Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review

Benef Microbes. 2018 Jun 15;9(4):603-611. doi: 10.3920/BM2017.0125. Epub 2018 Apr 26.


Evidence suggests that the gut microbiota might play an important role in fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS). Our goal is to systematically review the reported effect of probiotic treatments in patients diagnosed with FMS or CFS. A systematic review was carried out using 14 databases (PubMed, Cochrane Library, Scopus, PsycINFO, and others) in February 2016 to search for randomised controlled trials (RCTs) and pilot studies of CFS or FMS patient, published in the last ten years (from 2006 to 2016). The Jadad scale was used to asseverate the quality of the clinical trials considered. Two studies (n=83) met the inclusion criteria, which were performed in CFS patients and both studies were considered as a 'High range of quality score'. The administration of Lactobacillus casei strain Shirota in CFS patients, over the course of 8 weeks, reduced anxiety scores. Likewise, this probiotic changed the faecal composition following 8 weeks of treatment. Additionally, the treatment with Bifidobacterium infantis 35624 in CFS patients, during the same period, reduced inflammatory biomarkers. The evidence about the usefulness of probiotics in CFS and FMS patients remains limited. The studied strains of probiotics have demonstrated a significant effect on modulating the anxiety and inflammatory processes in CFS patients. However, more experimental research, focusing mainly on the symptoms of the pathologies studied, is needed.

Keywords: chronic fatigue syndrome; fibromyalgia; gut-brain axis; microbiota; nutrition; probiotics; systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Anxiety / psychology
  • Cytokines / analysis
  • Fatigue Syndrome, Chronic / immunology
  • Fatigue Syndrome, Chronic / microbiology
  • Fatigue Syndrome, Chronic / psychology
  • Fatigue Syndrome, Chronic / therapy*
  • Feces / microbiology
  • Fibromyalgia / immunology
  • Fibromyalgia / microbiology
  • Fibromyalgia / psychology
  • Fibromyalgia / therapy*
  • Gastrointestinal Microbiome / drug effects
  • Humans
  • Probiotics / pharmacology
  • Probiotics / therapeutic use*
  • Quality of Life


  • Cytokines