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The gut microbiota can alter this relationship to maintain homeostasis [13]

and it often causes major functional and emotional burden

Ethics declarations Ethics Approval and Consent to Participate Ethics approval was obtained from the Animal Ethics Committee of Joint Service Support Force 940 Hospital of PLA, and the experiment met the requirements of animal ethics

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The intestinal microbiota is directly implicated in the generation of trimethylamine from dietary choline and its metabolite phosphatidylcholine, as well as from dietary betaine and carnitine

119 However, a later systematic review of 32 randomized controlled trials in nearly 5,000 patients with various types of chronic pain, including fibromyalgia, found internet delivered CBT had small benefits for pain and functional disability, but these improvements were not sustained over time