Could gut bacteria and therefore diet hold important secrets about the causes of fibromyalgia syndrome?
Perhaps I should begin by describing the range of symptoms most commonly associated with fibromyalgia syndrome (FMS). According to the NHS1, increased sensitivity to pain is typically experienced by sufferers of FMS, it can be so severe that even a light touch can be a problem. There is evidence2 that when fibromyalgia patients are exposed to pain-inducing stimuli, they demonstrate a stronger neurologic pain signature that a control group (people without fibromyalgia). However, the pain is not restricted just to the sense of touch, it can also be provoked by things a person might see, inhale or eat. People living with FMS might also experience great tiredness, problems sleeping, muscle stiffness and spasms, irritable bowel syndrome (IBS), poor cognitive function and headaches. The syndrome is also frequently correlated with anxiety and depression. FMS can be a life-changing and debilitating condition, unfortunately, the causes are currently unknown, although abnormal levels of brain chemicals are thought to play an important role.
If the findings of a scientific study published last week3 are confirmed, FMS may have to be viewed in a totally new light. A team of scientists compared the gut microbiomes of 77 women with FMS to a control group. Significant differences were identified in the composition of the gut bacteria of these two groups. Through algorithmic analysis, the variance in the respective groups of microbiomes was found to be linked to FMS related issues (more than any other cause). So put simply, if the results translate to the wider population, people living with FMS are likely to have different gut bacteria than those without FMS. There is not any suggestion of causality here, that gut bacteria alone is the cause of fibromyalgia. However, we cannot avoid the speculative idea that changes to gut bacteria could mediate the symptoms experienced by FMS patients.
This is just one study, the results have to be replicated in order for provisional findings to be confirmed. But if demonstrated to be reliable, the evidence would signpost new ways to understand and possibly treat FMS. For example, can the composition of gut bacteria be changed away from that typically found in someone with FMS, to a profile resembling someone without FMS? If any such change led to a reduction or elimination of fibromyalgia symptoms, a new way to deal with this illness might be developed, perhaps linked to diet. This is particularly interesting when considered alongside studies that suggest chemicals found in everyday food such as bread may be able to disrupt the gut microbiome.
It will take a sustained period of research in scientific and clinical environments to confirm any of the speculative hypotheses discussed here. But at least two important issues emerge from this latest evidence. Firstly, that the gut-brain axis can be considered as a potential mediating factor is FMS, and secondly, that gut microbiome alteration may be correlated with non-visceral pain more generally. Therefore eating or not eating ‘healthily’ may be linked to an increasingly wide range of human health conditions.
The importance of the microbiome to human health is just starting to emerge, but our attitude to gut health hasn’t always been this enlightened.
Just a heads up for anyone interested in learning more about the changing relationship between humans and gut health. A short series The Gut Instinct: A Social History has been broadcast on BBC Radio 4 this week over five 15 minute episodes. At the time of writing the transmissions were still available on the BBC iPlayer here.
The concept was to explore how humans related to digestive processes and gut health across culture and time. There’s a lot of general information linked to the microbiome, some directly relevant to us today. The programme was written and presented by restaurant owner Tim Hayward and it seeks to offer an account relevant to a general audience, setting out major historical landmarks as well as important contemporary issues. Unusually for a British show, we actually hear adults talking about bowel movements and human waste in a practical and informative manner. The five-episode titles reflect the general content of the series (Gut Culture, A Window into the Gut, The Language of the Gut, The Disease of Civilisation and The Gut Speaks). Don’t expect much detailed science but I’d imagine anyone who tunes in to pick up some new morsels of gut knowledge, total listening time is just 75 minutes.
There may be a relationship between kefir and obesity.
I’m becoming increasingly convinced of the benefit of fermentation, that enriching beneficial gut bacteria has widespread effects on wellbeing and health. I’m still near the beginning of this journey and learning all the time. I’ve posted a series of articles linked to kefir, not because I’m an expert, but based of the apparent benefits accrued over the last two months from a small glass of kefir each day. I should also say that Maggie has lost a lot of weight over the time she has been drinking kefir, but, she has also been exercising. However weight loss isn’t my only reason for writing about this subject. A few months ago I felt obliged to take a course of antibiotics, I think it was a mistake ( I am aware of the downsides of this kind of medication) but it’s water under the bridge now. The subsequent decline in my overall health was striking. I started to have trouble concentrating and sleeping, I got a cold, suffered from reflux and saw an augmentation in weight.
I didn’t really connect these things with the antibiotics until I noticed that my bowel movements changed significantly. If you are new to the gut bacteria scene you might feel a little uncomfortable around talk about bowel movements, don’t be. A regular healthy bowel movement is one of the signs of a healthy balance in gut bacteria. So when I noticed I wasn’t going to the toilet regularly I though about the possible impact of antibiotics on my gut. I started to take kefir more regularly whilst keeping my usual prebiotic and probiotic consumption at the same level. The difference was gradual but pretty much everything started to improve after about five days. Two months later things are back where there were before the antibiotics. I’m much healthier, bowels are back to normal and……..I’ve lost weight without any exercise.
This isn’t a morality narrative about the harm of antibiotics. I believe antibiotics represent a life saving technology, and in the right place and time are essential. It’s their inappropriate overuse which I think is harmful.
My own anecdote is that I think it took two months to return the state of my gut bacteria to somewhere like normal, and I am a daily consumer of natural prebiotics and probiotics. In all of this story things pretty much fitted my modest understanding of the underlying science except the weight loss. I know that lack of diversity in gut bacteria is correlated with obesity generally but I hadn’t come across any research papers linking kefir to weight loss. If you can improve your gut health and pull your body weight closer to its optimum level this has to be a win-win. So I started to look through the scientific literature. The most recent research is featured here.
Can fibre reduce your chances of contracting colon cancer?
I have been a fan of Dr Michael Greger for some considerable time. He excels at explaining important and often complex nutrition research in a way that most people can understand. Michael recently wrote about the benefits of fibre to health, its crucial role in feeding the ‘good’ gut bacteria. Put simply out gut bacteria converts fibre into short-chain fatty acids (SCFA). SCFAs deliver a range of benefits and are thought to reduce the chances of contracting colon cancer.
It’s not simply that SCFA promote gut health generally, fibre helps to maintain gut flora. A failure to eat enough fibre can lead to the starvation and decline of healthy bacteria. This typically allows for an imbalance (dysbiosis), where potentially harmful bacteria begin to dominate, perhaps leading to a range of inflammatory diseases and even colon cancer. Further links even suggest a connection to cardiovascular disease, metabolic syndrome and type 2 diabetes.
A relative small amounts of fibre is needed to sustain healthy gut bacteria, in many cases just a handful of chickpeas every day. And yet there is evidence that many people in the USA and UK are failing to include sufficient fibre into their daily diet.
People suffering from migraines tend to have particular profile of bacteria linked to nitrate processing.
I am keen not to overstate the potential of any individual scientific study. However this story highlights exciting news about a potential relationship between bacteria and migraines. In 2016 The Guardian featured a study that appeared to demonstrate a link between the efficient break down of nitrates in humans and the occurrence of migraines. As I understand the research, migraineurs (people that suffer from migraine) tend to have more nitrate reductase bacteria in both the mouth and in stool samples, than the wider population.
Nitrate reductase genes are responsible for processing nitrates in food and drinks, point being the greater their abundance the more efficient the nitrate processing. So getting more nitrates from food (compared to non migraineurs) may be linked to triggers for migraines. Obviously further research will be needed but the link between nitrates and headaches is not new. What this study is demonstrating is that the key might rest with the microorganisms in the mouth and gut.
Many migraine sufferers are aware of a relationship between certain foods and increased risks of attacks, through chocolate and wine for example. It is also known that certain drugs high in nitrates can provoke severe headaches. When broken down, nitrates lead to increased blood circulation in the cardio vascular system, this increase may be a key factor in migraines. The complexity of the human microbiome, particularly the gut-brain axis, makes demonstrating causality between food and health challenging. However this seems like a promising area of research. Controlling the intake of foods high in nitrates might be a short term solution. But given that fruit and vegetables are rich sources of nitrates, cutting down on them could present a range of risks and benefits. For more information visit the Migraine Action or Migraine Trust websites.
We always welcome your feedback, comments in the text box below. Thanks for Peter for suggesting the subject and as always please read our disclaimer.
The overuse of antibiotics is a major health concern. Probiotics may support the lower consumption of antibiotics by boosting overall health in humans and animals.
I am in the process of writing a basic guide to probiotics, but a general description is,
‘microorganisms contained in some food and supplements that have proven and assumed benefits to human and animal health’.
A key point at the outset is that it is hard to prove causality in such matters. Demonstrating correlation (people that have particular gut bacteria tend to have or not have a particular illness) is much simpler. The evidence linking probiotics and health is both causal and correlational. The point of probiotics is to change (improve) the profile of gut flora so that it has more positive and less negative microorganisms. This is a long road of which we are at the beginning.
Antibiotics are drugs designed to destroy or inhibit the growth of bacteria harmful to humans, animals or other organisms. I acknowledge the potential lifesaving benefits of antibiotics, they are an important part of modern healthcare. But the widespread overuse of antibiotics in industrialized societies is creating superbugs, bacteria that are resistant to all known antibiotics. This problem was the subject of the film Resistance which I recently saw on Netflix. The issue of superbugs is not new and the discoverer of penicillin, Alexander Fleming discussed resistance in the mid 1940s. If you subject bacteria to an effective antibiotics most will die off, but surviving bacteria can develop resistance to that antibiotic. If you repeat the process often enough you risk creating bacteria over time, that become resistant to every antibiotic they have been exposed to.
Sometimes humans are given antibiotics when they are not needed, and so we may carry around bacteria that have a resistance to some antibiotics, this is a problem in itself. A key point that the film Resistance makes is that contemporary farming methods can involve the routine administration of antibiotics to hundreds of millions of animals every year. Antibiotics appear to make some animals grow bigger, thus increasing their cash value. However intensively farmed animals can live in insanitary conditions, exposed to fecal matter for most of their lives. Forcing animals to live in an environment where high levels of dangerous bacteria are present, thus necessitating the use of antibiotics as a routine measure, can be described as a perfect breeding ground for superbugs.
The standards of animal welfare vary from country to country and the use of antibiotics in the EU generally is lower than some other parts of the world. But it’s still a major problem according to a recent report. Conceptually the idea of eating animals is increasingly unacceptable to many people. However the logic of forcing animals to live in terrible conditions their whole lives, only sustained by large amounts of antibiotics is obviously flawed. Not only are people eating animals that have endured life long suffering underpinned by the consumption of drugs. But this process may also be creating bacteria resistant to those drugs. The use of last-resort antibiotics for humans such as colostin, is increasing according to official data. When colostin is used it can indicate other antibiotics were ineffective against the harmful bacteria.
So what has this got to do with fermentation and probiotics? Firstly antibiotics generally kill and inhibited some good bacteria. Where health is at risk this is clearly an appropriate course of action. However as the importance of gut flora to health becomes better understood we should consider the need to maintain gut bacteria at healthy levels. Secondly the better our overall health the lower the risk of illness and presumably the less need there will be to take antibiotics. Just to be clear, probiotics are not a substitute for antibiotics, there are some very dangerous bacteria in our environment for which antibiotics may be the only cure. My position is to abandon the overuse of antibiotics in animals and humans so that when we (and animals) get really sick we will have antibiotic treatments that continue to work. The third point is eating animals that have lived a life in potentially dangerous bacteria, sustained by routine antibiotic consumption seems irrational. Wouldn’t it make more sense to maintain animals in healthy conditions, with feed rich in probiotics, reducing the need for antibiotics in all but essential cases?
Show someone your love by taking an interest in their long-term health and wellbeing. Fermentation is a game changer.
The media (traditional and social) are full of valentine news, view and suggestions. Local traders, shops and supermarkets have an overwhelming array of products linked to St Valentine’s day. However the way in which you decide to treat your loved one says a lot about you. Whilst chocolates, Champagne or roses spring immediately to mind they may by simple clichés of what people are supposed to give, rather than lasting indications of love.
Perhaps a different approach would be to offer your partner (and yourself) something likely to offer nourishment and a lasting health benefit. It is easy to overstate the qualities of naturally fermented probiotics. But we can feel confident that they are likely to make a long lasting contribution to wellbeing in a number of ways. Evidence is starting to emerge that positive gut flora, may be correlated with, stable weight, and generally improved physical and mental health across a number of measures.
Clearly probiotics are not just for February the 14th, and moving towards a healthy diet is a long term project. But talking about fermented foods or trying them for the first time, may be a great way of showing your partner that you really care, and that you want them to enjoy the best possible health. When you create fermented foods at home, not only are your own family exposed to the product, but the idea and your positive actions can influence a wide circle of friends. Something that can’t be said of a bottle of fizz or a bunch of roses.
Whatever you do, and whoever you do it with have a great day.