The HPA axis and the genesis of chronic fatigue syndrome

  title={The HPA axis and the genesis of chronic fatigue syndrome},
  author={Anthony J. Cleare},
  journal={Trends in Endocrinology \& Metabolism},
  • A. Cleare
  • Published 1 March 2004
  • Psychology
  • Trends in Endocrinology & Metabolism

Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal (HPA) axis in a proportion of the patients with chronic fatigue syndrome (CFS), despite the negative studies and

Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome

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

A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome

Given the interindividual variation in the effectiveness of existing biological and psychological treatments, the need for novel treatment strategies such as those which target the HPA axis is clear.

The role of hypocortisolism in chronic fatigue syndrome

The hypothalamo–pituitary–adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome

There is no structural abnormality in the endocrine organs which comprise the HPA axis, thus it seems that hypocortisolemia found in the patients with stress-related disorder is functional.

Neuroendocrine disorder in chronic fatigue syndrome

One-time hormone measurement is not sufficient to detect hormonal imbalance in women suffering from CFS, and absence of a correlation between afternoon and morning cortisol level could be a more representative factor for detecting HPA axis disturbance.

Fibromyalgia and chronic fatigue: the underlying biology and related theoretical issues.

This chapter will focus on inflammatory and oxidative stress pathways and on the neuroendocrine system, which have been more commonly examined and suggest a role for the hypothalamic-pituitary-adrenal axis and cortisol in the pathogenesis of these syndromes.

Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research

Exposure to childhood stressors is associated with the subsequent development of fatigue syndromes such as CFS and FM, and related symptoms, and further studies are needed to identify the mechanisms underlying these associations.

Commonalities in the Features of Cancer and Chronic Fatigue Syndrome (CFS): Evidence for Stress-Induced Phenotype Instability?

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and Cancer-Related Fatigue (CRF) are syndromes with considerable overlap with respect to symptoms. There have been many studies that have



The neuroendocrinology of chronic fatigue syndrome.

  • A. Cleare
  • Psychology, Medicine
    Endocrine reviews
  • 2003
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.

The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders

Hypothalamo-pituitary-adrenal axis dysfunction in chronic fatigue syndrome, and the effects of low-dose hydrocortisone therapy.

It is concluded that the improvement in fatigue seen in some patients with chronic fatigue syndrome during hydrocortisone treatment is accompanied by a reversal of the blunted cortisol responses to human CRH, which reversed the previously observed blunting responses seen in these patients.

Blunted adrenocorticotropin and Cortisol responses to corticotropin‐releasing hormone stimulation in chronic fatigue syndrome

A diminished output of neurotrophic ACTH, causing a reduced adrenocortical secretory reserve, inadequately compensated for by adrenoceptor upregulation, may explain the reduced Cortisol production demonstrated in this study.

Glucocorticoid receptors in major depression: relevance to pathophysiology and treatment

Chronic fatigue syndrome.

The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study

We have developed a conceptual framework and a set of research guidelines for use in studies of the chronic fatigue syndrome. The guidelines cover the clinical and laboratory evaluation of persons

Short-term night-shift working mimics the pituitary-adrenocortical dysfunction in chronic fatigue syndrome.

It is concluded that the pituitary-adrenal responses to CRH are markedly disrupted after only 5 days of nighttime work, and these abnormalities mimic those previously observed in patients with chronic fatigue syndrome.

Predictors of fatigue following the onset of infectious mononucleosis

The psycho-behavioural predictors found in this study are amenable to intervention and should be tested in randomized controlled trials.

Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized controlled trial.

Although hydrocortisone treatment was associated with some improvement in symptoms of CFS, the degree of adrenal suppression precludes its practical use for CFS.