Roerink, Megan E, Roerink, Sean H P P, Skoluda, Nadine et al. · Hormones and behavior · 2018 · DOI
This study measured cortisol (a stress hormone) in hair and saliva samples from women with ME/CFS and compared them to healthy women. The ME/CFS patients showed lower cortisol levels, particularly a weaker morning cortisol rise. When some patients took a medication called anakinra (which reduces inflammation), their cortisol levels changed differently than in patients taking placebo, suggesting a link between the immune system and hormonal stress response in ME/CFS.
This research provides the first evidence that HPA axis dysfunction in ME/CFS extends to long-term cortisol measures (hair) and not just acute salivary markers. The finding that an immune-modulating drug alters cortisol patterns suggests HPA axis abnormalities may be linked to immune dysregulation, which could guide future treatment approaches targeting both systems.
This study does not prove that low cortisol causes ME/CFS symptoms or that anakinra is an effective treatment—it only shows associations and short-term hormonal changes. The small subset with hair cortisol data (46 per group) and lack of long-term outcome data limit conclusions about clinical significance. Correlation between immune markers and cortisol does not establish causation.
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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