The 2018 study, “Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons.” reports symptoms improvements with increases and decreases of certain bacteria associated with ME/CFS.
A reader asks me to do a recap of what the known shifts are, and thus what you wish to try to correct (and not inadvertently increase by the wrong supplements, probiotics or diet choices).
In terms of published studies, I have assembled a dynamic list on my website (not verified and subject to data entry errors) shown below for genus level and above. When an item is repeated on multiple lines, this means that we have multiple studies report it. H-High, L- Low, B- High or Low (outside of normal)

At the Strain Level, we also have a long list,

Using the citizen science aspect of my site, we do not have a information based on physician verification of precise clinical definition but solely on self-reporting of symptoms. If click on one of the above, say Bifidobacterium, we see two things listed:
- Citizen Science discoveries dealing with symptoms.
- Published studies listing conditions that may have the same shift (thus, potential conditions that ME/CFS may evolve to).
For 1 (EBV),2 (MCS), 4(Female), 5, 6 (Post exertional malaise) are in the list of items that are used for a ME/CFS diagnosis

Going over to Faecalibacterium (3 citations) – another LOW one, we see a more massive symptom list, many many are in the classic ME/CFS diagnosis list.

Doing another one, Streptococcus – a HIGH one for a change (3 citations – 2 high and 1 low), we see

Double Validation
One list of bacteria comes from studies on patients that conform to strict definitions of ME/CFS. The other list of bacteria comes out of the symptoms people self-report and their 16s microbiome results. We have a very strong agreement with the results coming from two independent approaches.
What does this mean?
It means that altering the microbiome will improve symptoms (as indicated in the study cited at the start; and in personal agreement with my own experience and many of my readers).
The next step is to determine which of these long lists of bacteria is involved with your ME/CFS/IBS etc. The old conventional tests only does a few of the bacteria — and do not cover all of those reported in studies. By old conventional tests, I mean:
- Bioscreen
- Biovis Microbiome Plus
- DayTwo
- Diagnostic Solution GI-Map
- GanzImmun Diagnostics AG Befundbericht
- Genova Gi Effects
- Genova Parasitology
- InVitaLab
- Kyber Kompakt
- Medivere: Darm Mikrobiom Stuhltest
- Medivere: Darn Magen Diagnostik
- Medivere: Gesundsheitscheck Darm
- Metagenomics Stool (De Meirleir)
- Smart Gut
- Verisana
- Viome
- XenoGene Informe De Microbiota Intestinal
A 16s report is strongly recommended (choices). Thryve offers the best “bang” (most taxa reported – 500-1200 different bacteria often) for the cost ($ < $100). Many 16s tests are sold direct to consumers and do not require going thru a physician (Just like DNA tests, for example 23andMe).
Once you know the bacteria involved, you need to know how to change them. If your physician, nutritionist or other health professional are well skilled and read on the microbiome, they should be able to guide you.
If they are not, I have created my free analysis and suggestion artificial intelligence engine http://microbiomeprescription.com/ which uses over 95,000 medical facts on the microbiome. You must review those suggestions with your medical profession because some may be inappropriate given other medical conditions.