Gut microbiome-immune-metabolic axis in fatigue: mechanistic insights and food science approaches, 2026, Kim

Dolphin

Dolphin

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Gut microbiome-immune-metabolic axis in fatigue: mechanistic insights and food science approaches - Food Science and Biotechnology

Fatigue is a heterogeneous symptom associated with lifestyle, infection, exercise, and chronic disease, but its biological links with the gut microbiome remain incompletely defined. This review summarizes clinical and mechanistic evidence connecting gut microbiome alterations with...
link.springer.com link.springer.com

Gut microbiome-immune-metabolic axis in fatigue: mechanistic insights and food science approaches​



Abstract​

Fatigue is a heterogeneous symptom associated with lifestyle, infection, exercise, and chronic disease, but its biological links with the gut microbiome remain incompletely defined.

This review summarizes clinical and mechanistic evidence connecting gut microbiome alterations with fatigue-related phenotypes, focusing on myalgic encephalomyelitis/chronic fatigue syndrome, post-acute COVID-19 syndrome, general adult fatigue, and exercise-induced fatigue.

Evidence was interpreted according to fatigue-related phenotype, microbiome function, microbial metabolite, gut barrier marker, inflammatory response, and food-based intervention.

Current studies suggest that reduced short-chain fatty acid production, impaired butyrate-producing capacity, gut barrier dysfunction, microbial translocation, low-grade inflammation, altered tryptophan metabolism, host energy imbalance, and gut-brain/gut-muscle axis signaling may contribute to fatigue-related physiological vulnerability.

Food components/ingredients, including dietary fiber, fermented food, prebiotic, probiotic, postbiotic, polyphenol, and polysaccharide, may support microbiome-mediated recovery pathways. Further controlled, phenotype-specific, multi-omics intervention studies are required.
 
The review looks a bit shallow in terms of understanding the actual theories or conclusions of the papers. For example: "Microbial shifts that favor the kynurenine route over serotonin synthesis can influence mood, sleep and central fatigue signaling, providing a plausible biochemical route by which gut dysbiosis translates into the profound exhaustion reported by patients." That leaves out the fact that 95% of serotonin in the brain is manufactured in the brain, so 5% from gut bacteria shouldn't have a significant effect.

They also imply--due to papers that imply, without substantial evidence--that the problems could be treated by diet change, probiotics, etc. While diet and gut microbiome can definitely has significant effects on ME symptoms, treatment is not as simple as adding some fibre and probiotics.

Not impressed by their synthesis. I don't think it adds anything to "mapping out the terrain" in a way that would lead to understanding how the gut might affect fatigue. Does their study of fatigue relate to ME's "fatigue-like" symptom?

I think their synthesis is the equivalent of having a pile of "to do" tasks, rearranging them (without dealing with any) and claiming that you've accomplished something important.
 
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