Probiotic Treatment For Blastocystis Hominis

blastocystis probiotic treatment for blastocystis hominis gut infections australian naturopathic treatment

Probiotics can be very helpful when approaching a Blastocystis hominis infection. Not only is there a ton of anecdotal evidence where people report that they feel better when taking probiotics to treat their Blastocystis infection but we actually have evidence to support the idea. 

This article will cover probiotic treatment approaches for Blastocystis infections and what particular probiotics to look.

 

Blastocystis hominis

Blastocystis hominis is, and always will be a subject of interest for me. Acute infection with this little protozoan bug, along with bacterial infections was my first experience with ongoing sub-par health. For an introduction to this parasite see here

Since writing this article I have had success treating my Blastocystis hominis parasite infection but it took years of working out the successful approach, combining different herbs, prebiotic formulations and specific probiotics to bring my gut health back into balance.

Over the years my thinking around treatment ideas have changed. Originally it went something like this

  1. Find the bug
  2. Kill the bug using antimicrobial herbs
  3. Rebuild the gut integrity and microflora

While this may seem overly simplistic to anyone who has done antibiotics and only felt worse it is the general approach of many practitioners, including functional medicine, naturopaths and herbalists. Delving into the complexity of the human body and the intricacies of our gut microbiome it became clearer and clearer that the approach of “find and kill” can lead some unfortunate people down the path of diminishing returns, not to mention diminishing gut flora.

 

Probiotics for Blastocystis hominis

There are a handful of specific probiotic species and even strains within those species that are helpful when dealing with gut infections like Blastocystis. 

One particular and very well researched probiotic was used in a study to treat Blastocystis hominis in children displaying symptoms including

  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting
  • Flatulence

The randomised, single blinded control trial compared Saccharomyces cerevisiae var. boulardii CNCM I-745 to the standard treatment, an antibiotic called metronidazole (which Blastocystis is becoming more and more resistant to), and a third group with no treatment at all. The treatment intervention lasted for 10 days.

 

Probiotic Treatment for Blastocystis – Results After 15 Days

The Probiotic group

  • experienced 77.7% clinical cure rate – this is based on the symptoms of the patients and not on stool analysis to confirm eradication of the parasite.
  • Analysing the stool found that only 72.2% had cleared the parasite.

The Antibiotic group

  • experienced 66.6% clinical cure rate (based on symptoms and not stool analysis).
  • Interestingly when analysing the stool the antibiotic group achieved a 80% clearance rate at 15 days.

The control group, receiving no treatment

  • experienced only 40% clinical cure rate
  • 26.6% stool analysis clearance rate.

 

Probiotic Treatment for Blastocystis – Results After 30 Days

They also checked in at day 30, 20 days after the intervention and found that

The probiotic group

  • 94.4% – based on symptoms
  • 94.4% – based on stool analysis

The antibiotic group

  • 73.3% based on symptoms
  • 93.3% based on stool analysis (interesting spread here)

The control group was treated with the antibiotic after day 15 so there was no data for them at day 30.

 

Assessing The Cure Rate For Blastocystis

It is worth noting that the trial seemed to screen for Blastocystis just one time when assessing the cure rates and this particular parasite has random shedding habits. It can be helpful to screen multiple times (up to three separate stool samples on different days) to determine whether you still have Blastocystis or not.

The other very important point that very few people are talking about is the importance of the particular strain of probiotic used. Many will assume that because this particular strain of Saccharomyces cerevisiae var. Boulardii, the CNCM I-745 aka biocodex strain, is helpful in the treatment of Blastocystis hominis that all strains of Saccharomyces cerevisiae var. Boulardii will be helpful. This is incorrect and research has looked into the differences displayed between different strains in the same species of probiotics.

Dr. Jason Hawrelak is the best source to dig into if you are interested in this subject. In a lecture he used the example of E. coli. Some strains of E. coli are members of healthy flora and some can contribute to a wide range of symptoms.

 

More On The Probiotic Saccharomyces boulardii

The Therapeutic Advances in Gastroenterology published an interesting review on Saccharomyces boulardii in 2011 looking at some promising research done on the yeast in regards to a range of different chronic and acute diseases including

  • Antibiotic-associated diarrhea
  • Clostridium difficile infection
  • Acute diarrhea
  • Persistent diarrhea
  • Enteral nutrition-related diarrhea
  • Traveler’s diarrhea
  • Helicobacter pylori infection
  • Chronic diseases
  • Crohn’s disease
  • Ulcerative colitis
  • Irritable bowel syndrome
  • Parasitic infections
  • Amebic colitis
  • Giardiasis
  • Blastocystis hominis
  • Human immunodeficiency virus (HIV)-related diarrhea

While digging into each and every point they covered is beyond this article it is worth noting a few key points found in the literature on the use of Saccharomyces boulardii.

  1. It has the ability to reach the colon intact (although in reduced numbers)
  2. Has the ability to survive the body temperatures (rare for yeasts)
  3. Is naturally resistant to antibiotics, leading to recommendations for supplementing while taking antibiotics or even antimicrobial herbs

Unfortunately at the moment the biocodex strain of Saccharomyces boulardii (CNCM I-745) isn’t available in Australia but it could be worth looking into international shipping options until it is. Alternatively there are a number of Saccharomyces boulardii strains on the Australian market that may possibly have similar effects. The problem here is that there is no solid data to backup the available strains and it results in a ‘try and see’ approach.

 

Closing Thoughts. Can Probiotics Cure Parasite Infections?

This is the million dollar question. Can probiotics cure parasite infections.

It isn’t a clear yes or no answer.

Since writing this article I have been contacted by a number of different people looking for more information on the use of probiotics in gut infections. As my understanding on the complexity of the gut ecosystem has evolved I now look at the use of probiotics as just one of many approaches to treating gut infections, parasites and bacterial dysbiosis.

A balanced approach of nurturing the gut with prebiotics and probiotics and intervening with well chose herbal antimicrobials appears to have the most success, is best tolerated and minimised damage to the gut microbiome. All good things. For a general overview on the different approaches see – Gut Infections And How To Deal With Them

Now I would like to hear from you. Have you had any experiences with probiotics to help with your health concerns? Share your thoughts below.

 

References and Resources

  1. Blastocystis hominis – A Protozoan Gut Parasite
  2. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection.
  3. Dr. Jason Hawrelak
  4. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders
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37 comments

  1. Hi Todd, thanks for your articles. I’m interested to know what strains you’re referring to in your statement “alternatively there are a number of Saccharomyces boulardii strains on the Australian market that may possibly have similar effects.”

    I’m in Brisbane and I’ve just finished a 10 day course of 3 antibiotics after I became impatient with the lack of success on natural antiparasitic meds for blasto. I’m feeling skeptical the antibiotics have worked, so I’m researching alternative treatments while i wait to test for blasto again.

    I’m also curious as to how your treatment for blasto is progressing. Have you had any luck?

    1. No problem at all. There are a number of available strains. Metagenics does one as does bioceuticals. You can also source them through Iherb from overseas. I have just heard from a company importing the strain referenced above – they are calling their product Yomogi (I’ll update the blog post asap!)
      Unfortunately after a few rounds of antimicrobials I still have blastocystis. I keep feeling like I’ve kicked it, then retest and it’s still there. The herbal antimicrobials have definitely helped immensely and have improved my symptoms in a big way! Still working out the best way forward. It’s a tough one to eliminate.

      1. Great, thanks for the info. There is a compounding chemist in Brisbane who stocks the Yomogi. I’ll look into it.

        Sorry to hear about your lack of success with kicking blasto. It’s such a bugger of a thing! I wish you all the best.

        1. Thanks Gita! Learning lots of life/health lessons with this bug. Still I’ll be over the moon when it’s finally gone!

      2. Hi Todd, I have been trying to find the strain they used in this study Saccharomyces cerevisiae var. boulardii CNCM I-745 in Australia. When I researched the Yomogi website the strain they use is Saccharomyces cerevisiae var boulardii Hansen CBS 5926 have they renamed it or is this not the same strain?

        1. yes apparently they are the same strain. I will be updating this blog article with the research papers that support this claim in the next week.

  2. Hey Todd,
    Any updates as to your recovery? I’ve had BH for 4 months and have also tried many things but still have it. I just purchased the Saccharomyces boulardii today (product name Floristor here in Canada). Praying it will work for me!

    1. Its a tough one to treat. I’ve come to look at the boulardii probiotic as an add on to other antimicrobial herbs, not so much a stand-alone treatment. Still worth a try, as it can help generally.

  3. Can i add here that it is important to NOT take general probiotics while you have Blasto. Blasto feeds on both good and bad so it is best to avoid until after it has been cleared.
    S.bouldarii is the only exception. The dosage for adults should be 500mg (2 caps twice or 3 times per day for at least 2 weeks)1
    It has also been said that antioxidants hinder the elimination of blasto.
    I had success using serrapeptase, pomegranate husk and seed as well as a liver refresh from iherb.

    Unfortunatly i became reinfected so starting the long painful journey again.

    1. very interesting info. I have been reading quite a bit on the pomegranate husk as an effective antimicrobial (did you find a good product?) but haven’t come across blastocystis feeding on the gut microflora.
      Good to hear that the biofilm (serrapeptase) was helpful in your treatment.
      What was the liver refresh product if you don’t mind sharing? I have noticed a number of elevated liver enzymes in people with chronic/long term blasto infection, it seems like a likely correlation.
      Thanks for sharing it greatly helps!
      Todd

    1. If they haven’t advertised the specific strain I would say not. That doesn’t mean that it isn’t helpful it just means that the effects are still unconfirmed. There are two different camps in probiotic research. One that says strain specificity is of utmost importance and the other that disagrees. If you feel like it’s helping then go for it!

    1. This is the big question. Some would say no and cite the huge percentage of asymtomatic people with blastocystis infection (this tends to be the stronger arguement). Others would encourage treatment and are concerned with the possible detrimental effects that blastocystis has even in asymptomatic people. Personally I haven’t made my mind up. Seeing as it is quite difficult to treat (generally speaking) I might lean towards not going on a full eradication program. I might change that opinion down the line though. Sorry for the long winded answer!

  4. How about L Plantarum and L Paracasei? these are 2 strains that are highly researched and have actual human studies behind them for healing many gut health related issues/leaky gut. I was getting very good results with a probiotic with these 2 strains was down to having to crap just once a day until and getting about 6-7 hours sleep until I ate a chocolate easter egg then all my IBS, nausea and stomach grumbling, gas and insomnia came back with a vengence, not gonna go near chocolate again until Im over this thing.

    1. absolutely! Those are a few well researched strains for sure (L. plantarum 299v has some evidence in IBS treatment). I have to circle back and update this article. I’ll be adding in the L. rhamnosus GG and the B. lactis Bb12, both great strains for intestinal imbalances that can accompany blastocystis infections. There are so many great probiotics to choose from!

  5. forgot to mention ive taken SB-Floraactiv before and it didnt agree with me gave me bad skin break outs and terrible insomnia but bowel motions were better.

  6. Hello Todd
    Your articles are really good and thank you. I have had gut issues a few years and recently tested positive for blasto, previous tests were negative. Would like to add the lactulose to my protocol but could only find Actilax at the chemist here in Wollongong, is this the same as lac-dol? Actilax ingredients are each 5ml contains 3.3 gr lactulose and not more than 0.50 gr galactose, .33 gr lactose, 0.50 gr epilactose and others.

    1. Hello eva. Thanks for the kind words!

      Lac-dol is a great lactulose approach (I used that with blastocystis and it helped my symptoms incredibly!). The therapeutic dose is 1 Tbs 2x daily but it isn’t best to start with that dose! Go low and go slow and build up over 2-4 weeks.

      If you do suffer from bloating and distention even from a small amount (I’m talking 1/8-1/4 tsp) of lactulose then there might be SIBO picture for you.

      Circle back and let us know how you went. The more we can share the better 🙂

      Take care

  7. Hi Todd
    I’m new at learning about natural therapies. I have that nasty blasto. Picked it up in Bali. I have been unwell with it and I am currently taking Flagyl. I don’t know what’s worse,flagyl or Anyway, I have just ordered some Yomogi online. Can I take tomography while I am taking flagyl?

    1. Please Michelle under no circumstances take Flagyl. There are countless documented articles on the web indicating that Flagyl will do nothing but make the blast super-resistant, i.e. even harder to eradicate. Prof. Thomas Borody at the Centre for Digestive Diseases has developed antibiotic treatment combinations that will, in most cases, eradicate blasto. I speak from experience, I had blasto 13 years ago, used to weigh 10.5 stone before the infection and dropped to 8.5 stone while infected with extreme abdominal distension and ibs and the worst fatigue and brain fog. After Prof Borody’s treatment, all fine. But seriously, flagyl is the absolute worst thing to take. Best wishes.

      1. Hey Michelle, yes you can take probiotics while taking antibiotics and many times they are recommended and help to increase the antibiotics effectiveness.

        Tony does bring up some valid points on flagyl (metronidazole), still it may work for you if you’ve already started it (here’s an article on some downsides of flagyl https://www.byronherbalist.com.au/parasite-infections/antibiotics-for-blastocystis/)

        Many times there is broader gut dysregulation at work (possibly triggered by the original blastocystis infection), herbs, probiotics (like the one mentioned above and others), prebiotics and fibre can all help to bring everything back into balance.

        Keep us posted on how you make out.

        Todd

  8. Todd, thank you for the informative data re: Saccharomyces boulardii (CNCM I-745) — would you know of a brand or manfacturer of that particular strain for the USA? There are many S. Boulardii products but either they are not that I-745 strain or they don’t indicate at all. I’ve contacted a few manufacturers and they finally email back but it’s not I-745. There’s one product Florastor that contains the right strain but it also contains LACTOSE and I’m highly lactose intolerant.
    Any advise would be GREATLY appreciated.

  9. I found a product called
    “Candida Remove” sold by a firm in America
    With rave reviews helping with Blastocystis
    What do you think?

    1. Hey aileen. There are a few reasons why I would avoid that particular product. The first one is that it contains grapefruit seed extract which is a contaminated product and can do some serious damage to your gut microbiota (more here https://www.byronherbalist.com.au/gut-health/sibo-complete-guide/#53-herbs-to-avoid). The second is the oregano oil. It is not a contaminated product but is extremely broad acting and can do some irreparable damage to your gut flora too.
      I prefer whole herbs (generally in tincture form) but realise that blastocystis can be very difficult to eradicate. Sometimes we blame blastocystis for other digestive dysregulations, that’s why it is so important to work with a quality practitioner!

    1. Hi David,

      Yes you are correct it does appear to be the same strain. There are a few reasons why I would point people towards florastor or perenterol depending on where you are located.

      Number one would be the lactose in the yomogi probiotic. It is a low dose but many patients with sensitive guts could possibly react. Perenterol also has lactose but florastor doesn’t.

      The second is questionable ingredient titanium dioxide found in Yomogi. This is generally regarded as safe and is used as a food whitener in many processed foods but I wouldn’t recommend consuming it and there have been some issues raised around its safety (here – https://www.smh.com.au/business/consumer-affairs/titanium-dioxide-food-additive-under-review-after-study-finds-cancer-links-20170127-gu03ao.html and here – https://www.foodnavigator.com/Article/2019/05/15/Is-titanium-dioxide-safe-to-eat-Fresh-research-raises-concerns-over-E171).

      That could me being overly cautious but I prefer not to consume food additives and wouldn’t recommend my patients to either.

      Thanks for taking the time to comment 🙂

      Todd

  10. Thank you for all of the information here. I currently have BH and have been diagnosed with Crohn’s disease. My current functional medicine doctor has me on Candibactin AR and Candibactin BR, Zinlori 75, and prebiotic fiber powder. I am finding that after just two weeks of this treatment approach I am having stomach sensitivities. The Candibactin-AR causes stomach distress at 4 capsules a day, so I now only take 2 a day and seem to handle it now. I have to take Zinlori with a snack, otherwise I get an upset stomach. I also get terrible gas and stomach gurgles when using the prebiotic fiber (only using 1/2 tsp). What do you think about this approach/supplements? I am feeling better other than the side effects from them. I have been reading a lot about soil based organisms and was thinking I may try Livespo colon. Now, that I have read this information I may try some of the probiotics mentioned above. Would you also recommend a multi-vitamin? Any suggestions would be greatly appreciated. Thanks!

    1. Hi Alisha, it sounds as if you have a great practitioner. The prebiotic addition is very important, but can be tricky to implement. Some patients tolerate some prebiotics, and other patients don’t tolerate the same ones at all! Very tricky. I appreciate that you are starting small. Sometimes I start very sensitive patients off with a pinch and keep them there for weeks. It is such a key part of my approach!

      I don’t have much experience with soil based probiotics. I don’t believe they are accessible to practitioners here in Australia (we have strict supplement regulations here).

      One biomarker that I don’t see often tested for in my patients with Crohn’s disease is the antibodies to Saccharomyces cerevisiae. Not every Crohn’s disease patient has this issue but if you do then removing yeast and even mushrooms from your diet can be a real gamechanger!

      More on the extensive research here –

      https://scholar.google.com.au/scholar?as_ylo=2016&q=saccharomyces+cerevisiae+and+crohns&hl=en&as_sdt=0,5&as_vis=1

  11. Ok I’m really confused as to where to start treating my BH and dientamoeba. Could you point me towards a good product or products to start please?

    Thank you. Great info here.

    Lisa.

    1. Hi Lisa, I very much recommend working with a skilled clinician when you are treating chronic digestive health issues. Many times other infections or overgrowths are at play with blastocystis and dientamoeba.

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