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Links between Serotonin Levels and Stress: Cortisol, Candida a./Mycetes, Omega 3/6 ratio and Dysbiosis (Skatole/Indoxyl Sulfate) Role in Chronic Fatigue Syndrome (CFS) and Depression

Abstract

Daniele Orlandoni 1* , Giuseppe Di Fede 1,2 , Mauro Mantovani 1 , Nava Consuelo 3 , Marco Tomasi 4 and Paola Fusi 5

Thanks to the large amount of evidence, a broader and more multidisciplinary vision of the intestine has emerged refers to the role that this anatomical structure plays in human body. A new sophisticated conception has arisen which has imposed a different approach in terms of investigating bowel importance and the repercussions that its functional deficit has towards other systems directly or indirectly related to it. It is, in fact, a complex structure interconnected with other systems (nervous, endocrine and immune) whose efficiency is strongly influenced by a condition of dysbiosis.

Intestinal microbiota attracts daily attention of a growing number of researchers and the data accumulated today allow us to highlight how dysbiosis plays a very important role in Irritable Bowel Syndrome (IBS), Inflamed Bowel Syndrome (IBD), Crohn's disease (CD) and even in Leaky Gut Syndrome (LGS) rather than Polycystic Ovary Syndrome (PCOS), food intolerance, diabetes, metabolic syndrome and fibromyalgia, cancer, etc.. However the composition of the microbiota is influenced diet, use/abuse of drugs, lifestyle and especially from stress and its reverberation on the Autonomous Nervous System (ANS), etc.

In our study we wanted to analyze how a condition of intestinal dysbiosis may be related to chronic fatigue syndrome (CFS) and depression through the exchange of information through the intestinal-brain axis (GBA).

We studied 33 subjects, 13 males and 20 females, who reported chronic fatigue syndrome or/and depression: We investigated their salivary cortisol levels, blood serotonin (5-hydroxytryptamine, 5-HT), omega 3/6 ratio, intestinal dysbiosis (calculated on the levels of urinary metabolites of tryptophan-TRP-: Indoxyl sulfate and skatole), and we looked for the presence of Candida a. or mycetes in the stool.

The data accumulated with this research show a correlation between the presence of Candida a./miceti, indoxyl sulfate urine values ??beyond the physiological (characteristic of dysbiosis) and low 5-HT levels. In addition, data analysis showed that the EPA/DHA values ??also show pro-inflammatory levels in case of dysbiosis and low 5-HT levels.

The relationship, however, with cortisol levels requires further research although this study showed a statistically significant positive correlation between these values, measured at specific times, and 5-HT levels.

With this research we wanted to try to highlight the existing contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.

Aim: We investigated the relationship between stress (evaluated through the measurement of salivary cortisol levels) and gastrointestinal efficiency measured as a function of intestinal fermentative and putrefactive dysbiosis, evaluating the levels of urinary indoxyl sulfate in the first case (a possible correlation with the presence of Candida a. or mycetes in the subjects feces was investigated), urinary skatole levels in the second one, in patients with chronic fatigue syndrome (SFC) and depression. In these patients we also have studied omega 3/6 ratio. Finally we have analyzed the impact that the alteration of all these parameters can have on the 5-HT levels.

This research attemps to highlight the contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.

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