I believe that I may have stumbled on to a uBiome signature for MCS and potentially some possible treatments (probably high herx  😦  ).

Data from Readers

I contacted readers who had shared their uBiome with me with the following question:

• 0 is NONE
• 5 for severe”

I then put the data into a table and applied a statistical test to it. The probability of getting this distribution at random (using ChiTest) was just 3%.

Back Story

During my analysis of a severe MCS ONLY uBiome (this post) I was interested in the report that all fruits was tolerated except for three. I dug into the unusual chemicals in these fruits and recognized something from a post on what is not produced when there is no Lactobacillus or Bifidobacteria. What was it? Urolithins

When someone reacts to a food we can safely assume that it is a toxin that is causing it. There are two paths:

• The food feeds a bacteria that produces a toxin
• The food contains a chemical that kills bacteria and thus releases toxins.

The second path lead me to see what else produces Urolithins?

“Urolithins (From DataPunk.Net)

Urolithins are microflora human metabolites of dietary ellagic acid derivatives such as ellagitannins. They are produced in the human gut, and found in the urine in the form of urolithin B glucuronide after absorption of ellagitannins-containing food such as pomegranate, strawberries, red raspberries, walnuts or oak-aged red wine.During intestinal metabolism by bacteria, ellagitannins and punicalagins are converted to urolithins, which have unknown biological activity in vivo in humans. Urolithins metabolites of pomegranate juice ellagitannins localize specifically in the prostate gland, colon, and intestinal tissues of mice, leading to clinical studies of pomegranate juice or fruit extracts for efficacy against several diseases.Ellagitannins exhibit low bioavailability and are transformed in the gut to ellagic acid and its microbiota metabolites. Urolithins are found in plasma mostly as glucuronides at low concentrations. Urolithins production is dependent on the gut microbiome enterotype. Individuals producing urolithins show a much higher abundance of the Clostridium leptum group of Firmicutes phylum than Bacteroides or Prevotella. Ellagitannin and ellagic acid metabolism to urolithins in the gut shows a large human interindividual variability and this has been associated with differences in the colon microbiota. Urolithins are dibenzopyranone metabolites that exert anti-inflammatory activity in vivo and are produced by the gut msomeicrobiota from the dietary polyphenols ellagic acid (EA) and ellagitannins. ”

The light went on for a hypothesis — MCS is the result of having very low level of Urolithins being produce by bacteria. There are only three known genus that produces it — two of which are normally ZERO for CFS patients. It was time to try to test it. Find out who had MCS and what their Gordonibacter levels were. The responses lead to the above table and given a small sample size of just 16 people, impressive statistical significance at the 3% level (better than some studies that I have read).

Proposed Model

Urolithins and/or the associated ellagic acid is able to suppress (unknown) bacteria genus (or genii) that results in MCS.  When this patient ate a food rich in ellagic acid, they had an adverse reaction from these bacteria being killed off. 

This may be totally wrong — it’s just the KISS inference from the available data.

To present it another way, MCS is caused not by a specific bacteria but due to the absences of urolithin producing bacteria. Think of Rickets — this is not the result of a bacteria, but due to the absence of sufficient Vitamin D. We need to think of “negative space” to borrow a term from artists.

Treatment Proposal

“ellagitannins-containing food such as pomegranate, strawberries, red raspberries, walnuts or oak-aged red wine.” should feed any remaining bacteria producing urolithins. Ideally, these should be taken with bifidobacteria or lactobacillus probiotics. You may not have any of your own, but the probiotics should start consuming the ellagitannins during their short stay in your gut.

Again this is speculative.

Bottom Line

This needs a proper study with at least 100 appropriately selected patients. The proposal of having “strawberries and red raspberries with a sprinkling of probiotics” sounds ridiculously simple for treatment.  No idea of how long it will take. I have concerns that it may produce a severe herx in some people. All of this is based on inference from available data.

• I favor the use of Bifidobacteria
• I favor not providing other food (such as milk or yogurt) — we want the bacteria to focus on the ellagitannins.

Please consult with your physician if you have MCS before attempting to put these suggestions in practice.