Intestines and Microbiome (contain over 75% of immune system cells)
Tests for Intestinal  toxic damage with effects on the immune system, mitochondria, glands and nervous system (Found in high percentage of ME cases)
(a) International and Canadian Criteria
(b) Tests for Leaky gut & Intestinal Dysbiosis
(c) Enteroviruses in the intestine
(d) Colonoscopy and Endoscopy to investigate intestinal abnormalities
(e) Test for Digestive status and Nutritional status & Vitamin and mineral status of patient
(f) Celiac test & Helicobacteria pylori test
g) Gluten Intolerance and Lactose Intolerance tests
(h) Cardiac and Vascular factors in bowel dysfunction
(i) Diet Analysis Test

Scientific and Medical Evidence - Listing of Research conducted worldwide section :
Intestinal abnormalities and Microbiome
Skin rashes, acne and allergies worsen after the onset of CFS
Environmental Toxins and hazards
Increased risk of Cancer
Increased oxidative stress
Abnormal levels of serum Chromogranin-A. Evidence of Celiac disease in some CFS patients
Genetic markers subsections.



Over 70% of the body's immune system cells are located in the GI tract. Intestinal dysfunctions, such as those seen in ME patients can adversely affect immune system function. Furthermore infections in the intestines can travel to other parts of the body via permeable gut, the blood supply, and through the nerves connecting to the gut. The NIH in the USA has made some important new discoveries in relation to the intestines, microbiome and the immune system. They have found that the gut plays an important role in immune dysfunctions and abnormalities, the lymph system, and autoimmune illnesses.



(a) ME Primer for Healthcare Professionals: based on Myalgic encephalomyelitis: International Consensus Criteria, 2012

Source: ME Primer for Healthcare Professionals: based on Myalgic encephalomyelitis: International Consensus Criteria, 2012

Also use Canadian Criteria 2003

(b) Tests for Leaky gut & Intestinal Dysbiosis

(i) Leaky gut
This is present in most ME/CFS patients and contributes to malabsorption, allergies, chronic inflammation and chronic immune activation.

Some research findings
Maes M, Coucke F, Leunis JC: Normalization of the increased translocation of endotoxin from Gram negative enterobacteria (leaky gut) is accompanied by a remission of chronic fatigue syndrome. Neuro Endocrinol Lett 2007, 28:739-744.

What Is Hiding in Your Gut? ME/CFS, Leaky Gut, Enteroviruses, and the Potential for Treatment

Check with specialists / consultants at your regional hospital or top state hospital or private labs to see if they do these special tests. If not, then the following labs can carry out these special tests.

Test for increased serum levels of IgA and IgM against the LPS of gram-negative enterobacteria, indicating the presence of an increased gut permeability which may contribute to the autoimmmunity seen in many ME/CFS patients. There are other tests which can confirm leaky gut. Contact the following labs :

Genova Laboratory

Redlabs in Belgium

European Laboratory of Nutrients, the Netherlands

Gut Fermentation Profile Test - Biolab Medical Unit

Metametrix labs


(ii) Intestinal Dysbiosis

Specific Breath test and Urine test recommended by Dr. Kenny De Meirleir, Belgium.

Dr. Kenny De Meirleir who has studied ME since the early 1990's and has developed an expertise in the subject recommends the following:

  • A breath test to diagnose overgrowth of bacteria in the gut. In a study of 143 patients, fructose malabsorption was found in 45.8% of patients. Lactose intolerance was found in 20.3%. Both can be measured via a simple hydrogen breath test:

     25 grams of fructose or lactose is administered to a fasting patient.

     Breath hydrogen levels are measured before administration and at 30 minute intervals for 3.5 hours.

  • A urine test to detect high levels of hydrogen sulfide. The test is related to the diagnosis and treatment of ME/CFS.These diagnostic tests are available at the following web address -
  • Research paper is available by clicking here

    More info. at: and

  • Research paper: Unraveling the origins of ME : Gastrointestnal Dysfunction, Production of Neurotoxins, and Environmental Exposure. Dr. Kenny De Meirleir et al. (2009)
  • Video

  • Cornell University, USA
    Ongoing research (2016) by Professor Maureen Hanson — Liberty Hyde Bailey Professor, Department of Molecular and Genetics, Cornell University, New York, USA has found abnormally high levels of  levels of lipopolysaccharides (LPS), as well as LBP and soluble CD14 (which are a natural consequence of high levels of LPS) in ME patients. They also found reduced levels of anti-inflammatory bacterial species (ruminococcae, which produce butyrate, an anti-inflammatory fatty acid) and species of bifidobacterium (which produce lactic acid) in ME/CFS patients. And with a combination of blood and gut tests they could identify 83% of sample correctly as coming from patients or controls. Tests are being developed to deliver 90 - 100% accuracy.


Blastocystis hominis

This is a parasite infection which can cause chronic fatigue, exhaustion, bloating cramping, diarrhea, excessive gas, irritable bowel syndrome. Many ME and CFS patients have this infection. This will require specialised tests in a hospital or private clinic.


(iv) Small Intestinal Bacterial Overgrowth (SIBO)
This can cause bloating, stomach cramps, diarrhea, heartburn, anemia, malabsorption, joint pain, cognitive problems, brain fog, constant fatigue, rashes, and headaches. A Gatroenterologist can test for this condition. The following videos by Dr. Siebacker can inform one about this condition.


(v) Inflammatory Bowel disease
- Faecal calprotectin test is recommended by Dr. Sarah Myhil
- Ulcerative Colitis and Crohns disease tests: Gut Immunology Profile Test

(vi) Comprehensive Digestive Stool Analysis with parasitology & Comprehensive parasitology test

It has been well established in medical science that chronic parasite infection of the intestines can cause extreme fatigue, brain fog and weakness. The weakened immune system in ME leaves patients very vulnerable to such infections. There is a sub-group of patients who have chronic parasite infections. Test for giardia, candida, roundworm, tapeworm, hookworm, pinworm, beefworm, amoebas, intestinal flukes, protozoal intestinal parasites, ascaris lumbricoides, Schistosoma blood flukes, Cryptosporidium. Use of private laboratories using modern technologies are recommended.

Comprehensive Intestinal Tests

- Genova Laboratory
- Metametrix Labs Microbial ecology profile
- Hypochlorhydria (Lack of stomach acid) Vascular endothelial growth factor (VEGF)- salivary test for hypochlorhydria

- Hypochlorhydria (Lack of stomach acid)
This can lead to poor digestion and absorption and to parasites.
- Vascular endothelial growth factor (VEGF)- salivary test for hypochlorhydria

(ix) Test Histamine levels
High histamine levels in the intestines can be caused by bad bacteria or intestinal dysbiosis or ingesting foods which raise histamine levels. Also impaired serum diamine oxidase (DAO) activity can lead to high histamine levels in the gut and the body. Histamine can increase inflammation in the gut and throughout the entire body, reduce digestion and absorption, and adversely affect the immune system and worsen the symptoms of ME. High histamine levels have been found in ME patients. It is a good indicator of intestinal dysbiosis.

  • Test serum diamine oxidase (DAO) activity
  • Test stool for histamine levels
  • Test intestines for histamine levels
  • Does the patient ingest foods and drinks with high histamine levels. High histamine levels in fish, cheese, hard cured sausages, sauerkraut, pickled cabbage, fermented foods, and alcoholic beverages
  • Does the patient take medical drugs or foods which impair diamine oxidase (DAO) activity in the gut
  • Does the patient have too much inflammation in the body - allergies, sinusitis, hives, eczema, inflammatory cytokines, etc. ?

- Serum diamine oxidase (DAO) activity as a diagnostic test for histamine intolerance. Ema Music. Mira Silar, Peter Korosec, Mitja Kosnik, Matija Rijavec. Clinical and Translational Allergy 2011, 1 (Suppl 1):P115
- Serum diamine oxidase activity as a diagnostic test for histamine intolerance. Mušic E, Korošec P, Šilar M, Adamic K, Košnik M, Rijavec M. Wien Klin Wochenschr. 2013 May;125(9-10):239-43.
Histamine and histamine intolerance. Laura Maintz and Natalija Novak. Am J Clin Nutr vol. 85 no. 5 1185-1196
Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches. Wantke F1, Götz M, Jarisch R. Clin Exp Allergy. 1993 Dec;23(12):982-5.
- Identification of a proton-chloride antiporter (EriC) by Himar1 transposon mutagenesis in Lactobacillus reuteri and its role in histamine production. Hemarajata P, Spinler JK, Balderas MA, Versalovic J.
- Lactobacillus reuteri-specific immunoregulatory gene rsiR modulates histamine production and immunomodulation by Lactobacillus reuteri. Hemarajata P, Gao C, Pflughoeft KJ, Thomas CM, Saulnier DM, Spinler JK, Versalovic J.
- Effect of chemico-physical parameters on the histidine decarboxylase (HdcA) enzymatic activity in Streptococcus thermophilus PRI60. Tabanelli G, Torriani S, Rossi F, Rizzotti L, Gardini F.
- Isolation and characterization of histamine-producing bacteria from fermented fish products. Moon JS, Kim SY, Cho KJ, Yang SJ, Yoon GM, Eom HJ, Han NS.
- Tyrosine- and histidine-decarboxylase positive lactic acid bacteria and enterococci in dry fermented sausages. Komprda T, Sládková P, Petirová E, Dohnal V, Burdychová R.
- PubMed articles on histamine and gut bacteria

Test for Candida Overgrowth
Test stool and urine, blood IgM and IgG and other blood subsets for Candida.
Genova Laboratory
Candida Antibody Profile - Saliva and Candida Antibody Profile - Blood
Redlabs in Belgium
Fitzwilliam FoodTest clinic, Dublin -

(xi) Test for Protein M

Bacteria and other pathogens have evolved to use a protein called 'Protein M' to block all antibodies produced by the human immune system. This remarkable discovery by scientists at the Scripps Research Institute in 2014 sheds new light on chronic bacteria infections in humans. As many ME patients have chronic infections, this information is important. Tests are being developed for Protein M. See paper below

Enteroviruses in the Intestines
Test intestinal tissue & muscle tissue for enteroviruses. Dr. Chia's test is the most accurate and reliable at present. Click on link for info. EV MED Research Enterovirus VP1 Immunoperoxidase stain Test Request Form (Dr. Chia)

The Enterovirus Foundation run by medical doctors and researchers provide timely updates on accurate enterovirus diagnosis -

Also the Wisconsin Viral Research Group (
Viracor  (  and
Genova Laboratory

Redlabs in Belgium

Dr. John Chia, is a world renowned doctor who has successfully treated ME patients. He has found that Enteroviruses are present in some subgroups of ME patients and that treating these Enterovirus infections can lead to significant improvement and recovery. He presents his medical experiences in the videos below:




(d) Colonoscopy and Endoscopy to investigate intestinal abnormalities

If you have severe intestinal problems over several weeks or months or years, you should consult a Gastroenterologist and seek his / her advise. They may ask you to undertake a colonoscopy and endoscopy to investigate intestinal abnormalities. This procedure is undertaken in a major hospital. These tests will measure intestinal structure and the existence of blockages, malformations, tumours, and serious infections. They do not measure intestinal function, performance and absorption of nutrients.
Also get Gut motility tests. Abnormalities are commonly found in ME patients


(e) Test for Digestive status & Vitamin and mineral status of patient

Check with specialists / consultants at your regional hospital or top state hospital or private labs to see if they do these special tests. If not, then the following labs can carry out these special tests. The best laboratories for this type of testing is the

Genova Laboratory

MetaMetrix Medical Laboratory.

Redlabs in Belgium

European Laboratory of Nutrients, the Netherlands


Vitamins, minerals, amino acids and fatty acids status of patient

Metametrix labs

Genova Laboratory

European Laboratory of Nutrients, the Netherlands

Biolab Medical Unit

(f) Celiac Test
& Helicobacteria pylori test

Celiac test can be carried out at the following:

Metametrix labs

Fitzwilliam FoodTest clinic, Dublin -

TDL laboratory

Test for Helicobacter pylori antibodies

TDL laboratory


(g) Gluten Intolerance and Lactose Intolerance tests

Gluten intolerance and Gluten allergy is common in ME/CFS patients. The saliva test is the most accurate test at present. Dr. Edward Conley of the Fatigue, Fibromyalgia and Autoimmune Clinic, Michigan, USA has information about these new saliva tests.

These test can be carried out at the following:

Metametrix labs

Fitzwilliam FoodTest clinic, Dublin -

Genova Laboratory

TDL laboratory

Darina Joyce Clinic, Galway


(h) Cardiac and Vascular factors in bowel dysfunction

Dr. Byron Hyde has found that this is a significant factor in many cases of ME.

'Bowel Dysfunction: vascular dysfunction may be the single most causal basis behind bowel dysfunction when it occurs.'
A Brief History of Myalgic Encephalomyelitis, by Dr. Byron Hyde


(i) Diet Analysis Test

Do you eat foods containing high levels of toxins and inflammation agents ?

  • hot dogs, sausages and cured meats which contain nitrosamines
  • sodas and fizzy drinks and diet drinks containing aspartame
  • foods containing MSG
  • foods containing GMO's
  • foods containing hydrogenated fats, trans fatty acids, and saturated fats. Margarine, canola oil, corn oil, peanut oil, soya oil, safflower oil
  • mucous forming foods such excessive potatoes, french fries (chips), cookies and sweets
  • refined sugars and foods containing refined sugars which can cause immune dysfunctions and inflammation. Stevia is healthier and safer.
  • processed and packaged foods containing additives and flavourings with E numbers
  • foods containing mercury – tuna, swordfish, shark
  • foods containing toxin residues from the land (arsenic in some rice)
  • table salt. Sea salt is healthier and safer.
  • chlorine in bathing / swimming water
  • flouride in drinking water
  • unfiltered drinking water

all of these increase toxin load on the body, and inflammation, with adverse effects on the body, in particular the immune system, the DNA, the mitochondria, the endocrine system and the brain and nervous system. Eliminate these foods and drinks from the diet.



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