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L. casei subspecies Shirota augments the immune response

By Dr. Davis | March 23, 2020 16 Comments

Enhancing our immune response is a worthwhile strategy to protect ourselves against viral infections, whether flu, rhinovirus (common cold), or coronavirus (COVID-19).

I’ve talked previously about how the basic Wheat Belly strategy of wheat/grain elimination reduces metabolic endotoxemia provoked by the gliadin protein that increases intestinal permeability; how wheat/grain elimination and sugar limitation avoids the drop in immune response that follows high blood sugars; how vitamin D restoration restores T-cell immunity against viruses (as well as against autoimmune conditions and cancers).

I’ve also discussed how our L. reuteri yogurt, because it provokes hypothalamic release of oxytocin, may reverse thymic involution of aging, i.e., atrophy of the thymus gland in the chest that is the seat of T-cell immunity. Thymus gland atrophy is responsible for immunosenescence, i.e., loss of immunity with aging. So far, every observation surrounding L. reuteri and oxytocin made in experimental models has held true in humans: accelerated skin healing, augmentation of dermal collage deposition. reduction in appetite (anorexigenic effect), etc. It is therefore likely that this aspect of oxytocin likely applies to humans, too, though not yet fully corroborated. I’ve also discussed how reducing/eliminating another cause of metabolic endotoxemia, SIBO (small intestinal bacterial overgrowth), also reduces body-wide inflammation that impairs immunity.

I’d like to further explore another immune system-building strategy: cultivating the probiotic bacterial species Lactobacillus casei subspecies Shirota. Human clinical trials have demonstrated marked enhancement of the immune response accompanied by reduced susceptibility to respiratory infections and accelerated recovery should infection occur.

Among the effects, both immune-enhancing and otherwise, of administration of L. casei Shirota include:

    • Several studies have demonstrated reduction in wintertime respiratory illnesses by over 50% and abbreviated duration of infections by 50%. Increase responsiveness of pneumonia when L casei Shirota is added to conventional antibiotics. Reduced duration of fever by 50% during norovirus infection among elderly residents of a retirement center. Enhanced immune system function includes increased protection provided by natural killer cells (that play an important role in cells that become infected with viruses) and increased anti-inflammatory IL-10.
    • L casei Shirota reduced incidence of pneumonia (48.6% vs. 14.3%) and diarrhea when administered to patients on ventilatory support
    • Reduction in perceived pain and disability over six months of supplementation, as well as inflammation marker C-reactive protein, in people with knee osteoarthritis
    • Improves efficacy of efforts to eradicate H. pylori from 76% to 94%
    • Accelerated recovery and improved healing in elderly people with radial (forearm) fractures
    • Reduced inflammatory markers (e.g., reduced IL-1 beta and increased anti-inflammatory IL-10) in the nasal mucosa, saliva, and blood in men after running a marathon (notably, achieved with 40 billion CFUs per day)
    • Reduced anxiety in people with fibromyalgia and chronic fatigue syndrome
    • Protects the body from developing insulin resistance
    • Reduced abdominal discomfort, blunt the rise in cortisol and prevent the decrease in bacterial species diversity associated with stress
    • Reduced constipation and increased regularity
    • Improvement in symptoms of irritable bowel syndrome and reduction of breath hydrogen gas (indicative of SIBO) with L. casei Shirota

Above (from Shida 2017) illustrates the reduction in upper respiratory tract infections (URTI, influenza, common cold, others) in men given 100 billion CFUs L. casei Shirota vs. placebo over about 3 months (the magnitude of bacterial counts, by the way, achievable by our own fermentation efforts, below, virtually impossible with commercial products available to us), demonstrating a reduction in infections by about half. (Bolder graph shows the L casei experience.) Not shown is the marked reduction in duration (5.0 vs. 2.8 days per episode), though not in severity.

One potential downside: Many of these studies were funded by the manufacturer of L. casei Shirota, introducing potential financial bias. However, I did not list the studies that demonstrated negative effects such as no reduction in allergic rhinitis and no improvements in blood sugar and measures of insulin resistance (including HbA1c, HOMA, fasting insulin) in obese pre-diabetic males, suggesting that there was no push to only publish positive outcomes. There is, no doubt, potential for bias but the weight of positive evidence that all point in the similar direction of enhancement of the immune response and reduction of inflammatory biomarkers suggest that these are likely genuine findings.

This strain of L. casei is commercially available in the U.S. as the Yakult brand of probiotic beverage, available through selected retailers, only having been introduced on a national basis since 2019. (Here is a store locator.) As with most commercially-prepared beverages, the manufacturer of Yakult does stupid things like use non-fat dairy and add sugar, so I would not recommend consuming Yakult off the shelf. I would instead suggest getting hold of some of the product, then making yogurt (or other fermented product) yourself. And we, of course, do not subscribe to typical yogurt-making rules and instead 1) ferment for extended periods of 24 or more hours and 2) ferment in the presence of prebiotic fibers to increase bacterial counts and richness of the end-product. Each 80 ml (2.7 ounce) bottle (5 servings) contains 6.5 billion CFUs of L. casei; a tablespoon or so provides more than enough to get you started, but may not be enough for effects such as protection from upper respiratory viral infection. Making “yogurt” from it therefore yields a bacterial count amplification system.

 

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Filed Under: News & Updates Tagged With: bowel flora, probiotic, undoctored, wheat belly

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About Dr. Davis

Cardiologist Dr. William Davis is a New York
Times #1 Best Selling author and the Medical Director of the Wheat Belly Lifestyle Institute and the Undoctored Inner Circle program.

Nothing here should be construed as medical advice, but only topics for further discussion with your doctor. I practice cardiology in Milwaukee, Wisconsin.

Comments & Feedback...

  1. John Kenney

    March 23, 2020 at 4:42 pm

    Sounds promising, but closest retail location is nearly 50 miles away.

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    • Bob Niland

      March 23, 2020 at 8:47 pm

      John Kenney wrote: «Sounds promising, but closest retail location is nearly 50 miles away.»

      40 here, but we’ve ordered some for curbside pickup anyway.

      It’s worth mentioning that unlike most of the Biogaia® products, this Yakult® probiotic is refrigerated in the retail chain of custody, and not suitable for mail-order (even with a reseller willing to ice-pack; due to massive uncertainties in the delivery networks at the moment).
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  2. Mary Sexton

    March 23, 2020 at 8:49 pm

    So would this replace l-reuterie yogurt or could they both be consumed anytime?

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    • Bob Niland

      March 24, 2020 at 9:21 am

      Mary Sexton wrote: «So would this replace l-reuterie yogurt or could they both be consumed anytime?»

      L. Casei Shirota is not a replacement for L. Reuteri. They make separate fermented foods with their own separate, perhaps overlapping, benefits.
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  3. Jeanne Shepard

    March 24, 2020 at 8:56 am

    Can these two strains of probiotic be combined when making yogurt?
    I asked this before; no response.

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    • Bob Niland

      March 24, 2020 at 9:22 am

      Jeanne Shepard wrote: «Can these two strains of probiotic be combined when making yogurt?»

      Mix as desired after fermenting, and don’t use the resulting mix for starter until more is known (at which time the answer still may be: don’t mix strains pre-ferment).

      re: «I asked this before; no response.»

      That’s because someone else had asked the same question on that post, about 7 hours before you did, and it had already been answered.
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    • Dan

      March 24, 2020 at 9:23 am

      No, make separate like your L. Reuteri Yogurt but ferment maybe an extra 24 hrs.

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  4. Mary Sexton

    March 27, 2020 at 12:19 pm

    How much of the l casei is needed to make quart of yogurt? Do I use insulin for this just as I do for the l reuterie yogurt?

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    • Bob Niland

      March 27, 2020 at 1:41 pm

      Mary Sexton wrote: «How much of the l casei is needed to make quart of yogurt?»

      Dr. Davis suggests 1 tbsp. (presumably per quart) in the article above. That’s what I used for my first batch, still brewing.

      re: «Do I use insulin for this just as I do for the l reuterie yogurt?»

      Inulin? Presumably. I did. Searching the literature so far hasn’t turned up insights on whether some other prebiotic would make a more ideal buffer.
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  5. SuperBoppy

    January 18, 2021 at 1:39 pm

    What is the recommended temperature for cultivating l. casei?

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    • Bob Niland

      January 18, 2021 at 8:30 pm

      SuperBoppy wrote: «What is the recommended temperature for cultivating l. casei?»

      105°F (40.6°C).
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      • SuperBoppy

        January 18, 2021 at 9:09 pm

        I presently culture the l. reuteri at 100F, so I suppose I would not be able to culture it and the l. casei at the same time – I would have to culture them at separate times, since I would be nervous about culturing the l. reuteri at 105F.

        BTW, do you know if is 105F typical for cultures in commercially made yogurts, and can they be cultured successfully the Wheatbelly way with the multiple cultures present in them (e.g. Dannon, Chiobani, etc)?

        Thanks for your response. I know you have a lot of knowledge in these things.

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        • Bob Niland

          January 18, 2021 at 10:04 pm

          SuperBoppy wrote: «… since I would be nervous about culturing the l. reuteri at 105F.»

          The Undoctored program has an experimental blend, including L.r, which is run at 106°F.

          These cultures have an inverted U-shaped growth rate response. On the low side, they just fall off to nil growth at freezing. On the high side, there’s usually a cut-off, above which the cultures expire. For L.r, that’s around 122°F.

          re: «… is 105F typical for cultures in commercially made yogurts…»

          As I understand it, more typically 105-115 (which is why non-adjustable standard yogurt makers are often unsatisfactory for our purposes). Retail yogurts also use a relatively short ferment time, and may add sugars after the ferment.

          re: «…and can they be cultured successfully the Wheatbelly way with the multiple cultures present in them (e.g. Dannon, Chiobani, etc)?»

          Not sure I understand the question.
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          • SuperBoppy

            January 19, 2021 at 7:47 am

            My last question I was not, perhaps, totally clear on. Dr. Davis discourages mixing cultures to make yogurts, especially with l. reuteri (for good reasons, I agree), yet commercial companies sell yogurt with multiple cultures included in them. Are these companies culturing the bacteria strains separately, then blending them together post culturing to create a multi-cultured yogurt, or do the cultures typically found in their yogurts “get along” with each other when culturing? I suppose they do, since numerous “how to” videos can be found on making your own yogurt from commercially available yogurt.
            I ask this because, in the past, I have made yogurt from a commercial brand. It started out well, but after several times making it, it seems to develop an “off” flavor to it, so I stopped making it. BTW, this commercial yogurt had six strains in it, including l. casei (although it probably wasn’t the “Shirota” strain – it didn’t specify). I think my mistake was that I was culturing it at the 100F, the same temp I use for the l. reuteri, and not 105F or higher.
            Anyway, this is why I was asking the question. I do like to eat regular yogurt once in a while to provide support for the “regular” bacteria found in most peoples system, and making it the Wheatbelly way seemed the logical thing to do to make it most effective.

          • Bob Niland

            January 19, 2021 at 10:43 am

            SuperBoppy wrote: « Are these companies culturing the bacteria strains separately, then blending them together post culturing to create a multi-cultured yogurt, or do the cultures typically found in their yogurts “get along” with each other when culturing?»

            My guess is that they are {usually} fermented from the separate cultures added at the start. Keep in mind, of course, that yogurt is a traditional food, and that the tradition likely relied on arbitrary environmental bacteria. Modern retail foods are constrained by legal definitions, so restricted to specific bacteria and strains, as well as hygiene practices. Volume product could be using any number of tricks.

            When I make a blend, I use separate saved starter of each bacterium required, and don’t try to use saved blend as starter — it might work, but I haven’t tried.

            re: «…but after several times making it, it seems to develop an “off” flavor to it, …»

            Using retail cultures in an extended-time process + prebiotic introduces variables I can’t predict. Using a generational method raises the question of ideal temp, and bacterial competition.
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    • Dan

      January 19, 2021 at 7:55 am

      For convenience I ferment L. Casei, BNR17, and GBI30 at 110 F for 48 hrs. Works for me

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