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Later complications may include arthritis or epididymo-orchitis, spondylitis, neurobrucellosis, liver abscess formation, and endocarditis, the latter potentially fatal

As of September 2023 it is on the FDA's Category 2 list of bulk drug substances that may not be compounded due to significant safety risks, and the agency has scheduled a Pharmacy Compounding Advisory Committee (PCAC) review for July 2026 covering proposed uses in opioid withdrawal, chronic insomnia, and narcolepsy

They perform various tasks, such as producing hormones, repairing damaged DNA, and building muscle tissue

The goal is to have a good balance of microorganisms where the healthy strains outweigh the not so healthy