For health professionals, impartially curated by OptiBac

A study1 on the gut flora of patients with a diagnosis of ME/CFS has recently been published in ‘Microbiome Journal’. The study authors took 48 ME/CFS patients and 39 healthy controls, and profiled their gut microbial diversity, using RNA gene sequencing. The study also looked at blood inflammatory markers, such as C-reactive protein (CRP) and Lipopolysaccharide (LPS).

About ME/CFS

Myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), is a chronic condition with no known cause and no widely accepted treatment. Primary symptoms include: fatigue, muscle and joint pain, poor quality of sleep, headaches and general malaise. In addition, many ME/CFS patients report gastrointestinal symptoms, such as IBS (see Probiotics Learning Lab for more glossary terms) and intestinal discomfort, resulting in more than average use of antacids and proton pump inhibitor (PPI) medication amongst ME/CFS sufferers than healthy individuals. Many of these common symptoms reported by ME patients are characteristic of inflammatory illnesses.

Headaches, fatigue and IBS are amongst the common symptoms of ME/CFS

Study results

Study results showed differences between the gut microbiome of ME/CFS patients and healthy controls. Bacterial diversity was decreased in the ME/CFS faecal samples, showing a particular reduction in both abundance and diversity of species belonging to the Firmicutes phylum of bacteria. Additionally, the results show an increase in specific species that are reported to be pro-inflammatory, with a reduction in anti-inflammatory species. For example, Faecalibacterium prausnitzii, which produces an anti-inflammatory protein, as well as butyric acid (a short-chain-fatty acid with anti-inflammatory and gut protective properties), is drastically reduced in ME/CFS cases. This genus is also often depleted in IBD and Ulcerative Colitis.

Serum markers of inflammation were also raised in the ME/CFS patients, with significantly higher levels of both CRP and LPS present in their blood samples. The study authors concluded that this increase in inflammatory markers suggests ongoing damage to the gut mucosa, potentially as a result of alterations to the microbiome, and said that:

‘’Our data converges to support the concept of a less diverse and unstable community of bacteria in the disorder. The cause of ME/CFS is unknown, but gut dysbiosis could be contributing to some of the symptoms and their severity.’’

Based on these study findings, the authors go on to say that: ‘’Developing therapeutic interventions aimed at reducing local inflammation, restoring gastrointestinal tract immunity and integrity and modifying the intestinal microbiome may ameliorate ME/CFS symptoms.’’

This study gives even more weight to the growing body of evidence showing just how many chronic conditions are characterised by an imbalanced gut flora. Whilst no one would go so far as to say that this dysbiosis is the sole cause of these conditions, it certainly provides therapists with more treatment options that may result in an improvement in symptoms.

To read more about the impact of our gut flora on our health, you may choose to read the following fascinating blog posts:

2 new studies back probiotics for diabetes

Parkinsons disease linked to gut bacteria

Or head over to the Probiotics Learning Lab and see:

Does our microbiota play a part in the development of arthritis?


1. Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome. Ludovic Giloteaux, Julia K. Goodrich, William A. Walters, Susan M. Levine, Ruth E. Ley and Maureen R. HansonEmail author. Microbiome20164:30.


  • Are folk with solitary rectal ulcer syndrome likely also to have the same profile if they also have ME and Fibromyalgia?

  • Probiotic Professionals

    Hello Linda,

    Thank you for your comments.
    I'll send you a personal response to your query.

    With kind regards,

    Nutritional Advisor

  • Thank you Kathy,
    I've only just read this blog. This research was presented in June, prior to publication, in London at the international Invest in ME Conference and will be in full on the conference DVD.
    Research on the gut microbiome in ME/CFS is also being done in UK at Norwich Research Park (Institute of Food Research) and the team published a review in June and a summary on the Gut Health and Food Safety Blog

  • Probiotic Professionals

    Hello Jo,

    Thank you for your comments, and the additional information.

    Kind regards,

    Nutritional Advisor

  • This is a very interesting piece of research. I'm wondering whether anyone is looking into producing a probiotic with the strains which were found to be depleted in this study. I'm sure most people with M.E. would snap them up!

  • Probiotic Professionals

    Hello Marion,

    Thank you for your comments.

    This is a question that we've seen a lot, and so in order to answer it I need to explain a little bit more about the microbiome.

    The populations of microorganisms in the human gut begin at birth and are usually well-established by the age of two. They are then affected and shaped over time by diet, lifestyle, environment and even genetic influences.All sorts of microbes may take up residence in the gut (and other areas of the body for that matter!), including bacteria, yeasts, viruses and parasites, and everyone's gut flora is as individual as their fingerprint.

    So there may be many reasons why there's a prevalence of bacteria related to different genera or species, and when it comes to trying to influence the composition of these populations, it's not always a case of directly supplementing with the 'right' type of bacteria, but more trying to encourage the survival of more desirable microorganisms.

    Again, this may possibly be done with diet and a healthy lifestyle, but introducing strains of bacteria known to have beneficial effects for their hosts could be another useful way of improving the intestinal environment and encouraging the growth of more helpful organisms.

    This type of research is still in its infancy, however, relatively speaking, though we're already able to identify certain strains of bacteria that do different jobs in the body and apply them accordingly. Maybe one day in the future, though, it will be possible to tailor your gut flora to suit you perfectly!

    Until then, you can't go wrong with looking at your diet, lifestyle and using a live cultures supplement that contains very well-researched strains of bacteria.

    Wishing you all the best,

    Nutritional Advisor

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