In meetings with Vitract.com (Canada and US) and PrecisionBiome.Eu (the EU) leadership this week, given the low cost of the new DeepSeek Large Language Model (LLM) model came up. Both of these firms are working on implementing their own variations of an expert system. At $6 million dollars, using DeepSeek open source model could easily done by venture capital back firms such as:

• Viome Life Sciences: – $175 million
  • Viome’s AI system, called ‘Vie’ which uses machine-learning models for many chronic diseases. Evidence trails do not appear to be available.
• Seed Health: $44 milion
• Phylagen: $14 million
• Holobiome: $9 million
• BIOHM: $7.5 million
• Jona: $5 million
  • Claims to use artificial intelligence to interpret microbiome data, analyze scientific literature, and provide actionable recommendations for probiotics, prebiotics, and dietary changes. Which AI models is not disclosed.
• BiomeSense: $3 million:
• HelloBiome: $4.8 million
  • Claims to uses patent-pending AI-powered technology that uses supervised machine learning
• Enbiosis: less than $1 million
  • Claims to have developed an AI algorithm that evaluates the relationship between gut bacteria and health parameters to create personalized nutrition strategies

The effectiveness is easily tested between the two, and made easier with a new addition on MicrobiomePrescription site. It allows you to take the high and low genus and ask these LLM AIs after getting the results of the Fuzzy Logic Expert System.

I have tried this with multiple samples and see that the LLM tended to rubber stamped answers similar to more intelligent influencers general advice ignoring the details. Below are some samples.

If you want to try it on your own favorite try the two below. The first one is a simple logic test: the same bacteria are listed as desired to both lower and to raise. All AI failed to see this issue!

What diet should I do to lower these bacteria: Acinetobacter, Anaerotignum, Barnesiella, Ruminococcus, Streptococcus, Subdoligranulum, Subdoligranulum and increase these bacteria: Acinetobacter, Anaerotignum, Barnesiella, Ruminococcus, Streptococcus, Subdoligranulum, Subdoligranulum?

The following has both different increases and decreases.

What diet should I do to lower these bacteria: Acinetobacter, Anaerotignum, Barnesiella, Ruminococcus, Streptococcus, Subdoligranulum, Subdoligranulum and increase these bacteria: Bombiscardovia, Faecalibacterium?

Results

Fuzzy Logic Expert System

ChatGPT

Perplexity

DeepSeek

This took many, many tries to get a response.

Black Box or Exposed Reasoning

Large Language Models hide their logic and are prone to Hallucination (artificial intelligence). Hallucinations makes them inherently unsafe for clinical use. On the other side, expert systems have their entire logic available. A good example is Example of Cross Validated Suggestions for Long COVID, where the full logic with links to studies is shown — with over 2100 links! An MD is easily able to evaluate suggestions and filter them by their own bias — or, be better informed on the current literature.

Additionally, counter indicated suggestions are included in the expert system evaluation. This is very unlikely with LLMs.

A more Complex Example

Rarely do we have such minor dysbiosis as shown above seen in most patients. Here is a more typical example.

What diet should I do to lower these bacteria: Acetobacterium, Acetobacterium, Acholeplasma, Acholeplasma, Alkaliphilus, Alkaliphilus, Alkaliphilus, Anaerotruncus, Anaerotruncus, Anaerotruncus, Anaerovibrio, Anaerovibrio, Butyrivibrio, Caldicellulosiruptor, Candidatus Amoebophilus, Coprobacillus, Dehalobacterium, Dolichospermum, Ethanoligenens, Fundidesulfovibrio, Fundidesulfovibrio, Hathewaya, Heliorestis, Heliorestis, Holdemania, Holdemania, Odoribacter, Odoribacter, Odoribacter, Odoribacter, Pseudoclostridium, Ruminiclostridium, Ruminiclostridium, Skermanella, Tindallia and increase these bacteria: Coprococcus, Dorea?

The above examples are both available on the Demo login of Microbiome Prescription.

For the last example, a full detailed report using the monte carlo model is attached below.

Bottom Line

The Fuzzy Logic Expert System used above have interesting statistics (here). Considering that it was produced by one person as a part time “hobby” over ~4 years should illustrate the feasibility of doing the expert approach. Mind you this person had the right skills:

• Taught AI at University for a few years
• Worked professionally in AI for firms such as Microsoft, Verizon, and Amazon
• World class programming skills (including white papers for Microsoft and others)
• Taught science at High School and Colleges (and has read medical papers since 15 y.o.)
• Is high functioning Autistic — allowing prolonged focused concentration on issues

This post indicate future trends:

IMHO, it is morally and professionally irresponsible for suggestions / therapies to be made without all of the evidence that the suggestions and/or therapies is based on to be available in a human (MD) readable format. To the best of my knowledge, none of the vague AI claims above provide that to their customers. “Machine Learning” is a black box. Claiming AI is often a marketing strategy that border on fraud.

• AI transparency: What is it and why do we need it? [2024]
• What is interpretability in machine learning?
• Explainable AI: A Review of Machine Learning Interpretability Methods [2020]

The details are different based on the individuals actual microbiome patterns.

Treatment Suggestions for Example Patient

This report is for Example Patient using a sample from BiomeSight. It uses their reported medical conditions, microbiome sample, US National Library of Medicine, and a fuzzy logic expert system to compute recommendations balancing study reliability and contraindications. These suggestions should always be reviewed by a medical professional before starting.

NOTA BENE: This is working solely from published studies. Other suggestions algorithms are available on Microbiome Prescription. The URL above may be sent to your MD if you wish to share it.

The reported condition(s) are

This person has a significant amount of bacteria known to form biofilms

Substances with a 🦠 are reported to reduce biofilms. See for studies.

1. Chronic Fatigue Syndrome – CFS,ME,Myalgic encephalomyelitis
   1. Coenzyme Q10 (CoQ10): Some studies have suggested that CoQ10 supplementation might have potential benefits in reducing fatigue and improving energy levels in individuals with CFS. However, more research is needed to establish its effectiveness for CFS specifically.
   2. Omega-3 Fatty Acids: Omega-3 supplements containing EPA and DHA have anti-inflammatory properties and may support overall health. Some individuals with CFS might consider omega-3 supplementation for potential benefits, although evidence supporting their use specifically for CFS is limited.
   3. Probiotics: The role of probiotics in managing CFS symptoms is an area of ongoing research. Some studies suggest that probiotics might impact gut health and the immune system, which could potentially affect symptoms in some individuals with CFS. However, specific probiotic strains, dosages, and their efficacy for CFS require further investigation.
   4. Vitamins and Minerals: Nutritional deficiencies are common in individuals with CFS, possibly due to poor dietary intake or other factors. Some individuals might have deficiencies in vitamins (such as vitamin D, B vitamins) or minerals (like magnesium or iron). Supplements might be recommended to address identified deficiencies.
2. Long COVID –
   1. Vitamin D: There is some research suggesting that maintaining adequate vitamin D levels might support the immune system and overall health, potentially reducing the risk of severe respiratory infections. However, its specific role in Long COVID management is not fully established.
   2. Omega-3 Fatty Acids: Omega-3 fatty acids from sources like fish oil may have anti-inflammatory properties that could potentially benefit individuals with Long COVID, particularly for symptoms related to inflammation.
   3. Probiotics: While not specific to Long COVID, maintaining gut health through probiotics might have an indirect positive impact on overall health and immune function. A healthy gut microbiome could potentially aid in immune regulation and reduce inflammation, although its direct effect on Long COVID is yet to be established.
   4. Multivitamins and Minerals: Ensuring adequate intake of essential vitamins and minerals through a balanced diet or supplements may support overall health, but their specific role in managing Long COVID requires further research.

Significant Bacteria Shifts

Based on the existing literature on the US National Library of Medicine and this microbiome sample, we have the following matches for bacteria shifts. There is a growing body of literature finding that the effectiveness of interventions depends on the existing microbiome. We filter by documented interventions that helps some with this condition and suggestions based on this person’s specific microbiome to produce this “double validated” list.

Bacteroidaceae – family : High 4 8 Bacteroides – genus : High 1 4 8 Bacteroides ovatus – species : High 4 Bacteroides uniformis – species : High 4 Blautia obeum – species : Low 1 13 Butyricimonas – genus : Low 5 8 Butyrivibrio – genus : Low 8 Cloacibacillus – genus : Low 8 Coprococcus – genus : Low 5 8 12 Coriobacteriaceae – family : Low 7 Coriobacteriia – class : Low 7 Dialister – genus : Low 8 Faecalibacterium – genus : High 6 13 Holdemania – genus : High 8 Lactobacillaceae – family : High 5 Lactobacillus – genus : Low 2 3 10 11 14

Mycobacteriales – order : Low 12 Negativicutes – class : Low 5 Odoribacter – genus : Low 5 Parabacteroides – genus : Low 5 Parabacteroides distasonis – species : Low 1 Paraprevotella – genus : Low 5 Pediococcus – genus : High 5 Phocaeicola vulgatus – species : High 9 13 Prevotella – genus : Low 5 8 14 Prevotellaceae – family : Low 5 8 13 Rhodospirillaceae – family : Low 8 Ruminococcaceae – family : High 7 Streptococcus – genus : Low 2 Tannerellaceae – family : Low 5 Veillonellaceae – family : Low 5

Cross Validated Suggestions

The following improves the bacteria identified above and also is reported in the literature of helping some people with this condition. Each is link to the source study.

(RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen} 75 1,2-dithiolane-3-pentanoic acid {a-Lipoic acid (ALA)} 53 2-Aminopentanedioic acid {glutamate} 55 a-Amino-3-indolepropionic acid {Tryptophan} 36 acetylsalicylic acid,aspirin 75 alpha-linolenic acid {Omega-3} 26 36 74 ascorbic acid {Vitamin C} 80 Astragalus 35 azithromycin,[CFS] 34 bifidobacterium infantis {B. infantis} 24 bifidobacterium longum {B.Longum } 71 cobalamin {Vitamin B-12} 36 Coenzyme Q10 {CoQ 10} 23 36 51 53 62 69 70 Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} 15 doxepin hydrochloride,(prescription) 40 doxycycline [CFS]🦠 31 D-ribofuranoside {Ribose} 25 26 36 Echinacea Moench {Echinacea} 80 eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} 26 36 erythromycin [CFS] 32 Far Infrared Therapy {Far infrared Sauna } 46 47 48 49 Ferrum {Iron Supplements} 36 folate {Vitamin B9} 17 18 19 20 36 50 glycyrrhizic acid {licorice} 65 66 67 guanfacine hydrochloride,(prescription) 40 indomethacin,(prescription) 75 ketotifen fumarate,(prescription) 36 38

Lacticaseibacillus casei {L. casei} 24 27 Lacticaseibacillus paracasei shirota {Yakult} 24 27 Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 71 liothyronine,(prescription) 38 low fodmap diet 39 Magnesium Compounds {Magnesium supplements} 22 59 60 61 62 63 maprotiline hydrochloride,(prescription) 64 midodrine hydrochloride,(prescription) 39 40 minocycline [CFS] 29 30 Momordica charantia {Bitter gourd} 54 N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} 36 40 72 N-Acetyl Cysteine {NAC} 36 naltrexone hydrochloride dihydrate,(prescription) LDN 36 38 41 76 77 78 79 Oenothera biennis {Evening Primrose Oil} 22 Panax … {Ginseng} 62 74 prednisone,(prescription) 75 Propolis {Bee glue} 80 pyridostigmine iodide,(prescription) 37 40 Rosa canina {Rosehip} 80 Selenomethionine {Selenium supplement} 36 51 52 ß-glucan {Beta-Glucan} 33 Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three} 28 Theobroma cacao {Cacao} 23 68 Thiamine {Vitamin B1} 55 56 57 trazodone hydrochloride,(prescription) 36 40 vitamin d🦠 36 58 Zinc {Zinc Supplements} 36 72 80

Alternative Names

Depending on where you are located, some names may be unfamiliar. Some of the items listed may not be identical but are deemed to be reasonable approximations.

(RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen}	Advil, Motrin, Nurofen, Brufen
1,2-dithiolane-3-pentanoic acid {a-Lipoic acid (ALA)}	Alpha-Lipoic acid,Thioctic acid,Lipoic acid.High in organ meats
2-Aminopentanedioic acid {glutamate}	L-Glutamic acid,2-Aminoglutaric acid,Glutamic acid
a-Amino-3-indolepropionic acid {Tryptophan}	Found in Chicken and Turkey, sardines and Lobsters
acetylsalicylic acid,aspirin	acetylsalicylsalicylic acid non-drug
alpha-linolenic acid {Omega-3}	ALA. Plant based, Flaxseed, otherwise see Fish oil NOT a-Lipoic acid (also ALA)
Astragalus	Astragalus polysaccharide
azithromycin,[CFS]	(3-micina, a sai qi, abacten, abacten forte, acex, acithroc, actazith, agitro, ai mi qi, amixef, anex-az, ao li ping, apo azithromycine, apo-azithromycin, aruzilina, arzomidol, asomin, aspen azithrom…
bifidobacterium longum {B.Longum }	May include Bifidobacterium longum subsp. infantis and Bifidobacterium longum subsp. longum
cobalamin {Vitamin B-12}	cyanocobalamin, methylcobalamin, adenosylcobalamin, hydroxocobalamin
Coenzyme Q10 {CoQ 10}	Ubiquinone,Ubidecarenone,Vitamin Q10,Mitoquinone
Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)}	Sijunzi Tang, Mixture of Radix Ginseng, Poria, Rhizoma Atractylodis Macrocephalae, Radix Glycyrrhizae
doxepin hydrochloride,(prescription)	(colian, doxepin, doxepin rth, doxepine, doxesom, doxure, noctaderm, sinequan, adnor, anten, antidoxe, apo-doxepin, dofu, doneurin, dospin, doxepin – 1 a pharma, doxepin al, doxepin dura, doxepin hol…
doxycycline [CFS]	(a-lennon doxycycline, acnedox, acti doxy, actidox, adjusan, adoxa, ai rui de an, alodox, ambrodoxy, ambroxol al comp., ambroxol comp.-ratiopharm, amermycin, apdox, apdoxy, apo-doxy, apprilon, ardox,…
D-ribofuranoside {Ribose}	d-Ribose
Echinacea Moench {Echinacea}	Coneflower, Purple coneflower, American coneflower
eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil}	Typically from salmon, mackerel, and sardines
erythromycin [CFS]	(a-mycin, a-mycin-ds, a/t/s, abboticin, abboticin es, abboticin novum, abboticine, acne, acne benz, acne biotic, acne hermal, acne zinc, acneout, acnerin, acnetrim, acni care, acni care 2%, acryth, a…
Far Infrared Therapy {Far infrared Sauna }	Iyashi Dôme
Ferrum {Iron Supplements}	Ferrous Sulfate,Ferrous Gluconate,Ferrous Fumarate,Iron Polysaccharide,Carbonyl Iron,Heme Iron Polypeptide
folate {Vitamin B9}	folic acid when referring to its synthetic form, folacin, pteroyl-L-glutamic acid, Wills factor
glycyrrhizic acid {licorice}	Glycyrrhiza glabra,liquorice
guanfacine hydrochloride,(prescription)	(estulic, guanfacine hcl actavis, intuniv, intuniv xr, tenex)
ketotifen fumarate,(prescription)	(airyfen, albalon, aljen, allerban, antifen, asdown, asdron, asfen, asmafen, asmarax, asmindin, asmofen, asperfin, astafen, asthacure, asthanil, asthonex, asthotifen, asumalife, athmin, bilozen, bron…
L-3-hydroxytrimethylaminobutanoate {carnitine}	In beef, minor amount is milk,chicken
Lacticaseibacillus casei {L. casei}	Streptobacterium casei,Lactobacillus casei
Lacticaseibacillus rhamnosus {l. rhamnosus}	lactobacillus rhamnosus, Lactobacillus casei subsp. rhamnosus
liothyronine,(prescription)	(bitiron, cynomel, eutroid, nei zhang qing, novothyral, thyreotom, thyreotom forte, thyrotardin, tiroideibsa, tresite f, prothyrid, thybon henning, combithyrex forte, combithyrex mite, cynoplus, cyto…
Magnesium Compounds {Magnesium supplements}	Magnesium citrate, Magnesium glycinate, Magnesium oxide, Magnesium chloride, Magnesium lactate, Magnesium malate, Magnesium taurate, Magnesium sulfate
maprotiline hydrochloride,(prescription)	(epalon, ludiomil, maprotilin zdravlje, colese, cronmolin, keproline, ladiomil, ludios, mapromil, maprotil, maprotilin, maprotilin mylan, maprotilina ratiopharm, maprotilin-ct, maprotiline hcl cf, ma…
minocycline [CFS]	(acneclin, bagomicina, borymycin, clinax, cyclimycin, cynomycin, dacnel, drenix, minima, minociclina genfar, minociclina richet, minocin, minocyclin rth, minosine, minot, seboclear, skid, aknemin, ak…
Momordica charantia {Bitter gourd}	Bitter melon, goya, bitter apple, bitter gourd, bitter squash, balsam-pear, karavila,Leprosy gourd
N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin}	a hormone primarily produced by the pineal gland
N-Acetyl Cysteine {NAC}	(abinac, acc, acc acute, acc akut hustenlöser, acc akut junior hustenlöser, acc baby, acc extra, acc hexal, acc hexal long, acc hot, acc junior, acc kid, acc kinder, acc long, acc mini, acc neo, acc …
naltrexone hydrochloride dihydrate,(prescription) LDN	Low dosage naltrexone, (abernil, adepend, nalerona, naltrexone, naltrexone accord, naltrexone accord healthcare, naltrexone aop, neksi, vivitrol, anarcol, antaxon, antaxone, contrave, dependex, desto…
Oenothera biennis {Evening Primrose Oil}	Evening Primrose Oil (EPO),Common evening primrose,Evening star,Sun drop,King’s cure-all
Panax … {Ginseng}	Asian or Korean ginseng,American ginseng,Renshen,Baiguo
Propolis {Bee glue}	Acide de Cire d’Abeille,Baume de Propolis
Rosa canina {Rosehip}	Briar rose,Common briar,Cynorrhodon,
Selenomethionine {Selenium supplement}	Sodium selenate, Methylselenocysteine, Selenocysteine. Found in Brazil Nuts, Tuna, Halibut and Sardines
ß-glucan {Beta-Glucan}	Beta-D-glucose polysaccharide, found in Oats, Barley, Rye, Wheat, oyster mushroom, sea weed
Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three}	A blend of Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus
Theobroma cacao {Cacao}	Used in making DARK Chocolate
Thiamine {Vitamin B1}	Aneurine
trazodone hydrochloride,(prescription)	(codipzona, trazodona bussié, trazodona genfar, trazodona ratiopharm, trittico, trittico ac, trittico retard, apo-trazodone, aspen trazodone, azona, cirzodone, desyrel, diapresan, diapresan lp, donar…
vitamin d	cholecalciferol,Vitamin D3, activated 7-dehydrocholesterol
Zinc {Zinc Supplements}	Zinc sulfate,Zinc acetate,Zinc gluconate,Zinc picolinate,Zinc citrate,Zinc oxide,Zinc monomethionine

Suggestions Impact On Each Bacteria Picked

Reviewing substances reported to help with this condition on the US National Library of Medicine, and which will correct the above bacteria shifts. the following are recommended. Some bacteria may lack literature because none of the studied substances for the condition(s) are known to modify the bacteria.

• Bacteroidaceae
  • alpha-linolenic acid {Omega-3} ^26 1307
  • bifidobacterium infantis {B. infantis} ^{24 36 74 242 1307}
  • bifidobacterium longum {B.Longum } ^71 2000
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxycycline [CFS]🦠 ^{15 31 249 1419}
  • Echinacea Moench {Echinacea} ^80 571
  • glycyrrhizic acid {licorice} ^{65 80 571 1337 1342}
  • Lacticaseibacillus casei {L. casei} ^{24 66 67 571 625}
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 27 625 820}
  • low fodmap diet ^{27 39 820 1045}
  • minocycline [CFS] ^29 249
  • Momordica charantia {Bitter gourd} ^30 54 249
  • N-Acetyl Cysteine {NAC} ^{36 54 571 1515}
  • Oenothera biennis {Evening Primrose Oil} ^22 1307
  • Panax … {Ginseng} ^62 2118
  • Propolis {Bee glue} ^{74 80 571 2118}
  • ß-glucan {Beta-Glucan} ³³
  • Theobroma cacao {Cacao} ^23 109
  • vitamin d🦠 ^{23 36 68 109 592 992}
  • Zinc {Zinc Supplements} ^{36 58 992 1468}
• Bacteroides
  • (RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen} ^{72 75 80 275 1468}
  • alpha-linolenic acid {Omega-3} ^26 1307
  • Astragalus ^{26 35 36 74 1307 2134 2240}
  • azithromycin,[CFS] ^{34 35 275 2227}
  • bifidobacterium infantis {B. infantis} ^{24 34 242 847}
  • bifidobacterium longum {B.Longum } ^71 2000
  • cobalamin {Vitamin B-12} ^{36 71 275 2007}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxepin hydrochloride,(prescription) ^{15 40 275 1419}
  • doxycycline [CFS]🦠 ^31 249
  • Echinacea Moench {Echinacea} ^{31 80 275 571 847}
  • erythromycin [CFS] ^{32 80 275 1337 1342}
  • Ferrum {Iron Supplements} ^{32 36 416 847}
  • folate {Vitamin B9} ^17 275
  • glycyrrhizic acid {licorice} ^{17 18 19 20 36 50 65 275 416 571}
  • guanfacine hydrochloride,(prescription) ^{40 66 67 275 571}
  • indomethacin,(prescription) ^75 275
  • ketotifen fumarate,(prescription) ^36 275
  • Lacticaseibacillus casei {L. casei} ^{24 38 197 275}
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 27 197 625 820 2037 2041 2044}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{27 71 661 820}
  • liothyronine,(prescription) ^{38 71 275 1983 1985}
  • low fodmap diet ^39 1045
  • maprotiline hydrochloride,(prescription) ^64 275
  • midodrine hydrochloride,(prescription) ^39 275
  • minocycline [CFS] ^{29 40 249 275}
  • Momordica charantia {Bitter gourd} ^{29 30 54 249 275}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{36 54 275 1515}
  • N-Acetyl Cysteine {NAC} ^{36 40 72 275 571}
  • naltrexone hydrochloride dihydrate,(prescription) LDN ^36 275
  • Oenothera biennis {Evening Primrose Oil} ^{22 38 41 76 77 78 79 275 1307}
  • Panax … {Ginseng} ^62 2193
  • prednisone,(prescription) ^{74 75 275 2193}
  • Propolis {Bee glue} ^80 571
  • pyridostigmine iodide,(prescription) ^{37 80 275 2074}
  • ß-glucan {Beta-Glucan} ^33 40 275
  • Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three} ^{28 33 1959 2094 2140}
  • Theobroma cacao {Cacao} ^23 109
  • Thiamine {Vitamin B1} ^{23 55 68 109 275 592}
  • trazodone hydrochloride,(prescription) ^{36 56 57 275}
  • vitamin d🦠 ^{36 40 275 992}
  • Zinc {Zinc Supplements} ^{36 58 416 992}
• Bacteroides ovatus
  • (RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen} ^{36 72 75 80 275 416 1468 1470}
  • azithromycin,[CFS] ^34 275
  • bifidobacterium infantis {B. infantis} ^{24 34 242 847}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxepin hydrochloride,(prescription) ^{15 40 275 1419}
  • doxycycline [CFS]🦠 ^31 249
  • Echinacea Moench {Echinacea} ^{31 80 275 571 847}
  • erythromycin [CFS] ^{32 80 275 1337 1342}
  • glycyrrhizic acid {licorice} ^{32 65 571 847}
  • guanfacine hydrochloride,(prescription) ^{40 66 67 275 571}
  • indomethacin,(prescription) ^75 275
  • Lacticaseibacillus casei {L. casei} ^24 197
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 27 197 625 820}
  • liothyronine,(prescription) ^{27 38 275 820}
  • low fodmap diet ^39 1045
  • minocycline [CFS] ^29 249
  • Momordica charantia {Bitter gourd} ^{29 30 54 249 275}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{36 54 275 1515}
  • N-Acetyl Cysteine {NAC} ^{36 40 72 275 571}
  • Propolis {Bee glue} ^80 571
  • ß-glucan {Beta-Glucan} ³³
  • Theobroma cacao {Cacao} ^{23 33 109 2230}
  • Thiamine {Vitamin B1} ^{23 55 68 109 275 592}
  • vitamin d🦠 ^{36 56 57 275 992}
  • Zinc {Zinc Supplements} ^{36 58 992 1468}
• Bacteroides uniformis
  • azithromycin,[CFS] ^{34 72 80 275 1468}
  • bifidobacterium infantis {B. infantis} ^{24 34 242 847}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxepin hydrochloride,(prescription) ^{15 40 275 1419}
  • doxycycline [CFS]🦠 ^31 249
  • Echinacea Moench {Echinacea} ^{31 80 275 571 847}
  • erythromycin [CFS] ^{32 80 275 1337 1342}
  • glycyrrhizic acid {licorice} ^{32 65 571 847}
  • guanfacine hydrochloride,(prescription) ^{40 66 67 275 571}
  • indomethacin,(prescription) ^75 275
  • Lacticaseibacillus casei {L. casei} ^24 197
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 27 197 625 820}
  • low fodmap diet ^{27 39 820 1045}
  • maprotiline hydrochloride,(prescription) ^64 275
  • minocycline [CFS] ^29 249
  • Momordica charantia {Bitter gourd} ^{29 30 54 249 275}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{36 54 275 1515}
  • N-Acetyl Cysteine {NAC} ^{36 40 72 275 571}
  • naltrexone hydrochloride dihydrate,(prescription) LDN ^36 275
  • prednisone,(prescription) ^{38 41 75 76 77 78 79 275}
  • Propolis {Bee glue} ^80 571
  • ß-glucan {Beta-Glucan} ³³
  • Theobroma cacao {Cacao} ^23 109
  • trazodone hydrochloride,(prescription) ^{36 68 109 275}
  • vitamin d🦠 ^{36 40 275 992}
  • Zinc {Zinc Supplements} ^{36 58 992 1468}
• Blautia obeum
  • a-Amino-3-indolepropionic acid {Tryptophan} ^{36 72 80 1468 1470 1603}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^71 196
  • low fodmap diet ^{39 71 371 1045}
  • Magnesium Compounds {Magnesium supplements} ^22 701
  • minocycline [CFS] ^{29 59 60 61 62 63 165 701}
  • Panax … {Ginseng} ^{30 62 165 1111}
  • Propolis {Bee glue} ^{74 80 1111 1563}
  • Theobroma cacao {Cacao} ^23 592
  • Zinc {Zinc Supplements} ^{23 36 68 592 601 1471 1917}
• Butyricimonas
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^{15 36 72 80 407 1471 1472 1474}
• Butyrivibrio
  • a-Amino-3-indolepropionic acid {Tryptophan} ^36 711
  • alpha-linolenic acid {Omega-3} ^26 499
  • Astragalus ^{26 35 36 74 499 505 965 1307}
  • bifidobacterium longum {B.Longum } ^{35 71 99 1035}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^{15 71 266 1419}
  • D-ribofuranoside {Ribose} ^25 1042
  • Ferrum {Iron Supplements} ^{25 26 36 341 1042 1914}
  • folate {Vitamin B9} ^17 1654
  • glycyrrhizic acid {licorice} ^{18 19 20 36 50 65 933 1654}
  • Lacticaseibacillus casei {L. casei} ^{24 66 67 118 933}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{24 27 71 118 156 371}
  • minocycline [CFS] ^29 82
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{29 30 36 82 165 846}
  • Oenothera biennis {Evening Primrose Oil} ^{22 36 40 72 499 846 1635}
  • Propolis {Bee glue} ^{22 80 505 1307 1559}
  • Theobroma cacao {Cacao} ^{23 80 592 1561}
  • vitamin d🦠 ^{36 68 592 652}
• Coprococcus
  • a-Amino-3-indolepropionic acid {Tryptophan} ^{36 58 652 711}
  • alpha-linolenic acid {Omega-3} ^26 499
  • ascorbic acid {Vitamin C} ^{26 36 74 80 499 505 906}
  • Astragalus ^35 1035
  • bifidobacterium longum {B.Longum } ^71 99
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^{15 71 266 1419 2004}
  • D-ribofuranoside {Ribose} ^25 1042
  • Echinacea Moench {Echinacea} ^{25 26 36 80 1042 1338 1914}
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 2174
  • Ferrum {Iron Supplements} ^{36 341 2174}
  • folate {Vitamin B9} ^17 1654
  • glycyrrhizic acid {licorice} ^{18 19 20 36 50 65 933 1654}
  • Lacticaseibacillus casei {L. casei} ^{24 66 67 118 933}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{24 27 71 118 156 371}
  • minocycline [CFS] ^{29 71 82 1981}
  • Momordica charantia {Bitter gourd} ^{29 30 54 82 165 1514}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^36 846
  • Oenothera biennis {Evening Primrose Oil} ^{22 36 40 72 499 846 1635}
  • Propolis {Bee glue} ^{22 80 505 1559}
  • vitamin d🦠 ^{36 80 652 1561}
  • Zinc {Zinc Supplements} ^{36 58 652 721 906 989 990 1471}
• Coriobacteriaceae
  • ascorbic acid {Vitamin C} ^{72 80 906 1471}
  • Astragalus ^35 1035
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 240
  • L-3-hydroxytrimethylaminobutanoate {carnitine} ^{21 36 240 1440}
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 36 73 820 1440}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{27 71 371 820}
  • minocycline [CFS] ^{29 71 82 1984}
  • vitamin d🦠 ^{30 36 82 137}
• Coriobacteriia
  • 2-Aminopentanedioic acid {glutamate} ^{36 55 58 137 906 1605}
  • a-Amino-3-indolepropionic acid {Tryptophan} ^36 711
  • ascorbic acid {Vitamin C} ^80 906
  • Astragalus ^35 858
  • bifidobacterium longum {B.Longum } ^71 485
  • Coenzyme Q10 {CoQ 10} ^23 957
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^{26 36 51 53 62 69 70 240 957}
  • low fodmap diet ^36 39 240
  • minocycline [CFS] ^29 82
  • Momordica charantia {Bitter gourd} ^{30 54 82 1514}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^36 1636
  • Selenomethionine {Selenium supplement} ^{36 40 72 782 1636}
  • vitamin d🦠 ^{36 51 52 782 906}
• Dialister
  • ascorbic acid {Vitamin C} ^{36 58 80 906 989}
  • bifidobacterium longum {B.Longum } ^71 151
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 354
  • Panax … {Ginseng} ^{36 62 354 1109}
  • Propolis {Bee glue} ^{74 80 1109 1560}
  • ß-glucan {Beta-Glucan} ^33 333
  • vitamin d🦠 ^36 906
• Faecalibacterium
  • alpha-linolenic acid {Omega-3} ^26 58 906
  • Astragalus ^{26 35 36 74 499 2227}
  • azithromycin,[CFS] ^34 248
  • Ferrum {Iron Supplements} ^36 241
  • Lacticaseibacillus casei {L. casei} ^{24 36 156 2224}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{27 71 156 196}
  • low fodmap diet ^39 71 342
  • Momordica charantia {Bitter gourd} ^54 1515
  • Oenothera biennis {Evening Primrose Oil} ²²
  • Theobroma cacao {Cacao} ^{22 23 499 1917}
  • Thiamine {Vitamin B1} ^{55 68 212 1917}
  • vitamin d🦠 ^{36 56 57 212 741}
  • Zinc {Zinc Supplements} ^{36 58 214 741}
• Holdemania
  • Far Infrared Therapy {Far infrared Sauna } ^{46 72 80 214 1216}
  • L-3-hydroxytrimethylaminobutanoate {carnitine} ^{21 47 48 49 1216 1439}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{36 71 73 196 1439}
  • low fodmap diet ^{39 71 716 1045}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^36 1641
  • Thiamine {Vitamin B1} ^{40 55 72 212 1641}
  • vitamin d🦠 ^{36 56 57 212 567}
• Lactobacillaceae
  • (RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen} ^{58 75 468 567}
  • 1,2-dithiolane-3-pentanoic acid {a-Lipoic acid (ALA)} ^53 1290
  • alpha-linolenic acid {Omega-3} ^26 1811
  • azithromycin,[CFS] ^{34 36 74 203 1811}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxycycline [CFS]🦠 ^31 81
  • erythromycin [CFS] ^32 440
  • Ferrum {Iron Supplements} ³⁶
  • L-3-hydroxytrimethylaminobutanoate {carnitine} ^{21 36 341 434 542 620 926 1527 1528 1529 1530}
  • Oenothera biennis {Evening Primrose Oil} ^{22 36 73 926 1811}
  • Selenomethionine {Selenium supplement} ^36 738
  • Theobroma cacao {Cacao} ^{23 51 52 592 738}
  • vitamin d🦠 ^{23 36 68 137 592 601}
  • Zinc {Zinc Supplements} ^{36 58 101 137 575}
• Lactobacillus
  • 2-Aminopentanedioic acid {glutamate} ^{36 55 72 80 101 310 465 1468 1474}
  • a-Amino-3-indolepropionic acid {Tryptophan} ^{36 55 1601 1605}
  • alpha-linolenic acid {Omega-3} ^{26 36 389 1602 1603 2166 2236}
  • ascorbic acid {Vitamin C} ^{26 36 74 80 389 455 1307 2240}
  • Astragalus ^{35 80 860 1061}
  • bifidobacterium longum {B.Longum } ^{35 71 456 861 2101}
  • cobalamin {Vitamin B-12} ^{36 71 753 875 1004 1997 1998 1999 2000 2001 2002 2005 2006 2007 2008}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 1418
  • Echinacea Moench {Echinacea} ^80 1337
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^{26 80 240 1341}
  • erythromycin [CFS] ^{26 32 36 240 276 992 1808 1810 2174}
  • Ferrum {Iron Supplements} ^36 306
  • folate {Vitamin B9} ^{17 36 634 1650}
  • Lacticaseibacillus casei {L. casei} ^{17 18 19 20 24 36 50 118 1650 1651 1652}
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 27 118 205 324 475 519 1929 2036 2038 2040 2041 2043 2045}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{24 27 71 342 519 670 671 820}
  • Magnesium Compounds {Magnesium supplements} ^{22 71 1060 1981 1984 1986}
  • Momordica charantia {Bitter gourd} ^{54 59 60 61 62 63 1514}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^36 1638
  • N-Acetyl Cysteine {NAC} ^{36 40 72 465 1638 1639 1640 1641 1642}
  • Oenothera biennis {Evening Primrose Oil} ^{22 36 389 1106}
  • Panax … {Ginseng} ^{22 62 720 1307}
  • Propolis {Bee glue} ^{62 74 80 720 723 934 1110 1111 1112 1564 1950 2135 2193 2279}
  • Rosa canina {Rosehip} ^80 1219
  • Selenomethionine {Selenium supplement} ^36 353
  • ß-glucan {Beta-Glucan} ^{33 36 51 52 353 566 1812}
  • Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three} ^{28 33 667 1383 1452 1956 1957 1958 1960 1961}
  • Theobroma cacao {Cacao} ^23 92
  • Thiamine {Vitamin B1} ^{23 55 68 92 163 455 1915}
  • vitamin d🦠 ^{36 56 57 455}
  • Zinc {Zinc Supplements} ^{36 58 214 455 689 992}
• Mogibacterium
  • Echinacea Moench {Echinacea} ^{36 72 80 214 353 538 620 634 879 1339 1469 1472 1473 1475 1476}
• Mycobacteriales
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 240
  • low fodmap diet ^36 39 240
  • minocycline [CFS] ^29 82
• Negativicutes
  • azithromycin,[CFS] ^{30 34 82 203}
  • cobalamin {Vitamin B-12} ^{34 36 248 435}
  • Coenzyme Q10 {CoQ 10} ^23 957
  • minocycline [CFS] ^{29 36 51 53 62 69 70 82 957}
  • Momordica charantia {Bitter gourd} ^{30 54 82 1514}
  • Selenomethionine {Selenium supplement} ^36 782
  • ß-glucan {Beta-Glucan} ^{33 51 52 333 782}
  • vitamin d🦠 ^36 575
  • Zinc {Zinc Supplements} ^{36 58 575 609 991 1468}
• Odoribacter
  • Astragalus ^{35 36 72 80 859 1468 1469 1472}
  • bifidobacterium longum {B.Longum } ^71 2001
  • Lacticaseibacillus casei {L. casei} ^24 2039
  • Magnesium Compounds {Magnesium supplements} ^{22 27 701 2039}
  • Zinc {Zinc Supplements} ^{36 59 60 61 62 63 701 924}
• Parabacteroides
  • alpha-linolenic acid {Omega-3} ^{26 72 80 924 1307}
  • bifidobacterium longum {B.Longum } ^{26 36 71 74 1307 1811 2001}
  • Far Infrared Therapy {Far infrared Sauna } ^{46 71 777 2005}
  • folate {Vitamin B9} ^{17 47 48 49 777 1653}
  • Lacticaseibacillus casei {L. casei} ^{18 19 20 24 36 50 1653 2042}
  • Oenothera biennis {Evening Primrose Oil} ^{22 27 1307 2042}
  • Propolis {Bee glue} ^{22 80 1558 1811}
  • vitamin d🦠 ^{36 80 989 1562}
  • Zinc {Zinc Supplements} ^{36 58 989 992 1469}
• Parabacteroides distasonis
  • folate {Vitamin B9} ^{17 72 80 1469 1653}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{18 19 20 36 50 71 1653 1987}
  • Propolis {Bee glue} ^80 1558
  • vitamin d🦠 ^{36 80 989 1562}
  • Zinc {Zinc Supplements} ^{36 58 989 992 1469}
• Paraprevotella
  • 2-Aminopentanedioic acid {glutamate} ^{55 72 80 1469 1605}
  • acetylsalicylic acid,aspirin ^75 84
  • bifidobacterium longum {B.Longum } ^71 99
  • Echinacea Moench {Echinacea} ^{71 80 1339 1996}
  • Ferrum {Iron Supplements} ^36 628
  • Lacticaseibacillus casei {L. casei} ^24 118
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{27 36 118 1637}
  • ß-glucan {Beta-Glucan} ^{33 40 72 159 1637}
  • Theobroma cacao {Cacao} ^23 326
  • vitamin d🦠 ^{36 68 187 326}
• Pediococcus
  • azithromycin,[CFS] ^{34 58 187 203}
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • doxycycline [CFS]🦠 ^31 81
  • Ferrum {Iron Supplements} ³⁶
  • Lacticaseibacillus casei {L. casei} ^{24 36 197 341 434 620}
  • vitamin d🦠 ^{27 36 137 197}
  • Zinc {Zinc Supplements} ^{36 58 101 137}
• Phocaeicola vulgatus
  • (RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid {ibuprofen} ^{36 72 75 80 101 275 310}
  • azithromycin,[CFS] ^34 275
  • bifidobacterium infantis {B. infantis} ^{24 34 242 847}
  • doxepin hydrochloride,(prescription) ^40 275
  • doxycycline [CFS]🦠 ^31 249
  • erythromycin [CFS] ^{31 32 275 847}
  • folate {Vitamin B9} ^{17 32 416 847}
  • guanfacine hydrochloride,(prescription) ^{18 19 20 36 40 50 275 416}
  • ketotifen fumarate,(prescription) ^36 275
  • Lacticaseibacillus casei {L. casei} ^{24 38 197 275}
  • maprotiline hydrochloride,(prescription) ^{27 64 197 275}
  • minocycline [CFS] ^29 249
  • Momordica charantia {Bitter gourd} ^{29 30 54 249 275}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^36 275
  • prednisone,(prescription) ^{40 72 75 275}
  • Propolis {Bee glue} ^80 1562
  • pyridostigmine iodide,(prescription) ^37 275
  • ß-glucan {Beta-Glucan} ^33 40 275
  • Theobroma cacao {Cacao} ^23 109
  • Thiamine {Vitamin B1} ^{55 68 109 275}
  • Zinc {Zinc Supplements} ^{36 56 57 275 1470}
• Prevotella
  • 2-Aminopentanedioic acid {glutamate} ^{55 72 80 1470 1605}
  • a-Amino-3-indolepropionic acid {Tryptophan} ^36 2236
  • acetylsalicylic acid,aspirin ^75 84
  • alpha-linolenic acid {Omega-3} ^26 1811
  • Astragalus ^{26 35 36 74 965 1811 2177 2269}
  • bifidobacterium longum {B.Longum } ^71 99
  • Echinacea Moench {Echinacea} ^{71 80 1339 1999}
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 992
  • Far Infrared Therapy {Far infrared Sauna } ^{36 46 777 992}
  • Ferrum {Iron Supplements} ^{36 47 48 49 434 777}
  • Lacticaseibacillus casei {L. casei} ^{24 36 118 628}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{27 71 118 905}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{36 71 1637 1982 1986}
  • Oenothera biennis {Evening Primrose Oil} ^{22 36 40 72 1637 1811 2149}
  • Panax … {Ginseng} ^62 1109
  • ß-glucan {Beta-Glucan} ^{33 74 159 1109}
  • Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three} ^{28 33 566 1444 2094}
  • Theobroma cacao {Cacao} ^23 326
  • Thiamine {Vitamin B1} ^{23 55 68 212 326 592}
  • vitamin d🦠 ^{36 55 56 57 187 212 1604}
  • Zinc {Zinc Supplements} ^{36 58 187 924}
• Prevotellaceae
  • 2-Aminopentanedioic acid {glutamate} ^{55 72 80 924 1605}
  • acetylsalicylic acid,aspirin ^75 84
  • alpha-linolenic acid {Omega-3} ^26 1811
  • Astragalus ^{35 36 74 858 1811}
  • bifidobacterium longum {B.Longum } ^{35 71 99 965}
  • Echinacea Moench {Echinacea} ^{71 80 1339 1996 2003}
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^{26 80 992 1340}
  • Far Infrared Therapy {Far infrared Sauna } ^{26 36 46 777 992 1809}
  • Ferrum {Iron Supplements} ^{36 46 47 48 49 434 777 1217}
  • glycyrrhizic acid {licorice} ^{36 65 628 840}
  • Lacticaseibacillus casei {L. casei} ^{24 66 67 118 840}
  • N-[2-(5-methoxy-1H-indol-3-yl)ethyl]acetamide {Melatonin} ^{27 36 118 1637}
  • Oenothera biennis {Evening Primrose Oil} ^{22 40 72 1637 1811}
  • Panax … {Ginseng} ^62 1109
  • Propolis {Bee glue} ^{74 80 1109 1558}
  • ß-glucan {Beta-Glucan} ^33 159
  • Streptococcus faecalis, Clostridium butyricum, Bacillus mesentericus {Bio-three} ^{28 33 566 1957 1958 2259}
  • Theobroma cacao {Cacao} ^23 326
  • Thiamine {Vitamin B1} ^{23 55 68 212 326 592}
  • vitamin d🦠 ^{36 55 56 57 187 212 1604}
  • Zinc {Zinc Supplements} ^{36 58 187 624 924}
• Rhodospirillaceae
  • vitamin d🦠 ^{36 72 80 924}
• Ruminococcaceae
  • alpha-linolenic acid {Omega-3} ^26 58
  • azithromycin,[CFS] ^{34 36 74 248}
  • doxycycline [CFS]🦠 ^31 96
  • Ferrum {Iron Supplements} ^36 241
  • folate {Vitamin B9} ^17 825
  • glycyrrhizic acid {licorice} ^{18 19 20 36 50 65 825 933}
  • Lacticaseibacillus casei {L. casei} ^{24 66 67 156 933}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{27 71 156 196}
  • low fodmap diet ^39 71 342
  • Oenothera biennis {Evening Primrose Oil} ²²
  • Zinc {Zinc Supplements} ^36 214
• Streptococcus
  • ascorbic acid {Vitamin C} ^{72 80 214 404}
  • azithromycin,[CFS] ^{34 80 195 558 906}
  • cobalamin {Vitamin B-12} ^36 2213
  • Decoction of Four Noble Drugs {Sijunzi Decoction (SJZD)} ^15 407
  • eicosapentaenoic acid (EPA),docosahexaenoic acid (DHA) {Fish Oil} ^26 240
  • folate {Vitamin B9} ^{17 36 240 2213}
  • Lacticaseibacillus rhamnosus {l. rhamnosus}🦠 ^{18 19 20 36 50 71 1986 2213}
  • N-Acetyl Cysteine {NAC} ^36 1106
  • Theobroma cacao {Cacao} ^23 592
  • vitamin d🦠 ^{36 68 592 906}
  • Zinc {Zinc Supplements} ^{36 58 101 906}
• Tannerellaceae
  • alpha-linolenic acid {Omega-3} ^{26 36 72 80 101 214 879 1307 1473}
  • Far Infrared Therapy {Far infrared Sauna } ^{26 36 46 74 1217 1307 1811}
  • Ferrum {Iron Supplements} ^{36 47 48 49 628 1217}
  • folate {Vitamin B9} ^17 1653
  • Oenothera biennis {Evening Primrose Oil} ^{18 19 20 22 36 50 1307 1653}
  • Propolis {Bee glue} ^{22 80 1558 1811}
  • vitamin d🦠 ^36 624
  • Zinc {Zinc Supplements} ^{36 58 624 989 992 1469}
• Veillonellaceae
  • ascorbic acid {Vitamin C} ^{72 80 906 1469}
  • bifidobacterium longum {B.Longum } ^71 151
  • D-ribofuranoside {Ribose} ^{25 71 531 1996}
  • Lacticaseibacillus paracasei shirota {Yakult} ^{24 25 26 36 531 532 533 714}
  • Panax … {Ginseng} ^{27 62 714 1109}
  • Propolis {Bee glue} ^{74 80 1109 1560}
  • ß-glucan {Beta-Glucan} ^33 333
  • Theobroma cacao {Cacao} ^{23 33 593 1957}
  • vitamin d🦠 ^{23 36 68 593 906 1916}

Additional Suggestions

There are many other interventions computed to correct the bacteria shifts/abnormalities seen with this person. This is based on not-published studies and patent pending methods for selecting the bacteria. The suggestions are based on studies from the US National Library of Medicine modifying those bacteria. The top 30 suggestions are listed below and the top 30 items to avoid.

Items to add

Items to avoid

Sucralose {Splenda}Ligilactobacillus salivarius {L. salivarius}Secale cereale {Rye}Lactobacillus gasseri {L.gasseri}Euterpe oleracea {Acai}chlorhexidineShen Ling Bai Zhu San {?????}restricted-fiber diet {low fiber diet}Rheum × hybridum {Rhubarb}Zingiber officinale Roscoe {ginger}Taraxacum officinale {Dandelion}loperamide hydrochloride,(prescription)Citrus polymethoxyflavone {Nobiletin (oranges and lemons)}Polyethylene oxide sorbitan mono-oleate {Polysorbate 80}Lentilactobacillus kefiri {Kefibios}(2E,4E)-5-(1,3-Benzodioxol-5-yl)-1-(1-piperidinyl)-2,4-pentadien-1-one {Piperine}Monascus purpureus x Oryza sativa {Red yeast rice}Piper nigrum {black pepper}??(2S)-2-amino-4-carbamoylbutanoic acid {Glutamine}TudcaUnder cookded animal protein {Rare meat}Rosa rugosa {Rugosa rose}Azadirachta indica {Neem}Arctostaphylos uva-ursi {Bearberry}Bifidobacterium longum subsp. longum BB536 {BB536}Latilactobacillus sakei {Lactobacillus sakei}Carica papaya {papaya}Ocimum tenuiflorum {Tulsi}Biotin {Vitamin B7}Nicotine, Nicotine Patch

Slow digestible carbohydrates. {Low Glycemic}dietary fiberFiber, total dietaryfruitfruit/legume fibre(2->1)-beta-D-fructofuranan {Inulin}pectin {pectin}High-fibre diet {Whole food diet}Malus domestica {apple}arabinogalactan {arabinogalactan}oligosaccharides {oligosaccharides}bacillus,lactobacillus,streptococcus,saccharomyces probioticlaminaria digitata {Oarweed}resistant starchGanoderma sichuanense {Reishi Mushroom}Outer Layers of Triticum aestivum {Wheat Bran}grapesAmylum {Starch}Saccharomyces cerevisiae var boulardii {S. boulardii}Lactobacillus plantarum {L. plantarum}red wineHericium erinaceus {Lion’s Mane Mushroom }Traditional Mediterranean diet {Mediterranean diet}Poly[ß-D-xylopyranose(1->4)] {Xylan}Human milk oligosaccharides (prebiotic, Holigos, Stachyose)Abstention from eating {Fasting}polyphenolsDiferuloylmethane {Curcumin}Capsicum annuum {Peppers} {Cayenne Pepper, Hot Pepper}Ulmus rubra {slippery elm}

Reference

The following is a partial list of the critical citations used above. Click on 📚 to go to study

1	📚 Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome (Microbiome ) Vol: 5 Issue: 1 Pages: 44 Pub: 2017 Apr 26 ePub: 2017 Apr 26 Authors Nagy-Szakal D,Williams BL,Mishra N,Che X,Lee B,Bateman L,Klimas NG,Komaroff AL,Levine S,Montoya JG,Peterson DL,Ramanan D,Jain K,Eddy ML,Hornig M,Lipkin WI
2	📚 Support for the Microgenderome: Associations in a Human Clinical Population. Scientific reports (Sci Rep ) Vol: 6 Issue: Pages: 19171 Pub: 2016 Jan 13 ePub: 2016 Jan 13 Authors Wallis A,Butt H,Ball M,Lewis DP,Bruck D
3	📚 Correction to: Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons. Journal of translational medicine (J Transl Med ) Vol: 16 Issue: 1 Pages: 39 Pub: 2018 Feb 23 ePub: 2018 Feb 23 Authors Wallis A,Ball M,Butt H,Lewis DP,McKechnie S,Paull P,Jaa-Kwee A,Bruck D
4	📚 Potential role of microbiome in Chronic Fatigue Syndrome/Myalgic Encephalomyelits (CFS/ME). Scientific reports (Sci Rep ) Vol: 11 Issue: 1 Pages: 7043 Pub: 2021 Mar 29 ePub: 2021 Mar 29 Authors Lupo GFD,Rocchetti G,Lucini L,Lorusso L,Manara E,Bertelli M,Puglisi E,Capelli E
5	📚 Reversion of Gut Microbiota during the Recovery Phase in Patients with Asymptomatic or Mild COVID-19: Longitudinal Study. Microorganisms (Microorganisms ) Vol: 9 Issue: 6 Pages: Pub: 2021 Jun 7 ePub: 2021 Jun 7 Authors Kim HN,Joo EJ,Lee CW,Ahn KS,Kim HL,Park DI,Park SK
6	📚 The gut microbiome of COVID-19 recovered patients returns to uninfected status in a minority-dominated United States cohort. Gut microbes (Gut Microbes ) Vol: 13 Issue: 1 Pages: 1-15 Pub: 2021 Jan-Dec ePub: Authors Newsome RC,Gauthier J,Hernandez MC,Abraham GE,Robinson TO,Williams HB,Sloan M,Owings A,Laird H,Christian T,Pride Y,Wilson KJ,Hasan M,Parker A,Senitko M,Glover SC,Gharaibeh RZ,Jobin C
7	📚 Gut Microbiota May Not Be Fully Restored in Recovered COVID-19 Patients After 3-Month Recovery. Frontiers in nutrition (Front Nutr ) Vol: 8 Issue: Pages: 638825 Pub: 2021 ePub: 2021 May 13 Authors Tian Y,Sun KY,Meng TQ,Ye Z,Guo SM,Li ZM,Xiong CL,Yin Y,Li HG,Zhou LQ
8	📚 Gut Microbiota Interplay With COVID-19 Reveals Links to Host Lipid Metabolism Among Middle Eastern Populations. Frontiers in microbiology (Front Microbiol ) Vol: 12 Issue: Pages: 761067 Pub: 2021 ePub: 2021 Nov 5 Authors Al Bataineh MT,Henschel A,Mousa M,Daou M,Waasia F,Kannout H,Khalili M,Kayasseh MA,Alkhajeh A,Uddin M,Alkaabi N,Tay GK,Feng SF,Yousef AF,Alsafar HS
9	📚 Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut (Gut ) Vol: Issue: Pages: Pub: 2022 Jan 26 ePub: 2022 Jan 26 Authors Liu Q,Mak JWY,Su Q,Yeoh YK,Lui GC,Ng SSS,Zhang F,Li AYL,Lu W,Hui DS,Chan PK,Chan FKL,Ng SC
10	📚 Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19. Frontiers in medicine (Front Med (Lausanne) ) Vol: 7 Issue: Pages: 389 Pub: 2020 ePub: 2020 Jul 7 Authors d`Ettorre G,Ceccarelli G,Marazzato M,Campagna G,Pinacchio C,Alessandri F,Ruberto F,Rossi G,Celani L,Scagnolari C,Mastropietro C,Trinchieri V,Recchia GE,Mauro V,Antonelli G,Pugliese F,Mastroianni CM
11	📚 It Ain`t Over `Til It`s Over: SARS CoV-2 and Post-infectious Gastrointestinal Dysmotility. Digestive diseases and sciences (Dig Dis Sci ) Vol: Issue: Pages: Pub: 2022 Mar 30 ePub: 2022 Mar 30 Authors Coles MJ,Masood M,Crowley MM,Hudgi A,Okereke C,Klein J
12	📚 Respiratory dysfunction three months after severe COVID-19 is associated with gut microbiota alterations. Journal of internal medicine (J Intern Med ) Vol: 291 Issue: 6 Pages: 801-812 Pub: 2022 Jun ePub: 2022 Mar 17 Authors Vestad B,Ueland T,Lerum TV,Dahl TB,Holm K,Barratt-Due A,Kåsine T,Dyrhol-Riise AM,Stiksrud B,Tonby K,Hoel H,Olsen IC,Henriksen KN,Tveita A,Manotheepan R,Haugli M,Eiken R,Berg Å,Halvorsen B,Lekva T,Ranheim T,Michelsen AE,Kildal AB,Johannessen A,Thoresen L,Skudal H,Kittang BR,Olsen RB,Ystrøm CM,Skei NV,Hannula R,Aballi S,Kvåle R,Skjønsberg OH,Aukrust P,Hov JR,Trøseid M,NOR-Solidarity study group.
13	📚 Gut microbiota in COVID-19: new insights from inside. Gut microbes (Gut Microbes ) Vol: 15 Issue: 1 Pages: 2201157 Pub: 2023 Jan-Dec ePub: Authors Zhou B,Pang X,Wu J,Liu T,Wang B,Cao H
14	📚 Integrated ‘omics analysis for the gut microbiota response to moxibustion in a rat model of chronic fatigue syndrome. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan (J Tradit Chin Med ) Vol: 43 Issue: 6 Pages: 1176-1189 Pub: 2023 Oct ePub: Authors Chaoran LI,Yan Y,Chuwen F,Heng LI,Yuanyuan QU,Yulin W,Delong W,Qingyong W,Jing G,Tianyu S,Xiaowei S,Xue W,Yunlong H,Zhongren S,Tiansong Y
15	📚 Goldenseal (Hydrastis canadensis L.) and its active constituents: A critical review of their efficacy and toxicological issues. Pharmacological research (Pharmacol Res ) Vol: 160 Issue: Pages: 105085 Pub: 2020 Jul 16 ePub: 2020 Jul 16 Authors Mandal SK,Maji AK,Mishra SK,Ishfaq PM,Devkota HP,Silva AS,Das N
16	📚 Open Trial of Vitamin B12 Nasal Drops in Adults With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Comparison of Responders and Non-Responders. Frontiers in pharmacology (Front Pharmacol ) Vol: 10 Issue: Pages: 1102 Pub: 2019 ePub: 2019 Sep 20 Authors van Campen CLM,Riepma K,Visser FC
17	📚 Response to vitamin B12 and folic acid in myalgic encephalomyelitis and fibromyalgia. PloS one (PLoS One ) Vol: 10 Issue: 4 Pages: e0124648 Pub: 2015 ePub: 2015 Apr 22 Authors Regland B,Forsmark S,Halaouate L,Matousek M,Peilot B,Zachrisson O,Gottfries CG
18	📚 [Vitamin B12 and chronic fatigue]. Lakartidningen (Lakartidningen ) Vol: 97 Issue: 5 Pages: 501 Pub: 2000 Feb 2 ePub: Authors Hägglöf M
19	📚 [Vitamin B12, chronic fatigue and injection treatment]. Lakartidningen (Lakartidningen ) Vol: 96 Issue: 50 Pages: 5610 Pub: 1999 Dec 15 ePub: Authors Björkegren K
20	📚 Liver extract-folic acid-cyanocobalamin vs placebo for chronic fatigue syndrome. Archives of internal medicine (Arch Intern Med ) Vol: 149 Issue: 11 Pages: 2501-3 Pub: 1989 Nov ePub: Authors Kaslow JE,Rucker L,Onishi R
21	📚 Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia. Journal of alternative and complementary medicine (New York, N.Y.) (J Altern Complement Med ) Vol: 16 Issue: 3 Pages: 235-49 Pub: 2010 Mar ePub: Authors Porter NS,Jason LA,Boulton A,Bothne N,Coleman B
22	📚 Cognitive behaviour therapy for the chronic fatigue syndrome. Evening primrose oil and magnesium have been shown to be effective. BMJ (Clinical research ed.) (BMJ ) Vol: 312 Issue: 7038 Pages: 1096; author reply 1098 Pub: 1996 Apr 27 ePub: Authors Chilton SA
23	📚 Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association (J Hum Nutr Diet ) Vol: 30 Issue: 3 Pages: 247-259 Pub: 2017 Jun ePub: 2017 Jan 22 Authors Campagnolo N,Johnston S,Collatz A,Staines D,Marshall-Gradisnik S
24	📚 Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review. Beneficial microbes (Benef Microbes ) Vol: 9 Issue: 4 Pages: 603-611 Pub: 2018 Jun 15 ePub: 2018 Apr 26 Authors Roman P,Carrillo-Trabalón F,Sánchez-Labraca N,Cañadas F,Estévez AF,Cardona D
25	📚 The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study. Journal of alternative and complementary medicine (New York, N.Y.) (J Altern Complement Med ) Vol: 12 Issue: 9 Pages: 857-62 Pub: 2006 Nov ePub: Authors Teitelbaum JE,Johnson C,St Cyr J
26	📚 Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review. Australian and New Zealand journal of public health (Aust N Z J Public Health ) Vol: 41 Issue: 4 Pages: 338-344 Pub: 2017 Aug ePub: 2017 Jun 14 Authors Jones K,Probst Y
27	📚 A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome. Gut pathogens (Gut Pathog ) Vol: 1 Issue: 1 Pages: 6 Pub: 2009 Mar 19 ePub: 2009 Mar 19 Authors Rao AV,Bested AC,Beaulne TM,Katzman MA,Iorio C,Berardi JM,Logan AC
28	📚 A systematic review of enteric dysbiosis in chronic fatigue syndrome/myalgic encephalomyelitis. Systematic reviews (Syst Rev ) Vol: 7 Issue: 1 Pages: 241 Pub: 2018 Dec 20 ePub: 2018 Dec 20 Authors Du Preez S,Corbitt M,Cabanas H,Eaton N,Staines D,Marshall-Gradisnik S
29	📚 Oral Minocycline Therapy Improves Symptoms of Myalgic Encephalomyelitis, Especially in the Initial Disease Stage. Internal medicine (Tokyo, Japan) (Intern Med ) Vol: 60 Issue: 16 Pages: 2577-2584 Pub: 2021 Aug 15 ePub: 2021 Apr 26 Authors Miwa K
30	📚 Could Minocycline Be a “Magic Bullet” for the Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? Internal medicine (Tokyo, Japan) (Intern Med ) Vol: 60 Issue: 16 Pages: 2527-2528 Pub: 2021 Aug 15 ePub: 2021 Apr 5 Authors Numata T
31	📚 Long-term effect of cognitive behavioural therapy and doxycycline treatment for patients with Q fever fatigue syndrome: One-year follow-up of the Qure study. Journal of psychosomatic research (J Psychosom Res ) Vol: 116 Issue: Pages: 62-67 Pub: 2019 Jan ePub: 2018 Nov 12 Authors Raijmakers RPH,Keijmel SP,Breukers EMC,Bleijenberg G,van der Meer JWM,Bleeker-Rovers CP,Knoop H
32	📚 Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons. Journal of translational medicine (J Transl Med ) Vol: 16 Issue: 1 Pages: 24 Pub: 2018 Feb 6 ePub: 2018 Feb 6 Authors Wallis A,Ball M,Butt H,Lewis DP,McKechnie S,Paull P,Jaa-Kwee A,Bruck D
33	📚 Yeast Beta-Glucan Supplementation with Multivitamins Attenuates Cognitive Impairments in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients (Nutrients ) Vol: 15 Issue: 21 Pages: Pub: 2023 Oct 24 ePub: 2023 Oct 24 Authors Lacasa M,Alegre-Martin J,Sentañes RS,Varela-Sende L,Jurek J,Castro-Marrero J
34	📚 Azithromycin in chronic fatigue syndrome (CFS), an analysis of clinical data. Journal of translational medicine (J Transl Med ) Vol: 4 Issue: Pages: 34 Pub: 2006 Aug 15 ePub: 2006 Aug 15 Authors Vermeulen RC,Scholte HR
35	📚 Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract. BMJ supportive & palliative care (BMJ Support Palliat Care ) Vol: Issue: Pages: Pub: 2024 Jun 4 ePub: 2024 Jun 4 Authors Banihashemi ZS,Azizi-Fini I,Rajabi M,Maghami M,Yadollahi S
36	📚 [Post-COVID syndrome with fatigue and exercise intolerance: myalgic encephalomyelitis/chronic fatigue syndrome]. Innere Medizin (Heidelberg, Germany) (Inn Med (Heidelb) ) Vol: 63 Issue: 8 Pages: 830-839 Pub: 2022 Aug ePub: 2022 Jul 13 Authors Renz-Polster H,Scheibenbogen C
37	📚 Neurovascular Dysregulation and Acute Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Placebo-Controlled Trial of Pyridostigmine. Chest (Chest ) Vol: 162 Issue: 5 Pages: 1116-1126 Pub: 2022 Nov ePub: 2022 May 6 Authors Joseph P,Pari R,Miller S,Warren A,Stovall MC,Squires J,Chang CJ,Xiao W,Waxman AB,Systrom DM
38	📚 Advancing Research and Treatment: An Overview of Clinical Trials in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Future Perspectives. Journal of clinical medicine (J Clin Med ) Vol: 13 Issue: 2 Pages: Pub: 2024 Jan 6 ePub: 2024 Jan 6 Authors Seton KA,Espejo-Oltra JA,Giménez-Orenga K,Haagmans R,Ramadan DJ,Mehlsen J,European ME Research Group for Early Career Researchers (Young EMERG)
39	📚 Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians. Reviews on environmental health (Rev Environ Health ) Vol: 30 Issue: 4 Pages: 223-49 Pub: 2015 ePub: Authors Bested AC,Marshall LM
40	📚 Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Mayo Clinic proceedings (Mayo Clin Proc ) Vol: 98 Issue: 10 Pages: 1544-1551 Pub: 2023 Oct ePub: Authors Grach SL,Seltzer J,Chon TY,Ganesh R
41	📚 Low-dose naltrexone for post-COVID fatigue syndrome: a study protocol for a double-blind, randomised trial in British Columbia. BMJ open (BMJ Open ) Vol: 14 Issue: 5 Pages: e085272 Pub: 2024 May 13 ePub: 2024 May 13 Authors Naik H,Cooke E,Boulter T,Dyer R,Bone JN,Tsai M,Cristobal J,McKay RJ,Song X,Nacul L
42	📚 Effects of Hyperbaric Oxygen Therapy on Long COVID: A Systematic Review. Life (Basel, Switzerland) (Life (Basel) ) Vol: 14 Issue: 4 Pages: Pub: 2024 Mar 26 ePub: 2024 Mar 26 Authors Wu BQ,Liu DY,Shen TC,Lai YR,Yu TL,Hsu HL,Lee HM,Liao WC,Hsia TC
43	📚 Reversible widespread brain (18)F-FDG PET hypometabolism in chronic fatigue syndrome treated by hyperbaric oxygen therapy. European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging ) Vol: 48 Issue: 5 Pages: 1680-1681 Pub: 2021 May ePub: 2021 Jan 9 Authors Mairal E,Barberon B,Laine N,Coulange M,Guedj E
44	📚 [Fibromyalgia and myalgic encephalomyelitis: The oxygen clue]. Vertex (Buenos Aires, Argentina) (Vertex ) Vol: XXVII Issue: 128 Pages: 252-255 Pub: 2016 Jul ePub: Authors Beretta P
45	📚 The efficacy of hyperbaric oxygen therapy in the management of chronic fatigue syndrome. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc (Undersea Hyperb Med ) Vol: 40 Issue: 2 Pages: 197-200 Pub: 2013 Mar-Apr ePub: Authors Akarsu S,Tekin L,Ay H,Carli AB,Tok F,Simsek K,Kiralp MZ
46	📚 Effects of Waon therapy on chronic fatigue syndrome: a pilot study. Internal medicine (Tokyo, Japan) (Intern Med ) Vol: 54 Issue: 3 Pages: 333-8 Pub: 2015 ePub: Authors Soejima Y,Munemoto T,Masuda A,Uwatoko Y,Miyata M,Tei C
47	📚 Targeting mitochondrial dysfunction in the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) – a clinical audit. International journal of clinical and experimental medicine (Int J Clin Exp Med ) Vol: 6 Issue: 1 Pages: 1-15 Pub: 2013 ePub: 2012 Nov 20 Authors Myhill S,Booth NE,McLaren-Howard J
48	📚 [A new treatment: thermal therapy for chronic fatigue syndrome]. Nihon rinsho. Japanese journal of clinical medicine (Nihon Rinsho ) Vol: 65 Issue: 6 Pages: 1093-8 Pub: 2007 Jun ePub: Authors Masuda A,Munemoto T,Tei C
49	📚 The effects of repeated thermal therapy for two patients with chronic fatigue syndrome. Journal of psychosomatic research (J Psychosom Res ) Vol: 58 Issue: 4 Pages: 383-7 Pub: 2005 Apr ePub: Authors Masuda A,Kihara T,Fukudome T,Shinsato T,Minagoe S,Tei C
50	📚 Clinical activity of folinic acid in patients with chronic fatigue syndrome. Arzneimittel-Forschung (Arzneimittelforschung ) Vol: 56 Issue: 6 Pages: 399-404 Pub: 2006 ePub: Authors Lundell K,Qazi S,Eddy L,Uckun FM
51	📚 Does Coenzyme Q10 Plus Selenium Supplementation Ameliorate Clinical Outcomes by Modulating Oxidative Stress and Inflammation in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? Antioxidants & redox signaling (Antioxid Redox Signal ) Vol: 36 Issue: 10-12 Pages: 729-739 Pub: 2022 Apr ePub: Authors Castro-Marrero J,Domingo JC,Cordobilla B,Ferrer R,Giralt M,Sanmartín-Sentañes R,Alegre-Martín J
52	📚 Therapeutic Effect and Metabolic Mechanism of A Selenium-Polysaccharide from Ziyang Green Tea on Chronic Fatigue Syndrome. Polymers (Polymers (Basel) ) Vol: 10 Issue: 11 Pages: Pub: 2018 Nov 15 ePub: 2018 Nov 15 Authors Shao C,Song J,Zhao S,Jiang H,Wang B,Chi A
53	📚 Coenzyme Q10 + alpha lipoic acid for chronic COVID syndrome. Clinical and experimental medicine (Clin Exp Med ) Vol: 23 Issue: 3 Pages: 667-678 Pub: 2023 Jul ePub: 2022 Aug 22 Authors Barletta MA,Marino G,Spagnolo B,Bianchi FP,Falappone PCF,Spagnolo L,Gatti P
54	📚 News and views in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): The role of co-morbidity and novel treatments. Medical hypotheses (Med Hypotheses ) Vol: 134 Issue: Pages: 109444 Pub: 2020 Jan ePub: 2019 Oct 22 Authors Comhaire F,Deslypere JP
55	📚 Effects of Qiye Shen`an Pian Combined with Glutamate and Vitamin B1 on Fatigue State, Immune Function and Quality of Life in Patients with Chronic Fatigue Syndrome. Alternative therapies in health and medicine (Altern Ther Health Med ) Vol: Issue: Pages: Pub: 2024 May 3 ePub: 2024 May 3 Authors Liu J,Liao J,Lin F,Nie C
56	📚 B-vitamins, related vitamers, and metabolites in patients with quiescent inflammatory bowel disease and chronic fatigue treated with high dose oral thiamine. Molecular medicine (Cambridge, Mass.) (Mol Med ) Vol: 29 Issue: 1 Pages: 143 Pub: 2023 Oct 25 ePub: 2023 Oct 25 Authors Bager P,Hvas CL,Hansen MM,Ueland P,Dahlerup JF
57	📚 Randomised clinical trial: high-dose oral thiamine versus placebo for chronic fatigue in patients with quiescent inflammatory bowel disease. Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther ) Vol: 53 Issue: 1 Pages: 79-86 Pub: 2021 Jan ePub: 2020 Nov 18 Authors Bager P,Hvas CL,Rud CL,Dahlerup JF
58	📚 Effect of intermittent vitamin D3 on vascular function and symptoms in chronic fatigue syndrome–a randomised controlled trial. Nutrition, metabolism, and cardiovascular diseases : NMCD (Nutr Metab Cardiovasc Dis ) Vol: 25 Issue: 3 Pages: 287-94 Pub: 2015 Mar ePub: 2014 Oct 22 Authors Witham MD,Adams F,McSwiggan S,Kennedy G,Kabir G,Belch JJ,Khan F
59	📚 Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC complementary and alternative medicine (BMC Complement Altern Med ) Vol: 11 Issue: Pages: 87 Pub: 2011 Oct 7 ePub: 2011 Oct 7 Authors Alraek T,Lee MS,Choi TY,Cao H,Liu J
60	📚 [A case of chronic fatigue syndrome who showed a beneficial effect by intravenous administration of magnesium sulphate]. Arerugi = [Allergy] (Arerugi ) Vol: 41 Issue: 11 Pages: 1605-10 Pub: 1992 Nov ePub: Authors Takahashi H,Imai K,Katanuma A,Sugaya T,Hisano K,Motoya S,Aoki S,Sugiyama T,Yachi A
61	📚 Intravenous magnesium loading in chronic fatigue syndrome. Lancet (London, England) (Lancet ) Vol: 340 Issue: 8811 Pages: 124-5 Pub: 1992 Jul 11 ePub: Authors Clague JE,Edwards RH,Jackson MJ
62	📚 Prospective observational study of treatments for unexplained chronic fatigue. The Journal of clinical psychiatry (J Clin Psychiatry ) Vol: 66 Issue: 5 Pages: 625-32 Pub: 2005 May ePub: Authors Bentler SE,Hartz AJ,Kuhn EM
63	📚 [Therapy of chronic fatigue syndrome]. Nihon rinsho. Japanese journal of clinical medicine (Nihon Rinsho ) Vol: 50 Issue: 11 Pages: 2679-83 Pub: 1992 Nov ePub: Authors Uchida A
64	📚 Psychotropic treatment of chronic fatigue syndrome and related disorders. The Journal of clinical psychiatry (J Clin Psychiatry ) Vol: 54 Issue: 1 Pages: 13-20 Pub: 1993 Jan ePub: Authors Goodnick PJ,Sandoval R
65	📚 Chronic fatigue syndrome and liquorice. The New Zealand medical journal (N Z Med J ) Vol: 108 Issue: 998 Pages: 156-7 Pub: 1995 Apr 26 ePub: Authors Baschetti R
66	📚 Chronic fatigue syndrome and liquorice. The New Zealand medical journal (N Z Med J ) Vol: 108 Issue: 1001 Pages: 234-5 Pub: 1995 Jun 14 ePub: Authors Welch JC
67	📚 Liquorice and chronic fatigue syndrome. The New Zealand medical journal (N Z Med J ) Vol: 108 Issue: 1002 Pages: 259 Pub: 1995 Jun 28 ePub: Authors Baschetti R
68	📚 High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome. Nutrition journal (Nutr J ) Vol: 9 Issue: Pages: 55 Pub: 2010 Nov 22 ePub: 2010 Nov 22 Authors Sathyapalan T,Beckett S,Rigby AS,Mellor DD,Atkin SL
69	📚 Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients (Nutrients ) Vol: 13 Issue: 8 Pages: Pub: 2021 Jul 30 ePub: 2021 Jul 30 Authors Castro-Marrero J,Segundo MJ,Lacasa M,Martinez-Martinez A,Sentañes RS,Alegre-Martin J
70	📚 Supplements for Chronic Fatigue Syndrome? P & T : a peer-reviewed journal for formulary management (P T ) Vol: 41 Issue: 9 Pages: 587-8 Pub: 2016 Sep ePub: Authors
71	📚 Synbiotic Supplementation Improves Quality of Life and Inmunoneuroendocrine Response in Patients with Fibromyalgia: Influence of Codiagnosis with Chronic Fatigue Syndrome. Nutrients (Nutrients ) Vol: 15 Issue: 7 Pages: Pub: 2023 Mar 25 ePub: 2023 Mar 25 Authors Hinchado MD,Quero-Calero CD,Otero E,Gálvez I,Ortega E
72	📚 Effect of Melatonin Plus Zinc Supplementation on Fatigue Perception in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Antioxidants (Basel, Switzerland) (Antioxidants (Basel) ) Vol: 10 Issue: 7 Pages: Pub: 2021 Jun 23 ePub: 2021 Jun 23 Authors Castro-Marrero J,Zaragozá MC,López-Vílchez I,Galmés JL,Cordobilla B,Maurel S,Domingo JC,Alegre-Martín J
73	📚 Abnormalities of carnitine metabolism in chronic fatigue syndrome. European journal of neurology (Eur J Neurol ) Vol: 2 Issue: 5 Pages: 425-8 Pub: 1995 Nov ePub: Authors Majeed T,de Simone C,Famularo G,Marcellini S,Behan PO
74	📚 Long COVID and its Management. International journal of biological sciences (Int J Biol Sci ) Vol: 18 Issue: 12 Pages: 4768-4780 Pub: 2022 ePub: 2022 Jul 11 Authors Koc HC,Xiao J,Liu W,Li Y,Chen G
75	📚 Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach. Diseases (Basel, Switzerland) (Diseases ) Vol: 12 Issue: 5 Pages: Pub: 2024 May 6 ePub: 2024 May 6 Authors Calcaterra V,Zanelli S,Foppiani A,Verduci E,Benatti B,Bollina R,Bombaci F,Brucato A,Cammarata S,Calabrò E,Cirnigliaro G,Della Torre S,Dell`osso B,Moltrasio C,Marzano AV,Nostro C,Romagnuolo M,Trotta L,Savasi V,Smiroldo V,Zuccotti G
76	📚 Potential Therapeutic Benefit of Low Dose Naltrexone in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Role of Transient Receptor Potential Melastatin 3 Ion Channels in Pathophysiology and Treatment. Frontiers in immunology (Front Immunol ) Vol: 12 Issue: Pages: 687806 Pub: 2021 ePub: 2021 Jul 13 Authors Cabanas H,Muraki K,Eaton-Fitch N,Staines DR,Marshall-Gradisnik S
77	📚 Low-dose Naltrexone Improves post-COVID-19 condition Symptoms. Clinical therapeutics (Clin Ther ) Vol: 46 Issue: 3 Pages: e101-e106 Pub: 2024 Mar ePub: 2024 Jan 23 Authors Tamariz L,Bast E,Klimas N,Palacio A
78	📚 Low-dose naltrexone as a treatment for chronic fatigue syndrome. BMJ case reports (BMJ Case Rep ) Vol: 13 Issue: 1 Pages: Pub: 2020 Jan 6 ePub: 2020 Jan 6 Authors Bolton MJ,Chapman BP,Van Marwijk H
79	📚 Naltrexone Restores Impaired Transient Receptor Potential Melastatin 3 Ion Channel Function in Natural Killer Cells From Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. Frontiers in immunology (Front Immunol ) Vol: 10 Issue: Pages: 2545 Pub: 2019 ePub: 2019 Oct 31 Authors Cabanas H,Muraki K,Staines D,Marshall-Gradisnik S
80	📚 Potential Anti-Inflammatory and Anti-Fatigue Effects of an Oral Food Supplement in Long COVID Patients. Pharmaceuticals (Basel, Switzerland) (Pharmaceuticals (Basel) ) Vol: 17 Issue: 4 Pages: Pub: 2024 Apr 5 ePub: 2024 Apr 5 Authors Noce A,Marrone G,Di Lauro M,Vita C,Montalto G,Giorgino G,Chiaramonte C,D’Agostini C,Bernardini S,Pieri M
81	📚 Abnormal Weight Gain and Gut Microbiota Modifications Are Side Effects of Long-Term Doxycycline and Hydroxychloroquine Treatment Antimicrobial Agents and Chemotherapy (Antimicrob Agents Chemother ) Vol: 58 Issue: 6 Pages: 3342-3347 Pub: 2014 Jun ePub: Authors Angelakis E,Million M,Kankoe S,Lagier JC,Armougom F,Giorgi R,Raoult D
82	📚 GUT MICROBIOTA DYSBIOSIS IS LINKED TO HYPERTENSION Hypertension (Hypertension ) Vol: 65 Issue: 6 Pages: 1331-1340 Pub: 2015 Apr 13 ePub: 2015 Apr 13 Authors Yang T,Santisteban MM,Rodriguez V,Li E,Ahmari N,Carvajal JM,Zadeh M,Gong M,Qi Y,Zubcevic J,Sahay B,Pepine CJ,Raizada MK,Mohamadzadeh M
83	📚 Modulation of the gut microbiota composition by rifaximin in non-constipated irritable bowel syndrome patients: a molecular approach Clinical and Experimental Gastroenterology (Clin Exp Gastroenterol ) Vol: 8 Issue: Pages: 309-325 Pub: 2015 Dec 4 ePub: 2015 Dec 4 Authors Soldi S,Vasileiadis S,Uggeri F,Campanale M,Morelli L,Fogli MV,Calanni F,Grimaldi M,Gasbarrini A
84	📚 The Influence of Nonsteroidal Anti-Inflammatory Drugs on the Gut Microbiome Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (Clin Microbiol Infect ) Vol: 22 Issue: 2 Pages: 178.e1-178.e9 Pub: 2015 Oct 16 ePub: 2015 Oct 16 Authors Rogers MA,Aronoff DM
85	📚 Impact of probiotic supplements on microbiome diversity following antibiotic treatment of mice Gut Microbes (Gut Microbes ) Vol: 7 Issue: 2 Pages: 101-114 Pub: 2016 Mar 10 ePub: 2016 Mar 10 Authors Grazul H,Kanda LL,Gondek D
86	📚 Impact of diet and individual variation on intestinal microbiota composition and fermentation products in obese men The ISME Journal (ISME J ) Vol: 8 Issue: 11 Pages: 2218-2230 Pub: 2014 Apr 24 ePub: 2014 Apr 24 Authors Salonen A,Lahti L,Salojärvi J,Holtrop G,Korpela K,Duncan SH,Date P,Farquharson F,Johnstone AM,Lobley GE,Louis P,Flint HJ,de Vos WM
87	📚 Gastric microbiota in the functional dyspepsia patients treated with probiotic yogurt BMJ Open Gastroenterology (BMJ Open Gastroenterol ) Vol: 3 Issue: 1 Pages: e000109 Pub: 2016 Sep 16 ePub: 2016 Sep 16 Authors Nakae H,Tsuda A,Matsuoka T,Mine T,Koga Y
88	📚 Sodium butyrate attenuates high-fat diet-induced steatohepatitis in mice by improving gut microbiota and gastrointestinal barrier World Journal of Gastroenterology (World J Gastroenterol ) Vol: 23 Issue: 1 Pages: 60-75 Pub: 2017 Jan 7 ePub: 2017 Jan 7 Authors Zhou D,Pan Q,Xin FZ,Zhang RN,He CX,Chen GY,Liu C,Chen YW,Fan JG
89	📚 Low-dose penicillin in early life induces long-term changes in murine gut microbiota, brain cytokines and behavior Nature Communications (Nat Commun ) Vol: 8 Issue: Pages: 15062 Pub: 2017 Apr 4 ePub: 2017 Apr 4 Authors Leclercq S,Mian FM,Stanisz AM,Bindels LB,Cambier E,Ben-Amram H,Koren O,Forsythe P,Bienenstock J
90	📚 Energy-dense diet triggers changes in gut microbiota, reorganization of gut-brain vagal communication and increases body fat accumulation Acta neurobiologiae experimentalis (Acta Neurobiol Exp (Wars) ) Vol: 77 Issue: 1 Pages: 18-30 Pub: 2017 ePub: Authors Vaughn AC,Cooper EM,DiLorenzo PM,O’Loughlin LJ,Konkel ME,Peters JH,Hajnal A,Sen T,Lee SH,de La Serre CB,Czaja K

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A reader asked for clarity / dosage levels for fiber intake. This is what I found.

“However, while existing studies encourage high-fiber diets, the specific recommended intake with the specific mechanism of action of different fiber types in treatment has not been clarified”[2024]

The Lancet analyzed observational studies and clinical trials conducted over nearly 40 years. They found that eating at least 25-29g of dietary fiber per day was associated with a 15-30% decrease in all-cause and cardiovascular-related mortality, as well as reduced incidence of coronary heart disease, stroke, type 2 diabetes, and colorectal cancer by 16-24%. [2019]

The United States Department of Agriculture (USDA) has provided guidelines for adults aged 19 years and above regarding their recommended daily values (DV). These guidelines suggest consuming 28 g of fiber. Australia suggests 30g for men and 25 g for women. From looking at prior recommendations from USDA, I am very suspect that is “a bare sufficiency” amount and not optimal.

Note that good bacteria can become bad without enough fiber. Akkermansia muciniphila exacerbates food allergy in fibre-deprived mice [2023]

From A cross-sectional study on the relationship between dietary fiber and endometriosis risk based on NHANES 1999–2006 [2024] We see surveyed amount are by quartile as below which allows us to define ranges based on US consumptions.

• 0-10.9 g Low fiber
• 10.9-18.12 g
• 18.12-27.95 g
• 27.95-111.4 g High fiber

An international study, The association between dietary quality index- international and metabolic risk factors in RaNCD cohort study [2024] has much higher ranges but in thirds and not quarters:

• 0 – 33.33 g Low fiber (i.e. 1/3 of population)
• 33 – 66 g
• Over 66 g High Fiber (i.e. 1/3 of population)

This is consistent with the US tending to low fiber consumption. Another international study report an average of 47 g/day +/1 20g. [2024]

From Global overview of government-endorsed nutrition labeling policies of packaged foods: a document review [2024] we see a constant: “and more dietary fibers •No thresholds for critical nutrients were found”

Effects of dietary fiber on human health [2022]

This summary highlights benefits:

• Reduce obesity
• Reduce diabetes risk
• Reduce Cancer risk including: Ovarian, Pancreatic, Prostate, Brest, Colorectal , Head and neck
• Reduce Intestinal disease
• Reduce the risk of cardiovascular disease. 
• Inhibit allergic rhinitis 
• Natural chelating agent

Bottom Line

I could not locate any studies that identified an optimal or threshold benefit level (i.e. there was no further health benefit by increasing fiber more). The following is from perplexity.ai, if you have diet restrictions then asking for a menu excluding those items.

What type of diet would get 66g of fiber?

Breakfast

• 1 cup cooked oatmeal (4 g)
• 1 medium apple with skin (4.8 g)
• 1/4 cup chia seeds (9.75 g)

Lunch

• 1 cup cooked kidney beans (13.1 g)
• 1 cup cooked quinoa (5.2 g)
• 1 cup cooked broccoli (2.4 g)

Dinner

• 1 medium baked potato with skin (3.8 g)
• 1 cup cooked split peas (16.3 g)
• 1/2 avocado (5 g)

Snacks

• 1 cup raspberries (8 g)
• 1 medium pear (5.5 g)
• 3 cups air-popped popcorn (3.45 g)

Total fiber: 66.3 g or  approximately 1,885 calories

The above was produce by Perplexity.ai. If you have food restrictions, etc. Tell those restrictions to that AI and ask how to get the suggested fibre.

First what do I mean by these abbreviation?

• MCAS – Mast Cell Activation Syndrome as well as many other issues
• EMF – Electromagnetic Fields– from sunlight to microwave to cellular radio wave
• GRAS – Generally Recognized As Safe — an item deemed safe by authorities but may lack hard evidence. See GRAS History. It also include items that are “grandfathered” in and later shown to be unsafe:
  • Example: Smoking was healthy
  • PCB and Asbestos were safe

This is not intended to be JFK Jr like conspiracy theory — just raising questions and suggest testing approaches. If something is new and a potential profit maker, effective testing is never done.

EMF – Electromagnetic Fields

The chart below shows the scope of EMF

We know that values across this entire spectrum can cause disease, typically cancer.

• “Too much ultraviolet (UV) radiation from the sun can damage DNA in your skin cells and cause skin cancer. ” [Src]
• “Ionizing radiation, such as X-rays, has enough energy to remove tightly bound electrons from atoms. This process can lead to DNA strand breaks or alterations, potentially resulting in mutations that may cause cancer or other health issues.” [Src]
• “Cancer in radar technicians exposed to radiofrequency/microwave radiation” [src]

In today’s world, we are adding more and more electromagnetic frequencies:

• Cell Phones – 800 MHz, 850 MHz, 1700 MHz, 1900 MHz, and 2100 MHz (or 2.1 GHz)
• Wifi – 2.4 GHz, 5 GHz, 6 GHz
• Bluetooth – 2.4 GHz,

An analysis of data from five Northern European countries showed an increased risk of acoustic neuroma in those who had used a cell phone for 10 or more years [2600 studies on pubmed].

Microbiome shifts from radio waves

Several bacteria are known to be altered due to radio frequency (RF) exposure. Research has shown that RF radiation can affect bacterial growth, antibiotic sensitivity, and microbial composition.

1. Enterococcus faecalis:

• Exposure to 900 MHz and 2.4 GHz RF radiation altered its antimicrobial sensitivity1.
• After 6 hours of exposure, the bacteria showed decreased susceptibility to antibiotics.
• Longer exposure (24 hours) increased the bacteria’s susceptibility to antibiotics1.
• RF-exposed bacteria showed faster growth rates compared to non-exposed bacteria1.

2. Klebsiella pneumoniae:

• Exposure to 900 MHz RF radiation for 12 hours significantly increased its sensitivity to various antibiotics2.
• RF-exposed bacteria showed faster growth in the exponential phase compared to non-exposed bacteria2.

3. Gut microbiota:

• Exposure to 4.9 GHz RF radiation altered the gut microbial composition in mice, reducing microbial diversity3.
• The relative abundance of Firmicutes increased, while Muribaculaceae decreased after RF exposure3.

4. Other bacteria:

• Studies have shown that RF exposure can affect the growth and antibiotic sensitivity of Escherichia coli, Enterococcus hirae, and Staphylococcus aureus1.

Hypothesis: Some conditions may be encouraged by RF Exposure

Whether this includes Mast Cell Activation Syndrome is to be determined. It is clear that other conditions are impacted.

What can you do:

• Avoid carrying cell phone on your person, i.e. place on desk at home or car seat driving
• Avoid Bluetooth headsets
• Keep WiFi hubs as far away from your usual living space as practical

Experiment: Go camping in an area that is very low RF (turning off cellphones) My own favorite area is the drive between Hay River and Yellowknife in the Northwest Territories of Canada.

Prior Posts

Dealing with ME/CFS and many microbiome dysfunction is rarely a short journey

• ME/CFS Continues Improvement + Lab Read Quality Issues [Feb 2024]
• Update on ME/CFS Person [Sep 2023]
• Follow up Microbiome Analysis from a prior post [Apr 2022]
• Rosacea, Circulation and mild CFS [Dec 2021]

Comparisons

I have done a trimmed version below excluding ranges from most various labs. Remember lab ranges are suspect because of The taxonomy nightmare before Christmas… For the measures based on other samples from the same lab, we see improvement from the prior test although we have 15% more bacteria reported.

Criteria	12/3 2024	9/2 2024	1/22 2024	9/12 2023	2/22 2024	8/11 2022	3/25 2022	12/3 2021	8/31 2021
Lab Read Quality	9.8	9.1	7.9	3.5	9.7	5.5	6.2	3.6	7.8
GanzImmun	14	16	16	16	15	15	17	17	20
Outside Range from Lab Teletest	17	23	20	20	24	24	22	22	25
Outside Lab Range (+/- 1.96SD)	7	12	5	15	10	11	9	9	14
Outside Box-Plot-Whiskers	47	48	54	56	42	36	42	59	42
Outside Kaltoft-Møldrup	85	113	123	70	139	56	78	59	140
Bacteria Reported By Lab	689	600	511	399	666	478	613	456	572

Looking at Symptom Matching Patterns, we see significant improvement. 10 have improved and 1 has become worse. Remember that with 15% more bacteria, the odds matching should increase if there was no change.

Remember, Microbiome Prescription does not claim to cure or fix issues; it’s aim is produce suggestions that are more likely to help than picking random items. Let us look ahead for the next leg of the journey for better health.

Going Forward

Since we have Symptoms entered, we will get 3 sets of suggestions, two will produce probiotics only. The Using PubMed Studies to filter is ignored since we have a good collection of symptoms. I view this choice to be inferior because the reported shifts are suspect due to The taxonomy nightmare before Christmas…

From the 51 symptoms indicated, we ended up with 49 bacteria deemed to high or low. That is about 7% of the reported bacteria. I usually expect 5-10% of the bacteria being flagged using symptoms. If the percentage is over 10%, I advocate removing milder symptoms — why? to reduce “noise” in targeting bacteria.

In terms of results, there was an unexpected result, walnuts and aspartame were near the very top suggestion(. This was followed by a bunch of antibiotics with 50% being reported by specialist to help CFS. These include (in order).

• amoxicillin [CFS]
• metronidazole [CFS]
• ciprofloxacin [CFS]

The top probiotics were:

• Lacticaseibacillus casei {L. casei}
• Limosilactobacillus reuteri {L. Reuteri}
• Bifidobacterium longum subsp. longum BB536 {BB536}
• Saccharomyces cerevisiae var boulardii {S. boulardii}
• Lactobacillus gasseri {L.gasseri}

Only one vitamin makes it above by arbitrary 50% of highest priority: Vitamin A. My personal approach taking Vitamin A is 5-7 days of 50,000 IU per day. This dosage is deemed safe, especially for a short period [2004]. This approach came from the Complete German Commission E Monographs. View this as an antibiotic to include in the rotation.

Amino Acids were: {glycine}, {Theanine} and {Glutamine}. Common supplements: Tauroursodeoxycholic acid  a.k.a. Tudca. Diet type: Low FODMAP. Herbs or spices: Morinda citrifolia {Noni}.  {Baicalin },  {garlic}, {Eugenic acid} – usually found in  clove, cinnamon, nutmeg, basil, and bay leaf.

Foods of special interest:

• walnuts
• Propolis {Bee glue}
• {Almonds}
• Taraxacum officinale {Dandelion} i.e. tea
• Secale cereale {Rye}
• Whole Cow milk {Whole Milk}
• blueberry
• {Acai}

I will leave it to the reader to review the avoids (the top ones include: {slippery elm}, {Stevia}, Heyndrickxia coagulans {B. coagulans}, High Fat and High Sugar diets).

The probiotic list are only those with no adverse effects and positive effect. This boils down to two: Lacticaseibacillus casei (as above) and  Lactobacillus Helveticus

KEGG Probiotics

Based on Compound, we have:

And for Enzymes

Why E.Coli probiotics are not in the first list.

The first list is based on published studies. Most published studies use 16s (cheap) processing and that technology is very weak for detecting E.Coli so shifts go unseen and unreported. See ME/CFS: The Evils of Lactobacillus Probiotics? for more information. The table below show that Shotgun detects E.Coli 90-100% of the time, while 16s detects it 0.1% to 50% of the time. If the research cannot see it, they cannot report what shifts it.

The KEGG approach is not dependent on someone doing a study with (expensive) shotgun testing; it uses the genetics of the bacteria alone.

Notes on Changing Symptoms

My first draft of this post used his symptom list before he trimmed it of items that are now mild. The core suggestions did not change much — but there was some reordering happening.

Trying out the new Over and Under Represented Algorithm

The question is how do you deal with over or under represented? I mentally stepped away from this individual sample and realized that for a population of similar people, you will try to increase the under represented and decrease the over represented. Using this as my initial algorithm, I went to the Old UI where you can individually select it (if you have symptoms entered).

The top items were the same antibiotics as above

And the commercial probiotics had the top one being one of those listed above.

This suggests that there is significant convergence in suggestions although a very different path was taken. Adding this to the above consensus, I noticed a few significant shifts:

• Walnuts dropped down the list (but at #6 for foods)
• Bifidobacterium longum moved to the top for probiotics
• {Dandelion} moved back to the top for foods

I extracted a “everyone agrees” food list that is shown below

• Taraxacum officinale {Dandelion}
• Petroselinum crispum {Parsley}
• (2E,4E)-5-(1,3-Benzodioxol-5-yl)-1-(1-piperidinyl)-2,4-pentadien-1-one {Piperine}
• Citricidal {Grapefruit seed extract}
• Hibiscus {Rose mallow}
• Euterpe oleracea {Acai}
• Myristica fragrans {Nutmeg}
• Apium graveolens {Celery}
• Carum carvi {Caraway}
• Armoracia rusticana {Horseradish}
• Dysphania ambrosioides {Epazote}
• Coriandrum sativum {Coriander}
• Sinapis alba {yellow mustard}
• Cuminum cyminum {Cumin}
• Tea tree
• Garcinia mangostana {Mangosteen}

Bottom Line

Assuming antibiotics are available, I would do the following sequence with 7-10 days of each.

1. metronidazole [CFS]
2. Bifidobacterium longum subsp. longum
3. Vitamin A (Increases B.Longum and E.Coli)
4. Symbioflor-2
5. amoxicillin [CFS]
6. Limosilactobacillus reuteri {L. Reuteri} (No studies found that it is decreased by amoxicillin)
7. ciprofloxacin [CFS]
8. Bifidobacterium longum subsp. longum (ciprofloxain increases it)
9. Mutaflor

While not listed at all in the consensus, I would suggest doing d-ribose concurrently because it increases both E.Coli and Bifidobacterium. It does show up in the under/over representation as a negative with no impact on the other 6 suggestions list — so I would ignore this negative.

As always, no one knows how to precisely fix the microbiome, the above is computed (thus no human bias) to most likely help.

On Facebook, in response to my post ME/CFS: The Evils of Lactobacillus Probiotics?, a reader raised a question about MCAS

I responded with two studies from PubMed

• “mast cell degranulation is impaired following exposure to bacteria such as escherichia coli” Escherichia coli exposure inhibits exocytic SNARE-mediated membrane fusion in mast cells [2014]
• “non-pathogenic commensal escherichia coli bacteria can inhibit degranulation of mast cells.” Non-pathogenic commensal Escherichia coli bacteria can inhibit degranulation of mast cells [2008]

I forwarded these on to a friend suffer from MCAS. She responded that she was mentally lost in the studies. She decided to ask Perplexity. to explain. She was delighted with the response and I thought that Perplexity should have a guest post!

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This abstract describes how mast cells, which are key players in allergic reactions, release inflammatory substances through a process called degranulation. Here’s a simplified explanation:

Mast Cell Degranulation Process

1. Mast cells contain small packages (granules) filled with inflammatory chemicals.
2. When triggered, these granules fuse with the cell’s outer membrane to release their contents.
3. This fusion is controlled by a set of proteins called SNAREs, including Syntaxin4, SNAP23, and VAMP8.

Normal Degranulation Mechanism

1. A protein called IKKβ attaches to and modifies (phosphorylates) SNAP23.
2. The modified SNAP23 then joins with Syntaxin4 and VAMP8.
3. This three-protein complex drives the fusion of granules with the cell membrane, releasing the inflammatory substances.

Effect of E. coli on Degranulation

The researchers discovered that exposing mast cells to E. coli bacteria interferes with this process:

1. E. coli prevents IKKβ from interacting with and modifying SNAP23.
2. As a result, SNAP23 doesn’t join with Syntaxin4 and VAMP8 as effectively.
3. This disrupts the formation of the protein complex needed for granule fusion.
4. Consequently, the release of inflammatory substances from the granules is reduced.

In essence, the study shows that E. coli can suppress the allergic response of mast cells by interfering with the molecular machinery responsible for releasing inflammatory chemicals.

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Similarly, I was ping by a reader who said “You can’t buy these in the US” — That is correct in that you will not find them in your local health food store. I live in the US and have no trouble getting them by internet order shipped to my door:

• Mutaflor: Feel Good Natural Health Store.
• Symbioflor-2: German Apotheke

All of these strains have many studies published.

This is a preview of the next generation of analysis. I described a mathematical model in Microbiome Guilds, Metabolites and Enzymes. I mentioned a concept in it and over the weekend tried the concept out. It worked and is very sweet.

To explain it, look at the chart below. The blue line is for those that have a symptom and the orange line is what is expected. If you divide observed by expected for different percentiles, you get an odds ratio. Most people know odds ratio (OR) from things like:

For current male smokers consuming >30 cigarettes daily:

• Squamous Cell Carcinoma (SqCC): OR = 103.5
• Small Cell Lung Cancer (SCLC): OR = 111.3
• Adenocarcinoma (AdCa): OR = 21.91

This pattern does not determine that you will absolutely get it. It means that your are more likely — odds. (My native environment as a statistican)

Biomesight Bacteria

The genus bacteria listed below, each have at least an odds ratio of 1.5 for general fatigue using Biomesight data if your percentile is below the amount show. I stopped listing at 10%ile items

• Bifidobacterium <= 48.7
• Collinsella <= 41
• Coprococcus <= 39.3
• Desulfosporosinus <= 38.7
• Lachnobacterium <= 37.6
• Oribacterium <= 35.8
• Lactobacillus <= 30.5
• Pseudobutyrivibrio <= 29.5
• Legionella <= 28.9
• Roseburia <= 28.3
• Faecalibacterium <= 27.8
• Lachnospira <= 27.3
• Turicibacter <= 27.1
• Mycoplasma <= 25.8
• Peptococcus <= 24.3
• Coraliomargarita <= 23.8
• Sedimentibacter <= 23.7
• Rhodothermus <= 23
• Tindallia <= 22.4
• Thiothrix <= 21.8
• Eubacterium <= 21.7
• Thermicanus <= 21.6
• Sutterella <= 21.5
• Alkaliphilus <= 21.5
• Luteibacter <= 21.1
• Sphingobacterium <= 21.1
• Candidatus Phytoplasma <= 20.5
• Anaerostipes <= 20.4
• Haemophilus <= 19.9
• Moorella <= 19.1
• Catenibacterium <= 18.7
• Olivibacter <= 18.5
• Novispirillum <= 18.4
• Butyricimonas <= 18.3
• Natronincola <= 17.9
• Macrococcus <= 17.3
• Runella <= 16.6
• Tepidanaerobacter <= 16.1
• Caldicellulosiruptor <= 15.7
• Enterococcus <= 15.4
• Serratia <= 15.3
• Salinicoccus <= 15.2
• Gemella <= 14.9
• Odoribacter <= 14.7
• Thiohalorhabdus <= 14.6
• Dorea <= 14.2
• Escherichia <= 14.1
• Chlorobaculum <= 14
• Parabacteroides <= 14
• Calothrix <= 13.8
• Megasphaera <= 13.8
• Selenomonas <= 13.6
• Acetobacterium <= 13.6
• Slackia <= 13.4
• Pseudoclostridium <= 13.4
• Peptoniphilus <= 12.4
• Tetragenococcus <= 12.2
• Johnsonella <= 12
• Akkermansia <= 11.8
• Veillonella <= 11.5
• Holdemanella <= 11.5
• Streptococcus <= 11.2
• Pectinatus <= 11.2
• Pedobacter <= 11.1
• Klebsiella <= 11
• Dysgonomonas <= 11
• Erysipelothrix <= 10.9
• Desulfurispora <= 10.7
• Dolichospermum <= 10.5
• Mogibacterium <= 10.4
• Bilophila <= 10.2
• Ruminiclostridium <= 10.2
• Finegoldia <= 10.1

If you have 10 of them then 1.5 ^ 10 = 57x greater odds of having general fatigue. It is NOT one bacteria causing it, or even a specific group of bacteria, but different combinations of possible bacteria.

I should mention that these numbers only applies to Biomesight data. “results from one pipeline cannot be safely applied to another“. For background see: The taxonomy nightmare before Christmas.

Ombre Equivalent Bacteria

If you have Ombre’s microbiome results, these are the critical bacteria:

• Collinsella <= 44.2
• Erysipelatoclostridium <= 41.8
• Bifidobacterium <= 41.1
• Thomasclavelia <= 39.2
• Lactobacillus <= 30.1
• Dorea <= 27.4
• Fusicatenibacter <= 24.1
• Gemmiger <= 23
• Terrisporobacter <= 17.9
• Sutterella <= 16.1
• Coprobacter <= 15
• Coprococcus <= 13.7
• Haemophilus <= 13.6
• Flavonifractor <= 13
• Casaltella <= 13
• Ruminiclostridium <= 12.5
• Faecalicatena <= 12.3
• Mediterraneibacter <= 11.9
• Slackia <= 11.8
• Paraprevotella <= 11.5
• Eubacterium <= 11.3
• Subdoligranulum <= 11.2
• Lachnospira <= 10.3
• Phocaeicola <= 10.2

uBiome Equivalent Bacteria

This illustrates well the fact that ranges will differ a lot between tests.

• Subdoligranulum <= 43
• Faecalibacterium <= 38.9
• Pseudobutyrivibrio <= 26.2
• Veillonella <= 22.4
• Dorea <= 21.4
• Fusicatenibacter <= 21.1
• Hespellia <= 19
• Oscillibacter <= 18.6
• Roseburia <= 18.2
• Odoribacter <= 17.9
• Collinsella <= 15.9
• Intestinibacter <= 15.8
• Bifidobacterium <= 15.1
• Clostridioides <= 14.6
• Papillibacter <= 14.5
• Actinomyces <= 14.2
• Sutterella <= 12.9
• Blautia <= 12.8
• Parabacteroides <= 11.9
• Marvinbryantia <= 11.6
• Anaerotruncus <= 10.8

Bottom Line

This transforms the ability to determine if a bacteria is too high or low. Given a symptom or condition, we can determine the bacteria likely involved and if the level is likely (odds) to contribute to the symptom.

We can thus focus on exactly the bacteria of concern and ifnore the noise elsewhere.

Stay tune, there is a lot of coding to do to implement this.

Trial of algorithm

I was helping someone transfer data from biomesight.com and decided to run their latest sample thru the odds ratio I had derived this weekend. She marked their symptoms, see below. The numbers are the odds ratio.

The evidence that hypersensitivity to noise is likely microbiome dysfunction based is sweet — since there is no conventional treatment for it.

Backstory:

Hello, I’m a 21-year-old with a moderate case of CFS. Currently, I’m having serious problems with concentration, reading, memory, and executive function to the extent of needing a caregiver. I react to any food with neurological symptoms and gas, and my energy production is so impaired that I get hungry just two hours after a large meal. I would like to hear your analysis of the sample, especially your opinion about the sky-high amounts of Bilophila wadsworthia.

At 13 years old, I started having hemiplegic migraines with aura, including paralysis, speech, vision, and orientation loss due to an ATP1A2 mutation. These were thought to be incurable until I randomly found an off-label local medicine, metamizole, which is prohibited in the US, Canada, and the EU but is available in my home country, Ukraine. This medication was effective in mitigating the aura. I started taking it every day for four years starting at age 16. Recently, I learned that it increases prostaglandins and has an immunosuppressant effect like NSAIDs in general. I suspect that my daily use of this medication may have contributed to developing CFS and hypersomnia through unchecked mucosal infections.

I was also diagnosed with 160,000 copies of HHV6 in my blood via PCR, which persisted for years (I stopped testing for it). I tried valganciclovir, artesunate and IFN-a, which did nothing but further worsened my baseline. A year and a half ago, I started Joshua Leisk’s Born Free protocol (https://bornfree.life/download/BF_Protocol.pdf), which improved my metabolic situation significantly. However, I coincidentally started living in an unhygienic, mold-infested environment, and subsequently had GI and Eustachian tube infections. After taking nifuroxazide, amoxicillin, and metronidazole a year ago, my condition worsened to a moderate level, and I haven’t recovered since.

I suspect that gut issues are the cornerstone of my problems, but I am quite lost lost regarding how to handle them. I am eager for any new information.

The model that I use for ME/CFS is some event (stress, food poisoning, virus, inoculation or dozen of other possible events) cause the microbiome to shift in response. The shifts can result in a feedback loop that keeps this “evil microbiome” shift going. A percentage recover naturally over time, and we have a longitudal study from Bergen Norway to illustrate this. The trigger was giardiasis for a large number of people. A medicine like metamizole on a continuous basis can easy cause this to happen.

Analysis

We have two samples available, so let us look at the before and after antibiotics comparison. My impression is that the antibiotic made things worse. The latest sample has more items out of range despite having ~20% less bacteria reported

Since we are nominally dealing with ME/CFS, we can use the cross validated suggestions to get conservative suggestions of what may help

The result is a massive list!

We will backtrack to “Just Give Me Suggestion Including Symptoms” so we can rank order these suggestions.

The top items are antibiotics, with 60% being those used to treat ME/CFS (i.e. on the above cross validated list). I tend to follow Jadin’s approach so, do one of those marked [CFS] for a course (7-10 days) and the next month(3 weeks off), move to a different one. After the 3rd one, get a new microbiome test to see the next course adjustment.

Probiotics are dominated with Bifidobacterium species. I would tend to do 3 weeks on one strain between antibiotics, working up to a dosage of 50 BFU. At present, my favorite source is Maple Life Science™: they ship worldwide, typically the packages arrive with manufacture dates 4-6 weeks before (thus LIVING probiotics), and very reasonable cost. Yakult and Kefibios can be difficult to obtain in some countries.

Going over to KEGG suggested probiotics and although we are approaching it from a totally different path, we have consensus.

• Top was L. Casei Probiotic Powder (aka Yakult above) [5.5]
• Maple Life Science™ / Bifidobacterium lactis [5.2]
• Maple Life Science™ / Bifidobacterium infantis [4.57]
• Maple Life Science™ / Lactobacillus reuteri [3.91]
• PIANETA FARMA/KefiBios [3.68]

For prebiotics, just three stand out, take them with the above probiotics

For vitamins (can be taken continuously), I would suggest adding them one at a time (every 3-4 days) in case some create significant (good or bad) reactions.

For flavonoids, the list is very ME/CFS typical.

Second Pass – Cross Validated Suggestions

I picked these from the short list of options in the old UI.

The number of bacteria matches were relatively few.

The suggestions are shown below. Note that Lacticaseibacillus casei and Lacticaseibacillus paracasei shirota. Are on this list, just as they were above. Avoid other lactobacillus probiotics.

Questions and Answers

Some questions:
— what are your thoughts on the sky-high levels of Bilophila (any specific advice on managing that?) and the very low overall species diversity. I did some troubleshooting with a CGM, and every time I eat some animal fat—and to a lesser extent, animal protein—after carbs, I experience a hyperglycemic spike. I attribute that and my brainfog to a Bilophila overgrowth (H2S & acetaldehyde). When I’m on a vegan diet, my blood sugar is generally perfect, except for one hypoglycemic event at night but it’s really problematic to sustain this diet long-term.
— also, which advice here is aimed at increasing lactobacillus abundance as the recommended probiotics are mostly bifido?

Response

Here we hit a philosophy crossroad.

• The road most travelled is focusing on the bacteria most heard about and trying to address them one by one.
• The road that I take is to ignore this chatter, and aim to adjust everything in one pass using mathematical models.
  • Often I have read that something like Lactobacillus increases for a subset of people if other bacteria are present, (or absence).
  • I view this approach is most likely to cause desired changes and not chasing this bacteria or that bacteria.

Microbial Interdependence

Microbial interdependence occurs when different bacterial species rely on each other for growth or survival. This can happen through various mechanisms:

• Metabolic cross-feeding: One species produces metabolites that another species uses for growth.
• Signaling interactions: Chemical signals from one species trigger responses in another.
• Modification of the environment: One species alters the local environment in ways that benefit another species.

Given that concentration is an issue, there is a high probability that high d-lactic acid is involved. This would cause me to suggest avoiding lactobacillus probiotics entirely. It is impossible to determine which retail brands produce d-lactic acid.

Bottom Line

Go slow, slowly increase dosages, keep track of your reactions on paper (or electronically). Some suggestions will have no effect, others may have dramatic effects.

Postscript and Reminder

As a statistician with relevant degrees and professional memberships, I present data and statistical models for evaluation by medical professionals. I am not a licensed medical practitioner and must adhere to strict laws regarding the appearance of practicing medicine. My work focuses on academic models and scientific language, particularly statistics. I cannot provide direct medical advice or tell individuals what to take or avoid.My analyses aim to inform about items that statistically show better odds of improving the microbiome. All suggestions should be reviewed by a qualified medical professional before implementation. The information provided describes my logic and thinking and is not intended as personal medical advice. Always consult with your knowledgeable healthcare provider.

Implementation Strategies

1. Rotate bacteria inhibitors (antibiotics, herbs, probiotics) every 1-2 weeks
2. Some herbs/spices are compatible with probiotics (e.g., Wormwood with Bifidobacteria)
3. Verify dosages against reliable sources or research studies, not commercial product labels. This Dosages page may help.
4. There are 3 suppliers of probiotics that I prefer: Custom Probiotics , Maple Life Science™, Bulk Probiotics: see Probiotics post for why

Professional Medical Review Recommended

Individual health conditions may make some suggestions inappropriate. Mind Mood Microbes outlines some of what her consultation service considers:
A comprehensive medical assessment should consider:

• Terrain-related data
• Signs of low stomach acid, pancreatic function, bile production, etc.
• Detailed health history
• Specific symptom characteristics (e.g., type and location of bloating)
• Potential underlying conditions (e.g., H-pylori, carbohydrate digestion issues)
• Individual susceptibility to specific probiotics
• Nature of symptoms (e.g., headache type – pressure, cluster, or migraine)
• Possible histamine issues
• Colon acidity levels
• SCFA production and acidification needs

A knowledgeable medical professional can help tailor recommendations to your specific health needs and conditions.

Back Story

My journey to how I ended up where I am now is that I’ve always been one to catch illnesses like colds, flus, and stomach bugs easily. I was also frequently medicated with antibiotics for many years as a kid. Looking back, of course my microbiome is a mess. 

To date, I have had COVID 6 times (that I know of/positive tests – there was probably more that didn’t “show up” or that I may have dismissed as a cold). 

The first time I had Covid was January 2020, before it was “a thing”. It was later confirmed that it was indeed COVID, with an antibody test sometime in February-March 2020 when I donated blood. I was the sickest I’ve ever been in my life (26yo then, I’m 30 now). My main symptoms were feeling out of breath and lightheaded, as well as gastrointestinal (diarrhea and vomiting) – which at the time, no one was acknowledging that COVID could have any gastro symptoms, so I kept getting dismissed that it couldn’t have possibly been COVID. I was sick for a solid week and a half and it took me about 8 weeks to get back to feeling somewhat normal and not out of breath etc. 

 I’ve missed so much work because of this illness and I just keep catching it – the most recent time being just a month ago. 

I developed the skin condition Rosacea around late 2022-early 2023 which I believe is microbiome related – I’ve tried many topical prescriptions that don’t do a dang thing, and it has since spread to my eyes and I now have Ocular Rosacea as well.

 I’ve always had chronic constipation but it is worse since 2020. I have fatigue and am always tired, no matter how much I sleep. At one point I had high iron, so I was told to donate blood to lower it, but then my iron and ferritin fell so low that I was told to stop and instead take iron supplements to get my iron and ferritin back up – which I cannot tolerate, because it causes stomach issues for me. 

I’d love to figure out how to really improve my microbiome and finally heal from all of this. I’m constantly living in fear that I’ll catch COVID again and lose any progress I’ve made. 

Analysis

• Rosacea is a chronic inflammatory skin condition that can have systemic effects and comorbidities. While not directly linked to ME/CFS or long COVID, it shares some characteristics of chronic inflammatory conditions. I have encountered several ME/CFS with it
• Constipation is commonly associated with ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome).

Both are suspected to be cause by imbalance of gut flora (microbiome).

We see a lot of pattern matching to other people with the same symptoms.

But since we are dealing with a situation with some cross-validation data being available (i.e. lists of things with studies that helps with the symptom/diagnosis), I like to start there. On [Changing microbiome tab].

Updated Analysis

The original draft was done before the Simple UI was released. There was 6 forecast matches over 70%, so I went with symptoms, Despite having 11 symptoms, only 9 bacteria was selected.

The suggestions are shown below

Probiotics

These are the top items, some can be hard to get. Some of my usual sources are:

• Heyndrickxia coagulans {B. coagulans} [6/4 ]
• Bifidobacterium breve {B. breve} [5/4]
• bacillus subtilis {B.Subtilis } [10/3]
• Lacticaseibacillus paracasei {L.paracasei}[2/3]
• Lactobacillus gasseri {L.gasseri}[1/1]

The above are based on how they are known to alter other bacteria from published studies. Next I swing over to KEGG to see which probiotics can provide metabolites and enzymes that the person is low in. This is a complimentary approach that does not depend on a study being done, rather working from the DNA of the microbiome. I have annotated the above with their [Metabolite/Enzymes] scores above. The highest lactobacillus was 4, Bifidobacterium [7]. One bacillus ranked high, but is not easily available as a probiotic: Bacillus thuringiensis -[15/9]. My preferred sequence would be to start with B.Subtilis and then B. Coagulans.

Foods

The food menu suggests that Turkey and Chicken are the best meats. Kiwis and Soy are next. To avoid: carrots, beans, sweet potatoes,

Vitamins are the usual for ME/CFS

One word of warning — do not use B-Complex. They contain some B-vitamins that are to be avoided. Get the specific B-vitamins shown.

Postscript and Reminder

As a statistician with relevant degrees and professional memberships, I present data and statistical models for evaluation by medical professionals. I am not a licensed medical practitioner and must adhere to strict laws regarding the appearance of practicing medicine. My work focuses on academic models and scientific language, particularly statistics. I cannot provide direct medical advice or tell individuals what to take or avoid.My analyses aim to inform about items that statistically show better odds of improving the microbiome. All suggestions should be reviewed by a qualified medical professional before implementation. The information provided describes my logic and thinking and is not intended as personal medical advice. Always consult with your knowledgeable healthcare provider.

Implementation Strategies

1. Rotate bacteria inhibitors (antibiotics, herbs, probiotics) every 1-2 weeks
2. Some herbs/spices are compatible with probiotics (e.g., Wormwood with Bifidobacteria)
3. Verify dosages against reliable sources or research studies, not commercial product labels. This Dosages page may help.
4. There are 3 suppliers of probiotics that I prefer: Custom Probiotics , Maple Life Science™, Bulk Probiotics: see Probiotics post for why

Professional Medical Review Recommended

Individual health conditions may make some suggestions inappropriate. Mind Mood Microbes outlines some of what her consultation service considers:
A comprehensive medical assessment should consider:

• Terrain-related data
• Signs of low stomach acid, pancreatic function, bile production, etc.
• Detailed health history
• Specific symptom characteristics (e.g., type and location of bloating)
• Potential underlying conditions (e.g., H-pylori, carbohydrate digestion issues)
• Individual susceptibility to specific probiotics
• Nature of symptoms (e.g., headache type – pressure, cluster, or migraine)
• Possible histamine issues
• Colon acidity levels
• SCFA production and acidification needs

A knowledgeable medical professional can help tailor recommendations to your specific health needs and conditions.

ME/CFS has many causes, a very common cause are virus (in the case of Long COVID, the COVID virus).

Back Story

A quick summary of my story: I got ME/CFS after two viruses about a month apart in late 2016, when I was 27 – one upper gastrointestinal and one upper respiratory. After struggling to work for a couple of months after my body eventually gave up and I had to be signed off sick, and then eventually let go. I haven’t returned to any work since. I would say I am at the moderate end of the spectrum – able to socialise outside of the house on occasion as long as transport isn’t too strenuous, but not well enough to do things on a consistent basis, with obviously lots of rest all the time. Since then I’ve been on a journey seeing various doctors mostly to no avail, although not for a few years now. 

My main symptoms now: 

• Fatigue
• Muscle weakness 
• POTS
• Unrefreshing sleep 
• Various mild / moderate pain
• Very prone to overheating / sweating

I take 40mg Duloxetine once a day, ostensibly for nerve pain although it has helped significantly with my overall energy levels and wellbeing, moving me from severe to moderate from when I started taking it a few years ago. 

It’s worth pointing out that over the course of my illness I have tried several probiotics and things suggested with the gut. These are as follows (if I remember correctly): 

• Optibac
• BioKult 
• Generic acidophilus probiotic 
• GI Synergy antimicrobials
• Yakult (more on that in a minute) 

Every single one of these has caused these symptoms of varying severity: 

• Increased blood pooling 
• Sore throat 
• Flushing
• Fatigue
• Disorientation 
• General malaise 

So in general I have stayed away from things to do with the gut because of these bad experiences. Yakult is actually something I stopped only recently – I read your blog post about d-lactate and given it’s so cheap and easy to get hold of decided to give it a go. I would say that while the other probiotics caused those symptoms almost on the first or second dose, with Yakult it took a lot longer to set in. I took it for 3 weeks before I finally realised that I was at the same place symptom-wise as the others, it just took me much longer to get there. A shame as it i was a low-cost and easy thing to try. They’re obviously all doing something! Just not what I’d like, haha. 

Review of Back Story vs Microbiome Sample

Filtering by reported symptoms yield just two bacteria, both low: Lactobacillales and Natronincola. Suggestions were Barley, Oats, whole grain diet, {Reishi Mushroom},Slow digestible carbohydrates. {Low Glycemic}.

I did the simple suggestions option since the number of symptom matches to symptoms prediction was low. We found 43 bacteria out of range. None of the following probiotics were on the recommended list: Optibac, BioKult, Generic acidophilus probiotic, GI Synergy antimicrobials, Yakult

Going over to KEGG Computed Probiotics Report, we have these being the top one

• mutaflor / mutaflor – most expensive
• symbiopharm / symbioflo 2
• Bacillus Subtilis – usually cheap
• miyarisan (jp) / miyarisan: Clostridium butyricum – On main suggestion list

Working down the list we have:

• Lacticaseibacillus rhamnosus
• Lactiplantibacillus plantarum
• Limosilactobacillus reuteri – On main suggestion list

Since economics is cited, I would suggest ordering one bottle of each from Maple Life Science. They are direct from factory to retail customers; ships world wide; no shipping costs. Cost per bottle is around $9

• Limosilactobacillus reuteri
• Lactiplantibacillus plantarum
• Lacticaseibacillus rhamnosus
• Bacillus Subtilis

For the other ones, see how you react to these first. My usual suggestion is one capsule for ONE of these on the first day, increase according to your reaction. If adverse reaction, move on to the next one. Once the bottle is empty, go to the next one.

Personally, my own ME/CFS experience favors Mutaflor — but it created a massive herx for 2 weeks; so I tend to suggest moving it to the very end.

Other issues

I have no information on Duloxetine impact on the microbiome. Other suggestions have many familiar in treating ME/CFS over the last 30 years. The include:

• {Whey}
• {Chicory}
• resveratrol-pterostilbene x Quercetin {quercetin x resveratrol}
• Lycopene {Glucosamine (GS)}
• {Chitosan}
• green tea

Unusually, B-vitamins are not high on the list. If you take them, keep to Vitamin B1,B2 and B12.

Going over to the Food Site we have these nutrients at the top

The first one, Resveratrol, is found in fresh grapes in the supplement form is not desired. The second one is mainly in raw Chicory . The third one is found in Black elderberry (and a small amount in Pomegranate). The fourth item, (-)-Epigallocatechin, is found in Green/Oolong Tea and Broad Beans. The next one, Cyanidin 3-O-xyloside, is mainly in Black chokeberry (and a small amount in Blackberries). Hesperetin is found in Lime and Oranges (not orange juice). Resistant starch is in Broad Beans, Lentils and Peas. Syringaresinol is found in Rye (i.e. whole 100% rye bread) and the Swedish Cloudberry (likely out of season now). Diosmin is found in Hyssop (I tend to buy it as a supplement).

As a FYI, my regular “ME/CFS preventative” diet is usually heavy in grapes or Resveratrol (depending on season and price); 100% Rye Bread; Broad Beans and Lentils; Hesperetin and Diosmin.

Questions And Answers

• Q: The herx / die off stuff do you have any guidance on that? What I meant was: given my adverse reactions to any probiotic I have tried – whether that’s on the same day after initially taking, or eventually building up after several doses – how can I tell the difference between a reaction that’s bad and should cease taking it, or supposed “die off” symptoms, if you see what I’m saying. Basically how to tell the difference between stopping needing to stop taking a probiotic due to the symptoms its producing, or pushing on, and seeing if it tails off. Does that make sense? 
  • Your question makes a lot of sense. I have done a few posts on that:
    • Probiotic Herxheimer Reactions (2012) and Reminder: Probiotic can cause major herx!(2017)
    • Controlling a Herxheimer Reaction (2016) and Dealing with the Herx (2016)
    • The issue is more complex for probiotics because often extra ingredients are included which some people react to.
  • A short version for probiotics is this:
    • If the adverse effect is ongoing 18 hours later, it is likely an adverse reaction or feeding bad bacteria. Many studies find that some probiotics are not detectable after 24 hours (not true for all of them).
    • The duration of the reaction should be decreasing each day. You should feel a little better after the effect ebbed each day. Often, there can be a quick ending of the reaction. If it increased or do not change, it is likely an adverse reaction or feeding bad bacteria.
• I have improved the Lookup Modifier Page to flag what a probiotic is impacting. You need to break a mixture apart and examine it parts. Most of his probiotics were mixtures containing L. Acidophilus. Note that Sutterella is in common with both

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 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.