Fischer, Susanne, Skoluda, Nadine, Ali, Nida et al. · Journal of psychiatric research · 2022 · DOI
This study tested whether people with medically unexplained symptoms have different stress hormone levels than healthy people. Researchers measured cortisol (a stress hormone) in hair samples, which shows stress levels over the previous three months. They found that women with somatic symptom disorder (a condition involving excessive worry about physical symptoms) had lower cortisol than healthy women, but women with chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome did not differ from healthy controls.
For ME/CFS patients, this study addresses whether abnormal stress hormone regulation contributes to medically unexplained symptoms, a key hypothesis in fatigue and pain conditions. The finding that different groups of unexplained symptom disorders show distinct biological profiles suggests that ME/CFS may have different underlying mechanisms than conditions characterized primarily by symptom-focused anxiety, potentially guiding more targeted treatments.
This study does not prove that low cortisol causes somatic symptom disorder or that cortisol abnormalities are the primary driver of fatigue or pain in ME/CFS. The lack of correlation between reported stress/trauma and cortisol levels suggests cortisol changes may not simply reflect psychological stress, but cause-and-effect relationships cannot be established from this cross-sectional design. The findings apply only to women and may not generalize to men or other populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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