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Could Gut Bacteria Help Diagnose ‘Chronic Fatigue Syndrome’?

Medicine has come a very long way in the last century, but it still has a long way to go. Millions of people in the U.S. live with debilitating conditions that, for many reasons, scientists don’t understand. One such condition is systemic exertional intolerance disease (SEID)—an illness better known by its inaccurate common name, chronic fatigue syndrome. SEID is so poorly understood that, to date, there aren’t even any tests to diagnose it. But that may change, as researchers say they’ve found biological markers of the illness in the blood and gut bacteria of people with SEID. Their results were published in the journal Microbiome.

Because so little is known about the physical roots of this condition, and because it predominantly affects women (who are frequently told their unexplained symptoms are imaginary or psychosomatic), many doctors and researchers have argued that it’s actually a mental illness. But a mounting pile of evidence says otherwise.

Even the name of this illness is controversial. The phrase “chronic fatigue syndrome” (CFS) implies that people with the illness are just tired. In fact, the most definitive symptom of this condition is “post-exertional malaise” (another ill-conceived term)—that is, a physiological crash that leaves people completely exhausted after even a small amount of physical or mental activity. In the UK and elsewhere, the condition is called myalgic encephalomyelitis (literally “brain inflammation”), or ME. But brain inflammation doesn’t fully describe the illness either.

Last year, the Institute of Medicine, a federal agency, released a report decrying the lack of research on this disabling condition.

“Remarkably little research funding has been made available to study the etiology, pathophysiology, and effective treatment of this disease, especially given the number of people afflicted,” the report noted. The report’s authors suggested a new name—SEID—but even they admitted that this didn’t quite fit the bill. (For the sake of clarity for this story, we’ll use ME/CFS, an abbreviation that many people with the condition are using until researchers find a more accurate term.)

Gastrointestinal issues like irritable bowel syndrome and heartburn are another common ME/CFS symptom. Previous studies have suggested that something is wrong with the gut bacteria of people with ME/CFS, while others found problems in their immune systems.

To test these ideas, a team of researchers from Cornell University collected blood and stool samples from 48 people with ME/CFS and 39 healthy people. They analyzed the health and diversity of the bacteria in the stool samples and looked for markers of inflammation in their blood.

They found clear differences between the blood and guts of healthy versus sick people. Compared to healthy controls, people with ME/CFS had weaker and less diverse bacterial ecosystems in their guts, as well as higher levels of immune inflammation in their blood. These differences were so clear that the researchers were able to spot nearly 83 percent of the time which participants had ME/CFS just by looking at their bacterial and immune response results.

The researchers believe that these clear biological differences in people with ME/CFS could become a way to diagnose the disease.

Senior author Maureen Hanson is an expert in molecular biology and genetics. “Our work demonstrates that the gut bacterial microbiome in ME/CFS patients isn’t normal, perhaps leading to gastrointestinal and inflammatory symptoms in victims of the disease,” Hanson said in a press statement. “Furthermore, our detection of a biological abnormality provides further evidence against the ridiculous concept that the disease is psychological in origin.”

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Medicine
Why Haven't We Cured Cancer Yet?
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Walkathons, fundraisers, and ribbon-shaped bumper stickers raise research dollars and boost spirits, but cancer—the dreaded disease that affects more than 14 million people and their families at any given time—still remains bereft of a cure.

Why? For starters, cancer isn't just one disease—it's more than 100 of them, with different causes. This makes it impossible to treat each one using a one-size-fits-all method. Secondly, scientists use lab-grown cell lines cultivated from human tumors to develop cancer therapies. Living masses are far more complex, so potential treatments that show promise in lab experiments often don't work on cancer patients. As for the tumors themselves, they're prone to tiny genetic mutations, so just one growth might contain multiple types of cancer cells, and even unique sub-clones of tumors. These distinct entities might not respond the same way, or at all, to the same drug.

These are just a few of the challenges that cancer researchers face—but the good news is that they're working to beat all of them, as this TED-Ed video explains below.

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Health
Skipping Breakfast Could Be Bad for Your Heart
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There are mountains of evidence supporting the claim that breakfast really is the most important meal of the day. Getting something in your stomach in the first hours of the morning can regulate your glucose levels, improve your cognition, and keep your hunger in check. Now new research published in the Journal of the American College of Cardiology points to another reason not to wait until lunchtime to break last night’s fast. As TIME reports, people who skip breakfast are at an increased risk for atherosclerosis, a disease caused by plaque buildup in the arteries.

Researchers surveyed over 4000 men and women between the ages of 40 and 54 living in Spain. After looking at the dietary habits of each participant, they broke them into three groups: people who consumed more than 20 percent of their daily calories in the morning; those who got 5 to 20 percent; and those who ate less than 5 percent.

The subjects who ate very little in the a.m. hours or skipped breakfast all together were 2.5 more likely to have generalized atherosclerosis. This meant that plaque was starting to collect on the walls of their arteries, hardening and narrowing them and increasing the risk for heart attack or stroke. People who fell into the 5 to 20 percent calorie category were also more likely to show early signs of the disease, while those who ate the most calories in the morning were the healthiest.

These results aren’t entirely surprising. Previous studies have shown a connection between skipping breakfast and health problems like high blood pressure, high cholesterol, diabetes, and unwanted weight gain. A possible explanation for this trend could be that waiting several hours after waking up to eat your first meal of the day could trigger hormonal imbalances. The time between getting into and out of bed is the longest most of us go without eating, and our bodies expect us to consume some calories to help kickstart our energy for the day (drinking straight coffee doesn’t cut it). Another theory is that people who don’t eat in the morning are so hungry by the time lunch rolls around that they overcompensate for those missing calories, which is why skipping breakfast doesn’t make sense as a diet strategy.

But of course there are many breakfast skippers who aren’t motivated by health reasons either way: They just don’t think they have the time or energy to feed themselves in the morning before walking out the door. If this describes you, here are some simple, protein-packed meals you can prepare the night before.

[h/t TIME]

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