Researchers from Cornell University have finally shed light on the biological markers associated with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). This 2016 study found that analysis of inflammatory biomarkers and gut bacteria is able to predict the presence of ME/CFS . This work offers greater insight into a mystifying health condition that, until now, Science has been unable to describe with any notable significance.
What is Chronic Fatigue Syndrome?
Chronic Fatigue Syndrome is a complex and often debilitating disorder characterized by extreme bouts of fatigue. These symptoms are often brought after seemingly normal activity and have been noted as commonly starting after acute illnesses such as the flu. ME/CFS fatigue is often accompanied by physical pain, insomnia, and impaired cognitive function. Until now there has been little insight as to the origins of Chronic Fatigue syndrome or potential treatments. Most therapeutic approaches for ME/CFS are focused on symptom management . Certain supplements such as magnesium malate, melatonin, and turmeric are often used as a means of supporting energy levels, promoting more restful sleep, and reducing symptoms of inflammation. While helpful in many cases, those suffering from CFS have had very few options for addressing potential underlying causes. Sadly, many ME/CFS patients have been diagnosed with mental disease in the face of medical misunderstanding. This new research shows that the impact of our gut bacteria play a critical role in the development of ME/CFS, offers insight into potential future treatments, and clearly identifies this condition as having physiological markers.
Understanding the Microbiome
The human body is host to a diverse community of bacteria that, depending on the species, may help or hinder natural biological processes. Many bacteria such as Bifidobacterium species have been known to serve supportive roles in our body—such as reducing histamine levels. Broader studies have even shown that different genera of bacteria have the potential to alter our moods, emotions, and may impact symptoms of diseases such as Autism and Schizophrenia. Many of these bacteria are found in our digestive tract where they work to digest food, synthesize vitamins and help protect us from harmful pathogens . The awareness and study of these bacteria are not new, though Science is still learning their potential impact on human health. Generally speaking, it seems that a diverse range of ‘good’ bacteria is most-closely associated with better health. Cornell researchers found that CFS patients had a low diversity of bacteria—which would support such notions.
Previous research into the relationship between ME/CFS and gut bacteria found promising results with probiotic therapy. CFS patients are often known to exhibit GI issues such as diarrhea, nausea or constipation . These are all regarded as potential symptoms of microbial dysbiosis—but on their own offer little insight into specific disease etiology. Other research has shown that certain types of bacteria, known to produce higher levels of D-Lactic Acid, are associated with CFS. This research found that ME/CFS patients were more likely to have higher overall bacterial counts, larger predominance of gram-negative bacteria, higher counts of E.Faecalis and S.sanguinis, and that larger overall production of the D-type Lactic acid is seen . Other works have shown that CFS also typically exhibits symptoms of inflammatory disease, noted by increased levels of C-reactive protein and inflammatory cytokines. Overall, past research has shown strong potential that chronic fatigue syndrome is likely associated with gut-bacteria balances and the presence of inflammatory cytokines in the blood stream. This notion has been confirmed by new research from Cornell, and offers much promise in the future diagnosis and treatment of ME/CFS.
Bacteria & Biomarkers
The Cornell study investigated 48 patients with an existing ME/CFS diagnosis, 34 of whom reported symptoms of gastrointestinal distress. In this study, 25 members of the test group indicated they had experienced a rapid onset of symptoms after such acute illness as the flu. Cornell researchers also investigated the connection of leaky gut syndrome to CFS. This analysis was conducted through the measurement of plasma levels of C-reactive protein (hsCRP), lipopolysaccharides (LPS), and intestinal fatty acid binding protein (I-FABP). Conceivably, these markers would be seen in elevated number in the presence of intestinal damage such that gut bacteria and other compounds could freely enter the blood stream. Levels of soluble CD14, a biomarker for detecting bacterial infections, were also measured. Researchers found that levels of nearly all these compounds were higher in ME/CFS patients, which LPS, sCD14, and LBD all being the most statistically significant (P<0.0005).
ME/CFS can accurately be identified by the measurement of certain inflammatory biomarkers and microbial analysis of stool samples
The second scope of investigation in this study performed stool analysis to identify the presence and composition of bacteria in ME/CFS patients relative to healthy control subjects. This was designed as an effective means to identify any bacteria species, or bacterial imbalances that may contribute to the presence of ME/CFS. Researchers broke down analysis into Phylum-level and Family-level and found significant differences between healthy patients and those with ME/CFS. Researchers noted that such bacteria types as Bifidobacterium and Faecalibacterium were much higher in healthy individuals. After collecting data and structuring it for analysis, researchers then applied a deep-learning algorithm as a means to establish a way to effectively diagnose ME/CFS. This took into account data from test and control groups, and was able to correctly identify a ME/CFS diagnosis with 82% accuracy when taking into account stool data and inflammatory markers, and 75% accuracy when taking into account stool samples alone. This illustrates that ME/CFS can accurately be identified by the measurement of certain inflammatory biomarkers and microbial analysis of stool samples.
Chronic fatigue syndrome is a debilitating disease that can sometimes last for years. Currently there is no FDA approved treatment for ME/CFS and our current understanding hardly offers any hope to those suffering from the condition. Previous research has shown a potential connection between alterations in gut bacterial as a potential identifier for ME/CFS, but didn’t offer much specific insight. This new research from Cornell has shown that ME/CFS can be accurately predicted by inflammatory markers in the blood and by stool analysis for microbial composition. This knowledge may help pave the way for better understanding how treatments with specific probiotics and live-bacteria foods may help address symptoms of ME/CFS. A likely place to start would be in the supplementation of the Bifidobacterium and Faecalibacterium bacteria types and, drawing from previous research, the avoidance of D-Lactic acid producing bacteria.
- Borody TJ, Nowak A, Finlayson S. The GI microbiome and its role in chronic fatigue syndrome: a summary of bacteriotherapy. ACNEM J. 2012;31(3):3–8.
The Article Researchers Connect Chronic Fatigue Syndrome to Gut Bacteria Imbalance was originally published on the Isotrope website