I have been back-channeled by several people on what tests to do. There are several approaches possible:
- Assume that you have similar to the reported gut-flora dysfunction presented at the 1998 Clinical and Scientific Meeting in Australia by Butt HL [1,2], Dunstan RH , McGregor NR , Roberts TK, Harrison TL and Grainger JR from Department of Biological Sciences, University of Newcastle, Newcastle Australia (partially confirmed by Richard Schloeffel, MD at the 2001 Clinical and Scientific Meeting)
- Test using one of the commercial gut bacteria packages
- Find a state of the art university department willing to test…
For myself, I assumed that I matched the pattern seen in the population of 27 CFS patients that was reported on.
Normal Gut Bacteria Populations
You should know that every person’s gut bacteria is different. Fecal transplants work much better from blood relatives than spouses or strangers. It appears that gut bacteria is inherited (possible influenced by DNA).
|Bacteroides||1010 – 1012|
|Bifidobacterium||108 – 1011|
|Clostridium||106 – 1011|
|Eubacteria||109 – 1012|
|Lactobacillus||106 – 1010|
|Peptostreptococcus||1010 – 1012|
|Enterobacter (Escherichia Coli and other)||104 – 1010|
|Staphylococcus||104 – 109|
I will be reviewing these two tests today (please tell me of any additional tests that you are aware of). Note that most of these tests are marked with “assays are For Research Use Only“.
- Genova’s Metametrix, which is used by Dr. Sarah Myhill, MD in the UK. A sample report is here
- Genova DigestiveTests (Great Smokies) – quite popular in the US, sample report is here and here. The use a 1-4 rating that can be confusing to interpret (a reading of “3” could be Normal, High or Low:
- Diagnos-Techs GI Health Panel™:. Sample Here
So how do you evaluate these? My take is:
- Do they cover the families reported from Australia (if they cover other stuff, that is fine)?
- Do they provide information on overgrowth or undergrowth (Especially for E.Coli)? Is the information more than “No issue” or “Issue”?
|Australian Results||Metametrix||Great Smokies||Diagnos-Techs|
|Low Bifidobacterium species||yes||Yes||?|
|Low Lactobacillus species||yes||Yes||?|
|Low Bacteroides species||yes||No||?|
|Low Escherichia coli||yes||Yes||Yes|
|High Enterobacter species||no||Yes(*)||?|
* – indicate appearance of single species of the family test
My general opinion is that Myhill’s choice is the best for CFS. I will do a future post on the ideal test (IMHO).