Scott, L V, Teh, J, Reznek, R et al. · Psychoneuroendocrinology · 1999 · DOI
This study looked at whether the adrenal glands (small organs that help manage stress and energy) are physically smaller in people with ME/CFS. Researchers used CT scans to measure adrenal gland size in 8 ME/CFS patients who showed signs of adrenal underfunction and compared them to 55 healthy people. They found that the adrenal glands in ME/CFS patients were about 50% smaller than in healthy controls, suggesting that adrenal shrinkage may occur in some ME/CFS patients.
This study provides the first anatomical evidence that adrenal gland shrinkage may be a physical marker of HPA axis dysfunction in a subset of ME/CFS patients. Understanding whether adrenal atrophy is a pathophysiological mechanism could inform future diagnostic approaches and potential therapeutic interventions targeting the HPA axis.
This study does not prove that adrenal atrophy causes ME/CFS or occurs in all ME/CFS patients, as only a selected group with abnormal ACTH responses was imaged. The small sample size and selection bias mean findings cannot be generalized to the broader ME/CFS population. Causality cannot be established; adrenal shrinkage may be a consequence rather than a cause of ME/CFS pathology.
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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