A reader wrote:

“This week on our ABC National TV, the head of a big city hospital’s chronic fatigue clinic stated that there are no biological markers for chronic fatigue, so the best treatment was graded exercise and CBT. Unfortunately his opinion is very powerful here in patients getting government funding for help.”

See this link: http://www.abc.net.au/news/2018-07-18/chronic-fatigue-treatments-set-for-review/10007356

Beware of demanding a marker for all!

For most conditions there are multiple markers, if a significant number shows up — then conventional medical practice is to assume that condition. CFS traditionally require X out of Y symptoms that persisted for 6 months with all probable conditions accounting for those symptoms being excluded. It is unreasonable to expect every mixture of symptoms to have the same biological markers.

Statistically Significant Biological Markers against Control Populations

• Brain Scans:  See this post for citations from PubMed
  • Magnetic resonance imaging (MRI)
    • Abnormalities seen in 78% of EBV-associated CFS patients
  • Positron Emission Tomography (PET):
    • 50% of CFS patients show abnormal scans
  • Single-photon emission computerized tomography (SPECT)
    • 80% of CFS patients show abnormal scans
• Hypercoagulation [2001]
  • 80% of patients had a hypercoaguable state
  • 83% of patients had a hereditary abnormality.
• Microbiome (gut bacteria shifts)
  • “individuals were classified correctly as ME/CFS with a cross-validation accuracy of 82.93 %.” [See post for citations]
• Review from 2012 (PubMed)
• 
• Review from 2015
• 
• 

Bottom Line

There are multiple markers. If a suspected CFS patient is tested for 2 (hereditary coagulation abnormality and SPECT scan), the odds of both being negative appears to be 3%.

Treatment is a different question — my focus has been on microbiome shifts. Several readers have reported major improvement with this approach — some returning to work (with some symptoms remaining). Fecal Matter Transplants have repeatedly resulted in short term remission — rarely lasted more than 6 months with several readers who have shared their experiences.

Microbiome shifts cannot be resolved with eating yogurt, kefir or even 99% of health food stores probiotics. There are overgrowths that  need to reduced and undergrowths that need to be encouraged. At present, uBiome or thryve microbiome tests appear to be the best path forward — with end product production of the microbiome population appearing to be very significant for symptoms seen.

A reader wrote today:

“I have been trying B. longum BB536 as I have read it lowers d lactate producers

Seems its helping gut function but giving hot flashes and some heart palps, wondering why?”

The light went on — I have just gotten a reasonable size of end-products relationships (5800). Perhaps we may be lucky and get some idea of what B.longum does.

So I have added end products to the bacteria detail pages. For example:

http://microbiomeprescription.com/Library/Details?taxon=216816&taxname=Bifidobacterium%20longum

And you will see at the bottom of the page:

End Products

• ?-Amino butyric acid (GABA)
• Biotin (Vitamin B7)
• Folate (Vitamin B9)
• Lactic acid
• L-Tryptophan
• Pyridoxine
• Thiamine (Vitamin B1)
• Urolithins

If I go to another probiotic, Lactobacillus acidophilus,  I see a different combination,

End Products

• ?-Amino butyric acid (GABA)
• Acetylcholine
• Cobalamin (Vitamin B12)
• Lactate
• Lactic acid
• Trimethylamine
• Urolithins
• Vitamin K

Or looking at my favorite Japanese probiotic,  Miyarisan (Clostridium butyricum)  we see here

End Products

• Acetate
• Butanol
• Butyrate

And another Japanese one, Lactobacillus Casei

End Products

• ?-Amino butyric acid (GABA)
• Acetylcholine
• Cobalamin (Vitamin B12)
• Histamine
• Lactate
• Lactic acid
• ß-Glucan
• Trimethylamine
• Urolithins

Bottom Line

This presents a very different way of looking at probiotics. If you have a low amount of an end product (or symptoms associated with a low amount), then you may wish to surf thru the probiotics listed (with other bacteria) here.

For more information on EndProduct determination from a uBiome or Thryve sample, see:

• End Product Analysis Expanded
• End Product Explorer is up

• Some answers to a reader’s questions on EndProducts Beta

• End Products Analysis is now in Beta

• Using multiple Ubiome results to monitor progress
• End Product Predictions vs New CFS Study

Over the last week, I have been expanding the end product analysis. The main reason is that the first iteration found very strong clustering of end products with patients that had certain symptoms.

A visual may help:

If you take all of the points and look at the red averages using the standard deviation of all of the points, it would not be significant.  If you took the red average and red standard deviation and compare to the average for all of the points — you will get statistical significance. Something that you can see visually above.

This post refers to the site: http://microbiomeprescription.com/ If you have a thryve or ubiome analysis, you can upload it there and get further analysis done.

Personal Comparison

I have added some new columns to the page for comparison to people reporting themselves as healthy.

As you can see above, you may have a very low or very high percentage and it is not deemed significant using the health population average and standard deviation.

If you go over to the symptom explorer, and  add in a symptom, i.e. Neurological-Sleep: Night Sweats , you will see discover some items are missing… for example: 2-Methyl-butanal and 2-Butanone

You will also note that people with this condition are VERY LOW … having zero is not unexpected.

Bottom Line

There are now some 80 end products being reported now using more information about which bacteria produces each product.

This does not always give simple suggestions… in a few cases, it does — a specific Vitamin or amino acid is low. When dealing with high levels, that is more complex because it means killing off some bacteria 😦 .

A reader query revealed a bug. The suggestions applies to what you have — if you have no lactobacillus or no bifidobacterium THEN there is no bacteria to modify!

I have just added code to add a ZERO (0) value if you have none reported. This will cause items to increase lactobacillus and bifidobacterium to be added to suggestions.

A reader asked if Streptococcus was known to be associated with any psychiatric disorders.  My immediate response is YES, Dr Philippe Bottero had an reported remission rate of over 75% in treating patients at a psychiatric hospital with antibiotics back in the late 1990’s.  His success with a non-conventional approach resulted in his ability to practise being severely restricted by the establishment (according to private information) – Report is here on treatment.

Jump ahead a few decades and what do we find on PubMed?

• Detection of anti-streptococcal, antienolase, and anti-neural antibodies in subjects with early-onsetpsychiatric disorders.[2015]
  • • “Infection with group A Streptococcus (StrepA) can cause post-infectious sequelae, including a spectrum of childhood-onset obsessive-compulsive (OCD) and tic disorders with autoimmune origin (PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)…The simultaneous detection of all three of these antibodies could provide valuable information for the etiologic diagnosis of individuals with early-onset obsessive-compulsive disorders associated with streptococcal infection and, consequently, for prescribing suitable therapy.

   

•  Streptococcal upper respiratory tract infections and exacerbations of tic and obsessive-compulsive symptoms: a prospective longitudinal study. [2011]
• Detecting pediatric autoimmune neuropsychiatric disorders associated with streptococcus in children with obsessive-compulsive disorder and tics. [2004]
• Neurocognitive functioning in youth with pediatric autoimmune neuropsychiatric disorders associated with streptococcus. [2011]
• Pediatric autoimmune neuropsychiatric disorders associated with Streptococcus in identical siblings. [2011]
• Association between streptococcal infection and obsessive-compulsive disorder, Tourette’s syndrome, and tic disorder. [2005]

And for other bacteria:

• Psychiatric symptoms in patients with Shiga toxin-producing E. coli O104:H4 induced haemolytic-uraemic syndrome.[2014]
• Clinical and neuropsychological characteristics of general paresis misdiagnosed as primarypsychiatric disease. [2016] – “Our findings reinforce the importance of performing serologic testing for syphilis. This should be a part of the evaluation of patients with psychiatric disorders, especially patients with cognitive impairment. “
• Bacterial neuroactive compounds produced by psychobiotics.[2014]
• [A psychiatric disorder reveals a neurobrucellosis]. 2016
• Possible association of Bifidobacterium and Lactobacillus in the gut microbiota of patients with major depressive disorder. [2016] “Our results provide direct evidence, for the first time, that individuals with lower Bifidobacterium and/or Lactobacillus counts are more common in patients with major depressive disorder compared to controls.”

Bottom Line

The presence or absence of some bacteria can cause psychiatric effects. This is not restricted to Streptococcus.