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… Expand
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References

SHOWING 1-10 OF 105 REFERENCES
The HPA axis and the genesis of chronic fatigue syndrome
  • A. Cleare
  • Biology, Medicine
  • Trends in Endocrinology & Metabolism
  • 2004
TLDR
It is presented the case that there is no specific change to the HPA axis in CFS and that the observed changes are of multifactorial aetiology, with some factors occurring as a consequence of the illness. Expand
Does hypothalamic-pituitary-adrenal axis hypofunction in chronic fatigue syndrome reflect a 'crash' in the stress system?
TLDR
This comprehensive hypothesis on HPA axis hypofunction in CFS may stimulate diagnostic refinement of the illness, inform treatment approaches and suggest directions for future research, particularly focusing on the neuroendocrine-immune interface and possible links between CFS, early and recent life stress, and depression. Expand
Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome
TLDR
CFS is globally associated with reduced cortisol responses in the combined low-dose dexamethasone/corticotropin-releasing factor test, but this effect is only clearly present in CFS patients without a history of ELS, which provides further support for an enhanced glucocorticoid negative feedback and/or a reduced central HPA axis drive in C FS. Expand
Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome.
TLDR
Although it cannot definitively account for the etiology of the mild glucocorticoid deficiency seen in chronic fatigue syndrome patients, the enhanced adrenocortical sensitivity to exogenous ACTH and blunted ACTH responses to oCRH are incompatible with a primary adrenal insufficiency. Expand
Associations between neuroendocrine responses to the Insulin Tolerance Test and patient characteristics in chronic fatigue syndrome.
TLDR
The results of a strong association between the integrated ACTH response and the duration of C FS emphasizes the need to consider factors known to be risk factors for the chronicity of CFS symptoms, such as profound inactivity, deconditioning and sleep abnormalities, as possible candidates for secondary causes of neuroendocrine dysregulations in CFS. Expand
Salivary cortisol response to awakening in chronic fatigue syndrome
TLDR
This naturalistic test of the HPAaxis response to stress showed impaired HPA axis function in CFS, with lower cortisol response to awakening. Expand
Low-Dose Dexamethasone Suppression Test in Chronic Fatigue Syndrome and Health
TLDR
Enhanced negative feedback of the hypothalamus-pituitary-adrenal axis could be a plausible explanation for the previously described alterations in hypothalamus/pituitaries/adrenals axis functioning in chronic fatigue syndrome. Expand
24-Hour Pituitary and Adrenal Hormone Profiles in Chronic Fatigue Syndrome
TLDR
Patients with CFS demonstrated subtle alterations in HPA axis activity characterized by reduced ACTH over a full circadian cycle and reduced levels during the usual morning physiological peak ACTH secretion, providing further evidence of subtle dysregulation of the H PA axis in CFS. Expand
The neuroendocrinology of chronic fatigue syndrome.
TLDR
It is suggested that more prospective cohort studies be undertaken in groups at high risk for CFS, that patients with CFS are followed up into recovery, and that multidimensional assessments are undertaken to unravel the influence of the various confounding factors on the observed endocrine changes in CFS. Expand
Diurnal excretion of urinary cortisol, cortisone, and cortisol metabolites in chronic fatigue syndrome.
TLDR
This study provides further evidence for reduced basal HPA axis function in patients with CFS, based on lower free cortisol and cortisone levels, but this is not corroborated by cortisol metabolite data. Expand
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