The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS), 2022, Scheibenbogen et al

Myalgic encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS) is a neglected, debilitating multi-systemic disease without diagnostic marker or therapy. Despite evidence for neurological, immunological, infectious, muscular and endocrine pathophysiological abnormalities, the etiology and a clear pathophysiology remains unclear. The gut microbiome gained much attention in the last decade with manifold implications in health and disease.

Here we review the current state of knowledge on the interplay between ME/CFS and the microbiome, to identify potential diagnostic or interventional approaches, and propose areas where further research is needed. We iteratively selected and elaborated on key theories about a correlation between microbiome state and ME/CFS pathology, developing further hypotheses. Based on the literature we hypothesize that antibiotic use throughout life favours an intestinal microbiota composition which might be a risk factor for ME/CFS. Main proposed pathomechanisms include gut dysbiosis, altered gut-brain axis activity, increased gut permeability with concomitant bacterial translocation and reduced levels of short-chain-fatty acids, D-lactic acidosis, an abnormal tryptophan metabolism and low activity of the kynurenine pathway.

We review options for microbiome manipulation in ME/CFS patients including probiotic and dietary interventions as well as fecal microbiota transplantations. Beyond increasing gut permeability and bacterial translocation, specific dysbiosis may modify fermentation products, affecting peripheral mitochondria. Considering the gut-brain axis we strongly suspect that the microbiome may contribute to neurocognitive impairments of ME/CFS patients. Further larger studies are needed, above all to clarify whether D-lactic acidosis and early-life antibiotic use may be part of ME/CFS etiology and what role changes in the tryptophan metabolism might play. An association between the gut microbiome and the disease ME/CFS is plausible.

As causality remains unclear, we recommend longitudinal studies. Activity levels, bedridden hours and disease progression should be compared to antibiotic exposure, drug intakes and alterations in the composition of the microbiota. The therapeutic potential of fecal microbiota transfer and of targeted dietary interventions should be systematically evaluated.

Open access, https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/full

 

imho we are still very much in the dark regarding the gut biome and many papers seem to have jumped on the topic creating a new fad . until their is much better evidence regarding benefits potential harms i see this talk of fecal transplants for multiple different disorders as a guessing game .

 

Some pwME say probiotics help. Of course there are many types and quality varies.

IME, these are not permanent fixes, nor even long-term ones, as the modest effects wear off pretty much daily. But at least it's something for some pwME.

There is a CBC TV program about autism that discusses some with this disease find probiotics helpful. I believe prescription probiotics are discussed in this TV program.

I will have a look for a link to this show

 

I certainly took a fair number of antibiotic "tablets" prior to grade school. They were sort of like Necco Wafers, if anyone remembers those. I took them for recurrent inner ear infections, which are fairly common in young children because the draining eustachian tube is easily blocked when you're small. Otologists I've seen have been surprised that I'm not at least partially hearing impaired due to all the scarring they see.

 

My daughter's gut microbiome has been a real issue. She had intolerances as a child which manifested as a skin condition but which resolved through diet. These were/ are dose dependent.

H Pylori after onset. Just tested positive for SIBO. Can't do dairy.
52 week lead in for gastroenterology.

She is the " healthiest" eater of the 3 kids and can be very disciplined.

 

There is a member of ME Action Scotland currently in remission after fecal transplant.