Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome

@article{Papadopoulos2012HypothalamicpituitaryadrenalA,
  title={Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome},
  author={Andrew S. Papadopoulos and Anthony J. Cleare},
  journal={Nature Reviews Endocrinology},
  year={2012},
  volume={8},
  pages={22-32}
}
The weight of current evidence supports the presence of the following factors related to hypothalamic–pituitary–adrenal (HPA) axis dysfunction in patients with chronic fatigue syndrome (CFS): mild hypocortisolism; attenuated diurnal variation of cortisol; enhanced negative feedback to the HPA axis; and blunted HPA axis responsiveness. Furthermore, HPA axis changes seem clinically relevant, as they are associated with worse symptoms and/or disability and with poorer outcomes to standard… 

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