Svag
Gør probiotika noget for humøret?
Meta-analyserne er svagt positive. De bagvedliggende studier er små, korte og så heterogene, at svag positivitet er, hvad man ville forvente, selv hvis intet virkede.
Hvad metaanalyserne viser
Poolede analyser af probiotika, præbiotika og synbiotika for symptomer på depression og angst rapporterer små positive effekter [1][2][4], og et systematisk review kommer frem til forenelige konklusioner [3]. Taget for pålydende er det et positivt fund.
Set i lyset af studiernes karakteristika er det meget svagere. Studierne er små, korte, bruger forskellige stammer i forskellige doser og måler symptomskalaer i ikke-kliniske populationer, hvor regression mod middelværdien er betydelig. Små positive poolede effekter fra en litteratur med disse egenskaber er præcis, hvad publikationsbias producerer.
Probiotika og humør
Stammeproblemet
Dette er det problem, som den forbrugerorienterede dækning oftest overser. Lactobacillus rhamnosus GG og Bifidobacterium longum 1714 er forskellige organismer med forskellige metaboliske output. Evidens for den ene siger ikke noget om den anden, ligesom evidens for ét antibiotikum ikke overføres til et andet.
De fleste produkter i almindelig handel angiver kun slægt og art uden en stammebetegnelse, hvilket betyder, at man ikke kan matche dem med noget studie, selv hvor et relevant studie findes. Et produkt, der ikke navngiver stammen, har i praksis ingen evidens.
Hvor probiotika faktisk har bedre evidens
Litteraturen om humør er den svage ende. Der findes stærkere anvendelser, og det er værd at være tydelig om forskellen:
- Antibiotikaassocieret diarré. Rimelig evidens, specifikke stammer.
- Forebyggelse af rejsediarré. Metaanalyseret med moderat effekt — se vores rejsemedicin-side.
- Kolik hos spædbørn, for bestemte stammer.
- Pouchitis efter kolektomi, hvor evidensen er relativt stærk.
Det, disse har til fælles: en specifik tilstand, en specifik stamme og en plausibel kort årsagskæde. Humør har ingen af disse.
Hvad man kan gøre i stedet
Fodr de bakterier, du allerede har. Fibre og fermenterede fødevarer ændrer mikrobiomet mere pålideligt end at sluge en kapsel med organismer, der for det meste ikke koloniserer — se fibre. Det er mindre sælgbart og betydeligt bedre understøttet.
Ofte stillede spørgsmål
Bør jeg tage et probiotikum?
Koloniserer probiotika min tarm?
Er yoghurt lige så god?
Hvad med afføringstransplantation?
Relateret læsning
References
Every citation below links to the original peer-reviewed record on PubMed or via DOI. Nothing here is a substitute for medical advice.
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