I don't think SBOs are the entire picture. I am fairly confident that often in the case of ME there is a variable that is causing the intestinal villi to deteriorate or inflame. This could be an infection producing thiaminase (an enzyme that destroys thiamine in the body) possibly being produced by a bacteria as is seen in livestock. It could be an infection of any kind - a neurotransmitter imbalance causing gut inflammation and immune dysfunction... list goes on.
In any event the intestinal villi problem goes hand in hand with the poor functional status of the liver in ME (poor alcohol tolerance being a great example of this). Ultimately something is impairing the nutritional status of the body in my opinion.
And when you start getting into vitamin deficiencies from malabsorption or anti-vitamin metabolites (of which there are more than just thiaminase), entire metabolic cycles are disrupted. A thiamine deficiency for example could entirely disrupt the Krebs Cycle via interference with the pyruvate dehydrogenase complex. Lactate can also build up ... any of these is enough to greatly impair liver function.
SBOs may be one tool in addition to orthomolecular methods of restoring nutrition to a body that has compromised absorption and or the presence of anti vitamin metabolites such as thiaminase.
http://en.wikipedia.org/wiki/Thiaminase
Infection alone by mycoplasma and unwanted bacteria is enough to disrupt the pyruvate dehydrogenase complex
http://www.ncbi.nlm.nih.gov/pubmed/8856841
http://www.ncbi.nlm.nih.gov/pubmed/6423397
Gut bacteria also synthesize neurotransmitters and are capable of producing and reducing lactate.
As I have said in past posts, I think in the future we will see an entire branch of medicine evolve that treats specific diseases and deficiencies with restoration of specific gut flora.
So lol for a second I will pretend I was Klinghardt who likes to say "If I was a bug I would do such and such to disrupt the body's defenses and ensure my survival..."... well if I was a bug I would definitely first try to interfere with mitochondrial dependent cycles like the pyruvate dehydrogenase complex/krebs cycle and B complex status.
I have seen great results from taking individual coenzyme forms of b vitamins in high amounts like benfotiamine. I don't get these same results when taking a multivitamin or even a coenzyme complex multivitamin. I'm not sure even science knows the state of competitive inhibition these vitamins are capable of, or the degree to which the various coenzyme and non coenzyme forms of each vitamin is capable of absorbing in a potentially already compromised intestinal villi. I think glutamine in powdered form (I take 2 spoonfulls a day - I just stick the spoon full of glutamine in my mouth and wash it down with water immediately and it dissolves) can be particularly useful considering our ancestors were eating pounds and pounds of animal flesh containing probably close to 200 grams of glutamine per day which is essential to rebuild the intestinal villi.
Furthermore I would say that with the knowledge of thiaminase producing bacteria and potential interruptions in these metabolic cycles, supraphysiological doses of vitamins are a good bet even in spite of normal b vitamin status on a lab result.
I know from first hand experience with cows that their intestinal villi depend on the type of gut flora they have. For example if they are switched to a grain diet from a grass diet and are not innoculated with lactic acid utilizing bacteria their intestines upon post mortem examination look like they were left in a blast furnace and the villi are totally destroyed from the lactic acid generated that otherwise could have been prevented with innoculation with lactic acid utilizing bacteria.
How does this apply to humans... well our doctors love rxing antibiotics. And considering most people probably have pathogenic bacteria in them at any given moment, it would take only a matter of days of killing good bacteria with antibiotics for potentially bad bacteria to take hold. And then you factor in that some of the good bacteria could have been synthesizing vitamins, reducing lactate and doing all kinds of good things aside from just inhibiting pathogenic infection...and it is thus one mechanism to develop ME.
Patients with malabsorption often have low interferon levels which could explain why viruses wreak havoc in ME patients.
Strptomyces griseu is just one bacteria that is found everywhere, even in soil - which is capable of producing mitochondrial toxins. It is also capable of inhibiting the actions of thiamine - to which a treatment with supraphysiological doses of thiamine could potentially compensate for.