New Study Suggests Chronic Fatigue Syndrome Is Not in Your Head; It's in Your Gut

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
July 18, 2023
Woman suffering from chronic fatigue.

Chronic fatigue syndrome (also known as myalgic encephalomyelitis/chronic fatigue syndrome or ME/CFS) is a complex disorder that affects about 2.5 million Americans. U.S. Centers for Disease Control and Prevention reports that ME/CFS can strike anyone, but it most often occurs among middle-aged Caucasian women.

Chronic fatigue is often mistaken for ME/CFS; yet the two conditions are considerably different. While chronic fatigue can be long-term like ME/CFS, extreme tiredness is usually the main symptom and generally stems from stress, nutritional deficiencies, insomnia, overexertion, depression or another condition. And while the typical ME/CFS patient also experience exhaustion, the Mayo Clinic reports that it’s also typical to have symptoms that can take a lasting toll on your health, such as:

  • Disrupted, poor quality sleep
  • Extreme fatigue and general malaise after mental or physical exertion that lasts 24 hours or longer
  • Difficulty concentrating and remembering information
  • Muscle aches, joint pain, headaches
  • Enlarged lymph nodes in neck or underarms
  • Sore throat

ME/CFS also can co-occur with conditions other conditions including: 

  • Fibromyalgia
  • Chronic pelvic pain and/or Interstitial cystitis
  • Irritable bowel syndrome
  • Temporomandibular joint dysfunction (TMJ)
  • Multiple chemical sensitivity

ME/CFS lacks a specific diagnostic test, and its symptoms mimic those of other conditions, making it difficult for doctors to diagnose. If a doctor suspects ME/CFS, they often conduct a wide range of screenings to rule out other illnesses before settling on an ME/CFS diagnosis. 

For years, stress was considered the primary culprit in CFS/ME. But over time, experts realized a growing list of issues like early menopause, brain abnormalities, inherited viruses also were possible triggers. But additional National Institutes of Health-funded studies also suggest that disruptions in gut microbes may be a signature for ME/CFS, according to two studies published in Cell Host & Microbe.

In a small study, conducted at Columbia University Mailman School of Public Health, researchers compared bacterial species of study participants with ME/CFS to that of healthy control participants. ME/CFS participants had very low levels of Faecalibacterium prausnitzii and Eubacterium rectale -- bacteria that produce butyrate, a fatty acid involved in gut health. For instance, a few butyrate functions include supplying energy to cells that line the gut, supporting gut immunity and protecting the digestive tract against diseases. Meanwhile, these participants had elevated levels of nine other types of bacteria linked to inflammatory bowel disease and autoimmune conditions. 

In the second study, researchers from Jackson Laboratory (Farmington, CT), collected fecal and blood samples from a group of participants diagnosed with ME/CFS within the last four years, a group of participants who’ve lived with ME/CFS for more than 10 years and a group of healthy participants. Results showed:

  • 4-year ME/CFS group had less microbial diversity, lower levels of Faecalibacterium prausnitzii and a  bacterial strain involved in metabolizing tryptophan.
  • 10+-year ME/CFS group had different compilations of microbiomes, but they were more balanced and like participants in the healthy group. However, their symptoms were more severe and metabolic irregularities were more progressive.

“The bottom line is: If you are struggling with GI symptoms, particularly if you’re also dealing with fatigue, muscle aches or sore throat, ask your doctor to look into ME/CFS, along with digestive conditions,” says Kaminetsky. 

Controlling Chronic Fatigue Syndrome Symptoms

If you’re diagnosed with ME/CFS, there is no cure, but there are some steps you can take that may help ease its symptoms; for instance:

Track your energy/fatigue levels: Keep a diary of what days of the week and times of the day you feel more or less fatigued to assist you in determining a pattern of energy levels. This can help you adjust your schedule to be most effective at accomplishing work, school and household responsibilities.

Control your energy levels: Learn to pace yourself. Avoid overexertion when you feel more energetic, as it can lead to exhaustion, requiring days to recover. Studies have suggested that light exercise like stretching, walking and swimming can help alleviate some symptoms and raise energy levels. Further, a healthy diet consisting of plenty of fruits, vegetables, whole grains, lean proteins and low-fat dairy products can be of more value to a ME/CFS patient than processed foods.

Follow the basic principles for improved sleep: Keep your bedroom dark, quiet and at a comfortable temperature. Make sure you have a good mattress and comfortable pillow. If you cannot fall asleep within 15 minutes, find an activity that can help you feel sleepy like reading or meditating. Avoiding caffeine, alcohol and tobacco hours before your bedtime can also help you sleep better.

If you have been diagnosed with ME/CFS, your doctor can help you manage the condition, treat other conditions associated with ME/CFS and coordinate your care with specialists. Don’t have an MDVIP-affiliated doctor? MDVIP has a nationwide network of doctors. Find one near you and begin your partnership in health»



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New Research Sheds Light on Chronic Fatigue Syndrome / Janet Tiberian, MA, MPH, CHES / September 15, 2015

About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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