Mandarano, Alexandra H, Giloteaux, Ludovic, Keller, Betsy A et al. · PeerJ · 2018 · DOI
This study looked at tiny organisms called eukaryotes (which include fungi and parasites) living in the gut of people with ME/CFS compared to healthy people. Researchers found that people with ME/CFS had slightly less diversity of these organisms and some differences in fungal types, though these differences were small. The findings suggest that gut imbalances in ME/CFS may involve more than just bacteria.
Understanding the complete gut microbiome—including fungi and other eukaryotes—is important because many ME/CFS patients have gastrointestinal symptoms and inflammation. This research expands beyond bacteria to reveal a more complete picture of how the gut environment differs in ME/CFS, potentially opening new avenues for treatment and diagnosis.
This study does not prove that eukaryotic changes cause ME/CFS symptoms or that correcting these imbalances would improve health. The nonsignificant findings mean the observed differences may be due to chance, and the study cannot establish whether any identified organisms contribute to disease mechanisms or could serve as reliable diagnostic markers.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Mandarano, Alexandra H, Giloteaux, Ludovic, Keller, Betsy A, Levine, Susan M, & Hanson, Maureen R (2018). Eukaryotes in the gut microbiota in myalgic encephalomyelitis/chronic fatigue syndrome.. PeerJ. https://doi.org/10.7717/peerj.4282
BibTeX
@article{mecfsatlas-mandarano-2018-eukaryotes-gut,
author = {Mandarano, Alexandra H and Giloteaux, Ludovic and Keller, Betsy A and Levine, Susan M and Hanson, Maureen R},
title = {Eukaryotes in the gut microbiota in myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {PeerJ},
year = {2018},
doi = {10.7717/peerj.4282},
note = {PubMed: 29375937},
url = {https://www.mecfsatlas.com/evidence/mandarano-2018-eukaryotes-gut},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/mandarano-2018-eukaryotes-gut
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