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Table 1 Probiotics for fatigue and depression - proposed pathways - adapted from Medical Hypotheses - Logan, et al.[[2]] and Logan, et al.[[3]]

From: Intestinal microbiota, probiotics and mental health: from Metchnikoff to modern advances: Part II – contemporary contextual research

•  Direct protection of the intestinal barrier
•  Influence on local and systemic antioxidant status, reduction in lipid peroxidation
•  Direct, microbial-produced neurochemical production – e.g. GABA
•  Indirect influence on neurotransmitter/neuropeptide production
•  Prevention of stress-induced alterations to overall intestinal microbiota
•  Direct activation of neural pathways between gut and brain
•  Limitation of inflammatory cytokine production
•  Modulation of neurotrophic chemicals including brain-derived neurotrophic factor
•  Limitation of carbohydrate malabsorption
•  Improvement of nutritional status – e.g. omega-3 fatty acids, minerals, phytochemicals
•  Limitation of small intestinal bacterial overgrowth
•  Reduction of amine/uremic toxin burden
•  Limitation of gastric/intestinal pathogens (e.g. Helicobacter pylori)
•  Analgesic properties