ere is My Question:
Probiotics in general are not recommended in cancer patients who are immunocompromised due to the potential of probiotics to cause infections r/t to the bacteria in the probiotics. Would that be true for MS patients who are on disease modifying drugs, especially if the WBC and absolute neutrophils have dropped with therapy? It seems patients on DMD's are potentially at risk for infection and probiotics might increase the risk.
Most individuals are not at risk for infection due to probiotics; however, your point that this may not be the case in individuals on disease modifying therapies is valid. With that said, my review of the literature does not address this question very well.
Early clinical research with small cohorts seem to be well tolerated among MS patients, and in some cases seem to influence the expression of the immune system in a favorable way (https://www.ncbi.nlm.nih.gov/pubmed/29679417). More research with larger cohorts and longer duration of exposure to probiotics will be necessary to better understand the risk of infection in this setting of MS on disease modifying therapy.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
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