Lower Bacterial Diversity in ME/CFS Patients

Kathy Wheddon Nutritional Therapist DipION

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 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.

woman suffering from headache
Headaches, fatigue and IBS are amongst the common symptoms of ME/CFS

Study results

Study results showed differences between the gut microbiome (find out more about the microbiome in our sister site, the Probiotics Learning Lab) 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?

Or find out more about probiotics


  1. 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.