Do Gut Bacteria Influence Chronic Fatigue Syndrome?

Here at Healthpath, we’re proud to offer evidence-based advice. However, we’re aware that science can seem a bit impenetrable and dry. Boring, even.

We also believe that education is the first step to regain control. We read a lot of scientific papers, so we thought it would be a good idea to create a digest (no pun intended) of some of the key research.

We hope these plain-English versions bring the science to life and—even more importantly—help you address your symptoms for good.


“Anaerobe High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis / chronic fatigue syndrome patients”


What’s the title in plain English?

A study looking at whether gut bacteria play a role in chronic fatigue syndrome.


What did they do?

Previous studies have suggested that dysbiosis (unbalanced gut bacteria) is linked to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In this study, stool (poop) samples from 43 patients from Belgium and Norway were compared with stool samples from 36 healthy people. They were analysed to determine if there were any similarities between their gut bacteria profiles.


What are the take-home points from the study?

1. Participants were recruited based on symptoms of unexplained fatigue, accompanied by memory loss, sore throat, muscle pain and unrefreshing sleep. The results demonstrated that those with ME/CFS had similar gut bacterial profiles when compared to healthy people. On further analysis, alterations in gut bacteria in the ME/CFS group were more significant in the Norwegian group.

2. There were also differences between the healthy people (controls) of the two different geographical origins. For example, Norwegian controls had a significantly lower percentage of Bacteroidetes bacteria and a threefold increase in the Firmicutes/Bacteroidetes ratio compared to Belgium controls. A higher value for this ratio has been found to indicate obesity. The authors explained that differences could be down to the influence of genetics, as well as key dietary differences between Belgian and Norwegian diets.

3. Even though there was a causal association between gut bacteria alterations in ME/CFS patients, a major limitation of this type of study is that it’s non-experimental. This means it doesn’t ‘prove’ causation, but instead draws associations together between different variables. Furthermore, we don’t know if gut bacteria are the causative factor for developing ME/CFS, or if alterations in gut bacteria occur as a consequence of the condition.

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The Healthpath view

Stool testing can provide a comprehensive overview of gut health and may be a useful tool to diagnose dysbiosis in ME/CFS patients. A Registered Nutritional Therapist will consider this—alongside a broad range of other influencing factors—when supporting a person with this condition.

Read the full published study here

Tegan Philp BA PgDip MSc is a Registered Nutritional Therapist. Passionate about all things gut-related, her master’s dissertation was on the role of the microbiome in cardiovascular outcomes. Tegan has over eight years’ experience working for leading nutrition colleges in both Australia and the UK. You can learn more about Tegan on her practitioner page or connect with her via LinkedIn.

Ref: Frémont, M., Coomans, D., Massart, S. and Meirleir, K. De, 2013. Anaerobe High-throughput 16S rRNA gene sequencing reveals alterations of intestinal microbiota in myalgic encephalomyelitis / chronic fatigue syndrome patients. Anaerobe, [online] 22, pp.50–56. Available at: <>.

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