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Is Chronic Fatigue Syndrome a gut issue?

Chronic fatigue syndrome (CFS) is a very frightening and complicated disorder. Defined as severe exhaustion that can’t be relieved by rest, this condition has frustrated modern medicine for a long time.

Also known as myalgic encephalomyelitis (ME/CFS), this disease has no real triggers or underlying conditions, and diagnosing it requires a lot of time and testing. Although anyone can have CFS, women are far more likely to suffer from it than men, most commonly in their middle years.

Its symptoms run the gamut, from extreme fatigue lasting more than a day and unexplained joint or muscle pain to enlarged lymph nodes, headaches, poor sleep and even irritable bowel syndrome (IBS).

While CFS is a condition with very few connections, research teams at Columbia and Cornell Universities have found important markers that link it to the human gut.

83 percent accurate

The discovery that connects chronic fatigue syndrome to the human gut was a welcome confirmation to Cornell researchers that its origins were definitely not psychological.

“Our work demonstrates that the gut bacterial microbiome in ME/CFS patients isn’t normal, perhaps leading to gastrointestinal and inflammatory symptoms in victims of the disease,” says Dr. Maureen Hanson, senior author of the study, according to a press release. “Furthermore, our detection of a biological abnormality provides further evidence against the ridiculous concept that the disease is psychological in origin.”

For the record, the Cornell study compared blood and stool samples from 48 CFS patients to 39 health controls. The links to a gut health connection were obvious.

Chronic fatigue patients had less gut bacteria diversity and their blood samples showed signs of inflammation linked to leaky gut. Stool samples also found markers for ulcerative colitis and Crohn’s disease, even more serious gut problems.

Moreover, scientists were able to detect which patients were battling CFS based on microbiome testing with 83 percent accuracy.

Gut imbalances affect severity

Mirroring the Cornell findings, Columbia researchers also found bacterial imbalances – too much of some bacterial species including Faecalibacterium – in the fecal samples of the 50 chronic fatigue syndrome patients they examined (versus an equal number of healthy ones), according to the study appearing in Microbiome.

These imbalances varied depending on whether CFS patients were also suffering from IBS or not (21 of the 50 patients did have IBS). Also, depending on which bacteria imbalance chronic fatigue syndrome patients had and the metabolic pathways affected, the severity of their symptoms differed too.

“Individuals with ME/CFS have a distinct mix of gut bacteria and related metabolic disturbances that may influence the severity of their disease,” says Columbia researcher Dorottya Nagy-Szakal, according to a press release.

Probiotic success

Despite all of the attention paid by Columbia and Cornell researchers, a few scientists already had an eye on the intersection of gut health and chronic fatigue syndrome.

In fact, a systemic review of studies appearing very recently in Beneficial Microbes cited studies that showed how using probiotics may be effective in treating CFS and fibromyalgia.

(Both studies cited in this review used proprietary strains of Lactobacillus and Bifidobacterium, the two building blocks of EndoMune Advanced Probiotic.)

Based on these results, it seems more likely probiotics could become part of a more comprehensive treatment plan for chronic fatigue syndrome. 

“If we have a better idea of what is going on with these gut microbes and patients, maybe clinicians could consider changing diets using prebiotics such as dietary fibers or probiotics to treat the disease,” says Ludovic Giloteaux, a researcher in the Department of Molecular Biology and Genetics at Cornell University.

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