Salivary Cortisol Profiles in Chronic Fatigue Syndrome

Wood, Barbara; Wessely, Simon; Papadopoulos, Andrew; Poon, Lucia; Checkley, Stuart

doi:10.1159/000026469

Cited by 51 publications

(30 citation statements)

References 22 publications

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“…This has not been previously described in CFS -as two small studies did not find such differences [15,16] although it has been reported in fibromyalgia [18], pain syndromes [19] and of course depressive illness [20]. However, in each of these reports the lack of diurnal variation has accompanied elevated plasma cortisol levels rather than the mild hypo-cortisolaemia generally found in CFS.…”

Section: Discussionmentioning

confidence: 70%

“…The effect sizes of these differences, extracted from the published figures, are -0.7, -3.8 and +5.5 respectively. Another group have also found a non-significant reduction in baseline morning cortisol levels [14], while two other small studies have recently reported non-significant elevations in morning cortisol [15,16], but none of these have reported exact figures that would allow effect size computation. Demitrack et al [2] reported significantly lower evening cortisol levels in CFS (effect size -2.9), which still requires replication as the trend of our result (effect size +0.2) and those of other published reports [15,16] is against this.…”

Section: Discussionmentioning

confidence: 99%

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Diurnal Variation of Adrenocortical Activity in Chronic Fatigue Syndrome

et al. 1998

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Baseline morning and evening serum cortisol and ACTH concentrations, and diurnal changes in hormone levels, were measured in 30 patients with chronic fatigue syndrome (CFS) but without concurrent depressive disorder and a control group of 15 weight-, age- and sex-matched healthy volunteers. Morning cortisol levels were non-significantly lower in CFS patients, while evening levels were non-significantly higher. ACTH concentrations were non-significantly higher in both the morning and evening. The diurnal change in cortisol levels was significantly less in CFS than in controls (p < 0.05). In CFS subjects, evening levels of cortisol correlated significantly with measures of general health and physical functioning, while diurnal change in cortisol was positively correlated with measures of functional improvement over the past year and current social functioning. These results suggest that there is a relationship between adrenocortical function and disability in CFS, but do not reveal the causal connection.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Diurnal Variation of Adrenocortical Activity in Chronic Fatigue Syndrome

et al. 1998

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“…In summary, in about half of the investigations there was evidence for lowered cortisol levels in CFS. There is only 1 report of elevated salivary cortisol levels in CFS [16] . In all the other studies, no differences were found between CFS patients and control individuals.…”

Section: Hpa Axis Disturbances In Cfsmentioning

confidence: 99%

Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

Eede

Moorkens

Houdenhove³

et al. 2007

Neuropsychobiology

110

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There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in a proportion of the patients with chronic fatigue syndrome (CFS), despite the negative studies and methodological difficulties. In this review, we focus on challenge studies and on the role of the HPA axis in the pathogenesis of CFS. Mild hypocortisolism, blunted adrenocorticotropin response to stressors and enhanced negative feedback sensitivity to glucocorticoids are the main findings. Several underlying mechanisms have been proposed. Currently, it is a matter of debate whether these disturbances have a primary role in the pathogenesis of CFS. However, even if the HPA axis dysfunctions are secondary to other factors, they are probably a relevant factor in symptom propagation in CFS.

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“…Because abnormal thyroid function can be a common cause of fatigue, and this fatigue resolves with adequate treatment [7], patients with hypo-or hyperthyroidism are excluded from a diagnosis of CFS. Several studies have suggested that mild hypocortisolemia might be a cause of the fatigue in CFS [8][9][10], but other studies have failed to find abnormal cortisol (CORT) levels in CFS patients [11] or have found elevated adrenocortical hormones [12]. Because the subjects in this study were female, and ovarian cycles and estrogens can affect pituitary-adrenal function, plasma estradiol (E 2 ) was measured in this study.…”

mentioning

confidence: 93%

Hormonal Responses to Exercise in Chronic Fatigue Syndrome

et al. 2001

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Chronic fatigue syndrome (CFS) is a debilitating disease characterized by severe, unexplained fatigue and postexertional exacerbation of symptoms. We examined basal endocrine function in a group of CFS patients and a carefully matched group of sedentary controls. The subjects then completed a graded, maximal exercise test on a treadmill, and additional blood samples were drawn 4 min and a day after the end of exercise. There were no differences in basal hormone levels before exercise. Plasma adrenocorticotropin, epinephrine, prolactin and thyrotropin responses 4 min after exercise were lower in the CFS group, but the growth hormone response may have been exaggerated, and the plasma norepinephrine response was similar to that in controls. The next day, there were no differences in hormone levels between the groups, which suggests that long-term changes in endocrine function are unlikely to be a cause of the prolonged fatigue that occurs in CFS patients after a bout of exertion.

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Salivary Cortisol Profiles in Chronic Fatigue Syndrome

Cited by 51 publications

References 22 publications

Diurnal Variation of Adrenocortical Activity in Chronic Fatigue Syndrome

Diurnal Variation of Adrenocortical Activity in Chronic Fatigue Syndrome

Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

Hormonal Responses to Exercise in Chronic Fatigue Syndrome

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