In this post, I am going to represent my model as a series of diagram with the typical reported path “CFS after a flu-like illness” — which may actually be the flu!
- Metagenomics: A New Way to Illustrate the Crosstalk between Infectious Diseases and Host Microbiome . ” In particular, Firmicutes andProteobacteria phylum, as well as the Moraxellaceae family could be identified as the predominated bacteria in the patients with H1N1 influenza in both reports. It suggested the potential correlation between these bacteria and influenza infection.”
- Regulation of lung immunity and host defense by the intestinal microbiota. 
The Stuck Microbiome
The microbiome normally returns to it’s prior state, this post looks at the evidence that a percentage does not return – and is often called post-infection fatigue (because the infection triggering it was known and was successfully treated).
The evidence from changing the microbiome (via a fecal transplant) results in remission strongly suggests that the microbiome is the source of the CFS symptoms.
The number of lines increases greatly as you move from the left to the right, and I have omitted many on the right side.
Items like stress and environmental chemicals, also alters the microbiome. There are DNA differences between people with CFS, FM and IBS. The set of symptoms that manifest appears to be a combination of microbiome shift and DNA of the person.
The research challenge is picking the item that is the origin, the one that arrows lead from. To me, the repeated remission reported by fecal transplants within days(although not all stay in remission) leads me to believe this is the root cause and the target for creating a true remission. Every study try to address the other areas have resulted in eventual symptom improvement but not remission. For an approach to deem superior, it must:
- result in full remission within 3 days.
- persist for several months at least.
None of the many many protocols, except fecal transplants have reached this level. Fecal transplants is not available to everyone — and unfortunately do not persist always.
My Thinking Evolution
One of the key understanding that I came to was that the trigger of CFS was not the maintainer of CFS. Think of smoking and lung cancer. If you get lung cancer and stop smoking, the lung cancer does not go away. The same applies to viruses that cause cancer — eliminating the virus does not eliminate the cancer. My focus went from looking for this mystical infection that have eluded researchers for decades to how this condition kept going.
The second stage was seeing that there are sets of “Post-Infection Syndromes”, especially one in Norway where the infection that caused it was known in a population and treatment was successful — but the symptoms kept going and going (with the percentage every few months going down). After two years, a percentage became stuck in the symptoms. Symptoms that would be CFS if the MD did not know about the triggering infection (but because it was known, it was not technically CFS by formal definition!).
The third item was that fecal transplant result in immediate (for several months at least) remission for a high percentage of CFS patients. Yes, the transplant will impact the immune system — because the bacteria that the immune system is exposed to have been changed. When I looked at Jadin’s antibiotics and the gut bacteria analysis from Australia, we see that her antibiotics reduce the overgrowths (she believed she was treating occult ricketessia infection — but the same prescription also reduced the overgrowth).
The last item was that studies found that several diseases can be identified solely from a microbiome sample with 90% accuracy. There appears to be two relationshipd:
- a disease –> microbiome change AND
- a microbiome change –> SUPPORTS the disease.
Chicken and the egg — so I concluded that we need to break the egg.
Breaking the Eggs
You can break eggs by dropping them on the floor, using a sledge hammer, squeezing them in your hand until they break. We need to break the egg appropriately.
There is complexity because there are (at least) three families of bacteria with overgrowth and three with undergrowth and a drop of diversity. For all three of the undergrowth there are probiotics available (somewhere in the world). But just taking them blindly does not result in a nice omelette.
Lactobacillus bacteria/probiotics (in general) reduces/kill Bifidobacterium and E.Coli (also undergrowth). Bifidobacterium probiotics increases lactobacillus.
My recommended recipe for our broken eggs is:
- Bifidobacterium probiotics containing many different bifidobacterium species and NO Lactobacillus. 5+ Billion CFU/day
- E.Coli Probiotics (both are made in Germany):
- Increase Variety of species (these do not contain any E.Coli, Lactobacillus or bifidobacterium)
Whether a positive only approach (probiotics) or a rotating (ant-bacteria + probiotics (which are also bacteria) is best varies between people.