The Link Between Post-Viral Fatigue and Gut Health

The Link Between Post-Viral Fatigue and Gut Health

Post-viral fatigue syndromes, such as chronic fatigue syndrome (CFS) and the like, are debilitating conditions that can occur following viral infections. Many people report debilitating energy losses, problems with thinking clearly, and ongoing headaches, nausea and mood problems. 

While the exact causes of these syndromes remain elusive, emerging research suggests that the gut microbiome, intestinal permeability, and gut-brain connection play a crucial role in our risk of going on to develop post-viral syndromes. 

The Gut Microbiome and Intestinal Permeability

The gut microbiome, a complex ecosystem of trillions of microorganisms residing in our gastrointestinal tract, plays a pivotal role in maintaining our overall health. Recent studies have shown that alterations in the gut microbiome composition, known as dysbiosis, are associated with various health conditions, including poor immunity, metabolic and mood disorders, inflammation and post-viral fatigue syndromes.

Research has demonstrated that dysbiosis can contribute to increased intestinal permeability, commonly referred to as "leaky gut." When our intestinal barrier becomes compromised, toxins, microbial metabolites, and undigested food particles can pass through and enter the bloodstream, triggering aberrant immune responses. This heightened immune activation can lead to chronic inflammation and further perpetuate a dysregulated gut and immune system that can lead to post-viral fatigue syndromes.

Gut-Brain Connection and Neuroinflammation

The gut-brain connection refers to the bidirectional communication between the gut and the central nervous system (CNS) through neural, immune, and endocrine pathways. The gut microbiome influences this communication by producing various metabolites and neurotransmitters that can directly affect brain function and our behaviour.

In the context of post-viral fatigue syndromes, dysbiosis-induced inflammation in the gut can trigger neuroinflammation, a state of chronic inflammation in the brain. Neuroinflammation has been linked to the development of several neurological disorders, including fatigue syndromes. It is believed that inflammatory molecules released by the gut microbiota can cross the blood-brain barrier, causing neuroinflammation and contribute to fatigue, cognitive impairment (brain fog), and other symptoms experienced by individuals with these syndromes.

Preventing Post-Viral Fatigue Syndromes:

Given the intricate connection between the gut microbiome, intestinal permeability, and post-viral fatigue syndromes, addressing gut health and nutritional deficiencies may offer potential avenues for the prevention and management of these conditions.

Improving the Gut Environment

Promoting a diverse and balanced gut microbiome is crucial for overall health. Consuming a diet rich in fibre, fermented foods (e.g., yogurt, sauerkraut), and prebiotic-rich foods (e.g., onions, garlic, leeks) can help nourish our beneficial gut bacteria populations. 

Probiotic supplements, such as Lactobacillus, Bifidobacterium and Bacillus coagulans strains, may also be beneficial in restoring ‘good bacteria’ to favourably support a healthy microbial balance and to crowd out unfriendly species causing problems. 

Prebiotic fibres, such as partially hydrolysed guar gum (PHGG), acacia fibre and banana starch can be supplemented to help facilitate the fuel (food) our good gut bacteria need to multiply and survive, as well as positively influence the gut environment (such as pH) to make it a desirable place for our friendly bacteria to flourish.

Supporting and Restoring Gut Wellbeing During and After Antibiotics

One of the major ways the gut becomes compromised is through antibiotic therapy. It goes without saying, that antibiotics are an important tool to be able to access when we need to get on top of serious infections. However, without proper attention being paid to replenishing a stripped gut environment post-antibiotics, we can set ourselves up for further health problems. 

Antibiotics indiscriminately kill bacteria. They do not preferentially kill just the bad (pathogenic) bacteria, but our good bacteria get wiped out in the crossfire. Our gut then has a huge workload ahead of it, to restore and replenish the depleted system once we stop our antibiotic therapy. Just like sand dunes at the beach become compromised without a network of vegetation to hold them together, similarly, the gut can quickly become compromised if we don't have access to the right nutrients, fibres and foods that help rebuild some of this lost function. 

Getting into the habit of thinking that ‘the real work begins’ once we stop antibiotic therapy, can go a long way to restore losses in gut function, and provide some support and protection from going on to develop secondary health problems, such as post-viral syndromes. 

Removing Potential Gut-Immune Triggers

When the gut environment has become compromised, the barrier lacks the structural integrity to prevent foreign particles from entering our bloodstream. So whilst soothing and healing the gut lining is vitally important, reducing or completely removing many inflammatory triggers can help reduce the burdens upon the compromised gut-immune interface. This frees up the gut to focus on healing, repair and essential maintenance. 

Triggers may include;

  • High sugar diets
  • Gluten
  • Dairy
  • Alcohol
  • Preservatives
  • Other food groups that you may be sensitive to, such as salicylates, oxalates, or amines.

Removing triggers doesn’t have to be permanent, but can go a long way to helping the gut to hone its workload into healing, rather than defending and constantly putting out ‘spot fires’. 

Nutrient Deficiencies Compromise Immune Resilience

Post-viral fatigue syndromes are often associated with nutrient deficiencies, such as vitamin D, B vitamins, magnesium, and omega-3 fatty acids. Optimising nutrient intake through a balanced diet and/or targeted supplementation, can help provide our body with the resources it needs when you need to fight off illness and maintain long-term wellbeing. 

Stress Erodes Gut and Nervous System Health

As the saying goes, an ounce of prevention is worth a pound of cure. Most of us experience fluctuating stress levels in our everyday life. Work, family, financial stress, whatever it may be, we should take steps to identify where we can implement ways to nourish and support our nervous system to ride the waves of stress so we can manage our health accordingly. 

Stress places a significant burden on our nutrient needs. We burn through many important nutrients as stress levels surge, such as vitamin C, zinc, B vitamins and magnesium. If we identify that we’re under stress, it can be worthwhile considering the levels of these nutrients as they are also important for our energy production, neurotransmitters (mood) and immunity. 

If we know we’re under significant stress, we can also turn to many wonderful relaxing herbal medicines to support our nervous system wellbeing. Herbs such as Ashwagandha, Withania, Rhodiola and L-theanine fom Green Tea, all help to reduce the burden stress can place on our body. Many of the herbal medicines that support stress have spill-over effects into other systems of the body such as inflammation, gut health and immunity.

Stress also decimates our microbiota and important first-line immune defence systems, such as secretory IgA. So staying on top of gut health is vitally important during times of stress. 

Supporting Gut Health Transforms Wellbeing

It’s no wonder there is a connection between post-viral fatigue syndromes and gut health status. 

A healthy gut is an important gateway to;

  • Improving immune resilience
  • Supporting healthy microbiota, that serve our wellbeing
  • Better availability of nutrients, due to proper functioning digestive capabilities
  • Better mood, concentration and performance
  • Controlling systemic inflammatory load
  • And much more. 

Look after your gut, so it can look after you.


König RS, et al. The Gut Microbiome in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). Front Immunol. 2022 Jan 3;12:628741. 

Wade G. Chronic fatigue syndrome linked to lower levels of some gut bacteria. New Scientist 2023 Feb 8 

Maes M, et al. Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria. Neuro Endocrinol Lett. 2008;29(6):902-910.

Liu Q, et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut 2022;71:544-552.

Osgood M. Chronic fatigue syndrome is in your gut, not your head. 2016 Jun 27 Science Daily

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