Abstract
Chronic fatigue syndrome (CFS) is complex illness of unknown etiology. Among the broad range of symptoms, many patients report disturbances in the emotional realm, the most frequent of which is anxiety. Research shows that patients with CFS and other so-called functional somatic disorders have alterations in the intestinal microbial flora. Emerging studies have suggested that pathogenic and non-pathogenic gut bacteria might influence mood-related symptoms and even behavior in animals and humans. In this pilot study, 39 CFS patients were randomized to receive either 24 billion colony forming units of Lactobacillus casei strain Shirota (LcS) or a placebo daily for two months. Patients provided stool samples and completed the Beck Depression and Beck Anxiety Inventories before and after the intervention. We found a significant rise in both Lactobacillus and Bifidobacteria in those taking the LcS, and there was also a significant decrease in anxiety symptoms among those taking the probiotic vs controls (p = 0.01). These results lend further support to the presence of a gut-brain interface, one that may be mediated by microbes that reside or pass through the intestinal tract.
Highlights
Chronic Fatigue Syndrome (CFS) is a medically unexplained illness, characterized by persistent and relapsing fatigue [1,2]
In a series of case reports, separate researchers concluded in 1923 that 'the administration of acidophilus milk is recommended in the treatment of psychoses as a means to physical betterment' [16]. In this pilot study we found that the oral administration of Lactobacillus casei strain Shirota (LcS, Yakult Honsha, Tokyo, Japan) caused a significant rise in fecal Bifidobacteria spp. and Lactobacillus spp
The rise in Lactobacilli was an expected finding, the concomitant rise in Bifidobacteria suggests that there may be far reaching effects of oral probiotics on other microbial residents of the gastrointestinal tract. This finding supports previous research showing that the oral administration of Lactobacillus plantarum 299 V caused a significant rise in fecal Bifidobacteria levels [17]
Summary
Chronic Fatigue Syndrome (CFS) is a medically unexplained illness, characterized by persistent and relapsing fatigue [1,2]. Ongoing experimental studies in this area have recently shown that in the animal model of depression, the oral administration of a probiotic can increase plasma tryptophan levels, decrease serotonin metabolite concentrations in the frontal cortext and dopamine metabolite concentrations in the amygdaloid cortex [12]. With this background, the current investigation was initiated to determine if orally administered probiotics could make a difference in symptoms of depression and anxiety in adult patients with chronic fatigue syndrome.
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