Chronic Fatigue Syndrome and Morning Cortisol Levels
Posted by Dr Wilson's Adrenal Fatigue Team on Mon, Feb 08, 2010
Medical professionals would do well to look at their fatigued patients in terms of their morning cortisol levels. By allowing their patient’s adrenal glands to function at optimal levels, cortisol levels become normalized, allowing their bodies to more effectively regulate blood sugar levels optimizing not only energy production, but optimizing health and wellness in general. Dr. Wilson, the “stress” doctor and world authority on fatigue, stress and adrenal function actually coined the phrase “adrenal fatigue” in 1998. Dr. Wilson found through his extensive research spanning over 30 years that there is almost no part of the body which is not affected to some degree by cortisol. The following study highlights the importance of salivary cortisol testing correlating with fatigue and appeared in the March 2008 issue of JCEM, Journal of Clinical Endocrinology & Metabolism, one of the four journals published by The Endocrine Society.
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 produced by the adrenal glands, 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, Georgia, 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 generalized to the population suffering from CFS. In this study, women with CFS exhibited significantly lower morning cortisol profiles when compared with well women.
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."
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. To learn more about the Society, and the field of endocrinology, visit http://www.endo-society.org.
If the Endocrine Society takes salivary cortisol and CFS seriously enough to publish these results in their prestigious journal, why does the medical profession (and particularly the endocrinologists) not take note and finally regard that low morning cortisol is linked with fatigue, with adrenal fatigue to be more precise?
Eric Bakker ND