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Thanks to KeithJVaz bringing the 2nd Microbiome Medicine Summit to our attention, I have listened to some fascinating talks. It was driven home, again and again, that up to 80% of our immune system is based in the gut so working to optimise gut health could not be more important for those of us with an auto-immune disease.

One of the most memorable talks was by Dr Marco Ruggiero, formerly Professor at the University of Florence, Italy, on the subject of delivering probiotics to the body.* Basically, the way we take our probiotics makes a huge difference to how effective they are going to be. In a nutshell, the probiotics need to be delivered to the body within a living culture to be fully effective. Swallowing a capsule of freeze-dried probiotics might make a small positive difference, but will have nowhere near the impact of the same probiotics being consumed within a medium in which they are actively functioning. There is probably no finer example of such a mediums than the mix of colostrum and milk a new-born mammal receives from its mother's breast - it's a potent powerhouse of probiotic stimulus. This post is about how we can re-create that.

The short version
1) Go to bravo-europe.com, find a supplier in your area, buy the fermented fruit juice kit and follow instructions
2) Buy - or even better, make - your own kombucha or (coconut) water kefir. When it has brewed to the strength you like, remove the grains along with any lemon, dried fruit , ginger etc. Start a secondary fermentation (there is lots of Information available online about this). Add the appropriate quantity of your chosen probiotic (I make a 3 day batch at a time). If liquid, pour in / if in capsule form, pull open capsule and sprinkle in. Add chondroitin sulphate (again, I use a 3 day dose). My chondroitin comes as a tablet so I pound it into a powder in a pestle and mortar (putting the tablets into a bag and bashing them with something heavy would work as well). Add the chondroitin sulphate powder to the liquid & probiotic mix. DO NOT OMIT THE CHONDROITIN - IT'S REALLY IMPORTANT. Leave the mixture to continue fermenting at room temperature for 24 hours. Refrigerate and drink over three days. Don't eat anything sugary at the same time. Don't forget to get a new batch going.

The longer version
A team of Canadian researchers were working with a group of HIV positive people in East Africa. With HIV, a virus renders the immune system inactive. To cut a long story short, the researchers decided to find out if improving the gut health would help the target group. They taught local women to make a live probiotic yoghurt and had staggeringly successful results. The HIV positive people who consumed the yoghurt had test results at least as good as when they had been on anti-viral drugs. The researchers published their results, expecting much praise for the low-cost strategy and brilliant results but were roundly criticised for suggesting a strategy that required cumbersome appliances like refrigerators in a tropical climate. The researchers returned to their laboratory and freeze dried the same probiotics and packaged them in capsules before returning to East Africa and dispensing the capsules to their target group. The results were dismal. There was a tiny improvement with the freeze dried probiotics but nowhere near the impact of the same probiotics delivered in a Iive yoghurt.

The same technique of delivering probiotics in a live culture has since been used on subjects suffering a variety of neurological conditions, including Alzheimers, with - according to Dr Ruggiero - astonishing results. Dr Ruggiero has hundreds of academic papers to his name, so for full details, one would have to search his publications.

Fortunately for us, the talk recorded for the 2nd Microbiome Medicine Summit dealt with how we derive the same benefits if we do not consume dairy products. The answer is to go back to the first days of life, when our fledgling immune system was first formed. The first substance a new-born mammal receives from its mother is not milk. That may take a few days to arrive. Instead, the baby receives colostrum - a clear liquid that is stuffed with immune-system stimulating substances. Gradually milk is added to the flow. What the breast-fed baby receives is not sterile. In passing through the mother's body bacteria are added. While colostrum does not ferment, milk does and the baby's gastro-intestinal tract starts to act as mini bio-reactor. It used to be thought that the human brain was sterile but within the last couple of years it has been discovered that the human brain contains bacteria and has a micro biome all of its own. It is the macrophages that are generated in the baby's gastro-intestinal tract that are responsible for transporting bacteria to the brain.**

The question Dr Ruggiero and his research team asked themselves in relation to the question of an efficient way of delivering probiotics without recourse of dairy products was which of all the molecules in the colostrum were primarily responsible for the immune-stimulating properties and how could this be regenerated? The answer they came up with was chondroitin sulphate, a common supplement found in health food shops. The microbes metabolise the chondroitin to make oligosaccharides which then stimulate macrophages which then carry microbes through to the brain.

This finding essentially means that we can re-create the formation of human micro-biome at birth, make it at home and drink it every day.

Since his retirement, Dr Ruggiero has set up a company in Switzerland - bravo-europe.com - that sells the kits to make both dairy and non-dairy versions of probiotics to be consumed in line with the above principles. The Bravo-Euope.com website has links to distributors around the world.***

In his talk for the 2nd Microbiome Medicine Summit, Dr Ruggiero also made clear, however, that one could easily create a non-dairy version of this super-charged probiotic drink at home. it essentially involves adding a portion of the probiotics that are important the human micro biome to a fermented drink like water kefir (or kombucha), adding chondroitin sulphate and allowing the mix to ferment for a further 24 hours at room temperature, before refrigerating and drinking on a daily basis.

Which takes us back to the short version at the top of this page. That describes what I started doing a couple of weeks ago:

Kefir: I bought my kefir starter grains from happykombucha.co.uk, and followed the instructions that came with the kefir grains
Probiotics: I buy Bio-Kult probiotics from Amazon. I also currently add a daily dose of 5ml B. clausii****
Chondroitin sulphate: mine comes from Healthspan.co.uk (who ship worldwide)

I let my kefir ferment for 2-3 days, remove the grains and start a secondary fermentation with a new supply of dried fruit or apple juice. At the same time, I add the probiotics & chondroitin and let the mixture stand at room temperature for the another day or two of fermentation before refrigerating and drinking.

I carry out a fair amount of experimentation on my long-suffering body and have learnt the hard way that it pays to introduce innovations gradually. I am now up to two glasses of kefir a day (half kefir, half sparkling water) but I would advise anyone starting a regime like this to start with a small quantity and build it up.

Good gut health to one and all,


* The talk by Dr Ruggiero was only available to listen to for free during the event but is most likely still available to purchase through the organiser's website: http://microbiomemedicinesummit.com

** Listening to Dr Ruggiero talking about the huge significance of the colostrum in these first few days of life for the formation of the immune system made me wonder how many of us with MS might have missed out on these crucial first days of breastfeeding, and whether this plays in a role in the likelihood of developing MS? I found a discreet way of asking my mum if I was breastfed (no need to make her feel bad) and learnt that I wasn't. Apparently the matron in the maternity home decreed that I was no heavier after an initial feed and therefore put me on bottled milk. Interestingly, Dr Ruggiero touched on this very subject in his talk - saying that mothers frequently worried that their newborns were not putting on weight in the initial days but that this was perfectly ok. The weight gain would come once the milk started flowing.

*** Both the main Bravo-Europe site and some of the distributor sites, like the UK one, carry a lot of helpful information (including the advice to hold the probiotic mix in the mouth for a minute before swallowing). While the information on the Bravo-Europe pages is obviously all about working with the kits they sell, there are useful tips we can learn from if we want to make own fermented probiotic drink.

**** Bacillus clausii is available from the Italian company Sanofi and marketed under their Enterogermina label. They have several products that all carry the Enterogermina label so it"s important to check the small print. Bacillus clausii is sold as a liquid suspension in packets of 20. Each 5ml dose contains 2 million Bacillus clausii. One takes a 5ml dose 3 times a day - dissolved into a bit of liquid and taken with food - for 4-6 weeks and then continues a maintenance dose of 5ml a day. Enterogermina is available to buy without prescription in Italy, where it has been freely available for 60 years. It should also be available to buy over the counter in the US. It is not licensed in the UK for some reason, so I had to order it from Italy:

http://www.farmacia-ciarcia.it/en/farma ... results=13
The Gut Microbiome is KEY to optimal health.
The OMS site & forum are brilliant! Thanks, everyone! :D
A big thank you for the time and effort you have putting into researching and posting for the good or our health. I was wondering if you have noticed any improvements since starting your regime? I suffer with symptoms of irritable bowel and am interested to try your technique.
Hello Joy,

I am glad you found the information of interest! You ask if this probiotic regime might conceivably help you with IBS symptoms and the answer has to be a resounding YES.

One of my nearest and dearest has struggled with very debilitating IBS for many, many years. We have tried countless approaches and treatments and the only thing that has ever made any lasting positive difference has been changing the bacterial balance in the gut. We once did this with a DIY FMT (faecal material transplant) and the results were staggeringly successful and lasted well over a year. Full details of how we went about it are in a post in the 'Love your gut' thread of the Microbiome forum. A year or so later, the IBS started to make a return. A suitable donor was no longer available, so we started experimenting with probiotics. The regime we hit on - before I listened to Marco Ruggiero's talk - was simply to mix the contents of probiotic capsules into a 3 day portion of live goat yoghurt which the (ex) IBS sufferer ate every morning. It took a few weeks but the IBS has gone and he is symptom-free. Eating a dairy yoghurt is obviously not an option for you, or anyone with MS who is following the OMS regime.. According to Ruggiero, you could achieve the same results by filling suppository capsules with the probiotic yoghurt mix and going about things 'from the other end'. The casein molecules are apparently too big to pass through the gut lining, so this method should be safe for people with dairy intolerance etc.

Or you could go down the route I outlined in the post above. I am fortunate enough never to have experienced full-blown IBS but I have had unsatisfactorily loose movements, bloating, flatulence and rather horrid urgency issues. At I write, these problems are all in the past and I am currently as regular as clockwork and performing to A* standards!

This follows six months of a lot of attention to gut health including drinking home-made kefir every day. Three or four months ago I started taking probiotics in capsule form. A couple of months ago I started emptying the capsule contents into my kefir and drinking it straight away. A few weeks ago I started carrying out the process described in the post above, of letting the probiotics and chondroitin ferment in the kefir for the last 24 hours of brewing.

Having only been on the latest version of the regime a couple of weeks, it's probably a bit too early to judge how well it's working for me. I am by no means free of MS symptoms but 3 positive things have happened in the last 10 days: a) I have been able to halve my nighttime dose of painkiller + muscle relaxant (and still get good sleep!); I am feeling more 'can do' and have embarked on tasks and activities that have been off-liimits for several years; yesterday I received comments to the effect that I seemed to be walking much better.

It is on my 'To Do' list to write a longer post on a) IBS and what we have learnt over the years and b) Healing the gut. Got far more going on in my life at the moment than I would ideally like but hopefully I will get to these posts before too long.

In the meantime, I do hope you achieve some improvement if you decide to try the probiotic regime.

All the best,

The Gut Microbiome is KEY to optimal health.
The OMS site & forum are brilliant! Thanks, everyone! :D
Hi Jette,

Just a quick note to say thank you for posting the above. Since starting OMS, my stomach has been unhappy, so I've ordered my kefir grains and I'm going to give this a go and see how it goes.

Thanks again
Hi Jette,
Thanks for taking so much trouble to post the findings of all your research - no small task! I appreciate it - it stops me floundering around trying to find the information for myself. There's a lot out there.......
I'm sure that others appreciate it as much as I do!!
I to would like to add my thanks!

It's also very important to keep in mind that many beneficial bacteria species for your microbiome can be introduced by making a variety of cultured vegetables and other fermented foods, such as freshly caught fish and then fermented. This is one of the best ways to ensure that your body gets a good variety of probiotics and also has a decent chance of having those probiotics get absorbed through the digestive process, rather than simply rely on probiotics that gave been "processed." Eating a variety of cultured foods is the key--both veggies that grow undergrown and above ground (carrots, beets, onions, cabbage, green beans, cucumbers, herbs, etc.) Better yet is to use organic vegetables that you grow yourself or come from a trusted source. Lightly wash them off and use them to make your fermented foods. This ensures that you have a chance of also introducing good "soil" based probiotics, which are becoming more and more important.

To also increase the staying power of the probiotic foods you consume it's also important to consume enough variety of prebiotic foods. One good goal is to try to consume a few different prebiotic foods each day.
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