You know a healthy gut is essential to a healthy body and mind, right? But what if a healthy gut is also required to overcome fatigue? What if gut health was the key to increasing your energy?
In the not too distant past, researchers believed that chronic fatigue syndrome was a psychiatric disorder (that fatigue you have, it’s not real. It’s all in your head!). They were even so bold as to call CFS the “yuppie flu”. The era of the yuppie flu was only 30 (or so) years ago! Thankfully, research progressed. And the latest research has put the health of your gut under a new light. Your gut health is so important that an altered microbiome could be the main source of chronic fatigue syndrome.
Once the “yuppie flu” mindset came to pass, researchers actually started taking CFS seriously. They put a concerted effort into looking at what might actually cause chronic fatigue. New understandings of chronic fatigue syndrome suggested CFS came from genetics, infectious diseases (like the Ebstein-Barr virus), or even hormones. While all of these play a role, the latest research suggests that the health of your microbiome (gut) may have a much greater influence on your energy levels than researchers ever thought.
What is the microbiome and how does it relate to fatigue?
Your microbiota consists of 10-100 trillion microbial cells. Yes, there is way more bacteria cells than there is “you” cells. The microbiome consists of the genes these bacteria cells harbor. (1)
To put in perspective of how unique your gut is when compared to anyone else’s, consider the following: you, me, and every other human inhabiting this planet share about 99.9% of the same genes. That 0.1% is what separates you from everyone else (genetically speaking). But your gut microbiome is likely 80-90% different than anyone else on this planet. (2, 3) If you want to talk about individuality, forget genetics, look at your gut!
What if doctors were able to prescribe medication based on the composition of your gut? I’d argue that taking your microbiome diversity (not just your genetic diversity) into account will result in better clinical outcomes than we see today.
So, there may be a 0.1% difference in the genes of someone with chronic fatigue syndrome compared to those with healthy energy levels. But there could be a massive (and often underlooked) difference between the gut health of someone with fatigue compared to those with so-called “normal” energy levels.
With this in mind, exploring the microbiome and how it relates to fatigue will be a pioneering new field of research. Fortunately, you may not have to wait long to see just how your gut influences your fatigue. Read on to learn more!
Your gut on fatigue
In 2016, researchers linked the gut microbiome to chronic fatigue. The genetic information of the bacteria in those with CFS (compared to healthy controls) was significantly reduced. Chronic fatigue sufferers had reduced diversity in their microbiomes. (4) Remember, a healthy microbiome is a diverse microbiome.
In addition to a reduced diversity, those with CFS also had an increase in bacterial species that are known to be pro-inflammatory. Meaning that these particular species of bacteria increase inflammation within the body. These pro-inflammatory species had out-competed the beneficial, or, anti-inflammatory bacterial species. It doesn’t take an expert to tell you that a healthy microbiome has more anti-inflammatory bacteria species than pro-inflammatory bacteria species.
Bacteria aside, researchers also found that the chronic fatigue group had an elevation of blood markers for bacterial translocation. (5) These markers are often referred to as lipopolysaccharides (LPS). Lipopolysaccharides should not be found in your blood. When they are, it signals that there is a leaky gut (intestinal permeability). (6)
When bacteria translocates, it means that the bacteria move from your gut (where they should be) to your bloodstream (where they should not be). It is commonly agreed that elevated lipopolysaccharides (LPS) are indicative of chronic inflammation. Chronic fatigue patients also had other elevated inflammatory markers including c-reactive protein (CRP), intestinal fatty acid-binding protein (I-FABP), and soluble CD14 (sCD14). (7)
Now let’s keep in mind that this was a small study. There were only 87 participants. And the study only drew correlations, not causations. Though researchers were able to guess with 83% certainty which people had CFS based solely on the above gut markers. Nevertheless, more research was needed. Fortunately, a follow-up study was done the next year.
The bacteria of fatigue
A second study done on the link between gut health and chronic fatigue syndrome followed one hundred participants. Fifty of which had CFS. The other 50 were healthy controls and were matched for age, gender, ethnicity, and geographic location.
This study found that there were specific bacterial strains that when found as a resident of one’s microbiome, could accurately predict whether (or not) the person had chronic fatigue syndrome. These bacterial strains include: (8)
When the above bacteria strains gain a strong foothold in your digestive tract, problems (like CFS) arise. In a healthy gut microbiome, you want to see a predominance of Lactobacillus, Bifidobacterium, Enterococci, and Clostridium species. (9) When your gut microbiome is lacking the beneficial bacteria strains and is instead full of the pathological bacteria strains, a condition called dysbiosis arises.
Dysbiosis is a medical term for a microbial imbalance or maladaptation inside the body. You can have dysbiosis in your gut, on your skin, in your urinary tract. Anywhere there are bacteria (which is everywhere) there’s the possibility of having a microbial imbalance (dysbiosis).
Dysbiosis is thought to be a potential cause of gut conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). (9, 10) And this could be why you see so many cases of IBS in those with chronic fatigue syndrome. Those with CFS seem to have a preponderance to gut dysbiosis.
In fact, CFS sufferers seemed to have a pattern of gut bacteria that remained consist amongst most participants of the study. Those with chronic fatigue had an increase in unclassified Bacteroides species and decreased Bacteroides vulgatus species. Participants with both IBS and chronic fatigue showed an increased abundance of unclassified Alistipes bacteria and decreased Faecalibacterium. (11)
In the same study, researchers also found that those with chronic fatigue syndrome had a lowered level of something called short-chain fatty acids (SCFA). (12) SCFAs are what’s produced when fiber is fermented in your gut. (13) To be crystal clear, the fiber that is most beneficial for the bacteria in your gut is something called soluble fiber.
Soluble fiber acts as “food” for the bacteria in your gut. It’s also commonly referred to as a prebiotic. Insoluble fiber is likely what comes to mind when you think of fiber. Insoluble fiber is the stuff that adds bulk to your stool and helps with bowel movements.
Most industrialized diets are low in both types of fiber. But they’re exceptionally low in soluble fiber. If your diet is low in soluble fiber, you’re going to have a decrease in short-chain fatty acid production. This often indicates that there’s not enough “food” (prebiotics) for your gut bacteria to thrive. Should this occur over the long-term, dysbiosis is probable!
Do you have dysbiosis?
Without a laboratory test, it can be pretty tricky to determine whether or not you have dysbiosis. The symptoms of dysbiosis are non-specific; meaning that they could be related to a variety of different conditions. This is why laboratory testing is the preferred means to identify the health of your microbiome.
At the time of this writing, the gold standard for testing involves culturing bacteria from stool samples. The laboratory will attempt to grow the species found within your stool. If they culture more “bad” bacteria than “good” bacteria within your stool, dysbiosis is probable.
But there are certain drawbacks to stool testing. Stool testing only tells you about the bacterial species that are expelled in your feces. These bacterial species may or may not actually take up long-term residence in your gut.
New methods of analyzing bacteria have started coming to market. Companies like Viome have begun using DNA/RNA sequencing of bacteria. This method will likely become the new gold standard. DNA/RNA sequencing is able to give a much more detailed look into what organisms are inhabiting your gut.
Common causes of dysbiosis
Dysbiosis is often the result of past action(s). In the clinic, I often see it caused by:
- Long-term antibiotic use.
- Previous bout(s) of food poisoning.
- Impaired thyroid function.
- Causing a decrease in intestinal motility (constipation).
- Prolonged periods of high stress.
- Eating the standard Canadian/American diet.
- Lack of fermented foods in your diet.
- Lack of fiber (specifically, soluble fiber) in your diet.
Often, the above actions result in SIBO infections and/or irritable bowel syndrome (IBS). Both IBS and SIBO constitutes a long-term stress to your body’s resources. They create an increase in inflammation. Over time, this can result in a decrease in cortisol output (hypocortisolism). And one of the main symptoms of lowered cortisol is fatigue.
To successfully treat (and overcome) chronic fatigue syndrome, I have found that your gut health needs to be optimized. That includes eliminating any possible infection(s) (dysbiosis, SIBO, parasites, etc.) and then following a nutrition plan that is aligned with your genetics.
Without a healthy gut, your energy levels are likely to be impaired!
To overcome fatigue, do you need to treat dysbiosis?
I want to again emphasize the correlation (not causation) between gut health/dysbiosis and chronic fatigue syndrome. With that said, in the clinic, I have found that achieving a healthy gut is essential to overcoming fatigue. If you want more energy, you need to ensure your gut health is optimized.
Below, I give five simple steps you can take tomorrow to start improving your gut health.
Five steps to optimize your gut health:
- Limit your consumption of refined food products.
- This includes foods like: chips, pop, candy, wheat products, and industrial seed oils. These foods have been shown to increase pathogenic bacterial strains in your gut.
- You can learn more about our fatigue reset diet here.
- Eat more whole foods.
- Follow this one rule: if your food doesn’t rot, don’t eat it.
- Increase your prebiotic intake.
- Specifically, soluble fiber. Soluble fiber increases short-chain fatty acid production. This will help to feed the good bacteria in your gut.
- Foods high in soluble fiber include: Jerusalem artichoke, chicory root, onions, garlic, leeks, and green plantains/bananas.
- Add a probiotic supplement
- One simple way to improve dysbiosis is by adding beneficial bacteria strains by way of probiotics.
- Supplements aside, try to consume a daily serving of raw fermented foods like sauerkraut, kimchi, or kefir.
- Get your gut tested
- I recommend performing both a SIBO breath test and a stool test (or, bacterial DNA/RNA sequencing).
- These two tests will help you to know the state of health (or dysbiosis) in both your large and small intestines.
These five steps will get you started on the road to healthy and happy guts. And as you now know, healthy and happy guts are likely necessary to overcome chronic fatigue syndrome.
Now, I want to hear from you.
How has the health of your gut affected your fatigue/energy levels?
Leave your reply in the comments section below!