The Colon Club

Hi all. Title explains it all. I have been seeing conflicting data (well not super hard evidence since they aren’t from trials). Any opinions on this? I used to take probiotic pills while on Keytruda but stopped them now. My response on Keytruda has been splendid. Now just loading up on “natural” probiotics like Kimchi, yogurt etc.

Do it. When I lived in Korea I couldn’t stand kimchi, now that I don’t, I can’t get enough of the stuff. Then again, Keytruda didn’t work for me.

There is limited data but here is my take:

Store bought commercial probiotics are likely almost entirely junk since they aren’t refrigerated, so they are mostly dead.

The data that does exist shows immunotherapy response is correlated with micobiome diversity. If you load up your biome with bugs that aren’t supposed to be there (eg lactobacillus). These bugs will crowd out a lot of other bugs and actually decrease your biome diversity. So I would be very cautious (and have have heard experts express the same concerns) regarding taking probiotics.

However, In theory taking “pre-biotics” (pretty much everything that gets eliminated in the FODMAP diet) will feed your gut bacteria and should encourage a more diverse flora. Fermented foods like kimchi should be full of pre-biopics and pro-biotics. I would eat them, simply because they are yummy.

The best way to increase your biome diversity is likely a fecal transplant - but these would need to be repeated too often to be practical. Maybe the best way to get a healthy biome is via the fecal-oral route the same way our ancestors maintained a healthy biome. You can figure out how one would do this, but no need to get into too much detail here.

Again, this is largely my opinion. There is very little data to support it.

plastikos wrote:Hi all. Title explains it all. I have been seeing conflicting data (well not super hard evidence since they aren’t from trials). Any opinions on this? I used to take probiotic pills while on Keytruda but stopped them now. My response on Keytruda has been splendid. Now just loading up on “natural” probiotics like Kimchi, yogurt etc.

My oncologist stopped my probiotics once I started with nivolumab.
I only take aspirin and an occasional course of vitamin d.
Beside this I try to stick to a vegan diet.

Not immunotherapy-related, but I've been prescribed 14 days of Florastor probiotic (available over the counter in the US) to help me recover from c diff, in addition to vancomycin. I was surprised that it isn't refrigerated, but it certainly doesn't seem to be hurting any. My sense of taste had been knocked for a loop and my tongue had turned dark green, and coffee tasted truly horrific. Within probably 5 days of starting the florastor, my sense of taste was back to normal and my tongue was looking much more normal too.

I can't say for sure if the probiotic is making a difference, but I can say that the last time I had the green tongue problem it seemed to take much longer for the weird ick to go away.