Most probiotic supplements are useless. Many may actually do more harm than good. That said, there are some probiotics out there that are worth buying. For the longest time I’ve been looking for a good probiotic that I can recommend to clients and the readers of Darwinian-Medicine.com, as well as use to improve my own health. I’m happy so say that I’ve found such a product.
Mutaflor is a supplement containing the bacterium E. coli Nissle 1917 (EcN) – a probiotic strain that has been used in both clinical settings and scientific studies for almost a century. I spoke warmly about this probiotic here on the blog a couple of years ago, but back then, I hadn’t yet had the chance to take a close look at the research on EcN. Now I have. I’ve also tried the product a second time myself, to make sure that it lived up to its reputation.
In today’s article I’ll take a closer look at this probiotic supplement. I’ve organized the post into a Q&A that answers the most common questions people have about EcN. Keep in mind, all of the suggestions and recommendations in today’s article should be considered general advice, not personalized medical advice.
- What separates this probiotic from other probiotics?
- What is the history behind the use of this probiotic?
- Is it safe to use this probiotic?
- Has this probiotic been used in scientific studies?
- Should I use this probiotic?
- Where can I buy Mutaflor, and how much does it cost?
- How many capsules should I take, and how long should I use the product?
- What can I expect will happen when I take it?
- Why should I trust this recommendation?
What separates this probiotic from other probiotics?
I know it’s a bold statement to say that this is the best probiotic on the market. I wouldn’t have made that statement if I didn’t believe in it though. I strongly suspect (I obviously can’t be completely sure, as there are many probiotics out there) that Mutaflor is indeed the best probiotic on the market. That said, I don’t favor this exact product. Other supplements containing similar types of bacteria may be equally good. Moreover, in a not so distant future, a new generation of probiotic supplements may become available on the market, some of which will likely be more effective than Mutaflor.
As the regular readers of this blog know well, I’m not a fan of probiotic supplements. Actually, as I’ve stated in my articles on this topic, I think most probiotic supplements do more harm than good. This is particularly true for high-potency, medical grade probiotics containing lactic acid bacteria. These products may be useful for people with a severely degraded gut microbiota, as they act as a Band-Aid that covers up some of the signs and symptoms of severe gut dysbiosis, such as bloating, flatulence, and autoimmune disease. They don’t repair a damaged gut microbiota though. Actually, they probably block the development of a diverse, resilient community of gut microbes, which is one of the reasons why I would never recommend the average Joe to use VSL#3 or other high-potency probiotics on a regular basis.
Mutaflor differs from most other probiotics that are out there in that it contains E. coli bacteria, not lactic acid bacteria. There’s nothing wrong with lactic acid bacteria per se, but based on my experience, the talks I’ve had with researchers, and the scientific research I’ve read, supplements containing strains of Bifidbacterium and/or Lactobacillus are not particularly effective at repairing a damaged gut microbiota. As I’ve stated in earlier articles, research suggests that these bugs rarely colonize the gut. Moreover, they may, in certain situations, kill or inhibit the growth of beneficial bacteria that are already present in the gut. I’m not a fan of the soil-based probiotics that are on the market today either.
Before the summer, I spoke to a leading researcher and pioneer in the microbiome field, a man who has spent more than 50 years (!!) doing microbiome research. He mentioned that, like me, he thinks many probiotics do more harm than good. He did recommend one probiotic though, a product he claimed was produced by “honest” researcher and had the ability to suppress appetite and favorably impact human health. Yes, you guessed it. The probiotic he mentioned was EcN.
EcN has been shown to be able to colonize the human gut (1, 2). Moreover, as you’ll see later, it has been scientifically proven to be effective in the treatment of several gut-related health problems.
What is the history behind the use of this probiotic?
The probiotic E. coli Nissle 1917 has – as you may have guessed from seeing its name – been in use almost 100 years. It was isolated from the feces of a soldier during the First World War. Unlike most of his army brothers, the soldier in question did not experience diarrhea, although he was exposed to the same unsanitary, pathogen-filled environment as his companions.
The physician and microbiologist Alfred Nissle suspected that the reason this soldier was protected against infection and gastrointestinal illness was that he harbored special E. coli bacteria in his gut. To investigate whether this was indeed the case, he analyzed the microbiota of the soldier. He obviously didn’t have advanced DNA sequencing technology, but he did manage to isolate several different types of microbes.
Nissle found that the microbiota of the healthy soldier contained a strain of E. coli that was not a part of the microbiota of the soldiers that got diarrhea. He suspected that this strain, which was later called E. coli Nissle 1917, was, at least partially, responsible for keeping the soldier diarrhea-free. To test this theory, he tried using the strain in the prevention and treatment of infectious diarrhea. These studies, as well as the experiments he did on himself, showed that the microbe did indeed help protect its host against invading pathogens.
In the years that have passed since then, the probiotic EcN has been used in clinical practice to treat several different types of gut disorders, including Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). The probiotic was famously used by Adolf Hitler, who is known to have suffered from frequent gastrointestinal problems. The story goes that Adolf praised the physician who treated him with this probiotic, because the microbe dramatically improved his gastrointestinal function.
Is it safe to use this probiotic?
As a society we’ve learned that E. coli is a bad bug that makes us sick. What the press articles about food poisoning and the dangers of E. coli fail to mention though is that not all strains of E. coli are out to do us harm. Actually, many can do us a lot of good. E. coli is a natural part of the human gut microbiota.
The bacterial strain that is found in Mutaflor – E. coli Nissle 1917 – is non-pathogenic one. It has been subjected to thorough scientific scrutiny. The weight of the evidence suggests that EcN is a very safe probiotic (2, 3).
That said, there is some evidence to suggest that EcN may trigger adverse health effects in severely immunocompromised hosts. A 2010 study found that EcN was able to breach the gut barrier of germ-free animals with a defective adaptive immune system (4). Although interesting, I wouldn’t put too much emphasis on these results, as they don’t necessarily apply to humans. Keep in mind, we humans don’t live in a sterile bubble; none of us are germ-free.
Whether it’s a good or a bad idea for someone with a severely compromised immune system to take EcN is unclear. If you have a severely damaged microbiota and defective immune system, you may want to consult a physician before taking this probiotic.
Has this probiotic been used in scientific studies?
Yes, it has. Actually, EcN is one of the most scientifically examined probiotic strains out there, perhaps only beaten by some lactic acid bacteria such as Lactobacillus acidophilus and Lactobacillus plantarum. Several studies have shown that EcN is useful in the treatment of gut conditions such as chronic constipation, ulcerative colitis, IBS, and crohn’s disease. Some studies indicate that the probiotic is very effective in the treatment of these conditions, while others have found that it has a more subtle impact – or no impact at all.
The gut microbiota is involved in virtually every physiologic process that occurs in the human body. Few, if any, good studies have looked into how the ingestion of EcN affects diseases of the brain, liver, and other non-gut organs. However, there’s no reason to believe that EcN can’t be used to treat a long list of different conditions that are characterized by gut dysbiosis and/or impaired gut function.
Here’s a list of some of the many studies and research papers that have been dedicated to EcN:
- The non-pathogenic Escherichia coli strain Nissle 1917 – features of a versatile probiotic (This is probably the best review article on EcN that has been published. It talks about the origin, history, microbiological characteristics, genetic properties, safety, and clinical efficacy of EcN)
- Escherichia coli Nissle 1917 (Mutaflor): new insights into an old probiotic bacterium.
- [Effect of administration of Escherichia coli Nissle (Mutaflor) on intestinal colonisation, endo-toxemia, liver function and minimal hepatic encephalopathy in patients with liver cirrhosis].
- A double-blind placebo-controlled trial to study therapeutic effects of probiotic Escherichia coli Nissle 1917 in subgroups of patients with irritable bowel syndrome
- [The treatment of intestinal diseases with Mutaflor. A multicenter retrospective study]
- Clinical use of E. coli Nissle 1917 in inflammatory bowel disease.
- [Treatment of chronic constipation with physiologic Escherichia coli bacteria. Results of a clinical study of the effectiveness and tolerance of microbiological therapy with the E. coli Nissle 1917 strain (Mutaflor)].
Should I use this probiotic?
As shown in the previous section, a large body of evidence indicates that EcN is effective in the treatment of several gut diseases and dysfunctions. If you harbor a damaged microbiota and/or suffer from any diseases or health problems associated with loss of microbiota diversity and/or gut dysbiosis, you should consider using this supplement. Most people in the world today harbor a microbiota that has been damaged by antibiotics, highly processed foods, etc. It could therefore be argued that we should all take steps to improve the health of our inner ecosystem.
That said, it’s not guaranteed that you will experience health improvements from taking this probiotic. If you are unsure about whether you should use this probiotic or not, then you should consult your physician.
Where can I buy Mutaflor, and how much does it cost?
It’s not that easy to get a hold of Mutaflor. You can’t just go to Amazon.com and buy it. I’ve ordered from Breakspear Medicial Group, a company based in the UK, in the past, and have only good things to say about their customer service. I’ve also got a practitioners account there.
You can also find other websites that sell Mutaflor, but many are in German. The ones that are in English are typically based in Canada or Australia and don’t provide international shipping. Unfortunately, Breakspear doesn’t either. They only ship to European countries, in part because the product has to be kept cold during transportation. When it’s sent over long distances, it may lose its potency, at least if it’s exposed to warmer temperatures.
Unfortunately, it seems to be very difficult to get a hold of Mutaflor in the U.S. If you live in the U.S. and want to try Mutaflor, your best bet may be to contact a Canadian retailer and ask whether they could ship the product to you.
Ordering Mutaflor from Breakspear Medicial Group is easy. All you have to do is to send them an e-mail to firstname.lastname@example.org or call them at +44 (0)1442 261 333 Ext 291. Include the following information when ordering: Name, address, contact details and card details. Also mention that you were referred by “Darwinian Medicine”.
The price of the product (20 capsules) is £17.45. Shipping costs lie between £15.00 and £20, depending on where you live. The shipping costs are quite high, because the product has to be sent via Express shipping in order to stay cold during transport. Keep in mind, different countries have different regulations regarding which products that are allowed to be sold and imported. Taxes and other fees also differ from country to country.
How many capsules should I take, and how long should I use the product?
Some probiotic manufacturers recommend that you use their products on a daily basis, indefinitely. I disagree with this recommendation. Actually, as you know if you’ve read my articles on probiotics, this practise may be “harmful”, as it may destabilize the gut microbiota. If the probiotics actually set up shop in the intestine, they do so shortly after you’ve started taking them. There’s no reason to take probiotics forever.
As for Mutaflor, it’s probably sufficient to take one capsule every day for 10-20 days and then stop taking it. Some may need to use it for a slightly longer time to get the desired effects though. A 2014 study found that exposure to a single, high dose of a probiotic E. coli strain resulted in prolonged colonization (1). That said, it’s probably much better to take EcN for at least 5 days (preferably more), rather than just taking one or two capsules and leaving it at that.
Mutaflor can also be effective for treating acute, infectious illness. If you ever get food poisoned, a couple of capsules containing EcN may help you out.
What can I expect will happen when I take it?
Mutaflor is a powerful probiotic. It’s common to experience flatulence, fatigue, and/or other mild health problems the first couple of days following the initiation of Mutaflor supplementation. These effects may be caused by the metabolic activity of EcN in the gut and/or they could be symptoms of a Herxheimer reaction. Usually, these problems disappear after a couple of days.
As shown earlier, several studies have shown that probiotics containing EcN favorably affects gut health. EcN may also improve brain health, decrease appetite, and lower inflammation, among other things. That said, there is no guarantee that the product will work for you. There is even a chance that it worsens your health, although the chance of this happening is probably slim.
Will Mutaflor fix my severely damaged gut microbiota?
No. The human gut microbiota is a complex ecosystem composed of hundreds of species of microorganisms. You won’t achieve great gut health simply by ingesting one probiotic. Mutaflor can certainly help aid the process of building a healthy microbiota, but to really be able to make some headway, you also need to add other tools to your tool box, such as fermented vegetables, fiber, and a healthy diet. If your gut microbiota is severely damaged, you may want to consider doing one or more microbiota transplants or taking acid-resistant “microbiota pills”.
Why should I trust this recommendation?
As the regular readers of Darwinian-Medicine.com know well, I rarely make any product recommendations here on the blog. The few times I do, the products I mention are ones that I strongly believe in and use myself. Moreover, I only recommend products that are backed by solid scientific data. As for probiotics, this is the only one I recommend at the moment. I think there are a couple of other probiotic products out there that may be useful, but they are all probably less powerful than this one.
I’m not involved in the company that produces Mutaflor. I do get 10% on each order made at Breakspear Medicial Group, but only if the customer mentions the name of this blog (Darwinian Medicine) or the number of my practitioners account (3DAR1601) when they make the purchase. I would have recommended Mutaflor regardless of whether I got these 10% or not. You are free to buy Mutaflor from any store you like.
If you decide to give this probiotic supplement a try, then please share your results and experience in the comment section!