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Increased d-lactic acid theory Another theory regarding the reduced intestinal pH and increased gut permeability in ME/CFS patients is the increased production of D-lactic acid due to the overgrowth of Gram-positive bacteria such as Enterococci and Streptococci, which leads to systemic inflammation, immune activation, and oxidative stress [22, 44]

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Abstract Fungal sulfur uptake is required for incorporation into the sidechains of the amino acids cysteine and methionine, and is also essential for the biosynthesis of the antioxidant glutathione (GSH), S -adenosylmethionine (SAM), the key source of methyl groups in cellular transmethylation reactions, and S -adenosylhomocysteine (SAH)