Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review.
Roman, P, Carrillo-Trabalón, F, Sánchez-Labraca, N et al. · Beneficial microbes · 2018 · DOI
Quick Summary
This review looked at whether probiotic supplements (live beneficial bacteria) might help people with ME/CFS or fibromyalgia. Researchers searched for high-quality studies and found only two small studies in ME/CFS patients. These studies showed that specific probiotic strains reduced anxiety and markers of inflammation, but there isn't enough evidence yet to say probiotics are a proven treatment.
Why It Matters
Understanding the role of gut microbiota in ME/CFS pathophysiology is important because it may identify new therapeutic targets. This review highlights that specific probiotics show promise for anxiety and inflammation—key ME/CFS features—but also reveals a critical gap in the research that limits clinical recommendations.
Observed Findings
Lactobacillus casei strain Shirota reduced anxiety scores in CFS patients after 8 weeks of treatment
Lactobacillus casei strain Shirota altered fecal microbiota composition after 8 weeks
Bifidobacterium infantis 35624 reduced inflammatory biomarkers in CFS patients over 8 weeks
Only 2 high-quality RCTs met criteria from 10 years of literature (2006–2016)
No studies meeting inclusion criteria were found in fibromyalgia syndrome patients
Inferred Conclusions
Specific probiotic strains may modulate anxiety and inflammatory processes in CFS patients
The current evidence base for probiotic treatment in CFS and FMS is too limited to support clinical recommendations
Future research must focus on core disease symptoms and include larger, well-designed trials
Gut microbiota may represent a modifiable target in CFS management
Remaining Questions
Do improvements in anxiety and inflammatory markers translate to improvement in ME/CFS-specific symptoms like post-exertional malaise or cognitive dysfunction?
Which probiotic strains or combinations are most effective, and at what doses and durations?
What This Study Does Not Prove
This review does not establish that probiotics are an effective treatment for ME/CFS or that microbiota dysbiosis causes ME/CFS. The extremely limited number of studies (only two) means these findings cannot be generalized, and the modest sample size leaves uncertainty about clinical significance. Improved anxiety and inflammatory markers do not necessarily translate to improvement in core ME/CFS symptoms like post-exertional malaise or fatigue.
Tags
Symptom:Fatigue
Biomarker:Cytokines
Method Flag:Weak Case DefinitionSmall SampleExploratory OnlyMixed Cohort