The Role of Gut Problems in ME/CFS

There has been quite a lot of confusion about the involvement of gut problems in ME/CFS. Many, but not all, sufferers report problems with food intolerances or IBS, and both Coeliac disease and Candida overgrowth have been claimed as the cause of ME/CFS.
When I was first ill I read a book claiming candida overgrowth as the cause of ME but I was pretty sure that at the time it played no role in my illness. However during my second illness I developed digestive problems after a particularly nasty tooth infection that required two courses of broad spectrum antibiotics. Now I find that the candida literature makes an awful lot of sense to my digestive problems. I’m sure it developed secondary to my illness, but I believe that this gut imbalance plays a major role in impeding my recovery.  I’ve also developed intolerances to gluten and sugar so have spent a lot of time researching the whys and wherefores of digestive issues and ME/CFS.
Here’s my take on how the various illnesses relate:
  • Coeliac disease and Candida overgrowth are both separate conditions from ME/CFS however they often seem to be related.
  • Because of the similar symptoms it is possible that some people who suffer from these conditions might have been mistakenly diagnosed with ME/CFS. However ME/CFS is a far more complex condition with dysfunctions in the immune system, neuroendocrine system and at the cellular energy level, each of these bodily imbalances impacting on the others.
  • Conditions such as Coeliac disease, IBS and Candida overgrowth, when untreated, can put such an enormous amount of stress on general health that they may contribute to the onset of ME/CFS in a person who is susceptible to developing this condition.  
  • The compromised immune system of an ME/CFS sufferer can make them more susceptible to developing Candida overgrowth and/or food intolerances.
  • Candida overgrowth can be linked to the development of gluten intolerance. A protein in the cell wall of the more harmful form of this organism is very similar to gluten. The antigens that our gut immune system produces to fight this form of candida also reacts to gluten.
  • Many ME/CFS sufferers also suffer from IBS. However there is no one identifiable cause of IBS. It is the name given to the collection of gut symptoms that seem to have varied causes.
  • The good news is that once these issues are identified and managed a strain is taken off the body and it then has a better chance of regaining balance in its many affected systems.

Understanding how ME/CFS can affect our gut health
Our gut is the front line of our immune system with 80% of our immune cells located there. When our immune system is compromised the balance of helpful and harmful micro-organisms is affected, a condition called gut dysbiosis. The balance of helpful and harmful microorganisms can also be affected by taking antibiotics. Harmful micro-organisms are mainly those whose metabolism produces substances toxic to our bodies. Some of these toxins can affect our digestive enzymes. When this happens we can struggle to properly digest certain food substances. When these substances are not properly digested they may be recognised by the immune system as toxins resulting in food sensitivities, and if they manage to enter into the blood stream they could even result in full blown allergies.
Candida albicans is a yeast that naturally lives in our gut. It is thought * that under certain conditions of gut dysbiosis and poor gut immune functioning, and with a diet high in sugars this yeast thrives. Under these positive conditions it develops a second form which burrows into the gut lining causing what it known as leaky gut syndrome. Leaky gut syndrome increases our likelihood of developing food intolerances and allergies and allows many other toxins access to our blood stream. When fed with sugars this yeast produces many toxins, that get into our blood system causing a wide range of symptoms and adds to the general toxic overload in the body.
(*The whole issue of Candida albicans in ME/CFS is much disputed by the medical profession. A gut overgrowth is only recognised as an issue by the NHS for illnesses where immunity is extremely compromised such as in the late stages of Aids and Cancer. However many alternative health professional and independent doctors do recognise it as an important issue for some ME/CFS sufferers.)
Gut health self-help
The consequences of poor gut health have a knock on effect on the rest of our body. In order to give our body the best possible chance of regaining its own healing balance I believe it’s really important to do what we can to improve our gut health. There are several measures we can take to improve our gut health:
  • Pro-biotic supplements contain friendly (helpful) bacteria that can help restore a healthy balance of gut flora. They can be taken as a preventative measure alongside a course of antibiotics, a particularly prudent measure when you know your immunity is compromised. Pro-biotic (live) yogurts also contain some strains of these helpful bacteria and could also be worth considering as a preventative measure for those with no current gut disturbances.
  • Identify and eliminate from your diet any foods that you have become intolerant of. This is often a case of trial and error. However there are certain elimination diets that can help but are only recommended under the supervision of a registered dietician. You can ask your GP for a referral if you believe food intolerances to be a real issue for you. If you suspect gluten intolerance contact your doctor immediately to ask for a blood test for Coeliac disease and do not eliminate gluten from your diet until after you have had this test.
  •  Digestive enzyme supplements may be useful if your gut symptoms seem to be triggered by a wide range of food, or even every time you eat.
  • Reducing the amount of refined sugars in your diet could help prevent the issue of yeast overgrowth.  If you suspect candida involvement in your gut ill health you could take an online questionnaire……. In my next post I will consider the anti-candida diet and the natural remedies that can help fight a yeast overgrowth.
  • Mindful eating. We can give our digestion a better chance to work by paying attention to our eating experience.  However good digestion practises will also have to be the subject of another post as this post is getting way too long!

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