

A February 2020 study (6) showed how managing uric acids levels in the blood, too much would cause inflammatory problems including gout, too little would be a contributing factor in depression, could help patients with inflammation and altered gut-brain communication. They found that when amino acid metabolism was disturbed with serine, glutamate (an amino acid that sends brain signals back and forth) and glutamine (an amino acid that works an an antioxidant in the intestines) being downregulated, problems of inflammation, neuropathy, and altered nerve communications occured.

Probiotics, chronic pain and depression

A March 2020 study (8) examined the frequent patient complaint of chronic pain and it’s partner problem, depression. They not the research as we have that “Recently, alterations in gut microbiota and metabolites derived therefrom have been found to potentially contribute to abnormal behaviors and cognitive dysfunction via the “microbiota-gut-brain” axis.” The researchers suggest, “Studying gut microbiota and its metabolites (the  vitamins, carbohydrates, proteins, and lipids that make it go), has contributed to the understanding of comorbidity of chronic pain and depression. Consequently, modulating dietary structures or supplementation of specific bacteria (probiotics) may be an available strategy for treating chronic pain and depression.

In  the medical journal of Reviews in the neurosciences (9) doctors writing in support of probiotics in helping patients with major depressive disorders wrote that the attention being given to probiotics stems from ineffective treatments currently being offered. “Despite intensified research efforts to improve the treatment options and remission rates in mood disorders, no disease modifying treatment exists for these disorders. Accumulating evidence implicates the involvement of the gut microbiota in processes relevant to etiopathology (the origins of) of central nervous system-based disorders. . . The concept of psychobiotics, which is bacterial-based interventions with mental health benefit, is emerging in the field.”

Dr. Brittany L. Mason, of the University of Texas Southwestern Medical Center wrote this in the journal Psychosomatics about the gut and patients with anorexia nervosa and depression. Physical and mental health is dependent on the environment, and feeding (eating disorders) is a prime example of this environmental exchange.  . . (Growing understanding shows) that gut bacteria regulate basic physiologic processes and are implicated in various disease states and contribute to regulation of mood. Responses to stress have effects on feeding behavior and mood and the regulation of the stress response by the gut microbiota could contribute to the dysfunction seen in patients with psychiatric illnesses.”

When the gut is stressed, the gut may communicate bad thoughts to the brain that lead to psychiatric illnesses. This is a common and developing theme.

Dr. Mason concludes: “Gut microbiota may contribute to dysfunction in psychiatric illnesses. New opportunities to modulate existing gut microbiota using probiotics could be novel targets for clinical interventions.” Probiotics may be the key for certain patients.(10)

“Stronger evidence to support the clinical use of probiotics in depressed populations”

A February 2021 study (10) supported the use of probiotics in depression. Here the researchers noted: “Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders.” In this review, the researchers examined seven previously published papers “capturing 404 people with depression. A random effects meta-analysis using treatment type (stand-alone vs. adjunctive) as subgroup was performed. The results demonstrated that probiotics are effective in reducing depressive symptoms when administered in addition to antidepressants, however, they do not seem to offer significant benefits when used as stand-alone treatment. . . This review offers stronger evidence to support the clinical use of probiotics in depressed populations and provides an insight into the mode of administration more likely to yield antidepressant effects.”

What this paper shows is something we have also seen, rarely do one treatment or “pill” work for depression. Probiotics can be a great benefit when incorporated into a more holistic approach. While the researchers of this paper suggest that probiotics would be helpful with anti-depressants, we may explore a non-pharmaceutical approach with probiotics as a viatl component.

If you would like to explore more information, please contact our office so we can start a conversation with you.

Related Articles

Stress, Inflammation, Premature Aging and Reduced Immunity

Is a Placebo a More Effective Antidepressant Than an Antidepressant?

Treating Gut Inflammation May Help Prevent Alzheimer’s Disease

Does Caloric Restriction Prevent Memory Loss?


1 Foster JA, Lyte M, Meyer E, Cryan JF. Gut microbiota and brain function: An evolving field in neuroscience. Int J Neuropsychopharmacol. 2015 Oct 4. pii: pyv114. doi: 10.1093/ijnp/pyv114.
2 Kim N, Yun M, Oh YJ, Choi HJ. Mind-altering with the gut: Modulation of the gut-brain axis with probiotics. Journal of Microbiology. 2018 Mar 1;56(3):172-82.
3 Dinan TG, Cryan JF. Brain-gut-microbiota axis and mental health. Psychosomatic Medicine. 2017 Aug 11.
4 Sarkar A, Lehto SM, Harty S, Dinan TG, Cryan JF, Burnet PWJ. Psychobiotics and the Manipulation of Bacteria–Gut–Brain SignalsTrends in Neurosciences. 2016;39(11):763-781. doi:10.1016/j.tins.2016.09.002.
5 Wang F, Zhou H, Deng L, Wang L, Chen J, Zhou X. Serine Deficiency Exacerbates Inflammation and Oxidative Stress via Microbiota-Gut-Brain Axis in D-Galactose-Induced Aging Mice. Mediators of Inflammation. 2020;2020.
6 Pan L, Han P, Ma S, Peng R, Wang C, Kong W, Cong L, Fu J, Zhang Z, Yu H, Wang Y. Abnormal metabolism of gut microbiota reveals the possible molecular mechanism of nephropathy induced by hyperuricemia. Acta Pharmaceutica Sinica B. 2020 Feb 1;10(2):249-61.
7 Li S, Hua D, Wang Q, Yang L, Wang X, Luo A, Yang C. The role of bacteria and its derived metabolites in chronic pain and depression: Recent findings and research progress. International Journal of Neuropsychopharmacology. 2020 Jan;23(1):26-41.
8 Li S, Hua D, Wang Q, Yang L, Wang X, Luo A, Yang C. The role of bacteria and its derived metabolites in chronic pain and depression: Recent findings and research progress. International Journal of Neuropsychopharmacology. 2020 Jan;23(1):26-41.
9 Rios AC, Maurya PK, Pedrini M, Zeni-Graiff M, Asevedo E, Mansur RB, Wieck A, Grassi-Oliveira R, McIntyre RS, Hayashi MA, Brietzke E. Microbiota abnormalities and the therapeutic potential of probiotics in the treatment of mood disorders. Reviews in the Neurosciences. 2017 May 8.
10 Mason BL. Feeding Systems and the Gut Microbiome: Gut-Brain Interactions with Relevance to Psychiatric Conditions. Psychosomatics. 2017 Jun 8.
11 Nikolova VL, Cleare AJ, Young AH, Stone JM. Updated Review and Meta-Analysis of Probiotics for the Treatment of Clinical Depression: Adjunctive vs. Stand-Alone Treatment. Journal of clinical medicine. 2021 Jan;10(4):647.

Sign Up For Our Blog

Sign Up for Our Newsletter

Get the latest news, research and articles.


* indicates required
Email Address
Site Design Rebecca Pollock
Site Development Alchemy + Aim