Ranisavljev, Marijana, Stajer, Valdemar, Todorovic, Nikola et al. · European journal of nutrition · 2024 · DOI
This study tested whether a special mixture of beneficial gut bacteria (probiotics) plus fiber and zinc could help people with post-COVID chronic fatigue syndrome (ME/CFS). Over three months, 26 patients took either the synbiotic mixture or a placebo, and researchers measured their fatigue, exercise recovery, and brain/muscle chemistry. The synbiotic group experienced better recovery after exercise and showed improvements in brain chemistry compared to the placebo group, though both groups felt less general fatigue.
Post-COVID ME/CFS affects millions globally with limited treatment options, and gut microbiota dysfunction is an increasingly recognized feature of the condition. This study provides preliminary evidence that targeted microbial supplementation may address both gastrointestinal issues and core ME/CFS symptoms like post-exercise malaise, offering a potentially safe and accessible intervention worthy of larger investigation.
This study does not prove that synbiotics are an effective treatment for ME/CFS—the small sample size (26 patients) and short duration limit confidence in the findings. It also cannot establish which specific bacterial strains or components drive any benefits, nor does it determine whether improvements would persist beyond 3 months or scale to diverse patient populations. The mechanisms linking improved brain metabolism to clinical symptom reduction remain unclear.
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
Ranisavljev, Marijana, Stajer, Valdemar, Todorovic, Nikola, Ostojic, Jelena, Cvejic, Jelena Helena, Steinert, Robert E, et al. (2024). The effects of 3-month supplementation with synbiotic on patient-reported outcomes, exercise tolerance, and brain and muscle metabolism in adult patients with post-COVID-19 chronic fatigue syndrome (STOP-FATIGUE): a randomized Placebo-controlled clinical trial.. European journal of nutrition. https://doi.org/10.1007/s00394-024-03546-0
BibTeX
@article{mecfsatlas-ranisavljev-2024-effects-month,
author = {Ranisavljev, Marijana and Stajer, Valdemar and Todorovic, Nikola and Ostojic, Jelena and Cvejic, Jelena Helena and Steinert, Robert E and Ostojic, Sergej M},
title = {The effects of 3-month supplementation with synbiotic on patient-reported outcomes, exercise tolerance, and brain and muscle metabolism in adult patients with post-COVID-19 chronic fatigue syndrome (STOP-FATIGUE): a randomized Placebo-controlled clinical trial.},
journal = {European journal of nutrition},
year = {2024},
doi = {10.1007/s00394-024-03546-0},
note = {PubMed: 39592468},
url = {https://www.mecfsatlas.com/evidence/ranisavljev-2024-effects-month},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/ranisavljev-2024-effects-month
Contribute
Private, reviewed by a human. Not a public comment thread.