Nutritional neuroscienceAug 6, 2019

Synbiotic and probiotic supplements and their effects on brain health markers, depression, and anxiety in hemodialysis patients

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Updated Mar 31, 2026

Abstract

Synbiotic supplementation for 12 weeks led to a significant decrease in depression scores for patients with depressive symptoms.

In patients with depression symptoms, the synbiotic group showed a significant reduction in the Hospital Anxiety and Depression Scale for depression (HADS-DEP) compared to both the placebo and probiotic groups.
All patients receiving synbiotics experienced a significant decrease in HADS-DEP compared to placebo.
While there were no significant differences in anxiety scores (HADS-ANX) among the groups, the synbiotic group showed a significant decrease in HADS-ANX from baseline.
A subgroup of patients with depressive symptoms exhibited a significant increase in serum brain-derived neurotrophic factor (BDNF) levels in the synbiotic group compared to both the placebo and probiotic groups.
Overall, synbiotic supplementation demonstrated greater effectiveness in improving depression symptoms and BDNF levels compared to probiotics among hemodialysis patients.

Simplified

BACKGROUND: The aim of this study was to investigate the effects of probiotic and synbiotic supplementation on the depression and anxiety symptoms and serum brain-derived neurotrophic factor (BDNF) level.

METHODS: Seventy-five HD patients were randomly assigned to receive the synbiotic (15 g of prebiotics, 5 g of probiotic containingT16,BIA-6,BIA-7, andBIA-8 (2.7 × 10 CFU/g each)) or probiotics (5 g probiotics as in synbiotic group with 15 g of maltodextrin as placebo) or placebo (20 g of maltodextrin) for 12 weeks. Serum BDNF was measured by ELISA kit. Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of depression (HADS-DEP) and anxiety (HADS-ANX). Lactobacillus acidophilus Bifidobacterium bifidum Bifidobacterium lactis Bifidobacterium longum7

RESULTS: From baseline to 12 weeks, synbiotic supplementation resulted in a significant decrease in HADS-DEP score in a subgroup of patients with depressive symptom (HADS-DEP ≥ 8) compared to the placebo and probiotic supplementation ( = .001, = .002, respectively) and in all patients compared to the placebo ( = .004). There was no significant difference among the groups in terms of HADS-ANX scores. However, the HADS-ANX scores decreased significantly in the synbiotic group compared to the baseline in all patients ( = .047) and also patients with depressive symptom ( = .03). In addition, in a subgroup of HD patients with depressive symptom, the serum BDNF increased significantly in the synbiotic group when compared to the placebo ( < .001) and probiotic group ( = .011). p p p p p p p

CONCLUSION: Overall, 12 weeks of synbiotic supplementation resulted in greater improvement in depression symptoms and serum BDNF level compared to the probiotic supplementation in HD patients especially in the subgroup of patients with depression symptoms.

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Synbiotic and probiotic supplements and their effects on brain health markers, depression, and anxiety in hemodialysis patients

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