Watai, Kentaro, Taniguchi, Masami, Azuma, Kenichi · International journal of molecular sciences · 2025 · DOI
This review examines how changes in gut bacteria may contribute to ME/CFS, fibromyalgia, and multiple chemical sensitivity—three conditions that share similar symptoms like fatigue, pain, and sensitivity to environmental triggers. The researchers found that people with these conditions tend to have fewer helpful bacteria and more harmful bacteria in their gut, which may affect how their immune system and brain work. The review suggests that treatments targeting the microbiome—such as probiotics or other interventions—might help, though more research is needed to confirm this.
This review provides a unifying biological framework connecting gut dysbiosis to ME/CFS pathophysiology, suggesting that microbiome-targeted therapies may offer new treatment approaches for a condition lacking effective standard therapies. By highlighting shared mechanisms across multiple environmental sensitivity illnesses, it may accelerate research into microbiome interventions and inform personalized treatment strategies for ME/CFS patients.
This narrative review does not prove that dysbiosis causes ME/CFS—it establishes association and mechanistic plausibility but cannot establish causation. The review does not demonstrate that current microbiome-targeted interventions (probiotics, FMT) are effective in ME/CFS, as controlled clinical evidence remains limited. Individual patient responses to microbiome interventions may vary significantly and require further investigation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →