chronic fatigue syndrome and dysbiosis

Chronic Fatigue? – Investigate the gut

The intestinal tract is also known as many things, the second brain, the center of immunity, the first line of defense, and all of these descriptions are far better at elucidating the critical role of this essential organ. It is true that dysfunction of intestinal tract has repercussions far beyond constipation and diarrhea. When you have a gut infection, dysbiosis, intestinal hyper-permeability or other pathologies the effects are far reaching including joint pain, chronic illness, anxiety and depression, brain fog, fatigue, hormonal imbalances, weight loss resistance, and the list goes on!

A recent article further supported the intestinal basis of multi system chronic disease, when they investigated the gut microbiome, or gut bacteria, of individuals with chronic fatigue syndrome, also formally known as myalgic encephalomyelitis (ME).  ME is a debilitating chronic condition hallmarked by pathological fatigue, lasting greater than 6 months, as well as other symptoms such as muscle or joint pain, sore throat, headaches, unrefreshing sleep and post exertional malaise.

Having worked closely with this population it is apparent that many people also experience chronic gastrointestinal symptoms, often diagnosed with irritable bowel syndrome, along with chemical sensitivities, and other aberrant immune system issues.

So how does this all fit together? Giloteaux et al1 suggest that those with ME have both immune activation, and immune dysregulation due to damage to the intestinal lining, that leads to an increase in the ability of intestinal microbes, and their toxins (known as lipopolysaccharide), to enter our blood stream. When the intestinal lining doesn’t function as a barrier, letting in the nutrients and keeping out the invaders, this can lead to immune system chaos! Another finding in this study was that individuals with ME also had a lower microbial diversity, with fewer anti-inflammatory bacterial strains, and less butyrate producing bacteria. Together, these things have been associated with increased inflammation in the body (joint pain, energy production issues, hormonal imbalances etc), abdominal pain/discomfort, food intolerances and fatigue.

What does this mean for your health?

The good news out of all of this is that as quickly as the scientific literature is progressing, so to is the ability of clinicians to run advanced testing and provide patients with insight into the state of their gastrointestinal tract. Stool testing, urinary organic acids testing (looking into gastrointestinal function,  nutrient deficiencies, and energy production pathways), and serum testing have all become staples of the modern diagnosticians office. Now, more than ever, we have the ability to isolate what could be the underlying issue causing a patients symptoms, and we have the research to provide insights into how to effectively and efficiently treat those concerns.

Whether you have myalgic encephalomyelitis or not, this article further supports that we in the medical field need to be further investigating the intestinal tract as the basis of disease. ME was long thought to be a psychosomatic or mental health condition and now, with more research, we are finding that there are pathological mechanisms at play. I fully believe that the more we research our lovely (or not so lovely) gut bugs the more we will find that other chronic ‘unexplained’ symptoms were not so unexplainable after all!


  1. Giloteaux, L. et al. Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome 4, 1–12 (2016).