Multi-Strain Probiotic Improves Tryptophan Metabolism and Symptoms in Chronic Fatigue Syndrome Patients with Co-Occurring Irritable Bowel Syndrome: An Open-Label Pilot Study.

Fatigue Severity Scale (FSS) Trajectory Probiotic intervention resulted in a continuous and highly significant reduction in fatigue severity across all time points (Friedman test: chi2 = 103.41, p < 0.001).

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Quinolinic acid (QA) showed a nominal decrease (median: 4.13 to 3.92 mg/gCr; p = 0.038), but this change did not reach statistical significance after correction for multiple comparisons ( q = 0.062) ( Figure 5 A). 3.3.3.

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The serotonin pathway marker, 5-HIAA, did not differ in absolute concentration, but the 5-HIAA/TRP turnover ratio showed a borderline significant elevation ( q = 0.052) ( Figure 3 D). 3.3.

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Tryptophan (TRP) availability showed a trend toward increase, but this was not statistically significant ( p = 0.073; q = 0.105) ( Figure 5 D). 3.4.

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