Table 1. Summary of the reported toxic, unintended, adverse effects following probiotic consumption (Lerner et al., 2019)

Categorization	Symptom	References
Infectious/Gastrointestinal	Bacteremia	Doron and Snydman, 2015; Sherid et al., 2016; Rao et al., 2018
	Sepsis	Doron and Snydman, 2015; Rao et al., 2018
	Fungemia	CDC, 2015; Rao et al., 2018
	Endocarditis, meningitis, endometritis, peritonitis, pneumonia	Sherid et al., 2016; Naqvi et al., 2018; Boumis et al., 2018
	Liver abscess	Sherid et al., 2016
	Diarrhea, abdominal cramps	Doron and Snydman, 2015
	Nausea, vomiting, flatulence, taste disturbance	Doron and Snydman, 2015; Rao et al., 2018
	Low appetite	Falcinelli et al., 2018
Allergic	Rhinitis	Sanders et al., 2010
	Wheezing bronchitis	Kopp et al., 2008
	Rash	Sanders et al., 2010
	d-Lactic acidosis	Sanders et al., 2010; Doron and Snydman, 2015; Rao et al., 2018
Genetic	Antibiotic resistance	Franz et al., 2001; Sanders et al., 2010; Rathnayake et al., 2012; Doron and Snydman, 2015; Kho and Lal, 2018
	Hemolysin	Franz et al., 2001; Sanders et al., 2010
	Gelatinase	Sanders et al., 2010
	DNAse	Sanders et al., 2010
	Enolase activating plasminogen	Sanders et al., 2010
	Metalloendopeptidase	Jasberg et al., 2018
	Cytolysin modification, transport, activation	Dufour et al., 2007
	Sex pheromones	Muthu et al., 2016
Patho-Toxogenicity	Enhanced adhesion and protein aggregation	Sanders et al., 2010; Doron and Snydman, 2015
	Mucolysis/hemolysis	Sanders et al., 2010; Doron and Snydman, 2015
	Bile salt hydrolysis	Doron and Snydman, 2015
	DNA degradation and proteolysis	Sanders et al., 2010
	Innate defense resistance	Sanders et al., 2010; Haase et al., 2018
	Food poisoning	Sanders et al., 2010
	Immune evasion or over stimulation	Sanders et al., 2010; Doron and Snydman, 2015
	Facilitated microbial conjugation/translocation	Sanders et al., 2010; Doron and Snydman, 2015
	Macrophage/monocyte chemotactism	Kitazawa et al., 2002
	Nanoparticles: Lactomicroselenium	Nagy et al., 2016
	Gastrointestinal ischemia	Doron and Snydman, 2015; Rao et al., 2018
	Mechanical choking	Doron and Snydman, 2015
	Peptide deamidation	Washington et al., 2013
	Epigenetic and mobilome manipulation	Haase et al., 2018