Backstory:

I got COVID in Feb 2022. Over the next few months I developed long COVID symptoms. Within 6 months I was severe (bedbound), and within a year I was very severe (24/7 dark silent zero stimulation bed rest). About six months ago I progressed back to being severe and have stayed there. I’ve been officially diagnosed as having ME/CFS as well as long COVID.

I have basically all the symptoms but the worst are light and sound sensitivity, post exertional malaise, brain fog, fatigue, and cognitive and sensory processing issues.

I have severe episodes of d lactic acidosis when I eat dairy. D lactic acidosis was actually my very first long COVID symptom.

If it’s relevant – all “mitochondria boosters” make me significantly worse. Ubiquinol/CoQ10 is what pushed me into being very severe. [Editor note: We have limited information on Coenzyme Q10  and cannot propose reasons for this response – it was not listed in the suggestions]

A few months ago my GI symptoms (diarrhea, bloating, stomach pain, etc.) got more severe, I think as a result of taking Pepcid[Famotidine] daily for MCAS. I tested positive for H Pylori and was off the charts for methane and hydrogen SIBO. [Famotidine is a weak positive, but positive]

I did a GI Map before starting treatment, which is uploaded to my profile. I then did 2 weeks of metronidazole + doxycycline + pepto bismal to try to tackle the H Pylori. My histamine intolerance and d lactic acidosis got MUCH worse during treatment. I did my BiomeSight test a week after finishing antibiotics.

Then I did 2 weeks of Xifaxan + Nitazoxanide + PHGG for the SIBO. I just finished this. My bloating is a little better but my histamine intolerance and d lactic acidosis worsened even further and now my cognitive function is the worst it’s been in months.

I’ve just started Mutaflor and have also obtained Symbioflor-2, Miyarisan, and Equilibrium, and am planning on cycling through those (in addition to whatever recommendations pop up from my BiomeSight test).

Analysis

The Eubiosis index and percentages of percentiles show quite dramatic (and a typical) results. We have a large number of bacteria which I am inclined to described as “pedal to the metal”. These are all at extreme levels. Chao Index and Shannon Index are at 0%ile and Simpson Index at 83%ile.

Some of these extremes bacteria ( > 90%ile) with known health impacts are:

• Fusobacterium / Fusobacterium nucleatum 
• Klebsiella / Klebsiella pneumoniae 
• Veillonella atypica 
• Actinomyces
• Bacillus
• Clostridium perfringens
• Eikenella / Eikenella corrodens
• Enterobacter / Enterobacter ludwigii
• Legionella
• Morganella
• Proteus
• Providencia
• Salmonella / Salmonella enterica
• Streptococcus anginosus
• Vibrio

Morganella is a known extreme histamine producer (Histamine and biogenic amine production by Morganella morganii isolated from temperature-abused albacore [2000]) which accounts for the histamine issues. The KEGG estimate of histamine producers is up at 84%ile. Most of KEGG estimators are at extreme – for example Oxalate is at 100%ile and Oxalate degrading is at 0%ile [which indicates a risk of kidney stones developing over time]

The Bacteria deemed unhealthy is an impressive list.

Going Forward

The joy of using an expert system is that despite a very complex microbiome, the system will grind thru all of the data and produce a better results than a human doing so. A human will typically pick one or two bacteria to address “and see what happens”.

The person has marked their symptoms so we have five sets of suggestions going into our consensus.

The top suggestions have a few antibiotics but a lot of items are intermixed between them. In such a scenario I favor not doing antibiotics.

One item in the avoids really stand out, proton-pump inhibitors (prescription) at -637.

The following are items picked above 400 or below 300. The reason to do 50% of the extreme button is not to overwhelm the brain with too many suggestions. Check the site for dosages[Click here].

• Supplements
  • vitamin d
  • Alpha-Ketoglutarate – likely hard to get
  • Ursolic acid – likely hard to get
  • inulin (prebiotic)
  • Human milk oligosaccharides (prebiotic, Holigos, Stachyose)
  • arabinogalactan (prebiotic)
• Probiotics
  • lactobacillus rhamnosus gg (probiotics) — see how you react, may not be the best choice.
  • lactobacillus reuteri (probiotics) – Use ONLY BioGai. It is known not to produce histamine or d-lactic acid
  • clostridium butyricum (probiotics),Miya,Miyarisan
  • enterococcus faecium (probiotic)
  • bifidobacterium longum (probiotics)
  • bacillus subtilis (probiotics)
• Herb and Spices
  • syzygium aromaticum (clove)
  • foeniculum vulgare,fennel
  • laser trilobum l.,kefe cumin
  • nigella sativa seed (black cumin)
  • Curcumin
  • neem
  • thyme (thymol, thyme oil)
  • triphala
  • and many more!
• Foods and Diet
  • ketogenic diet
  • methionine-choline-deficient (MCD) diet
  • soy
  • papaya
  • banana
  • barley — a regular suggestion for ME/CFS
  • xylaria hypoxylon (fungi)
  • laminaria digitata,oarweed – seaweed and laminaria hyperborea( tangle/cuvie – seaweed)
  • apple

So, for breakfast every day: Barley porridge with soy milk with slices of bananas/apples?

One at a Time and Rotate

We want to identify items that help or hurts you specifically. Tossing everything in at once denies us this knowledge. My general guidance would be:

• Spices and Herbs with meals
• Probiotics at bed time

Break the suggestions into 4 groups and take them for a week at a time. After 8 -12 weeks (2-3 cycles) get a new microbiome test to see changes. Keep up this pattern until you have new test results.

Remember our goal is to destabilize a stable dysbiosis. We effectively want to do a guerilla war against it — constantly hitting it from different places.

Questions

• Q: Question about herbs/spices. Is the recommendation to take them at the same time as probiotics? Or do a week of herbs, then a week of probiotics, and keep trading off? You’ve posted before about how some of the herbs can nullify the probiotics so I’m not sure how to stack correctly. 
  • Answer: If you click on one the herbs and spices you will be taken to a detail page where the first section is on the impact on probiotics. For the first item, we find that clove and clostridium butyricum have no interactions — so taking both on the same day is fine.

Similarly, for fennel we find that it actually enhances lactobacillus reuteri

So there is a manual process to identify what is neutral or helpful. If a herb or spice impacts every suggested probiotic, then either just do the herb, or keep 8-12 hours between them.

A recent study identifies which bacteria are involved: Defining Small Intestinal Bacterial Overgrowth by Culture and High Throughput Sequencing [2023].

At a high level, Small Intestinal Bacterial Overgrowth (SIBO) appears to have low levels of Streptococcus and Rothia.

SIBO is accounted for primarily by 2 E coli strains and 2 Klebsiella species. This remarkably specific group of microbes account for 40.24% of duodenal bacteria in SIBO subjects, compared with 5.6% in non-SIBO subjects.

Using Microbiome Prescription expert system with these 4 pieces of information, we can get some suggestions on how to shift the bacteria.

Including antibiotics into the scope, we have this list

My own preference for non-antibiotic treatment would be:

• triphala
• clostridium butyricum (probiotics),Miya,Miyarisan – using Miyarisan pressed tablets and letting them slowly dissolve in the mouth.
• oregano (origanum vulgare, oil)
• thyme (thymol, thyme oil)

Of special note is mutaflor escherichia coli nissle 1917 (probiotics) which to some may appear to be a contradiction to the results. It is not, this is a beneficial probiotic that is aggressive in pushing out bad E.Coli strains.

I would do only one at time for one week each — because a “herx” type reaction (temporary worsening of symptoms) may happen.

NOTE: Probiotics in capsules should not be used. The capsules may not dissolve until after the targeted area. Custom Probiotics sells powders of many of these probiotics with instruction to dissolve in a glass of water and then consumed. That process is likely to produce the best results.

Postscript – and Reminder

I am not a licensed medical professional and there are strict laws where I live about “appearing to practice medicine”.  I am safe when it is “academic models” and I keep to the language of science, especially statistics. I am not safe when the explanations have possible overtones of advising a patient instead of presenting data to be evaluated by a medical professional before implementing.

I can compute items to take, those computations do not provide information on rotations etc.

I cannot tell people what they should take or not take. I can inform people items that have better odds of improving their microbiome as a results on numeric calculations. I am a trained experienced statistician with appropriate degrees and professional memberships. All suggestions should be reviewed by your medical professional before starting.

The answers above describe my logic and thinking and is not intended to give advice to this person or any one. Always review with your knowledgeable medical professional.

A colleague gave me a list of bacteria producing different metabolites according to studies. The question arise – how accurate are making estimates. I am going to focus on one of them: Methane. The reason is simple that the microbiome data set that I have access to has self-reporting of SIBO which typically is an excess of methane.

I intend to do a three way analysis:

• Using the list of well documented bacteria he provided
• Using data from KEGG: Kyoto Encyclopedia of Genes and Genomes
• Using data from self-reporting.

This is a rough, on a paper napkin, analysis to explore this issue.

The methane list from studies is very short:

• Methanobrevibacter smithii
• Methanosphaera stadtmanae

From KEGG, we use C01438 (CH4) and have a list of 622 taxa capable of producing it. A few examples are:

• Serratia sp. AS12
• Serratia sp. AS13
• Sinorhizobium sp. CCBAU 05631
• Bradyrhizobium arachidis
• Cytobacillus kochii
• Cupriavidus sp. USMAA2-4
• Halarcobacter anaerophilus

We have 88 annotated samples with SIBO with a total population of 2461 samples. In the table below, units are cells out of one million detected.

Method	Average	Std Dev	Incidence
Studies	1378	4416	24% has some
KEGG	3432	10264	98% has some
Studies with SIBO	709	1753	29% has some
KEGG with SIBO	6901	36649	98% has some

The obvious conclusion is that KEGG is definitely superior with the count of bacteria doubling for SIBO samples while the studies approach resulted in the count count of bacteria being halved. Incidence of detection was unchanged KEGG and we notice an increase with studies, but only 29% of people with SIBO will have any methane estimated.

A second gas for SIBO is hydrogen Sulfide (C00283 H2S). Applying the same process.

Method	Average	Std Dev	Incidence
Studies	3635	5533	92% has some
KEGG	253720	155882	100% has some
Studies with SIBO	3689	4461	89% has some
KEGG with SIBO	289389	186070	100% has some

The results are not as dramatic as with methane. There was no change with Studies and a 14% increase in count using KEGG. The incidence rate went down slightly with studies.

Bottom Line

This drill down suggests that I made the right decision to deprecate the computations of metabolites using study data and shifted to using KEGG data.

The questions raised by this napkin computation is that the above process should be done with actual measurement of methane and hydrogen sulfide in samples to definitely identify the better process.

This is one of a continuing sequence of ad hoc analysis trying to raise questions about current process. See Technical Notes on Microbiome Analysis.

The microbiome data is available at https://citizenscience.microbiomeprescription.com/ . The Lab Source used for this post was “Biomesight”.

In the last 24 hours I saw/got two similar messages:

Has anyone heard of Tim spectrum who works in the uk, a scientist study’s the microbiom currently offering the Zoe app. Was thinking of trying this to see if he can help my blasted gut issues. Plus his based in the uk we’re I’m from as has study in a uk hospital kings college. And wondering if maybe just maybe my own gps might be able to jump on board and help me a little more . Paying for all these tests? Doing all these protocols? Paying all these naturel drs? Loosing a heel of a lot of weight in bank account? Looking ill? Diet after diets. And still friggin unwell . Absolutely sick to death of the whole thing . Anyone else out there feeling the same

Facebook

And from a direct email:

Tomorrow I have an appointment with a Gastroenterologist and had intended to share excerpts from my XXXX test and from my upload of the same to MicrobiomePrescription.com.  However, over the last few days I’ve spent a significant amount of time analyzing and comparing the two reports/data, and there’s such a discrepancy between them and their respective “Take/Don’t Take” suggestions that I don’t feel comfortable sharing the data from either report with the doctor.  

First, I want to make sure you know that I am well aware that XXXX and MicrobiomePrescription are never going to ‘match’, nor do I expect them to.  However, the data is so contradictory that I’m losing trust with it. 

Are you willing to look into these contradictions?  

From Email

Response

Yes, I have compared. Microbiome Prescript provides the full evidence trail for every single suggestion.
See https://blog.microbiomeprescription.com/2024/01/24/checking-suggestions-are-reasonable/ on how to do it.

XXXX does not provide this– often many sites references are pathetic, missing or based on a dietician’s / naturopath’s personal experience. I favor data from a clinical study with 100 people over what worked for 1 person.

Example from one site that I have access to. I have seen the same on other sites.

So we have advice without any evidence being provided.

Other sites, push their high profit margin products.

They provide bulk citations but nothing on which of the 9 overgrown pathogenic bacteria each will impact.

Their support people will reply per script… “It is well studied, look at all of the studies…”

MicrobiomePrescription would suggest an increase [opposite!].. and give links to the studies

And we provide links to the actual article on line (when possible). Not just the name of the study.
We also identify exactly what will be impacted and how.

One would likely be dismissed by your Gastroenterologist, the other — because of the full evidence trail, would be considered

You need to ask why they do not provide the same!!

MicrobiomePrescription was created by one person working in spare-time (full time work and supporting family). The other sites are for profit with paid employees. Often, venture capitals care not about quality or completeness — just sales. Hire 10 more marketing people instead of a caring scientist/researcher. I refer to this as “thirty pieces of silver” science.

See also Verify Before Buying – $$$ over Science is the norm

A reader messaged me because Hesperidin (polyphenol) was the top of his list and several friends. It was there also for me! It was up with antibiotics!

For all suggestions, there is the magic evidence button, 📚. Clicking it, I see 219 citations!! Priority is based on the number of citations.

The literature cites 74 different bacteria that it impacts. Since we infer a reduced impact to the parent and children, we end up with 2,300 bacteria influenced by it.

I double checked the database that were was not a typo and if it’s impact was not entered more than normal. It was not (I have checks in the database to prevent those typos, and they appeared to have work).

So WHY is it so common?

The reason is very simple, we have more information on what it impacts. We have 74 different bacteria. If we go to others, we see much fewer bacteria:

• Tulsi 17
• Olive Leaf 22
• magnolia bark 2

The priority is determined by how many bacteria it influences in a desired way x number of studies for each bacteria x number of each bacteria desired to be shifted. For example, if it takes just 100 to shift a bacteria to normal for Hesperidin, and a different bacteria needs 1000, the priority will be higher when they are more unless there are more studies showing the first bacteria is shifted (but not the second).

We use the term priority — and could use confidence, but confidence has too many different meanings in common speech.

The use of percentile when you have a very non-normal distribution does an elegant transformation of the data to a continuous uniform distribution. Our earlier note was based on statistical differences from the mean of the percentages; I repeated the process but used the mean of the percentiles.

One should be aware that for a specific bacteria, the mean(percentage) may have less then mean(percentile) being significant for some bacteria; while the mean(percentile) may have more than mean(percentile) being significant for other bacteria. In short, directionality is not preserved by the transformation to percentile. This is rarely the case with a normal distribution but does happen with microbiome data. It is a worthwhile exercise to understand this behavior because it is at odds with “common sense” but very true mathematically. Familiarity with the Cauchy distribution may help with the mind shift.

Bottom Line Summary

Using the percentile is slightly superior for prediction. Remember that 16% is the percentage expected from a random predictor. Remember by match, we means how often we get matches to predicted

Method	Average Correct Prediction Match	Winner on a Symptom	Average Taxons
Mean(Percentile)	23.5%	161	126
Mean(Percentage)	22.9%	96	97

The details by symptoms is below.

Symptom Name	Percentile Match	Mean Match
Comorbid: Inflammatory bowel disease	26.69	25.37
Infection: Lyme	26.39	26.26
DePaul University Fatigue Questionnaire : Muscle Pain (i.e., sensations of pain or aching in your muscles. This does not include weakness or pain in other areas such as joints)	26.37	21.69
DePaul University Fatigue Questionnaire : Easily irritated	26.30	21.03
Neurological-Vision: Blurred Vision	26.25	25.09
DePaul University Fatigue Questionnaire : Tense muscles	26.05	26.27
Neurological: Difficulty reading	25.98	23.59
DePaul University Fatigue Questionnaire : Weight change	25.85	25.79
Immune Manifestations: Hair loss	25.76	22.25
DePaul University Fatigue Questionnaire : Tingling feeling	25.75	24.20
Post-exertional malaise: Next-day soreness after everyday activities	25.74	23.13
Neurological-Vision: inability to focus eye/vision	25.74	22.38
DePaul University Fatigue Questionnaire : Muscle weakness	25.66	22.68
Comorbid: Mold Sensitivity / Exposure	25.62	26.26
Immune: Sensitivity to smell/food/medication/chemicals	25.62	21.61
Neuroendocrine Manifestations: intolerance of extremes of heat and cold	25.56	21.52
General: Heavy feeling in arms and legs	25.53	23.32
DePaul University Fatigue Questionnaire : Blurred Vision	25.53	22.49
DePaul University Fatigue Questionnaire : Difficulty comprehending Information	25.50	22.24
General: Myalgia (pain)	25.49	24.54
DePaul University Fatigue Questionnaire : Pain in Multiple Joints without Swelling or Redness	25.44	22.90
DePaul University Fatigue Questionnaire : New trouble with math	25.44	25.87
Neurological: Executive Decision Making (Difficulty making)	25.40	23.39
DePaul University Fatigue Questionnaire : Chilled or shivery	25.38	25.74
Neurological-Sleep: Inability for deep (delta) sleep	25.32	23.24
Neurological: Difficulty processing information (Understanding)	25.29	23.57
Post-exertional malaise: Rapid muscular fatigability,	25.28	21.44
Other: Sensitivity to mold	25.26	24.17
Comorbid: Small intestinal bacterial overgrowth (SIBO)	25.25	20.96
DePaul University Fatigue Questionnaire : Difficulty falling asleep	25.17	21.08
Pain: Joint pain	25.17	23.25
Immune Manifestations: Inflammation of skin, eyes or joints	25.14	23.55
DePaul University Fatigue Questionnaire : Difficulty following things	25.13	22.84
Virus: Epstein-Barr virus	25.09	23.30
DePaul University Fatigue Questionnaire : Temperature lower than normal	25.07	22.82
Immune Manifestations: Chronic Flatus / Flatulence / gas	25.00	21.39
Post-exertional malaise: Mentally tired after the slightest effort	24.93	22.40
DePaul University Fatigue Questionnaire : Sensitivity to Alcohol	24.86	22.52
Neurological: Dysautonomia	24.83	22.95
Neuroendocrine Manifestations: Muscle weakness	24.80	22.64
Neurocognitive: Difficulty expressing thoughts	24.75	20.27
Onset: 2000-2010	24.72	21.89
DePaul University Fatigue Questionnaire : Upset stomach	24.70	24.95
Immune Manifestations: Inflammation (General)	24.60	21.97
Comorbid-Mouth: Bruxism – Jaw cleanching / Teeth grinding	24.59	21.65
DePaul University Fatigue Questionnaire : Chemical sensitivity	24.58	25.19
DePaul University Fatigue Questionnaire : Difficulty reasoning things out	24.57	22.94
DePaul University Fatigue Questionnaire : Confusion/disorientation	24.56	25.87
DePaul University Fatigue Questionnaire : Frequently loose train of thought	24.55	23.09
Post-exertional malaise: Difficulty reading after mild physical or mental activity	24.54	20.25
DePaul University Fatigue Questionnaire : Trouble expressing thoughts	24.52	23.70
DePaul University Fatigue Questionnaire : Shortness of breath	24.49	22.88
DePaul University Fatigue Questionnaire : Abnormal sensitivity to light	24.45	24.32
Post-exertional malaise: Physically tired after minimum exercise	24.44	21.70
Official Diagnosis: Chronic Fatigue Syndrome (CFS/ME)	24.44	20.20
Neurological-Sleep: Sleep Apnea	24.43	30.42
Neurocognitive: Absent-mindedness or forgetfulness	24.42	21.07
Neuroendocrine Manifestations: Poor gut motility	24.42	20.04
DePaul University Fatigue Questionnaire : Slowness of thought	24.41	23.01
Gender: Female	24.41	20.35
Post-exertional malaise: Rapid cognitive fatigability,	24.40	21.05
Neurological: Cognitive/Sensory Overload	24.39	22.84
Post-exertional malaise: Inappropriate loss of physical and mental stamina,	24.39	20.33
Sleep: Problems falling asleep	24.37	19.75
DePaul University Fatigue Questionnaire : Eye pain	24.35	22.92
DePaul University Fatigue Questionnaire : Unrefreshing Sleep, that is waking up feeling tired	24.33	20.49
Neurocognitive: Unable to focus vision and/or attention	24.32	24.34
Immune Manifestations: Mucus in the stool	24.32	23.08
Immune Manifestations: Constipation	24.32	19.42
Physical: Work-Sitting	24.31	20.96
DePaul University Fatigue Questionnaire : Mood swings	24.30	22.58
Neurological-Sleep: Insomnia	24.27	20.91
Post-exertional malaise: Muscle fatigue after mild physical activity	24.26	21.75
DePaul University Fatigue Questionnaire : Ringing in the Ears	24.25	22.34
Immune Manifestations: new food sensitivities	24.25	21.28
Neuroendocrine Manifestations: cold extremities	24.24	19.68
Comorbid-Mouth: Dry Mouth	24.24	24.13
Neurocognitive: Feeling disoriented	24.24	24.51
Neuroendocrine: Alcohol intolerance	24.24	20.91
DePaul University Fatigue Questionnaire : Does physical activity make you feel worse	24.24	21.37
DePaul University Fatigue Questionnaire : Difficulty finding the right word	24.23	20.46
Neurological: Neuropathy	24.20	24.34
Comorbid: Migraine	24.20	24.54
Neurological: emotional overload	24.20	24.17
Age: 40-50	24.20	18.92
Immune Manifestations: Abdominal Pain	24.19	21.59
Neuroendocrine Manifestations: Rapid muscular fatiguability	24.13	22.24
Post-exertional malaise: Physically drained or sick after mild activity	24.06	22.15
Physical: Amalgam fillings	24.06	22.43
Neuroendocrine Manifestations: marked weight change	24.05	24.83
Pain: Pain or aching in muscles	24.05	21.54
Autonomic Manifestations: Orthostatic intolerance	24.04	23.20
Neuroendocrine: Lost or gained weight without trying	24.02	22.19
Neurological: Impairment of concentration	24.01	21.29
Neuroendocrine: Feeling hot or cold for no reason	24.00	22.53
Onset: Sudden	24.00	21.03
DePaul University Fatigue Questionnaire : Absent-mindedness	23.99	23.34
Autonomic: Shortness of breath	23.96	24.04
Sleep: Unrefreshed sleep	23.96	18.84
Neurological: Short-term memory issues	23.96	20.71
Autonomic Manifestations: irritable bowel syndrome	23.94	22.18
Physical: Steps Per Day 4000-8000	23.93	21.26
Autonomic Manifestations: light-headedness	23.89	23.75
Physical: Steps Per Day 2000-4000	23.89	22.21
Physical: Good Air Quality	23.89	24.27
Autonomic Manifestations: urinary frequency dysfunction	23.89	25.32
DePaul University Fatigue Questionnaire : Need to have to focus on one thing at a time	23.89	22.37
Official Diagnosis: Attention deficit hyperactivity disorder (ADHD)	23.88	25.24
Neurological-Audio: hypersensitivity to noise	23.88	22.04
Post-exertional malaise: General	23.87	20.19
Post-exertional malaise: Post-exertional malaise	23.86	21.48
DePaul University Fatigue Questionnaire : Difficulty staying asleep	23.83	22.37
Neuroendocrine Manifestations: Dry Eye (Sicca or Sjogren Syndrome)	23.82	21.35
DePaul University Fatigue Questionnaire : Impaired Memory & concentration	23.81	22.76
DePaul University Fatigue Questionnaire : Fatigue	23.81	21.21
Neurological-Vision: photophobia (Light Sensitivity)	23.81	25.02
Comorbid: Restless Leg	23.80	25.29
General: Fatigue	23.77	18.39
Neurocognitive: Brain Fog	23.75	19.88
Comorbid: Multiple Chemical Sensitivity	23.75	23.15
DePaul University Fatigue Questionnaire : Difficulty recalling information	23.75	21.10
Immune Manifestations: medication sensitivities.	23.75	21.01
Comorbid: Histamine or Mast Cell issues	23.74	20.41
Condition: Acne	23.74	21.63
Neurocognitive: Difficulty understanding things	23.73	20.84
Autonomic Manifestations: Postural orthostatic tachycardia syndrome (POTS)	23.73	22.83
Pain: Sensitivity to pain	23.72	26.02
Joint: Tenderness	23.72	24.26
Other: Sensitivity to vibrations	23.68	25.97
DePaul University Fatigue Questionnaire : Frequently get words or numbers in the wrong order	23.67	26.05
Neuroendocrine: Cold limbs (e.g. arms, legs hands)	23.67	21.42
Post-exertional malaise: Worsening of symptoms after mild mental activity	23.67	22.24
Immune Manifestations: Bloating	23.66	20.51
General: Headaches	23.66	22.25
DePaul University Fatigue Questionnaire : Difficulty retaining information	23.63	23.04
Autonomic: Heart rate increase after standing	23.60	20.51
Post-exertional malaise: Worsening of symptoms after mild physical activity	23.58	21.27
DePaul University Fatigue Questionnaire : Forgetting what you are trying to say	23.56	22.10
DePaul University Fatigue Questionnaire : Post-exertional malaise, feeling worse after doing activities that require either physical or mental exertion	23.56	20.52
Neuroendocrine Manifestations: worsening of symptoms with stress.	23.54	19.94
Condition: ME/CFS with IBS	23.53	21.15
Comorbid: Constipation and Diarrohea (not explosions)	23.51	21.70
Neurocognitive: Slowness of thought	23.51	21.35
Condition: Post-Traumatic Stress Disorder	23.49	27.09
Comorbid-Mouth: TMJ / Dysfunction of the temporomandibular joint syndrome	23.48	22.93
Autonomic: Dizziness or fainting	23.47	25.31
Age: 30-40	23.46	22.59
DePaul University Fatigue Questionnaire : Slow to react	23.44	23.99
DePaul University Fatigue Questionnaire : Concern with driving	23.43	25.82
Immune Manifestations: recurrent flu-like symptoms	23.43	22.86
Comorbid: Sleep Apnea Diagnosis	23.41	27.83
Neurological-Audio: Tinnitus (ringing in ear)	23.41	20.98
Autonomic Manifestations: palpitations	23.41	20.80
Immune Manifestations: Thick blood / Hypercoagulation	23.38	25.82
Neurocognitive: Problems remembering things	23.35	21.13
DePaul University Fatigue Questionnaire : Dizziness	23.35	24.74
Immune Manifestations: general malaise	23.33	19.84
Sleep: Problems staying asleep	23.33	20.03
Physical: Long term (chronic) stress	23.30	22.22
Immune Manifestations: tender lymph nodes	23.28	24.97
Sleep: Daytime drowsiness	23.27	21.07
DePaul University Fatigue Questionnaire : Abdomen pain	23.26	23.29
Neurocognitive: Can only focus on one thing at a time	23.25	21.20
Pain: Aching of the eyes or behind the eyes	23.23	24.86
DePaul University Fatigue Questionnaire : Depression	23.20	25.30
DePaul University Fatigue Questionnaire : Anxiety/tension	23.17	21.78
Immune Manifestations: Diarrhea	23.17	22.26
Neurocognitive: Difficulty paying attention for a long period of time	23.15	19.57
Official Diagnosis: Fibromyalgia	23.11	25.73
Physical: Breastfed	23.10	22.23
Official Diagnosis: Autism	23.09	22.72
Official Diagnosis: Irritable Bowel Syndrome	23.07	19.64
General: Anhedonia (inability to feel pleasure)	23.06	25.13
Age: 60-70	23.06	25.48
Neurological: High degree of Empathy before onset	23.03	25.21
Blood Type: O Positive	23.01	22.58
Physical: Steps Per Day < 2000	23.00	21.24
Condition: ME/CFS without IBS	22.99	21.23
DePaul University Fatigue Questionnaire : Headaches	22.99	22.21
Onset: Gradual	22.93	20.90
Immune Manifestations: Alcohol Intolerant	22.93	21.25
DePaul University Fatigue Questionnaire : Nausea	22.93	25.28
Immune: Viral infections with prolonged recovery periods	22.92	23.79
Neurological: Word-finding problems	22.91	21.30
DePaul University Fatigue Questionnaire : Allergies	22.91	21.39
Neuroendocrine Manifestations: Air Hunger	22.90	23.25
Autonomic Manifestations: Cortisol disorders or irregularity	22.87	26.22
Official Diagnosis: Allergic Rhinitis (Hay Fever)	22.85	20.06
Comorbid: Methylation issues (MTHFR)	22.85	24.23
Official Diagnosis: Gastroesophageal reflux disease (GERD)	22.76	24.27
Joint: Stiffness and swelling	22.75	25.95
General: Depression	22.73	22.15
Official Diagnosis: Mast Cell Dysfunction	22.71	23.61
Gender: Male	22.71	18.29
Age: 50-60	22.66	21.94
Autonomic: Inability to tolerate an upright position	22.63	25.39
DePaul University Fatigue Questionnaire : Racing heart	22.59	24.64
Condition: Non-Celiac Gluten Sensitivity	22.59	23.05
Comorbid: High Anxiety	22.56	22.02
DePaul University Fatigue Questionnaire : Hot or Cold spells	22.49	22.72
Sleep: Waking up early in the morning (e.g. 3 AM)	22.45	21.76
Physical: Northern European	22.44	21.58
Onset: less than 04 years since onset	22.43	22.47
Immune: Recurrent Sore throat	22.43	22.38
Official Diagnosis: COVID19 (Long Hauler)	22.41	20.18
General: Sinus issues with headaches	22.41	21.48
Blood Type: A Positive	22.38	21.61
DePaul University Fatigue Questionnaire : Sore Throat	22.37	25.17
DePaul University Fatigue Questionnaire : Walking up early in the morning (e.g. 3AM)	22.37	21.03
Immune: Tender / sore lymph nodes	22.37	24.62
DePaul University Fatigue Questionnaire : Need to nap during each day	22.37	21.23
Age: 20-30	22.27	19.37
DePaul University Fatigue Questionnaire : Feel unsteady on feet	22.26	23.61
Autonomic: Irregular heartbeats	22.25	23.87
Onset: 2010-2020	22.25	20.01
Physical: Tonsils removed	22.22	24.24
Autonomic: Nausea	22.17	22.59
Onset: less than 32 years since onset	22.15	26.14
Official Diagnosis: Autoimmune Disease	22.15	23.09
Physical: Pets	22.14	22.14
Condition: Generalized anxiety disorder	22.13	27.21
Comorbid: Mood Swings	22.13	25.38
DePaul University Fatigue Questionnaire : Feeling like you have a temperature	22.09	25.22
Comorbid: Hypothyroidism	22.07	22.74
Neurological-Sleep: Chaotic diurnal sleep rhythms (Erratic Sleep)	22.03	25.54
Autonomic: Ocassional Tachycardia (Rapid heart beat)	22.02	22.86
Comorbid: Fibromyalgia	22.01	24.58
Immune: Chronic Sinusitis	21.95	22.83
Official Diagnosis: Hypercholesterolemia (High Cholesterol)	21.94	28.51
Sleep: Need to nap daily	21.92	22.57
Neurological: Joint hypermobility	21.88	22.12
Autonomic Manifestations: exertional dyspnea	21.79	26.96
Pain: Myofascial pain	21.75	25.77
Autonomic Manifestations: nausea	21.71	22.62
Neurological-Sleep: Night Sweats	21.70	26.96
Immune: Flu-like symptoms	21.66	21.85
Physical: Organic Diet	21.62	23.80
Neuroendocrine: Temperature fluctuations throughout the day	21.60	25.29
Neurological: Myoclonic jerks or seizures	21.49	22.89
Neuroendocrine Manifestations: subnormal body temperature	21.43	24.68
DePaul University Fatigue Questionnaire : Night sweats	21.33	27.05
Neurological-Sleep: Vivid Dreams/Nightmares	21.31	26.39
Neuroendocrine Manifestations: sweating episodes	20.99	23.42
Neurological: Confusion	20.91	24.86
Comorbid-Mouth: Gingivits / Gum Disease	20.83	27.31
Neuroendocrine: Feeling like you have a high temperature	20.81	25.65
Autonomic Manifestations: bladder dysfunction	20.59	25.96
Onset: less than 02 years since onset	20.53	23.60
Onset: less than 16 years since onset	20.41	21.35
Neuroendocrine Manifestations: Painful menstrual periods	20.21	22.90
DePaul University Fatigue Questionnaire : Rash	20.12	23.90
Neuroendocrine Manifestations: Paraesthesia (tingling burning of skin)	19.75	22.42
Official Diagnosis: Depression	19.52	24.34
Physical: Eastern European	19.42	21.21
Neurological: Disorientation	18.84	27.99
Neuroendocrine Manifestations: Excessive adrenaline	18.16	25.52
Neurological: Seasonal Affective Disorder (SAD)	16.89	27.39

Looking at the bacteria taxons identified by each, we also see difference

Symptom Name	Percentile Taxons	Mean Taxons
Age: 20-30	131	100
Age: 30-40	245	61
Age: 40-50	202	138
Age: 50-60	112	91
Age: 60-70	45	124
Autonomic Manifestations: bladder dysfunction	21	125
Autonomic Manifestations: Cortisol disorders or irregularity	51	126
Autonomic Manifestations: exertional dyspnea	39	113
Autonomic Manifestations: irritable bowel syndrome	195	94
Autonomic Manifestations: light-headedness	110	121
Autonomic Manifestations: nausea	99	105
Autonomic Manifestations: Orthostatic intolerance	126	128
Autonomic Manifestations: palpitations	155	122
Autonomic Manifestations: Postural orthostatic tachycardia syndrome (POTS)	139	145
Autonomic Manifestations: urinary frequency dysfunction	98	97
Autonomic: Dizziness or fainting	93	132
Autonomic: Heart rate increase after standing	175	155
Autonomic: Inability to tolerate an upright position	68	115
Autonomic: Irregular heartbeats	63	114
Autonomic: Nausea	73	91
Autonomic: Ocassional Tachycardia (Rapid heart beat)	134	100
Autonomic: Shortness of breath	155	107
Blood Type: A Positive	93	97
Blood Type: O Positive	111	106
Comorbid-Mouth: Bruxism – Jaw cleanching / Teeth grinding	165	97
Comorbid-Mouth: Dry Mouth	132	121
Comorbid-Mouth: Gingivits / Gum Disease	27	105
Comorbid-Mouth: TMJ / Dysfunction of the temporomandibular joint syndrome	71	106
Comorbid: Constipation and Diarrohea (not explosions)	119	93
Comorbid: Fibromyalgia	80	80
Comorbid: High Anxiety	167	97
Comorbid: Histamine or Mast Cell issues	226	82
Comorbid: Hypothyroidism	116	103
Comorbid: Inflammatory bowel disease	86	83
Comorbid: Methylation issues (MTHFR)	106	99
Comorbid: Migraine	93	98
Comorbid: Mold Sensitivity / Exposure	114	79
Comorbid: Mood Swings	123	72
Comorbid: Multiple Chemical Sensitivity	85	68
Comorbid: Restless Leg	100	77
Comorbid: Sleep Apnea Diagnosis	69	114
Comorbid: Small intestinal bacterial overgrowth (SIBO)	149	100
Condition: Acne	128	75
Condition: Generalized anxiety disorder	24	114
Condition: ME/CFS with IBS	205	100
Condition: ME/CFS without IBS	161	87
Condition: Non-Celiac Gluten Sensitivity	108	103
Condition: Post-Traumatic Stress Disorder	84	80
DePaul University Fatigue Questionnaire : Abdomen pain	104	84
DePaul University Fatigue Questionnaire : Abnormal sensitivity to light	138	128
DePaul University Fatigue Questionnaire : Absent-mindedness	156	96
DePaul University Fatigue Questionnaire : Allergies	159	99
DePaul University Fatigue Questionnaire : Anxiety/tension	174	113
DePaul University Fatigue Questionnaire : Blurred Vision	114	96
DePaul University Fatigue Questionnaire : Chemical sensitivity	83	76
DePaul University Fatigue Questionnaire : Chilled or shivery	69	104
DePaul University Fatigue Questionnaire : Concern with driving	71	91
DePaul University Fatigue Questionnaire : Confusion/disorientation	102	84
DePaul University Fatigue Questionnaire : Depression	123	90
DePaul University Fatigue Questionnaire : Difficulty comprehending Information	173	87
DePaul University Fatigue Questionnaire : Difficulty falling asleep	152	81
DePaul University Fatigue Questionnaire : Difficulty finding the right word	205	95
DePaul University Fatigue Questionnaire : Difficulty following things	131	116
DePaul University Fatigue Questionnaire : Difficulty reasoning things out	123	102
DePaul University Fatigue Questionnaire : Difficulty recalling information	182	93
DePaul University Fatigue Questionnaire : Difficulty retaining information	150	96
DePaul University Fatigue Questionnaire : Difficulty staying asleep	172	128
DePaul University Fatigue Questionnaire : Dizziness	102	109
DePaul University Fatigue Questionnaire : Does physical activity make you feel worse	201	99
DePaul University Fatigue Questionnaire : Easily irritated	188	71
DePaul University Fatigue Questionnaire : Eye pain	80	113
DePaul University Fatigue Questionnaire : Fatigue	248	84
DePaul University Fatigue Questionnaire : Feel unsteady on feet	31	111
DePaul University Fatigue Questionnaire : Feeling like you have a temperature	44	92
DePaul University Fatigue Questionnaire : Forgetting what you are trying to say	169	83
DePaul University Fatigue Questionnaire : Frequently get words or numbers in the wrong order	67	108
DePaul University Fatigue Questionnaire : Frequently loose train of thought	141	85
DePaul University Fatigue Questionnaire : Headaches	116	101
DePaul University Fatigue Questionnaire : Hot or Cold spells	112	94
DePaul University Fatigue Questionnaire : Impaired Memory & concentration	204	87
DePaul University Fatigue Questionnaire : Mood swings	98	85
DePaul University Fatigue Questionnaire : Muscle Pain (i.e., sensations of pain or aching in your muscles. This does not include weakness or pain in other areas such as joints)	161	80
DePaul University Fatigue Questionnaire : Muscle weakness	176	99
DePaul University Fatigue Questionnaire : Nausea	83	114
DePaul University Fatigue Questionnaire : Need to have to focus on one thing at a time	178	77
DePaul University Fatigue Questionnaire : Need to nap during each day	110	109
DePaul University Fatigue Questionnaire : New trouble with math	17	86
DePaul University Fatigue Questionnaire : Night sweats	59	121
DePaul University Fatigue Questionnaire : Pain in Multiple Joints without Swelling or Redness	108	91
DePaul University Fatigue Questionnaire : Post-exertional malaise, feeling worse after doing activities that require either physical or mental exertion	217	80
DePaul University Fatigue Questionnaire : Racing heart	109	102
DePaul University Fatigue Questionnaire : Rash	43	68
DePaul University Fatigue Questionnaire : Ringing in the Ears	186	105
DePaul University Fatigue Questionnaire : Sensitivity to Alcohol	117	104
DePaul University Fatigue Questionnaire : Shortness of breath	109	100
DePaul University Fatigue Questionnaire : Slow to react	114	94
DePaul University Fatigue Questionnaire : Slowness of thought	170	95
DePaul University Fatigue Questionnaire : Sore Throat	82	93
DePaul University Fatigue Questionnaire : Temperature lower than normal	79	112
DePaul University Fatigue Questionnaire : Tense muscles	129	93
DePaul University Fatigue Questionnaire : Tingling feeling	127	94
DePaul University Fatigue Questionnaire : Trouble expressing thoughts	128	101
DePaul University Fatigue Questionnaire : Unrefreshing Sleep, that is waking up feeling tired	233	66
DePaul University Fatigue Questionnaire : Upset stomach	121	90
DePaul University Fatigue Questionnaire : Walking up early in the morning (e.g. 3AM)	130	94
DePaul University Fatigue Questionnaire : Weight change	96	85
Gender: Female	250	100
Gender: Male	267	81
General: Anhedonia (inability to feel pleasure)	40	112
General: Depression	148	116
General: Fatigue	299	63
General: Headaches	151	82
General: Heavy feeling in arms and legs	149	87
General: Myalgia (pain)	129	97
General: Sinus issues with headaches	72	86
Immune Manifestations: Abdominal Pain	159	90
Immune Manifestations: Alcohol Intolerant	138	96
Immune Manifestations: Bloating	254	84
Immune Manifestations: Chronic Flatus / Flatulence / gas	144	113
Immune Manifestations: Constipation	218	91
Immune Manifestations: Diarrhea	133	82
Immune Manifestations: general malaise	206	117
Immune Manifestations: Hair loss	149	90
Immune Manifestations: Inflammation (General)	186	89
Immune Manifestations: Inflammation of skin, eyes or joints	150	106
Immune Manifestations: medication sensitivities.	78	101
Immune Manifestations: Mucus in the stool	101	88
Immune Manifestations: new food sensitivities	131	94
Immune Manifestations: recurrent flu-like symptoms	102	119
Immune Manifestations: tender lymph nodes	80	138
Immune Manifestations: Thick blood / Hypercoagulation	44	114
Immune: Chronic Sinusitis	93	91
Immune: Flu-like symptoms	88	99
Immune: Recurrent Sore throat	118	98
Immune: Sensitivity to smell/food/medication/chemicals	149	79
Immune: Tender / sore lymph nodes	61	138
Immune: Viral infections with prolonged recovery periods	76	139
Infection: Lyme	57	126
Joint: Stiffness and swelling	71	117
Joint: Tenderness	73	94
Neurocognitive: Absent-mindedness or forgetfulness	195	85
Neurocognitive: Brain Fog	301	60
Neurocognitive: Can only focus on one thing at a time	218	66
Neurocognitive: Difficulty expressing thoughts	184	67
Neurocognitive: Difficulty paying attention for a long period of time	230	71
Neurocognitive: Difficulty understanding things	171	77
Neurocognitive: Feeling disoriented	127	86
Neurocognitive: Problems remembering things	213	94
Neurocognitive: Slowness of thought	196	84
Neurocognitive: Unable to focus vision and/or attention	168	108
Neuroendocrine Manifestations: Air Hunger	110	93
Neuroendocrine Manifestations: cold extremities	191	81
Neuroendocrine Manifestations: Dry Eye (Sicca or Sjogren Syndrome)	129	110
Neuroendocrine Manifestations: Excessive adrenaline	33	90
Neuroendocrine Manifestations: intolerance of extremes of heat and cold	202	57
Neuroendocrine Manifestations: marked weight change	51	113
Neuroendocrine Manifestations: Muscle weakness	142	123
Neuroendocrine Manifestations: Painful menstrual periods	27	81
Neuroendocrine Manifestations: Paraesthesia (tingling burning of skin)	45	112
Neuroendocrine Manifestations: Poor gut motility	198	91
Neuroendocrine Manifestations: Rapid muscular fatiguability	142	105
Neuroendocrine Manifestations: subnormal body temperature	51	145
Neuroendocrine Manifestations: sweating episodes	81	120
Neuroendocrine Manifestations: worsening of symptoms with stress.	235	86
Neuroendocrine: Alcohol intolerance	129	91
Neuroendocrine: Cold limbs (e.g. arms, legs hands)	166	84
Neuroendocrine: Feeling hot or cold for no reason	138	82
Neuroendocrine: Feeling like you have a high temperature	22	87
Neuroendocrine: Lost or gained weight without trying	116	96
Neuroendocrine: Temperature fluctuations throughout the day	37	79
Neurological-Audio: hypersensitivity to noise	203	85
Neurological-Audio: Tinnitus (ringing in ear)	227	115
Neurological-Sleep: Chaotic diurnal sleep rhythms (Erratic Sleep)	63	122
Neurological-Sleep: Inability for deep (delta) sleep	122	85
Neurological-Sleep: Insomnia	191	98
Neurological-Sleep: Night Sweats	86	106
Neurological-Sleep: Sleep Apnea	68	115
Neurological-Sleep: Vivid Dreams/Nightmares	73	107
Neurological-Vision: Blurred Vision	123	83
Neurological-Vision: inability to focus eye/vision	93	105
Neurological-Vision: photophobia (Light Sensitivity)	128	101
Neurological: Cognitive/Sensory Overload	172	80
Neurological: Confusion	63	72
Neurological: Difficulty processing information (Understanding)	156	91
Neurological: Difficulty reading	130	86
Neurological: Disorientation	41	90
Neurological: Dysautonomia	151	117
Neurological: emotional overload	132	82
Neurological: Executive Decision Making (Difficulty making)	139	76
Neurological: High degree of Empathy before onset	68	78
Neurological: Impairment of concentration	182	88
Neurological: Joint hypermobility	62	66
Neurological: Myoclonic jerks or seizures	20	100
Neurological: Neuropathy	67	96
Neurological: Seasonal Affective Disorder (SAD)	16	88
Neurological: Short-term memory issues	170	101
Neurological: Word-finding problems	193	80
Official Diagnosis: Allergic Rhinitis (Hay Fever)	118	62
Official Diagnosis: Attention deficit hyperactivity disorder (ADHD)	73	118
Official Diagnosis: Autism	112	115
Official Diagnosis: Autoimmune Disease	76	119
Official Diagnosis: Chronic Fatigue Syndrome (CFS/ME)	263	136
Official Diagnosis: COVID19 (Long Hauler)	249	150
Official Diagnosis: Depression	56	137
Official Diagnosis: Fibromyalgia	48	103
Official Diagnosis: Gastroesophageal reflux disease (GERD)	82	97
Official Diagnosis: Hypercholesterolemia (High Cholesterol)	23	104
Official Diagnosis: Irritable Bowel Syndrome	173	96
Official Diagnosis: Mast Cell Dysfunction	59	108
Onset: 2000-2010	96	99
Onset: 2010-2020	154	106
Onset: Gradual	108	89
Onset: less than 02 years since onset	66	120
Onset: less than 04 years since onset	84	82
Onset: less than 16 years since onset	57	92
Onset: less than 32 years since onset	50	108
Onset: Sudden	118	86
Other: Sensitivity to mold	109	82
Other: Sensitivity to vibrations	28	114
Pain: Aching of the eyes or behind the eyes	91	94
Pain: Joint pain	140	94
Pain: Myofascial pain	52	75
Pain: Pain or aching in muscles	145	98
Pain: Sensitivity to pain	80	106
Physical: Amalgam fillings	98	133
Physical: Breastfed	112	100
Physical: Eastern European	39	94
Physical: Good Air Quality	48	111
Physical: Long term (chronic) stress	167	150
Physical: Northern European	184	120
Physical: Organic Diet	28	92
Physical: Pets	124	81
Physical: Steps Per Day < 2000	133	115
Physical: Steps Per Day 2000-4000	117	111
Physical: Steps Per Day 4000-8000	102	107
Physical: Tonsils removed	72	122
Physical: Work-Sitting	183	79
Post-exertional malaise: Difficulty reading after mild physical or mental activity	158	95
Post-exertional malaise: General	197	82
Post-exertional malaise: Inappropriate loss of physical and mental stamina,	181	90
Post-exertional malaise: Mentally tired after the slightest effort	144	79
Post-exertional malaise: Muscle fatigue after mild physical activity	176	90
Post-exertional malaise: Next-day soreness after everyday activities	140	90
Post-exertional malaise: Physically drained or sick after mild activity	173	89
Post-exertional malaise: Physically tired after minimum exercise	193	80
Post-exertional malaise: Post-exertional malaise	198	93
Post-exertional malaise: Rapid cognitive fatigability,	158	86
Post-exertional malaise: Rapid muscular fatigability,	146	105
Post-exertional malaise: Worsening of symptoms after mild mental activity	155	68
Post-exertional malaise: Worsening of symptoms after mild physical activity	215	100
Sleep: Daytime drowsiness	175	71
Sleep: Need to nap daily	105	88
Sleep: Problems falling asleep	181	93
Sleep: Problems staying asleep	210	73
Sleep: Unrefreshed sleep	276	62
Sleep: Waking up early in the morning (e.g. 3 AM)	172	89
Virus: Epstein-Barr virus	123	89

Spot checking a few, we find that more bacteria to filter by seems to result in a higher percentage of matches. Consider Females:

• Measure: Using Percentile \ Using Mean
• Taxons: Gender: Female 250 \ 100
• Matches: Gender: Female 24.41% \ 20.35%

Bottom Line

The purpose of this post is to compare too methodologies. Neither appears absolutely superior to the other. For forecasting, it may be best to do each and takes the superior one. It is intended to show an alternative approach to this type of data.

The Percentile Advantage

If the lab being used provides percentiles over a diverse large population, you may not need a control group. The mean percentile of the population is 50 and the standard deviation of the population is 28.87 because we are dealing with a uniform distribution. We can then proceed to compute the mean of the percentiles of those with a condition and then compute the standard error resulting in a z-score.

The z-score will likely be a little lower than a perfect experiment because the large population will likely contain some with the condition being examined. Z-scores will actually be conservative, and the cost significantly less.

 I’ve been suffering from myalgic encephalomyelitis for over a year now (long covid or not, I don’t know), in an almost severe state for the last 6 months.

I recently had a Biomesight test and a long covid friend told me that you might be able to help me interpret my results.

Overview

Our usual first look visuals shows the dysbiosis and the typical pattern for ME/CFS and long COVID – an over abundance of bacteria at a low levels.

The forecast symptoms matches ME/CFS and Long COVID patterns

1.  83.3 % match for Neurological-Sleep: Inability for deep (delta) sleep on 42 taxa
2.  76.3 % match for Immune Manifestations: Hair loss on 38 taxa
3.  76.3 % match for Immune Manifestations: Mucus in the stool on 93 taxa
4.  75.2 % match for Neurocognitive: Problems remembering things on 141 taxa
5.  74.7 % match for Neurocognitive: Absent-mindedness or forgetfulness on 162 taxa
6.  74.6 % match for Neurological: Short-term memory issues on 71 taxa
7.  74.5 % match for Neuroendocrine Manifestations: cold extremities on 55 taxa
8.  74.3 % match for Neurocognitive: Can only focus on one thing at a time on 101 taxa

Drilling down into Health Predictors we see a rather high number, 13 items flagged. Looking at Dr. Jason Hawrelak Recommendations , we are at the 9%ile, not good.

Looking at Bacteria deemed unhealthy, we see the following very significant items.

• Bilophila genus 100%ile High Level Cause Brain Fog(Cognitive impairment) Citation

Addressing the problem

The process is simple, just click this buttom

Then use the filtering button to view different suggestions. The highest priority was 1000, lowest -765 so we will look to take items over 500 and aggressively avoid items below -350. The dosages come from this summary page that links to studies, dosages should be reviewed by your MD before starting.

• Vitamins (All of these are typical for ME/CFS and shown to help in studies).
  • Vitamin B-12 – 10   mg/day
  • Vitamin B1,thiamine hydrochloride – 1800   mg/day
  • Vitamin B6,pyridoxine hydrochloride – 50 mg/day
  • vitamin B7, biotin –300 mg/day
  • vitamin B3,niacin – 1000 mg/day
  • Vitamin C (ascorbic acid) – 3000   mg/d
• Supplements (take at least one of these each week – see above link for suggested dosages)
  • melatonin supplement
  • Hesperidin (polyphenol)
  • Arbutin (polyphenol)
  • diosmin (polyphenol)
  • luteolin (flavonoid)
• Herbs and Foods
  • garlic (allium sativum)
  • momordia charantia(bitter melon, karela, balsam pear, or bitter gourd)
  • Caffeine
  • whole-grain barley
  • sucralose
• Probiotics
  • lactobacillus kefiri (NOT KEFIR) — available in Italy only 🙁
  • Below the 500 threshold but should have some impact
    • lactobacillus reuteri (probiotics)
    • bifidobacterium infantis,(probiotics)
• Antibiotics (only picked those that have been used with ME/CFS by specialists). If done, they should be rotated and pulse (i.e. 7-10 days on one, 3 weeks off; then a different one is used). See Dr. C. Jadin’s approach.

The avoid list is often ignored by people. They should not be. These items feed the undesired shifts.

• Diet Style AVOIDS
  • ketogenic diet
  • hypocaloric hyperproteic diet
  • high saturated milk fat diet
  • fasting
• Foods AVOIDS
  • pectin
  • apple
  • Pulses
  • Pumpkin
  • pea (fiber, protein)
  • nuts
• Herbs AVOIDS
  • Slippery Elm
  • berberine
  • camellia
• Supplements AVOIDS
  • bile (acid/salts)
  • arabinogalactan (prebiotic)
  • Human milk oligosaccharides (prebiotic, Holigos, Stachyose)
  • resistant maltodextrin
  • xylan (prebiotic)
  • resistant starch
  • non-starch polysaccharides
  • bacillus licheniformis,(probiotics)
  • galactose (milk sugar)

Try for 8 weeks, then retest

While waiting for test results, keep to the suggestions.

• As is common with ME/CFS people, you may want to be done with the disease ASAP so much you toss yourself into it. I have been there and done that. Taking everything at once risk major herx reaction. The key is rotate and pulse. Avoid substances that cause herx that is longer than 6 hours — you are not ready for those, we need to take the longer path instead of trying to climb a cliff face.
• Try this pattern:
  • Take the probiotics, herbs and non-vitamin supplements into groups.
    • Week 1: take the probiotic for a week (#1 in priority)
    • Week 2: take one herb for a week (#1 in priority)
    • Week 3: one supplement for a week (#1 in priority)
    • Then go back to probiotic BUT take a different one (i.e. #2 in priority), same pattern for other things
  • After 8-12 weeks do a retest and see where suggestions have shifted
  • The goal is to destabilize a stable dysbiosis. In one sense, we want to do a guerilla war against it, not form up into a line and attempt march to frontal assault.

Questions and Answers

• Do you know if my ME is due to the covid with these results?
  • It is impossible to tell from the microbiome. COVID could make an existing case of ME/CFS worse. If you were fine prior, then it is likely that COVID causes ME (i.e. Long COVID). Over time the dysbiosis between ME/CFS and Long COVID become very similar.
• I’m allergic to penicillin (amoxycillin, etc.). What antibiotics can I take without it?
  • The best antibiotics that have been used by ME/CFS specialist were computed to be:
    • chloroquine diphosphate — anti-malarial and anti-rheumatoid agent and belongs to the drug class 4-aminoquinoline
    • dapsone – a sulfone, It works by decreasing swelling (inflammation) and stopping the growth of bacteria
    • neomycin –  belongs to the aminoglycosides group of antibiotics
    • metronidazole – belongs to the nitroimidazole antimicrobials. Metronidazole is one of the mainstay drugs for the treatment of anaerobic bacterial infections, protozoal infections, 
    • lymecycline –  tetracycline antibiotics.
  • My own preference would be to start with a tetracycline (lymecycline), followed by metronidazole, and then neomycin. This is largely based on the frequency of use that I have seen in the literature. At that point you should be retested.
    • I would follow Jadin’s pattern: 1 week on, 3 weeks off and then rotate to the next antibiotic.

Postscript – and Reminder

I am not a licensed medical professional and there are strict laws where I live about “appearing to practice medicine”.  I am safe when it is “academic models” and I keep to the language of science, especially statistics. I am not safe when the explanations have possible overtones of advising a patient instead of presenting data to be evaluated by a medical professional before implementing.

I can compute items to take, those computations do not provide information on rotations etc.

I cannot tell people what they should take or not take. I can inform people items that have better odds of improving their microbiome as a results on numeric calculations. I am a trained experienced statistician with appropriate degrees and professional memberships. All suggestions should be reviewed by your medical professional before starting.

The answers above describe my logic and thinking and is not intended to give advice to this person or any one. Always review with your knowledgeable medical professional.

Back Story

We would really like to take you up on your offer to make a youtube video (anonymous) to analyze my gut test results (OMBRE). We took a first pass on the website and found some interesting results but are a little overwhelmed at the suggestions. For reference, I have chronic fatigue after mostly recovering from POTS via the GAPS diet. This all started after giving birth. I attached the CSV from OMBRE in hopes that you are willing to help us out with this!

I understand well, my own wife developed ME/CFS also after giving birth.

Analysis

Her percentages of percentiles does not show the typical ME/CFS pattern which appears consistent with improvements from the GAPS diet.

Looking at General Health Predictors we have 17 predictors that are looking bad. Anti inflammatory Bacteria Score is 30%ile so inflammation is likely an issue

Going Forward

This person has entered their symptoms so we go with

Then use the filtering button to view different suggestions. The highest priority was 643, lowest -1014 (but 500 is where the list starts) so we will look to take items over 300 and aggressively avoid items below -250. The dosages come from this summary page that links to studies, dosages should be reviewed by your MD before starting.

• Vitamins (This looks like the usual list for ME/CFS and all are very high in priority, review dosages with your MD before starting)
  • Vitamin B1,thiamine hydrochloride – 1800   mg/day
  • Vitamin C (ascorbic acid) – 3000   mg/d
  • vitamin B3,niacin – 1000 mg/day
  • Vitamin B6,pyridoxine hydrochloride – 50 mg/day
  • vitamin B7, biotin –300 mg/day
  • Vitamin B9,folic acid – 5 mg/day
  • Vitamin B-12 – 10   mg/day
• Supplements
  • melatonin supplement
  • Hesperidin (polyphenol)
  • Arbutin (polyphenol)
  • diosmin (polyphenol)
  • luteolin (flavonoid)
• Probiotics
  • lactobacillus kefiri (NOT KEFIR) – available in Italy only
• Food and Diet
  • gluten-free diet
  • Caffeine
  • Just below 300, whole-grain barley with flaxseed (Note: barley has a different form of gluten then other grains)

Antibiotics

Usually these are not an option. But the suggested ones that are used by ME/CFS specialist are shown below

Avoids

• Supplements AVOIDS
  • pectin
  • oligosaccharides (prebiotic)
  • dietary phytoestrogens (isoflavones)
  • non-starch polysaccharides
  • Slippery Elm
  • inulin (prebiotic)
  • resistant maltodextrin
• Foods and Diet AVOIDS
  • fasting
  • Olive Oil
  • apple
  • Pulses
  • wheat bran
  • cruciferous vegetables (broccoli cabbage)
  • high fiber diet
  • soy
• Probiotics AVOIDS
  • lactobacillus plantarum (probiotics)
  • lactobacillus rhamnosus gg (probiotics)
  • bacillus coagulans (probiotics)

Try for 8 weeks, then retest

While waiting for test results, keep to the suggestions.

Questions And Answers

• When I got the list of suggestions, I started them all at once and herxed terribly. So much that I has to stop!
  • As is common with ME/CFS people, you want to be done with the disease so much you toss yourself into it. I have been there and done that. The key is rotate and pulse. Avoid substances that cause herx that is longer than 6 hours — you are not ready for those, we need to take the longer path instead of trying to climb a cliff face.
  • Try this pattern:
    • Take the probiotics, herbs and non-vitamin supplements into groups.
      • Week 1: take the probiotic for a week (#1 in priority)
      • Week 2: take one herb for a week (#1 in priority)
      • Week 3: one supplement for a week (#1 in priority)
      • Then go back to probiotic BUT take a different one (i.e. #2 in priority), same pattern for other things
    • After 8-12 weeks do a retest and see where suggestions have shifted
    • The goal is to destabilize a stable dysbiosis. In one sense, we want to do a guerilla war against it, not form up into a line and attempt march to frontal assault.
• You mentioned my patterns are inconsistent with people with CFS yet the suggestions are very consistent with people with CFS. Does this mean my patterns are less severe or is this wishful thinking?
  • Compared to the sample that I shared with you, less severe is my guess. You have less severe dysbiosis. ME/CFS has a wide variety of symptoms; each have great variability.
• I’m wondering if you think I should pursue the antibiotic route or if you think this should be last resort? Many people take garlic extract as a natural alternative to antibiotics. Do you think this might help/hurt?
  • My personal preference is antibiotics done correctly (pulses and rotation following Dr. Jadin’s approach). The reality is that it is often hard or impossible to get a prescribing physician on board – especially keeping on the antibiotics after significant improvement.
  • Garlic is a low positive [garlic (allium sativum)] so you are fine taking it. Remember that you should pulse it, ideally with other antibiotic herbs— none of them made it into the top set, but the low positive ones are below (all are higher priority over garlic):
    • hypericin, St. John’s Wort
    • thyme (thymol, thyme oil)
    • ginger
    • neem
    • tulsi
    • eugenol (from clove oil, nutmeg, cinnamon, basil,bay leaf.)
• You mentioned I have several pathogenic bacteria. What’s the best way to get rid of them? Is there a targeted antibiotic? 
  • All antibiotics have side-effects because they are broad spectrum. The computations for suggestions include these pathogenic bacteria — so rotating thru the antibiotics suggested should address these. My preference would be to do — in this sequence —
    1. metronidazole (antibiotic)s[CFS]
    2. azithromycin,(antibiotic)s[CFS]
    3. lymecycline (antibiotic)[CFS]
    4. clindamycin (antibiotic)s[CFS]
• You mentioned the general health predictors show 17 that are looking bad. Could you elaborate a bit on this?
  • Those bacteria comes from these studies:
  • A predictive index for health status using species-level gut microbiome profiling [2020]
  • Gut Microbiome Wellness Index 2 for Enhanced Health Status Prediction from Gut Microbiome Taxonomic Profiles [2023]
  • Microbiome-based disease prediction with multimodal variational information bottlenecks [2022]
    

Postscript – and Reminder

I am not a licensed medical professional and there are strict laws where I live about “appearing to practice medicine”.  I am safe when it is “academic models” and I keep to the language of science, especially statistics. I am not safe when the explanations have possible overtones of advising a patient instead of presenting data to be evaluated by a medical professional before implementing.

I can compute items to take, those computations do not provide information on rotations etc.

I cannot tell people what they should take or not take. I can inform people items that have better odds of improving their microbiome as a results on numeric calculations. I am a trained experienced statistician with appropriate degrees and professional memberships. All suggestions should be reviewed by your medical professional before starting.

The answers above describe my logic and thinking and is not intended to give advice to this person or any one. Always review with your knowledgeable medical professional.