Physical, mental and biochemical effects of probiotics in multiple sclerosis: A systematic review and meta-analysis
In brief
Probiotics improve fatigue and pain in multiple sclerosis
A meta-analysis of six placebo-controlled trials involving 282 adults with MS found that probiotic supplementation modestly reduced fatigue and pain, while having no effect on overall disability scores or depression. Inflammatory markers such as high-sensitivity C-reactive protein also fell. Larger, diverse trials are needed to confirm benefits and explore mechanisms.
- Journal
- Clinical nutrition (Edinburgh, Scotland) (Q1)
- Published
- 30 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Tamar Blanca-Serrano, Marina Agredano-Sánchez, Rosa María López Gigosos, Manuel Francisco Jiménez Navarro, Carmen María González-Domenech, Mario Gutiérrez-Bedmar
- PMID
- 42580083
- DOI
- 10.1016/j.clnu.2026.106747
Why clinicians should know about it
- Picked for Microbiology (medical) (top studies of the week, 16 August 2026): Probiotics in multiple sclerosis, neurology focus
- Picked for Biochemistry (medical) (top studies of the week, 16 August 2026): Probiotics in multiple sclerosis systematic review
- Picked for Critical Care and Intensive Care Medicine (top studies of the week, 16 August 2026): Probiotics in multiple sclerosis, unrelated to ICU care
Abstract
BACKGROUND AND AIMS: This systematic review and meta-analysis aimed to evaluate the effects of probiotic supplementation on physical, mental, and biochemical outcomes in adults with multiple sclerosis (MS). METHODS: A comprehensive search of major databases (PubMed, Embase, Scopus, Cochrane Library, and Web of Science) following PRISMA guidelines for studies published up to December 2025. RESULTS: Six randomized placebo-controlled trials (RCTs) involving 282 participants met the inclusion criteria. Interventions varied in probiotic strains, doses, and duration. Quantitative synthesis showed that probiotic supplementation produced significant beneficial effects on motor outcomes, particularly fatigue and pain. No significant improvements were observed in disability status measured by the Expanded Disability Status Scale. Mental health outcomes, including depression and general psychological well-being, did not demonstrate statistically significant changes following probiotic use. In addition, biochemical analyses revealed a moderate overall benefit, driven primarily by reductions in systemic inflammatory markers, including high-sensitivity C-reactive protein. Effects on oxidative stress parameters were inconsistent, though some studies reported decreased malondialdehyde levels and improved antioxidant capacity. CONCLUSION: Overall, findings suggest that probiotics may offer moderate benefits for symptom management in MS, particularly for fatigue, pain, and inflammation, while evidence for effects on mental health remains limited. Further well-designed, multi-ethnic RCTs integrating microbiome and immunological assessments are needed to confirm these results and clarify underlying mechanisms. PROSPERO registration number: CRD42024511183.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.