Synbiotic Supplementation Improves Quality of Life and Inmunoneuroendocrine Response in Patients with FM: 2023 Hinchado et al

Andy

Andy

Retired committee member
Full title: Synbiotic Supplementation Improves Quality of Life and Inmunoneuroendocrine Response in Patients with Fibromyalgia: Influence of Codiagnosis with Chronic Fatigue Syndrome

Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are two medical conditions in which pain, fatigue, immune/inflammatory dysregulation, as well as various mental health disorders predominate in the diagnosis, without evidence of a clear consensus on the treatment of FM and CFS.

The main aim of this research was to analyse the possible effects of a synbiotic (Synbiotic, Gasteel Plus® (Heel España S.A.U.), through the study of pro-inflammatory/anti-inflammatory cytokines (IL-8/IL-10) and neuroendocrine biomarkers (cortisol and DHEA), in order to evaluate the interaction between inflammatory and stress responses mediated by the cytokine-HPA (hypothalamic-pituitary-adrenal) axis, as well as mental and physical health using body composition analysis, accelerometry and previously validated questionnaires. The participants were women diagnosed with FM with or without a diagnostic of CFS.

Each participant was evaluated at baseline and after the intervention, which lasted one month. Synbiotic intervention decreased levels of perceived stress, anxiety and depression, as well as improved quality of life during daily activities. In addition, the synbiotic generated an activation of HPA axis (physiological cortisol release) that can compensate the increased inflammatory status (elevated IL-8) observed at baseline in FM patients. There were no detrimental changes in body composition or sleep parameters, as well as in the most of the activity/sedentarism-related parameters studied by accelerometry.

It is concluded that synbiotic nutritional supplements can improve the dysregulated immunoneuroendocrine interaction involving inflammatory and stress responses in women diagnosed with FM, particularly in those without a previous CFS diagnostic; as well as their perceived of levels stress, anxiety, depression and quality of life.

Open access, https://www.mdpi.com/2072-6643/15/7/1591
 
CFS is the most common comorbidity in patients with FM, ranging from 20–81% [4].
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In addition, several inflammatory and stress biomarkers have been found in our laboratories in previous studies (increased release of pro-inflammatory cytokines including IL-8 together with greater levels of cortisol and noradrenaline in the blood) when comparing FM patients with healthy individuals [6,7,10].
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So, a large proportion of people with FM have CFS. And higher levels of cortisol are characteristic of FM (and, by extension, CFS). But wait - higher cortisol? Wasn't it supposed to be lower cortisol? Or lower cortisol before breakfast? Or something? People are so sure these conditions have something to do with stress, that surely they have to do something to cortisol.

Commercial product
Within the probiotic strains present in Gasteel Plus® (Heel España S.A.U. laboratories, Madrid, Spain) are Bifidobacterium lactis CBP-001010, Lactobacillus rhamnosus CNCM I-4036, and Bifidobacterium longum ES1, as well as fructooligosaccharides (200 mg) as a prebiotic. Each Gasteel Plus® bar (300 mg) contains 1 × 109 colony forming units (CFU) of freeze-dried powdered bacteria in addition to 1.5 mg zinc, 8.25 g selenium, 0.75 g vitamin D and maltodextrin as an excipient.
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Sample
15 women, 7 also with CFS
So, small, and no healthy controls for comparisons

Outcomes - so many
Including two new ones for us:
COVID-19 questionnaires:
  • CAS (Coronavirus Anxiety Scale). The higher the score, the greater the sense of anxiety. Higher scores are related to higher anxiety towards COVID-19 [26].
  • FCV-19S (Fear of Coronavirus). The higher the score, the greater the sense of fear of the coronavirus [27].
 
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