The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a narrative review. — CFSMEATLAS
The potential therapeutic approaches targeting gut health in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a narrative review.
Hsu, Chou-Yi, Ahmad, Irfan, Maya, Rana Warid et al. · Journal of translational medicine · 2025 · DOI
Quick Summary
This review looked at how gut health might be connected to ME/CFS and found that people with ME/CFS often have different bacteria in their gut compared to healthy people. The researchers reviewed studies about various gut-focused treatments like probiotics, dietary changes, and other interventions that might help reduce ME/CFS symptoms by improving the gut-brain connection.
Why It Matters
Understanding the gut-microbiome connection in ME/CFS could open new treatment pathways for a disease with limited therapeutic options. This review emphasizes that personalized microbiome-based interventions might reduce neuropsychiatric and physical symptoms, potentially improving quality of life for ME/CFS patients who currently have few evidence-based treatments.
Observed Findings
ME/CFS patients demonstrate notable changes in gut microbiota diversity and composition compared to controls
Gut dysbiosis is associated with systemic inflammation in ME/CFS populations
Dysbiosis correlates with worsening cognitive and physical impairment severity
Multiple microbiome intervention categories have been explored in preliminary studies (probiotics, prebiotics, dietary approaches, fecal microbiota transplantation, pharmacological agents, sleep optimization, and moderate exercise)
Inferred Conclusions
Gut health dysfunction may contribute to ME/CFS pathophysiology through gut-brain axis mechanisms
Microbiome-targeted interventions warrant further rigorous investigation as potential therapeutic strategies
Standardized diagnostics and longitudinal studies are necessary to develop evidence-based microbiome therapies for ME/CFS
Remaining Questions
Which specific microbiome alterations are causal versus secondary consequences in ME/CFS pathogenesis?
Which microbiome interventions demonstrate efficacy in rigorous randomized controlled trials, and which patient subgroups respond best?
What This Study Does Not Prove
This narrative review does not establish causation between dysbiosis and ME/CFS—only association—nor does it prove that any specific microbiome intervention is effective in treating ME/CFS. The review itself cannot validate clinical efficacy; it identifies promising directions requiring rigorous randomized controlled trials before clinical recommendations can be made.
How can microbiome assessments be standardized and integrated into clinical diagnostic criteria for ME/CFS?
What is the optimal combination of microbiome interventions (probiotics, diet, exercise, etc.) and how should they be individualized based on patient characteristics?