Studies Shed New Light on How the Gut Microbiome Affects Chronic Fatigue Syndrome

In February 2023, two studies published in the journal Cell Host and Microbe showed correlations between chronic fatigue syndrome and the deficiency of specific microbes in the gut microbiome that produce an acid called butyrate.

Studies Shed New Light on How the Gut Microbiome Affects Chronic Fatigue Syndrome
Home to trillions of microorganisms, your gut microbiome may hold the key to understanding diseases such as chronic fatigue syndrome

What's in your gut?

That's the question researchers asked while conducting two new studies published in Cell Host and Microbe journal earlier this year.

The research focused on finding correlations between the development of chronic fatigue syndrome and the gut microbiome's state.

Though further studies are needed, preliminary results have been extremely promising, shedding new light on CFS and bringing scientists one step closer to understanding this complicated disease.

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What Is Chronic Fatigue Syndrome?

Also known as myalgic encephalomyelitis, chronic fatigue syndrome (ME or CFS) is a complex, debilitating disease primarily associated with constant, extreme tiredness. Though it's more common in adults between 40 and 60 years old, anyone can get ME/CFS that may last years, leading to severe disability. No medication has proven effective in treating ME/CFS, so chronic fatigue syndrome treatment currently centers around cognitive behavior and graded exercise therapy. According to the Centers for Disease Control and Prevention, approximately 2.5 million Americans suffer from ME/CFS. However, the actual number is likely much higher, as the CDC also estimates that 90% of people with ME/CFS have not been diagnosed.

Despite scientists tracking a host of symptoms in those with ME/CFS—including neurological, immunological, muscular, and endocrine abnormalities—the actual cause of the disorder is still a mystery, and there are currently no specific markers or tests that can diagnose ME/CFS directly. The main symptom of ME/CFS is constant tiredness that doesn't go away, even after rest or sleep. These feelings can intensify after physical or mental activity, causing disabling fatigue. ME/CFS can even affect someone's ability to perform daily tasks (like taking a shower or preparing a meal) and make it challenging to keep up with social and professional responsibilities. One in four people who are diagnosed with ME/CFS may also be bedridden for long periods.

Other common symptoms of ME/CFS include:

  • Hair loss
  • Dizziness
  • Sore throat
  • Weight Loss
  • Lack of energy
  • Trouble sleeping
  • Memory problems
  • Muscle cramps or spasms
  • Difficulty with concentration

There's good news, though!

The latest research into the gut microbiome has provided scientists with critical new data to help them begin understanding the causes of ME/CFS.

If left unchecked, symptoms of chronic fatigue syndrome can become overwhelming and debilitating, causing major disruptions to daily life.

What's the Gut Microbiome?

Your gut's microbiome is an expansive, diverse community of microorganisms living in the gastrointestinal tract—i.e., your stomach and intestines. These organisms can include microbes, viruses, bacteria, and fungi, among many others.

A hundred trillion microbes live in the human body, and the overwhelming majority of them are in your gut. The bacterial cells in your gut outnumber the rest of the cells in the human body by multiple factors of ten, making the gut microbiome one of your most vital internal ecosystems. In fact, some experts argue that the gut microbiome, due to its vast complexity, should be considered a separate organ within the endocrine system.

Research into the gut microbiome has ramped up in the last decade as scientists continue to learn about its far-reaching effects on a broad spectrum of human health and disease metrics, including ME/CFS.

Research Into ME/CFS and the Microbiome Is Ongoing

A groundbreaking study on ME/CFS was published in 2015 by the Center for Infection and Immunity (CII). In their conclusions, researchers were finally able to observe robust, definitive biological evidence of ME/CFS, repudiating earlier speculation that the disorder may be psychological. Then, in 2017, a second study published in the journal Microbiome tracked correlations between the condition of gut bacteria and instances of both ME/CFS and irritable bowel syndrome, a common disorder affecting the stomach and intestines. Research from 2021 and 2022 published in Scientific Reports and the International Journal of Molecular Sciences further corroborated earlier findings that abnormal levels of specific metabolites within the microbiome appear to play a role in the development of ME/CFS.

What Are the Latest Findings?

In February 2023, two studies published in the journal Cell Host and Microbe showed correlations between chronic fatigue syndrome and the deficiency of specific microbes in the gut microbiome that produce an acid called butyrate.

One of the studies, led by Dr. Julia Oh at the Jackson Laboratory Research Institute, divided 149 participants into two groups: 74 had been diagnosed with ME/CFS less than five years prior, while 75 patients had a diagnosis of more than ten years. A control group of 79 healthy adults also participated in the study. Among the group more recently diagnosed with ME/CFS, scientists observed various changes to the diversity of the gut microbiomes, most notably a deficiency of a specific microbe that produces butyrate. This four-carbon, short-chain fatty acid plays a vital role in the health of your gut. While the microbiomes of the group with long-term ME/CFS more resembled those of the healthy control group, scientists still observed several changes in the metabolites within the blood of those with CFS and differences in levels of specific immune cells.

A second study, led by Dr. Brent Williams at the Center for Infection and Immunity at Columbia University, studied the gut microbiomes of 106 people with ME/CFS and 91 healthy controls. Results showed significant correlations between the severity of ME/CFS symptoms and the levels of a specific butyrate-producing gut bacterium called Faecalibacterium prausnitzii. They also showed a higher load of bacteria in participants' stool samples and more frequent disruptions of interactions among bacterial species.

A Potential Breakthrough?

While it might be too early to hail these studies as definitive breakthroughs, scientists are optimistic about the potential that future research has to shed more light on chronic fatigue syndrome.

Dr. Julia Oh, lead author of one of the latest studies, declares that:

"It's important to note that this research shows correlation, not causation, between these microbiome changes and ME/CFS. But these findings are the prelude to many other mechanistic experiments that we hope to do to understand more about ME/CFS and its underlying causes."

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