We conclude that the improvement in fatigue seen in some
patients with chronic fatigue syndrome during hydrocortisone treatment
is accompanied by a reversal of the blunted cortisol responses to human
CRH
These data further suggest that the hypocortisolism
found in chronic fatigue syndrome may be secondary to reduced adrenal
gland output.
5-mg replacement dose of
hydrocortisone, and the remainder 10 mg
low dose hydrocortisone therapy (defined as 5-10 mg), in this study, was used to treat CFS. This study found an improvement in symptoms in these patients. Additionally, low cortisol was found in these patients with CFS. Their conclusion, was that low adrenal function is a component of CFS and low dose hydrocortisone therapy is an effective treatment.
Now, is the low cortisol as the result of increased metabolism as well?
A very small study, but vitamin C shown to reduce fatigue, perception of fatigue and reduced heart rate. This has implications in improving athletic performance. The question, what does high dose vitamin C due for fatigue, heart rate, and athletic performance.
low dose hydrocortisone therapy, 5-10 mg, shown to be effective short-term therapy in patients with chronic fatigue syndrome. Additionally, and very important, this study found no adrenal function suppression at these doses.
Severe sleep apnea associated with lower Testosterone levels and fatigue. The low level of Testosterone was the only factor predictive of fatigue and reduced activity in sleep apnea. This was only found in severe sleep apnea, not mild cases.
This study reveals CFS to be low adrenal cortisol output problem. In this study, low dose cortisol (hydrocortisone) therapy improved symptoms of fatigue and improved the CRH adrenal stimulation of adrenal cortisol production.
Discussion of the mitochondrial role in chronic fatigue syndrome. As the authors conclude, there is dysfunction, but whether the cause is primary or secondary or likely varies from individual to individual is yet undetermined.
low cortisol is a frequent finding in chronic fatigue syndrome. However, in the urine, the cortisol levels may be normal. This is a reflection of increased metabolism of cortisol. This is not a contradiction, but a metabolic effect.
It has been suggested in the literature that low salivary cortisol is a common finding in those with chronic fatigue. This study found no difference in the cortisol metabolite excretion. This would suggest that an increase metabolization of cortisol exists in those with CFS.
this study revealed symptom improvement with hydrocortisone treatment in those with CFS. Pre/post treatment was with serum cortisol and not salivary cortisol. This is a weakness of the study. The starting dosage of 25-30 mg hydrocortisone is high and with inadequate evaluation, this high dosage could have resulted in high dosage and adrenal suppression.
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