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Headache is reported by some patients and may be related to dehydration from gastrointestinal side effects or direct pharmacological effects

Specific strains such as Bifidobacterium lactis and Bifidobacterium bifidum have been documented to improve tear secretion and BUT ( Saccharomyces boulardii MUCL 53837 and Enterococcus faecium LMG S-28935 have been effective in alleviating subjective symptoms of DED ( Bifidobacterium and Lactobacillus plantarum not only increased tear secretion but also repaired CECs and reduced inflammatory markers like TNF- and IL-1 (Yun et al., 2021)

As the mitochondria become damaged, they leak their contents into the cellular cytoplasm, which the immune system recognizes as a danger signal, further amplifying the inflammatory response in a vicious, self-perpetuating cycle