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Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome...

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
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721
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Canada
http://www.sciencedirect.com/science/article/pii/S1984006315000632
(Open access)


Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study
  • Melinda L. Jackson
  • Henry Butt
  • Michelle Ball
  • Donald Lewis
  • Dorothy Bruck

Abstract
Chronic Fatigue Syndrome (CFS) is a multisystem illness, which may be associated with imbalances in gut microbiota. This study builds on recent evidence that sleep may be influenced by gut microbiota, by assessing whether changes to microbiota in a clinical population known to have both poor sleep and high rates of colonization with gram-positive faecal Streptococcus, can improve sleep. Twenty-one CFS participants completed a 22- day open label trial. Faecal microbiota analysis was performed at baseline and at the end of the trial. Participants were administered erythromycin 400 mg b.d. for 6 days. Actigraphy and questionnaires were used to monitor sleep, symptoms and mood. Changes in patients who showed a clinically significant change in faecal Streptococcus after treatment (responders; defined as post-therapy distribution<6%) were compared to participants who did not respond to treatment. In the seven responders, there was a significant increase in actigraphic total sleep time (p=0.028) from baseline to follow up, compared with non-responders. Improved vigour scores were associated with a lower Streptococcus count (ρ=−0.90, p=0.037). For both the responders and the whole group, poorer mood was associated with higher Lactobacillus. Short term antibiotic treatment appears to be insufficient to effect sustainable changes in the gut ecosystem in most CFS participants. Some improvement in objective sleep parameters and mood were found in participants with reduced levels of gram-positive gut microbiota after antibiotic treatment, which is encouraging. Further study of possible links between gut microorganisms and sleep and mood disturbances is warranted.
 

msf

Senior Member
Messages
3,650
This makes sense to me - I find that what I eat strongly influences how I sleep. Since I have been on the FODMAP diet, I wake up no more than once a night, whereas before it was every couple of hours.
 

msf

Senior Member
Messages
3,650
The Lactobacillus finding is interesting, is this because it also produces lactic acid?
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
The Lactobacillus finding is interesting, is this because it also produces lactic acid?
I would guess so but am not sure.

I expect he has heard it a thousand or more times, but I just love the appropriateness of the lead author's name to his study area...

Seriously, fixing the gut has benefited many of us, but I personally don't like to go down the antibiotic line other than the natural antibiotic grapefruit seed extract.

Mostly I have just relied on the right diet plus certain supplements. It has made a huge difference to my sleep and also anxiety levels.

Another approach is faecal transplant, which has helped some, I understand, but I really don't like the thought of it!
 

msf

Senior Member
Messages
3,650
Haha, I didn´t register the irony until you pointed it out.

I´m just about to take a course of antibiotics for this very purpose, but I can see why others would shy away from messing around with their already messed-up guts.

I don´t fancy the idea of a faecal transplant either, although one of the decolonization techniques I discovered recently must come close in terms of disgustingness - this is gut lavage, which is also used before colonoscopies.

NB. I just read that it has been used to treat severe sepsis!
 
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MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I´m just about to take a course of antibiotics for this very purpose, but I can see why others would shy away from messing around with their already messed-up guts.

I don´t fancy the idea of a faecal transplant either, although one of the decolonization techniques I discovered recently must come close in terms of disgustingness - this is gut lavage, which is also used before colonoscopies.

NB. I just read that it has been used to treat severe sepsis!

What is used to treat severe sepsis?

I prefer to avoid antibiotics, and gut lavage, because I have improved my gut function so much, and don't want to risk going back to the state it was in before, as I expect from experience that all my ME symptoms will also return with a vengeance, as they follow changes in gut function so closely.

I find that grapefruit seed extract seems to treat unwanted microbes without adversely affecting gut function - in fact it usually improves it for me.
 

Sea

Senior Member
Messages
1,286
Location
NSW Australia
I expect he has heard it a thousand or more times, but I just love the appropriateness of the lead author's name to his study area...

Haha yes, I have to admit I laugh everytime I see it. Another funny one was the name of the surgeon who removed my daughter's appendix - Dr Butchers
 

msf

Senior Member
Messages
3,650
Gut lavage has been used to treat severe sepsis once or twice, with good results.

Do you still have that lactic feeling, MeSci? I´m hoping that the antibiotics will help with this.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Gut lavage has been used to treat severe sepsis once or twice, with good results.

Do you still have that lactic feeling, MeSci? I´m hoping that the antibiotics will help with this.
I don't really know what you mean by a lactic feeling. When my gut is messed up the main gut symptoms are bowel looseness and urgency, and sometimes nausea and excessive hunger. Non-gut symptoms worsen soon after.

I do have various mostly-mild abdominal pains which fluctuate. At present these are most commonly gastroesophageal-type pains and groin pain, but I really don't know the cause. I have had gut problems on and off since childhood. Never really got to the bottom of it :lol: but my self-treatments have helped more than anything doctors have done.
 

msf

Senior Member
Messages
3,650
It´s the feeling that you get in your legs after you walk a long way, but I have it sometimes when I get out of bed in the morning.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
It´s the feeling that you get in your legs after you walk a long way, but I have it sometimes when I get out of bed in the morning.
Oh, that one. I don't think we are sure what the biochemical correlates of that are - is it hyperlactaemia, is it excessive carbonic acid, is it a mineral deficiency...? I would love to know.

Supportive of it being an excess of some kind of acid is the fact that it sometimes disappears quite fast when I take sodium bicarbonate, but only sometimes.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Hmm, maybe I will give it a go.
Why not read some of the threads about it before you try? Get an idea of whether it sounds likely to help you. Some people refer to it as baking soda. If you decide to try, try a low dose first (a good general rule when trying something).
 

M Paine

Senior Member
Messages
341
Location
Auckland, New Zealand
I'd like to know more and see more research into the correlation between various cytokine profiles and the gut epithelium microbiome. The paper recognizes, as one might expect, that the effects of antibiotics are transient. That the shift of Enterococcus and Streptococcus is returning to an 'unfavorable' level.

That healthy controls were observed to have lower baseline levels of these organisms seems to suggest that something is happening with these CFS patients that favors those microbes.

Perhaps that 'something' could be an immune mediated response? It would be an interesting exercise to separate CFS patients into groups via Cytokine profiles, and re-evaluate the gut microbiome in those patients.

Additionally it would be interesting to measure the Virome of these patients, and it's relationship with the profile of the intestinal microbiome.

It would seem that there is a great variation in the profile of one patient, to the next. It would seem logical to assume that sub-grouping the illness further might help to provide more targeted approaches to G.I. management.
 

msf

Senior Member
Messages
3,650
I´m a patient of KDM, and he explained to me why these bacteria flourish - basically changes in the body favour the growth of these bacteria, but I´m sure you would have guessed that anyway. I think he believes that these changes are immune mediated.
 

M Paine

Senior Member
Messages
341
Location
Auckland, New Zealand
This makes sense to me - I find that what I eat strongly influences how I sleep. Since I have been on the FODMAP diet, I wake up no more than once a night, whereas before it was every couple of hours.

I´m a patient of KDM, and he explained to me why these bacteria flourish - basically changes in the body favour the growth of these bacteria, but I´m sure you would have guessed that anyway. I think he believes that these changes are immune mediated.

Did they recommend the low FODMAP diet?
 

msf

Senior Member
Messages
3,650
No, but when I told KDM I was on it, he said that it was a good diet to be on. I´m not sure why he doesn´t recommend trying it to everyone, but he does tell them to eat a diet low in simple sugars, so fructose is out.

Has it helped you a lot? It´s the thing that has made the biggest difference (positive difference, that is) for me so far.
 

M Paine

Senior Member
Messages
341
Location
Auckland, New Zealand
I suppose that people who have IBS symptoms like diarrhea, constipation, gas, bloating and/or cramping would stand to gain the most from low FODMAP diets.

It would be interesting to know how the strains of bacteria mentioned in this paper respond to diets low in FODMAPs, however since it is likely that the immune system modulates the population of the microbiome, then it stands to reason that modulating diet alone may not be the most effective approach, and that modulating the immune system is a potential area for treatment strategy.