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Gut Bacteria Are Different in People With Chronic Fatigue Syndrome (TNYT)

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Gut Bacteria Are Different in People With Chronic Fatigue Syndrome
By NICHOLAS BAKALAR JULY 7, 2016 4:12 PM July 7, 2016 4:12 pm Comment
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wellcfs-tmagArticle.jpg

Donna Flowers, a former pro figure skater and physical therapist who works with elite athletes, was debilitated by chronic fatigue syndrome several times and was unable to work.Credit Heidi Schumann for The New York Times
  • study published in Microbiome, researchers recruited 48 people with C.F.S. and 39 healthy controls. Then they analyzed the quantity and variety of bacteria species in their stool. They also searched for markers of inflammation in their blood.

    The stool samples of those with C.F.S. had significantly lower diversity of species compared with the healthy people — a finding typical of inflammatory bowel disease as well.

    The scientists also discovered that people with C.F.S. had higher blood levels of lipopolysaccharides, inflammatory molecules that may indicate that bacteria have moved from the gut into the bloodstream, where they can produce various symptoms of disease.

    Using these criteria, the researchers were able to accurately identify more than 83 percent of C.F.S. cases based on the diversity of their gut bacteria and lipopolysaccharides in their blood.

    Finding a biomarker for C.F.S. has been an ongoing goal for researchers who hope to one day develop a diagnostic test for the condition. Still, the senior author of the study, Maureen R. Hanson, a professor of molecular biology at Cornell, said the bacteria blueprint in the new study is not yet a method of definitively diagnosing C.F.S. The importance of the finding, she said, is that it may offer new clues as to why people have these symptoms.

    “There’s a biological difference between people with C.F.S. and healthy people,” she said. “The long-lasting idea that it’s a psychological illness should be abandoned.”
 

barbc56

Senior Member
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3,657
One thing that confuses me is if other populations have the same biological results is that still a biomarker and how would that fact effect the ability to predict who has me/cfs? Would you have at add other factors/biomarkers to make a prediction more reliable? Would that mean you're more likely looking at a downstream effect? I would think even if it's a downstream effect, it's still valuable information.

I don't know if the above even makes sense since I may be misunderstanding the definitions. Maybe someone with more expertise on this could chime in.

The whole area of the gut in relation to disease is fascinating and will certainly be something to watch in the future.
 
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Bob

Senior Member
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One thing that confuses me is if other populations have the same biological results is that still a biomarker and how would that fact effect the ability to predict who has me/cfs? Would you have at add other factors/biomarkers to make a prediction more reliable? Would that mean you're more likely looking at a downstream effect? I would think even if it's a downstream effect, it's still valuable information.
All good questions and observations, barb. The study combined an assessment of gut populations with immune markers, in a computer analysis, in an attempt to identify biomarkers. So the study doesn't use gut populations alone. But the results weren't tested on a wider population, outside the study, so it's more than likely that they won't be successful biomarkers when replication efforts are carried out, but they may be a very good start to build upon. If other cohorts (e.g. people with other illnesses) have similar results then the biomarker potential would be reduced but could still be helpful in various circumstances. That's as far as my understanding goes, anyway. My guess is that these are downstream effects but, as you say, it's still useful info whether downstream effects or not.
 

panckage

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  • The stool samples of those with C.F.S. had significantly lower diversity of species compared with the healthy people — a finding typical of inflammatory bowel disease as well.
I'm going to play devil's advocate here and say our diet on average differs from regular people. When we lack energy our diets tend to be more spartan and less varied. And I know for my IBS I have to avoid a lot of foods. Given the expected reduced food diversity intake of PWME and IBS shouldn't it be expected that there is less species in our stool?

Has the above type of argument been ruled out?
 
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I'm going to play devil's advocate here and say our diet on average differs from regular people. When we lack energy our diets tend to be more spartan and less varied. And I know for my IBS I have to avoid a lot of foods. Given the expected reduced food diversity intake of PWME and IBS shouldn't it be expected that there is less species in our stool?

Has the above type of argument been ruled out?

I would be inclined to think that is not the major factor here, but rather the lack of diversity of gut flora.

What would be useful is if the scientists would identify the species of flora a particular antibiotic is likely to wipe out. That way people who have been subject to antibiotic use could look to supplement that particular species.

Also it's unlikely that PWME would be able to supplement for this lack of diversity but it would be useful for stool tests to identify majorly lacking species. That is what would be more useful rather than this hit and miss method of probiotic use.
 

Daffodil

Senior Member
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5,873
@panckage .... i have found that since i got ill, i have been REALLY hungry all the time...sometimes even waking up in the middle of the night to eat. i eat almost double the amount of food as i did before!
 

panckage

Senior Member
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777
Location
Vancouver, BC
@panckage .... i have found that since i got ill, i have been REALLY hungry all the time...sometimes even waking up in the middle of the night to eat. i eat almost double the amount of food as i did before!
That happened to me to too. Although for me it was due to IBS which I got a few years before CFS. I had the curious symptom that if I ate right before bed I would always wake up starving. If I didn't eat before bed I wouldn't be hungry when I work up :p

I guess I just wasn't digesting my food properly because when I was able to eliminate my IBS (through avoiding problem foods) I now eat way less and can go much longer between meals
 

JaimeS

Senior Member
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3,408
Location
Silicon Valley, CA
One thing that confuses me is if other populations have the same biological results is that still a biomarker and how would that fact effect the ability to predict who has me/cfs? Would you have at add other factors/biomarkers to make a prediction more reliable? Would that mean you're more likely looking at a downstream effect? I would think even if it's a downstream effect, it's still valuable information.

I don't know if the above even makes sense since I may be misunderstanding the definitions. Maybe someone with more expertise on this could chime in.

The whole area of the gut in relation to disease is fascinating and will certainly be something to watch in the future.

Actually two other smaller studies have found some similar results in other countries.
 

JaimeS

Senior Member
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3,408
Location
Silicon Valley, CA
Hey, everyone, please comment on that article. The comments section is gross and awful. Here's my comment:

ME/CFS patients tend to be more prone to infection, and might have taken more abx than controls.

However, this is the third study to note screwy levels of Firmicutes in particular. These other studies were not performed on the same patients in the same countries (where the most 'popular' antibiotic for different conditions differs) yet they found the same results.

ME/CFS is classified as neurological (as per the CDC and WHO), and there are documented biological abnormalities in the condition -- check out the International Consensus Criteria.

Yet the power of negative thinking, a la 'the Secret', is still a favorite rationale of the public. By being lazy -- or Type A overachievers, depending on who you ask -- we have primed our bodies to express illness. This expresses 'belief in a just world': the sick must have done something to earn their illness, or else anyone can get it for no reason at all, which would be unfair and therefore impossible. Yet a perceived moral high ground has no protective power. Anyone can get a chronic illness.

Studies have found that the emotional functioning of CFS individuals aligns with that of controls, and that severity of other symptoms does not correlate to emotional functioning. ME/CFS is not a form of depression, even if two people you knew once had both.

Finally, the idea that people who have depression or disability of ANY kind are unworthy of care comes through clearly in many of these comments, which is really disturbing.

Among comments:
  • CFSers are young twenty-somethings who don't want to face the world and choose to live with their parents
    • (what?! Average age of onset way higher -- this is an unconscious coupling of the 'lazy' picture of CFSers and modern frustration with 20-somethings not being able to 'make it' in today's miserable US economy.)
  • Just because you found evidence of biological abnormality doesn't mean that the psychology of these people's illness didn't cause that biological abnormality
    • (frequently -- the psychosomatic model is strong with these ones ;) Seriously, I was shocked how many times I saw a comment that was the equivalent of 'just because there is abundant biological evidence doesn't mean their brains aren't directing all this to happen,' wow.)
  • "I'll believe this when it's repeated."
    • (So far as I know, this is the third such study with significantly consistent results.)
  • "I knew two ppl with CFS and they were both depressed."
    • (What a great example of 'Proof By Example' logical fallacy! Eurgh, this represents 0.0001% of the people with ME/CFS in the US, this does not mean anything valid!)
  • If patients are depressed, this de facto means they are unworthy of care / attention / faking / should get over themselves.
    • (Implicit -- over and over and over again.)
Really disturbing. If you feel moved and motivated to make some intelligent comments to counteract others' ignorance please chime in.

I know it's online, but the fact that this is the NEW YORK TIMES is doubly galling: there was an outbreak there in the 1990s, there are a LOT of sick people in that area of the country. These people all KNOW someone diagnosed, I guarantee you, if they are NYers. The fact that they still are so ignorant is therefore both awful and willful.

-J
 

Sasha

Fine, thank you
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UK
Sorry to hear the comments are so crappy.

Don't forget to provide positive links to things that we want sensible people to see - to the OMF, #MEAction and so on.
 

JaimeS

Senior Member
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3,408
Location
Silicon Valley, CA
Mentioned the international consensus criteria -- lit what I wrote is the longest allowable comment. I could have split up into multiple comments, but I didn't want to appear to be spamming.

[Edit: others, though -- please do this!]

-J
 
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TigerLilea

Senior Member
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1,147
Location
Vancouver, British Columbia
@panckage .... i have found that since i got ill, i have been REALLY hungry all the time...sometimes even waking up in the middle of the night to eat. i eat almost double the amount of food as i did before!
I have found that the more exhausted I am, the more I feel the need to eat. According to Dr. Oz it has something to do with the Leptin hormone. I will also get up some nights to have a bite of cheese because I'm so hungry that it keeps me awake. And I always eat dinner so it's not like I didn't have enough to eat the day before.
 

TigerLilea

Senior Member
Messages
1,147
Location
Vancouver, British Columbia
I'm going to play devil's advocate here and say our diet on average differs from regular people. When we lack energy our diets tend to be more spartan and less varied. And I know for my IBS I have to avoid a lot of foods. Given the expected reduced food diversity intake of PWME and IBS shouldn't it be expected that there is less species in our stool?

Has the above type of argument been ruled out?
I don't know that I agree with that. For myself, I love to cook and I love to eat, so I tend to have a varied diet most of the time. Most meals are home cooked - I eat very little prepackaged food.
 

JaimeS

Senior Member
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Location
Silicon Valley, CA
Demeirleir has been saying exactly this for like 10 yrs or more.

Believe me, I'm not complaining -- rather, I'm in awe of the Cornell U. media team. This article is EVERYWHERE, and I agree, it's being presented like it's the first time gut dysbiosis was ever discovered in ME patients as the result of the work of reputable scientists.

I think science is used to findings being replicated a hundred times for more well-known illnesses, though. Three studies so far isn't impressive to others.

We're so used to such a low number of studies done on our illness that three small studies sounds like a smorgasbord of data.

-J
 
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ebethc

Senior Member
Messages
1,901
"The scientists also discovered that people with C.F.S. had higher blood levels of lipopolysaccharides, inflammatory molecules that may indicate that bacteria have moved from the gut into the bloodstream, where they can produce various symptoms of disease."

are lipopolysaccharides in the bloodstream proof of leaky gut?
 

mermaid

Senior Member
Messages
714
Location
UK
What are 'firmicutes'? Are they the Beneficial Bacteria in the gut? My Genova test did not mention firmicutes.
I had a stool test done some years ago and the BB were on the whole low in my stool apparently (well one was high but the others were very low or non existent, but I had not had antibiotics for probably 25 years or more.

Since then I have over time I hope improved matters as my gut functions much better now. Mostly I just make my own kefir and eat a good quality varied diet. I still have ME/CFS symptoms but some of them have improved over the past few years.