I had cholesterol issues with ME/CFS flares in the past. My last labs done 3 months ago — physician was very pleased with my cholesterol – pretty much ideal. This is confirmed in studies for a subset.

Many of the pathways and metabolites that were abnormal in CFS are also known to be features of dauer, a well-studied, long-lived survival and persistence state triggered by environmental stress (35, 36) (Table 5). Interestingly, we found that the direction of CFS abnormalities was opposite to metabolic syndrome (37) and opposite to the metabolic response to infection, inflammation, or environmental stress that has been called the CDR (7). For example, cholesterol, phospholipid, sphingolipid, and purine metabolism are all decreased in CFS and dauer but are increased in metabolic syndrome and the stereotyped CDR (Table 5). These facts suggest that CFS is an evolutionarily conserved, genetically regulated, hypometabolic state similar to dauer that permits survival and persistence under conditions of environmental stress but at the cost of severely curtailed function and quality of life.

Metabolic features of chronic fatigue syndrome [2016] A response is here

Remember that cholesterol issues are because of the ratio of good and bad cholesterol; not total cholesterol. This is shown in this study

The CFS group had higher levels of triglycerides (p = 0.03), MDA (p = 0.03) and CO (p = 0.002) and lower levels of HDL cholesterol (p = 0.001) than the control group. There were no significant differences in the levels of total protein, total cholesterol or LDL cholesterol.

Lipid and protein oxidation in female patients with chronic fatigue syndrome [2012] Higher LDL, Lower HDL, Higher Triglycerides, Lower total Cholesterol .

What Can you do?

My opinion is that the root cause is a static microbiome dysfunction – and thus correcting the microbiome is the ideal long term approach (addressing the cause and not the symptoms). According to the US National Library of Medicine studies:

• Jerusalem Artichoke (and by inference, inulin) [2020]
• Dill [2021]
• Fenugreek [2020]
• Whey protein [2020]
• Beta glucan (Barley and Oats) [2021]
• L-Carnitine Supplementation [2019]
• Black Cumin Seed – Nigella sativa [2020]
• Spirulina (blue-green algae) [2019] [2016]
• Vitamin D [2019] [2017]
• Turmeric and Curcuminoids [2019] [2017]
• Tulsi (Holy Basil) [2012] [2010]
• Sweet Potato ( Ipomoea batatas) [2021] [2021]
• Beans (Navy,black, pinto, kidney) – Canned Beans [2021]
• Soy protein(30+ grams/day) [2011] [2007]
• TWO apples per day [2020]
  • Warning: WHOLE APPLES, not juice “Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers” [2013]
• Only improves LDL – thus improves the ratio
  • α-linolenic acid
  • Grape Seed Extract (resveratrol) [2020]
  • Canola Oil [2018] Lowers LDL only (compared to sunflower oil),
    • No Olive Oil ” Also OO consumption reduced …significantly less than other plant oils.” [2019]
• Avoids
  • Avoid Eggs [2017] – One per day is acceptable [2020] – i.e. does not increase further.
  • Cinnamon [2021]
• No Impact (or not statistically/clinically significant)
  • Selenium [2017]
  • l-arginine [2020]
  • Folic Acid [2021] [2019]
  • Pomegranate [2017]
  • Blueberry [2021]

Please note what Apples demonstrated above — avoid D contains A and thus D must have the same effect. In general, the “raw natural form” is preferred over any processed form

Name of herb	Biological effects
Basil	Lowering LDL and total cholesterol, increase of HDL
Blueberry	Lowering triglyceride and LDL levels
Celery	Decreasing serum triglyceride, total cholesterol, LDL-C and hepatic triglyceride
Dandelion	Decreasing serum triglyceride, total cholesterol, LDL-C and increasing HDL-C
Dill	Decreasing serum triglyceride
Eugenol	Decreasing serum triglyceride, total cholesterol, LDL-C and increasing HDL-C
Evening primrose oil	Decreasing serum triglyceride, total cholesterol
Fenugreek	Decreasing serum triglyceride, total cholesterol, HDL-C
Ginger	Decreasing serum LDL-C and increasing HDL-C
Ginseng	Decreasing serum triglyceride, total cholesterol, LDL-C and increasing HDL-C
Grape	Lowering oxidized LDL and elevate HDL-C level
Green tea	Suppresses adiposity and affects the expression of lipid metabolism genes
Nigella	Decrease in triglyceride and increase in HDL-C
Psyllium	Decrease in LDL

Bottom Line

What strikes me about the above items is that they are often the same items suggested by the artificial intelligence algorithms on Microbiome Prescription for people with ME/CFS who have done a 16s Microbiome sample and uploaded it there.