Probiotics can be an important part of healing after Covid

Researchers are finding that Covid can disrupt your gut bacteria, and this can have many downstream effects. The gut microbiome is an important part of the immune system.

Consider taking this probiotic

Multiple studies have shown that Covid can significantly reduce the presence of Lactobacillus Rhamnosus, a "friendly" bacterial strain. Research suggests that taking a course of this probiotic can help modulate your immune system and reduce inflammation.

This probiotic is widely available with a well-established safety profile, spanning many years.

It's important to read the ingredients to ensure Lactobacillus Rhamnosus specifically is in there. (Any brand should work, but check ingredients carefully because there are many other types of the Lactobacillus family.)

You can find it commonly at online stores including here or here.

Take the probiotic for 6 weeks, but not longer.

Covid causes gut microbiome disruption

A recent study published in the scientific journal Gut says the microbiome of patients with Long Covid were characterized by higher levels of R. gnavus, B. vulgatus and lower levels of a key bacteria called F. prausnitzii. Persistent respiratory symptoms were correlated with opportunistic gut pathogens, and neuropsychiatric symptoms and fatigue were correlated with hospital-acquired gut pathogens, including C. innocuum and A. naeslundii. Butyrate-producing bacteria, including B. pseudocatenulatum and F. prausnitzii showed the largest inverse correlations with PACS (Long Covid) at 6 months.

F. prausnitzii: sentinel of the gut

Faecalibacterium prausnitzii has emerged as a “sentinel of the gut,” and may be a next-generation probiotic in gut disease improvement. You can't get an F. prausnitzii probiotic per se, but you may be able to increase your levels by taking prebiotics (such as inulin-type fructans, GOS supplements), Kiwifruit (such as Actazin and Livaux), B. longum (widely available in Align 24/7 Digestive Support) and B. coagulans. Also, consider increasing fiber in your diet and consuming less meat.

Butyrate supplements

Low butyrate levels may contribute to disruption of gut bacteria. Microbial diversity, in particular the diversity of the phyla (Bacteroidetes, Firmicutes) associated with single-chain fatty acids (SFCA’s) like butyrate, has been positively associated with total sleep time and sleep efficiency.

Dr. Leo Galland suggests taking a course of sodium butyrate, which is a short-chain fatty acid "prebiotic" that can foster good gut flora. It's commonly available at supplement stores or online.

Other gut supplements to consider

If you develop diarrhea or abdominal pain, Dr. Galland recommends taking a 1 month course of a probiotic called Tundrex. I haven't tried it myself but you can order it online from the manufacturer.

Look for side effects

Be careful; I suspect in some cases that taking over-the-counter probiotics for too long could result in symptoms that look like a fungal infection. Don't go overboard.

A more precision approach: Custom probiotics

There may be other changes to your gut microbiome. Everyone is different. If you continue to have digestive issues, you may benefit from submitting a stool sample for bacterial analysis and potentially taking custom probiotics. This is a little more involved, and costs are generally not covered by insurance. Read on for my experience with custom probiotics.

In 2021 I had my gut microbiome analyzed by two different companies: Ombre (formerly Thryve), and Floré by Sun Genomics. Both were good, but their services are slightly different.

In both cases you order online, and they ship a test kit in the mail. You capture a stool sample and send it back to their lab. (Of note: Ombre's test kit was easier and less "icky" than Sun Genomics.)

After a few weeks you get an online report with details about your gut bacteria. The report can be enlightening in some ways, but also vague in others. (Don't expect a smoking gun; instead you're more likely to find clues that can help you along your path to better health.)

Once you have your results, both companies want to sell you a subscription to their "custom" probiotics, based-on your gut bacteria. But there's a key difference between them, and it's not immediately obvious. Ombre basically assigns you to the closest match from their pre-made probiotic blends. With Sun Genomics, you get a unique blend created just for you.

In the end, I decided to continue with Sun Genomics, because I like that the probiotics are very customized. They can also adjust your blend over time. I especially liked that their subscription includes a free phone consultation with a gut expert (not just a customer service rep, but an actual specialist). The lady I spoke to was literally a biology scientist. You just have to ask for it.

Admittedly, these monthly subscriptions aren't cheap, but they both run specials all the time. You can also try canceling just for the sake of canceling -- they'll likely offer additional discounts to persuade you to stay.

See also: Exploring Probiotic Options with Flore: A Guide to Maximizing Benefits and Minimizing Costs

I don't plan to keep my subscription forever -- just until my health (hopefully) stabilizes. With Sun Genomics, you get a free test every 4th month. So after the next test, I plan to screenshot my results and cancel the subscription.

There's one more way to tackle this: get a test, then cancel your subscription immediately and find your own probiotics cheaper. (It's not as personalized but depending on your test, it might be just as effective.) If you decide to go this way, Ombre might be a better choice because you can download a complete list of your bacteria sequencing.

Some of the bacteria are well-known and are pretty clearly "good" or "bad" and your report will tell you if you have too little (or too much) of them. Depending on the bacteria, you can buy probiotics much cheaper elsewhere. But there's *lots* of nuances and exceptions to this route and it really requires reading the small print on product labels.