Varesi, Angelica, Deumer, Undine-Sophie, Ananth, Sanjana et al. · Journal of clinical medicine · 2021 · DOI
Many people with ME/CFS experience stomach and digestive problems alongside their fatigue and pain. This review explores how the bacteria living in our gut might be different in ME/CFS patients and could be contributing to symptoms. The researchers found that people with ME/CFS tend to have fewer types of gut bacteria compared to healthy people, and they discuss how treating the gut microbiome might help reduce ME/CFS symptoms overall.
This review connects gastrointestinal symptoms—commonly reported but often overlooked—to the biological underpinnings of ME/CFS, opening new therapeutic avenues. Understanding the role of the gut microbiota could lead to targeted interventions that address multiple ME/CFS symptoms simultaneously rather than treating them in isolation.
This systematic review does not establish that dysbiosis causes ME/CFS or prove that microbiota-targeted therapies will effectively treat the condition; it identifies an association and potential mechanisms. The review cannot determine whether altered microbiota are a primary driver, secondary consequence, or incidental finding in ME/CFS. Individual studies included may not have controlled for confounding variables such as diet, medication use, or comorbid conditions.
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
Varesi, Angelica, Deumer, Undine-Sophie, Ananth, Sanjana, & Ricevuti, Giovanni (2021). The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications.. Journal of clinical medicine. https://doi.org/10.3390/jcm10215077
BibTeX
@article{mecfsatlas-varesi-2021-emerging-role,
author = {Varesi, Angelica and Deumer, Undine-Sophie and Ananth, Sanjana and Ricevuti, Giovanni},
title = {The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications.},
journal = {Journal of clinical medicine},
year = {2021},
doi = {10.3390/jcm10215077},
note = {PubMed: 34768601},
url = {https://www.mecfsatlas.com/evidence/varesi-2021-emerging-role},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/varesi-2021-emerging-role
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