E3 PreliminaryModerate confidencePEM unclearCross-SectionalPeer-reviewedMachine draft
Abnormal thermoregulatory responses in adolescents with chronic fatigue syndrome: relation to clinical symptoms.
Wyller, Vegard Bruun, Godang, Kristin, Mørkrid, Lars et al. · Pediatrics · 2007 · DOI
Quick Summary
This study looked at how the body controls temperature in adolescents with ME/CFS compared to healthy teenagers. Researchers found that people with ME/CFS have abnormal responses to temperature changes, with their bodies struggling to regulate heat and cold properly. The study suggests this problem may be related to dysfunction in the nervous system's control of stress hormones like adrenaline.
Why It Matters
Abnormal temperature regulation and excessive sweating/shivering are common but poorly understood symptoms in ME/CFS. This study provides mechanistic evidence linking these symptoms to sympathetic nervous system dysfunction, potentially opening new avenues for understanding and treating these distressing thermoregulatory symptoms.
Observed Findings
- At baseline, ME/CFS patients had higher plasma norepinephrine, epinephrine, heart rate, and tympanic temperature than controls.
- During local hand cooling, acral skin blood flow decreased less in ME/CFS patients compared to controls.
- Vasoconstrictor events occurred at lower temperatures in ME/CFS patients than in controls.
- Core tympanic temperature decreased more during cooling in ME/CFS patients.
- ME/CFS patients reported significantly more shivering, sweating, sudden skin color changes, and feeling unusually warm.
Inferred Conclusions
- Adolescents with ME/CFS demonstrate abnormal catecholaminergic-dependent thermoregulatory responses at rest and during local cooling.
- These findings support a hypothesis of sympathetic nervous system dysfunction in ME/CFS.
- Abnormal thermoregulation may mechanistically explain common clinical symptoms such as excessive sweating and temperature sensitivity.
Remaining Questions
- Does sympathetic dysfunction in ME/CFS improve or worsen over time, and is it reversible with treatment?
- How do these thermoregulatory abnormalities relate to exercise intolerance and post-exertional malaise?
What This Study Does Not Prove
This study does not prove that sympathetic dysfunction is the primary cause of ME/CFS—only that it is associated with the condition. It does not establish whether thermoregulatory abnormalities are disease-causing or a secondary consequence of ME/CFS. The small sample size limits generalizability to the broader ME/CFS population.
Tags
Symptom:FatigueTemperature Dysregulation
Biomarker:Blood Biomarker
Phenotype:Pediatric
Method Flag:PEM Not DefinedWeak Case DefinitionSmall SampleExploratory Only
Metadata
- DOI
- 10.1542/peds.2006-2759
- PMID
- 17606539
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 8 April 2026
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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