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[DOI] [PMC free article] [PubMed] [Google Scholar] 167.OConnor JC, Lawson MA, Andr C, Briley EM, Szegedi SS, Lestage J, Castanon N, Herkenham M, Dantzer R, Kelley KW

Supplementation with Lactobacillus zhang significantly altered the gut microbiota composition of healthy volunteers (Zhang et al., 2014), increasing the abundance of beneficial bacteria ( Lactobacillus and Bifidobacterium ), short-chain fatty acids-producing bacteria (such as Prevotella ), and anti-inflammatory bacteria ( Faecalibacterium ), while significantly reducing the number of opportunistic pathogens ( Clostridium and Enterococcus faecalis )

This makes it one of the few compounds in this group with a completed regulatory pathway

While PEM can be triggered by muscular exercise, it can, in the same patient, also be triggered by other stressors, including cognitive exercise, mental or emotional strain, orthostatic stress or sensory overload