↑ 3.0 3.1 3.2 Scott, LV Dinan, TG (1998), 'Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers', J Affect Disord, 47 (1–3): 49-54, PMID 9476743.The Cortisol, PEM and Stress Management Link in Chronic Fatigue Syndrome by Cort Johnson in Health Rising.All You Need to Know About Cortisol and Its Health Effects.2018, A State-Space Investigation of Cortisol Alterations in Chronic Fatigue Syndrome.2018, Hair and salivary cortisol in a cohort of women with chronic fatigue syndrome (Abstract).2015, Salivary cortisol responses to household tasks among couples with unexplained chronic fatigue (Full Text).2014, The role of hypocortisolism in chronic fatigue syndrome (Abstract).2000, Review article - Chronic Fatigue Syndrome: A Dysfunction of the Hypothalamic-Pituitary-Adrenal Axis (Abstract).1998, Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers (Abstract).Ī 2003 double-blind, randomized, placebo-controlled trial of hydrocortisone in combination with fludrocortisone found no difference in self-reported outcomes from when patients received the placebo vs. In 1999, the Institute of Psychiatry, London, did a randomized crossover trial, in which Simon Wessely was an author, where low dose hydrocortisone treatments given to patients with chronic fatigue syndrome were found to reduce fatigue scores and that 28% of patients in the treatment group had reductions in scores that brought them to or close to normal in the short term. The authors concluded that: although hydrocortisone treatment was associated with some improvement in symptoms of CFS, the degree of adrenal suppression precludes its practical use for CFS. No statistical evidence of improvement was seen with the other self-rating scales. Clinical trials Ī 1998 double-blind, randomized, placebo-controlled trial found that low dose hydrocortisone led to a statistical improvement in one subjective score, the Wellness scale. As people with ME/CFS improved, their hypocortisolism improved. They found that there was a trend of lower hair cortisol concentrations in CFS patients, thus suggesting that hypocortisolism was long-term in ME/CFS. In 2018, Roerink, et al, studied hair cortisol concentrations in CFS patients to assess if hypocortisolism was a prolonged phenomenon. In addition to general hypocortisolism, ME/CFS patients have a decreased cortisol awakening response, ie, morning cortisol levels peak later compared to healthy controls. Hypocortisolism (a low cortisol level) frequently occurs in patients with ME/CFS, confirmed by studies measuring cortisol levels and in urine and saliva.

Low cortisol levels