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Chronic
fatigue syndrome and morning Cortisol
response
Newswise — People who suffer from chronic
fatigue syndrome (CFS) often endure months
of persistent fatigue, muscle pain, and
impaired memory and concentration.
Understanding the physiological changes that
accompany CFS, however, has been difficult,
but a new study accepted for publication in
the Journal of Clinical Endocrinology &
Metabolism (JCEM) reveals that abnormally
low morning concentrations of the hormone
cortisol may be correlated with more severe
fatigue in CFS patients, especially in
women.
“We’re learning more and more about the
complexities of the illness that is chronic
fatigue syndrome,” said William C. Reeves,
M.D., with the Centers for Disease Control
and Prevention in Atlanta, Ga., and lead
author of the study. “This research helps us
draw a clearer picture in regards to how CFS
affects people, which ultimately will lead
to more effective management of patients
with CFS.”
For their study, the researchers screened
19,381 residents of Georgia, selecting 292
people who had CFS, 268 who were considered
chronically unwell, and 163 who were
considered well to participate.
The
researchers then measured free cortisol
concentrations in saliva, which was
collected on regular workdays, immediately
upon awaking and 30 minutes and 60 minutes
after awakening.
The data indicated
different profiles of cortisol
concentrations over time among the groups,
with the CFS group showing an attenuated
morning cortisol profile.
Study participants were purposely screened
and enrolled from the community, rather than
from volunteers identified at a specialty
referral clinic.
The purpose of this study
design was to provide results that would be
more generalizable to the population
suffering from CFS. In this study, women
with CFS exhibited significantly attenuated
morning cortisol profiles compared with well
women. In contrast, men with and without CFS
showed no difference in cortisol levels.
This could explain why women are
predominately more likely to suffer from CFS.
This study confirms previous research
indicating that CFS is related to an
imbalance in the normal interactions among
the various systems of the body that work
together to manage stress.
“People with CFS
have reduced overall cortisol output within
the first hour after they wake up in the
morning, which is actually one of the most
stressful times for the body,” Dr. Reeves
said. “We need further studies to better
understand the relationship between morning
cortisol levels and functional status of a
patient suffering from CFS.”
Other researchers involved in this study
include Drs. Urs M. Nater, Elizabeth
Maloney, Roumiana S. Boneva, Brian M.
Gurbaxani, Jin-Man Lin, and James F. Jones
with the Centers of Disease Control and
Prevention; and Dr. Christine Heim with the
Emory School of Medicine in Atlanta.
A rapid release version of this paper has
been published on-line and will appear in
the March 2008 issue of JCEM, a publication
of The Endocrine Society.
Founded in 1916, The Endocrine Society is
the world’s oldest, largest, and most active
organization devoted to research on
hormones, and the clinical practice of
endocrinology.
Today, The Endocrine Society’s membership
consists of over 14,000 scientists,
physicians, educators, nurses and students
in more than 80 countries. Together, these
members represent all basic, applied, and
clinical interests in endocrinology.
The Endocrine Society is based in Chevy
Chase, Maryland. To learn more about the
Society, and the field of endocrinology,
visit our web site at
http://www.endo-society.org