What is the Connection between SIBO and CFS

[bdonovan]

I understand that many who have CFS also have SIBO. I read an article which describes a possible connection- exertion leading to more gut bacteria (SIBO) which spill over into the blood, leading to an immune response (CFS). But was hoping people might explain if this is the prevailing theory or if there are others- what are they?

The reason I ask is I have been diagnosed with both CFS and SIBO. My initial hydrogen breath test peaked at ~30. After Rifaximin and supplements, I tested again and it was negligible at 3; and my symptoms related to SIBO have mostly gone away. But I still have the fatigue.

Can I expect that my fatigue (or post extertion malaise- PEM) will go down over time now that the SIBO has been addressed. Or does that component of CFS have to be addressed independently. (For what it's worth, I have tested high for a number of markers related to inflammation; tested positive for two auto-antibodies, and had a positive test for bartonella; however the subsequent more granular bartonella test came negative).

 

[Crux]

SIBO and infections of any type can be exhausting, and recovery time can vary,

but it's the susceptibility that can remain.

Using myself as an example, I'm prone to infections because my body accumulates iron. This happens in mammals to varying degrees.

Taking measures to reduce iron has resulted in less infections.
That, along with lowering carbs. and fibers.

I still have a tendency for infections, sibo, etc. , so occasionally, I'll take rifaximin for the gut, and goldenseal tincture for respiratory infections.

 

[Mohawk1995]

The following is a theory that I think applies in this situation: If a primary feature of ME is supression of Metabolic processes then it would make sense that every biologic function that depends on energy can be impacted (which is basically everything). In the case of digestive functions, energy is required to maintain the homeostasis required for optimal function. Any offset of this homeostasis results in imbalances which include SIBO by definition. I have minimal knowledge of the exact pathological, biologic and biochemical processes that lead to SIBO. I am sure someone else smarter than I could explain that.

Because of the pervasive and systemic nature of the Metabolic supression in ME, it then will have a systemic impact. Individual presentation seems to be linked to that individual's genetic make up and predispositions. For some more pain related, to others more digestive functions, others fluid dynamics/BP issues and many more all of which can present in multiple variations with each or every function being impacted. Common for everyone are the functions most sensitive to metabolic supression...neurological functions. Neurophysiological metabolic rate is by far the highest of any tissue/organ in the body so it makes sense that most people with ME suffer from common issues including brain fog, migraines, sleep cycle disturbances and neurologic/neuromuscular tolerance to exertion (not just cardio-vascular or musculoskeletal). Theoretically then PEM may be primarily an adverse neurologic/neuromuscular response to exertion. Again just a theory but seems to match reality of people with ME.

 

[ljimbo423]

Sibo by it's very nature, is often extremely difficult to put into remission and keep it there. I was reading about a 23 year old woman that had sibo and other than that was healthy, no cfs etc. She went on a low carb diet, took 1 or 2 courses of antibiotics to start but did not see noticeable improvement.

She stayed on a low carb diet and took antibiotic herbs every day, with other supplements to heal her gut. It took her 2 full years of daily treatment to finally rid herself completely of sibo! This story is very common. As I said, she was 23 and otherwise healthy. I have severe sibo/dysbiosis, as determined through testing.

I didn't get sibo secondarily to cfs, I got sibo from about 40 courses of antibiotics over as many years. Although I do think that my cfs is making it more difficult for me to treat my sibo, because of all the dysfunctions. I believe sibo is the core issue behind my cfs, that's how it all started, causing a domino effect.

The sibo caused a leaky gut, the leaky gut causes immune system stimulation from lipopolysaccharies getting into the bloodstream and eventually, immune system exhaustion and imbalance/dysfunction. The immune system causes neuro-inflammation from microglial activation and increases oxidative stress levels. The oxidative stress causes mitochondrial dysfunction and methylation dysfunction. All theses dysfunctions feed each other.

Dysfunctional mitochondria create a high amount of oxidative stress, even when they are functioning optimally. When they are dysfunctional, they create higher amounts of oxidative stress, feeding there own dysfunction. Impaired mitochondria, could also cause more impairment of the immune system, and because the immune cells don't have the energy they need they become more dysfunctional.

This is just a theory that I have put together over the last 10 years and there is much more detail to it, that I didn't write here. I feel better today, after treating sibo aggressively in the last few months, than I have for years and I believe the reasons are because of what I have written above. It is a very difficult process for most I believe, but that doesn't mean it can't be done!

 

[Chriswolf]

I have to take a ridiculous amount of supplements to keep my body from succumbing to systemic bacterial infection which often seems to start in my gut.

As another poster has stated, GI infections can absolutely exacerbate fatigue but that might not be the total extent of the cause(s). I find keeping the potential for bacterial proliferation to be a preventative thing but not a complete solution.

Over the last two years I had to take at least three courses of antibiotics because the infection just made its way throughout my body until it was manifesting in the skin. At first my regular doc was skeptical but every time I would come back some 3-4 months after infection and he eventually got the picture.

I would say for me one of the things that's helped the most was getting my thyroid function where it should be. I am also periodically prescribed DHEA which for some bizarre reason helps my GI problems. If my bowels get inflamed and don't move well I know that an infection is not far behind, so I'm basically on a rotating schedule of things to prevent that from happening as well as preemptively cull bacteria before it can get out of control.

I take activated charcoal, I use apple cider vinegar and believe it or not these antiseptic lozenges that I swear help if you swallow them once they're small enough to do so.

Another thing that dramatically improved my gut problems was taking vitamin d, around 3000-5000iu per day, although I usually take it in the evening otherwise for some reason vitamin d makes me quite tired.

Another supplement that has helped my GI problems is bovine collagen and glutamine, I also take around 5000iu of vitamin A every couple of days which also has helped since I've been doing so for the last few months.