A randomized, double-blind, placebo-controlled pilot study of a probiotic in emotional symptoms of chronic fatigue syndrome
Open accessAbstract
Chronic fatigue syndrome (CFS) is complex illness of unknown etiology. Among the broad range of symptoms, many patients report disturbances in the emotional realm, the most frequent of which is anxiety. Research shows that patients with CFS and other so-called functional somatic disorders have alterations in the intestinal microbial flora. Emerging studies have suggested that pathogenic and non-pathogenic gut bacteria might influence mood-related symptoms and even behavior in animals and humans. In this pilot study, 39 CFS patients were randomized to receive either 24 billion colony forming units of Lactobacillus casei strain Shirota (LcS) or a placebo daily for two months. Patients provided stool samples and completed the Beck Depression and Beck Anxiety Inventories before and after the intervention. We found a significant rise in both Lactobacillus and Bifidobacteria in those taking the LcS, and there was also a significant decrease in anxiety symptoms among those taking the probiotic vs controls (p = 0.01). These results lend further support to the presence of a gut-brain interface, one that may be mediated by microbes that reside or pass through the intestinal tract.
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L. casei strain significantly reduced anxiety symptoms in patients with chronic fatigue syndrome.
“Furthermore, L. casei strain significantly reduced anxiety symptoms in patients with chronic fatigue syndrome (Rao et al. 2009)”
From Therapeutic effect of GLP-1 engineered strain on mice model of Alzheimer’s disease and Parkinson’s disease (2020) · cites this paper as Rao et al. 2009
There is preliminary evidence for reduced subjective feelings of anxiety and improved aspects of well-being after probiotic intake.
“Additionally, there is now preliminary evidence for reduced subjective feelings of anxiety and improved aspects of well-being after probiotic intake (Rao et al. 2009; Messaoudi et al. 2011).”
From Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers (2015) · cites this paper as Rao et al. 2009
The current results differ from previous findings that indicate subjective anxiolytic effects of probiotics.
“The current results also differ from previous findings that indicate subjective anxiolytic effects of probiotics (Rao et al. 2009; Messaoudi et al. 2011) as we found no effects of prebiotics on subjective measures of subclinical anxiety or perceived stress.”
From Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers (2015) · cites this paper as Rao et al. 2009
In individuals with chronic fatigue syndrome, 8 weeks of L. casei (8×10^7 CFU) reduced anxiety symptoms.
“A study by Rao et al. [277], reported that 8 weeks of 8 × 107 CFU of L. casei given to individuals with chronic fatigue syndrome reduced anxiety symptoms.”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [277]
In adults with chronic fatigue syndrome, 8 weeks of the same probiotic preparation had no effect on depression but significantly improved Beck Anxiety Inventory scores compared with placebo.
“There was no effect on depression, but those receiving the probiotic demonstrated significant improvement on the Beck Anxiety Inventory compared with the placebo group.131”
From The Gut Microbiome and the Brain (2014) · cites this paper as [131]
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- Authors
- Rao, A. V., Bested, A. C., Beaulne, T. M., Katzman, M. A., Iorio, C., Berardi, J. M., & Logan, A. C.
- Affiliations
- University of Toronto (CA)
- Women's College Hospital (CA)
- START Clinic (CA)
- Corresponding author
- Logan, Alan C
- Venue
- Gut Pathogens
- Published
- 2009-03-19
- Volume
- 1
- Issue
- 1
- Pages
- 6-6
- ISSN
- 1757-4749 (ISSN-L)
- PMC
- PMC2664325
- OpenAlex
- W2024392981
- Cited by
- 577
- References
- 31
- Citations by year
- 2026: 12 · 2025: 43 · 2024: 23 · 2023: 38 · 2022: 46 · 2021: 42 · 2020: 53 · 2019: 48 · 2018: 48 · 2017: 48 · 2016: 50 · 2015: 46 · 2014: 31 · 2013: 21 · 2012: 9
- FWCI
- 14.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Gut Pathogens (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- chronic fatigue syndrome, probiotics, Lactobacillus casei Shirota, anxiety, depression, gut microbiota, gut-brain axis, Bifidobacterium, functional somatic syndromes, mood symptoms
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