Do you find that there are issues with Prescript-Assist, MegaSporeBiotic, or S. boulardii with mold toxicity or yeast sensitivity issues, and are there certain patients where this would not be recommended?

Dr. Amy Nett: Generally with mold toxicity there’s no one probiotic that patients consistently don’t respond to well. Most of our patients who end up having mold toxicity—and by that I really mean chronic inflammatory response syndrome or mold-related illness—they actually seem to do very well with Prescript-Assist and MegaSporeBiotic. Saccharomyces boulardii I would be cautious with in people who have immune suppression, but otherwise people seem to tolerate Saccharomyces boulardii fairly well. I would say the only clear contraindication would be stay away from Saccharomyces boulardii when there is immune suppression. Prescript-Assist and MegaSporeBiotic tend to be pretty well tolerated, but again, some patients are just going to have a unique response that you don’t anticipate. They may not tolerate it well, and if that’s the case, just start them with another probiotic or very small doses and see if they’re able to tolerate an increase gradually.