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Adrienne Dellwo

CDC Studies Cortisol & Chronic Fatigue Syndrome

By January 18, 2008

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If you have chronic fatigue syndrome (CFS) and you're female, you probably woke up this morning with a really low cortisol level. A study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM) links low levels of the hormone to severe fatigue in female CFS patients - but not in male patients.

Cortisol is one of the weapons your body uses to fight stress, and in CFS, low levels may be what makes it hard to deal with not only psychological stress, but also physical stresses such as infection and exertion. Other research has shown differences in cortisol levels between men and women, including a recent study that found an unhappy marriage led to lower levels in women, but not in men. These differences could help explain why women are so much more susceptible to CFS.

What I find most exciting about this study isn't that it confirms differences in cortisol levels between those with and without CFS or between men and women. What really caught my attention was that most of the researchers are with the CDC. That's right, doctors with the Centers for Disease Control and Prevention are actively looking into biological indicators of CFS.

It was only in 2006 that the CDC acknowledged studies had provided credible evidence that CFS might have a biological basis, so to have these guys now working to find even more evidence seems to be a sign that the tides have turned. If the CDC is taking chronic fatigue syndrome more seriously, it could help convince more members of the medical community that it's a real medical condition and not an issue of psychology or whining. If you have any chronic doubters in your life, maybe they need to take a close look at this study and who's involved in it.

  • Read more about this study.
  • Learn about the causes of CFS.
  • Find people who understand CFS and how to manage it in our forum.
Comments
January 25, 2008 at 8:07 pm
(1) Kate says:

That CDC researchers are looking at cortisol levels isn’t surprising if you understand bio-politics. It isn’t as great as it sounds. As psychiatrists have tried to expand their influence into biomodels of illness one of the areas they have concentrated on are hormones, specifically cortisols. There is a psychoimmunological theory that stress levels coorelate with disease. This theory is far from proven however which doesn’t stop ideological adherents from trying to prove it, nor should it. All avenues need to be explored without “blaming” patients. The problem comes when these lines of research are the only ones funded. For example CDC research Dr. William Reeves who is listed as a virologist has also been a professor of psychiatry with Emory University in Atlanta although neither he nor the CDC advertise this. Dr. Reeves has claimed that ME/CFS patients are more vulnerable to stress and thus more likely to develop this organic brain disease. However, he doesn’t tell the whole truth and nothing but the truth. In a 2006 press conference he told reporters that stress was related to divorce and other forms of psychological stress ignoring the biological evidence that microbes such as viruses also “stress” the body and in the case of ME/CFS may well cause the disease. It also makes a difference whether researchers say disease is exacerbated by stress or caused by stress. Because of the problems with research definitions, not even the CDC knows which is the actual case.
Does any of this mean that stress and metabolism play no role in ME/CFS? Not at all. It simply means that research without context is meaningless. Accurate research is dependent on which variables are controlled for and how patients are defined. Until these issues are adequately addressed CDC, which is a public health organization, research or clinical research by anyone else for that matter remains limited.

January 25, 2008 at 8:10 pm
(2) Kate says:

That CDC researchers are looking at cortisol levels isn’t surprising if you understand bio-politics. It isn’t as great as it sounds. As psychiatrists have tried to expand their influence into biomodels of illness one of the areas they have concentrated on are hormones, specifically cortisols. There is a psychoimmunological theory that stress levels coorelate with disease – in this case psychological stres. This theory is far from proven however which doesn’t stop ideological adherents from trying to prove it, nor should it. All avenues need to be explored without “blaming” patients. The problem comes when these lines of research are the only ones funded. For example, CDC research Dr. William Reeves who is listed as a virologist has also been a professor of psychiatry with Emory University in Atlanta although neither he nor the CDC advertise this. Dr. Reeves has claimed that ME/CFS patients are more vulnerable to stress and thus more likely to develop this organic brain disease. However, he doesn’t tell the whole truth and nothing but the truth. In a 2006 press conference he told reporters that stress was related to divorce and other forms of psychological stress ignoring the biological evidence that microbes such as viruses also “stress” the body and in the case of ME/CFS may well cause the disease. It also makes a difference whether researchers say disease is exacerbated by stress or caused by stress. Those are two very different things. Because of the problems with research definitions, not even the CDC knows which is the actual case.
Does any of this mean that stress and metabolism play no role in ME/CFS? Not at all. It simply means that research without context is meaningless. Accurate research is dependent on which variables are controlled for and how patients are defined. Until these issues are adequately addressed CDC, which is a public health organization, research or clinical research by anyone else for that matter remains limited.

September 18, 2011 at 12:04 am
(3) John says:

Actually, Kate, the theory that psychological stress affects cortisol is very well proven…in fact cortisol IS a stress hormone, so it would be ludicrous if stress didn’t affect cortisol!

Also it is very well proven that stress is a significant factor in certain diseases such as heart disease.

I don’t see this as politics – CDC are just going where the science leads them.

As someone who has recovered from CFS, this seems to explain my illness very well. My own CFS seemed to be triggered by both a viral infection and stress.

I think the main point is that CFS doesn’t appear to be caused by an infection, only triggered by it. Stress and viruses do indeed affect the body’s stress system in the same way, and it seems to be this dysregulation of the stress system that is fundamental to CFS rather than a persistent infection.

September 21, 2011 at 7:28 am
(4) Rosa says:

Hi John,
As a sufferer of Chronic Fatigue for 40 years, I would love to hear what lead to your recovery. I have tried everything I can think of to help myself as the medical profession have written me off after they found that psychiatrists and psychologists could not help me. I feel that my condition is related to stress in that anything I try and do no matter how pleasurable leaves me totally drained. Even simple conversations with people leave me shaking. I have just started taking phosphatidyl serine to combat my body making extra cortisol but I am confused as to whether my body is making too much or not enough. I suffer chronic sweats at least every 2 hrs day and night. My heart feels as if it’s racing and these are made worse by any form of exercise. If anyone can help, I’d be glad to hear from you. many thanks,Rosa.

January 25, 2008 at 9:38 pm
(5) chronicfatigue says:

Kate,
Thanks for the information! It’s interesting to look into the politics of health. You’re so right that every discovery needs to be put in the appropriate context. Hopefully, if enough people are keeping track of all these developments, we can eventually piece them together to see the whole picture.

January 19, 2009 at 1:57 pm
(6) Lolly says:

Kate, thanks so much for letting us know about Reeves’ adjunct professorship. It all makes sense now-his useless psychiatric research, his research being published in psychiatric journals, and his involvement in research with Emory. Apparently, he got that position as a direct result of his CFS research at the CDC. Here’s an article by Craig Maupin about it:

http://www.cfidsreport.com/News/06-CDC_CFS_Reeves.htm

It also makes you wonder about the payoff he may be getting from big pharma, as the former director of the psychiatry department at Emory had to step down after an investigation for conflict of interest for receiving money from them:

http://wsbradio.com/localnews/2008/12/emory-psychiatry-head-quits.html

Reeves is not even looking at the disease that is CFS. It sounds like he is looking at people with PTSD or depression, and is then calling it CFS. The case definition that he is using does not even include the symptoms (including viruses) that people with true CFS have. Private institutes and universities are using the significantly more accurate Canadian case definition and are finding biological evidence of a disease in real CFS patients. Apparently for Reeves however, the big payoff is in palling around with big pharma. If he can convince enough people that CFS is a psychiatric disorder then it will be a potential goldmine for those companies, and for him as well.

February 9, 2009 at 9:33 pm
(7) Hip says:

This child abuse research study may paradoxically help support the viral explanation of chronic fatigue syndrome, rather than a psychological one!

Having had a respiratory and neurological virus myself, and having seen this virus slowly spread to all my family members, and some friends too, I have noticed how it has caused mental state changes in nearly everybody that caught it, to some degree. However, only one person (myself) actually got full chronic fatigue syndrome from this virus. Most people got off much more lightly, but nevertheless did display some permanent mental state changes.

So it is clear to me that such neurological viruses can cause subtle, subclinical mental state changes, as well as full CFS.

Most of the subclinical mental state changes I have observed in my family and friends have made people act a little strangely. In short: the virus causes subclinical but sub-optimal mental states.

Therefore, it is possible that as a virus slowly infects a whole family, some members will get CFS, but other members may experience these slightly abnormal mental states – and in very rare cases, it is these abnormal states that contributes to creating the abhorrent mind state that can go on to commit child abuse.

In other words, in etiological terms, it is not the experience of having been abused as a child that later causes CFS, but rather it is a neurological virus that, having spread around the family, caused CFS in some members, and also kicked off the brain changes that, in susceptible people, then led to the extreme behavior of child abuse.

Thus, read this way, rather than support the psychological causal theories of CFS, this data from Emory University on child abuse is more likely to support a viral etiology of CFS.

In general, more research should be done on people that have one or more neurological viruses in their systems, even if they are apparently without overt symptoms. These neurological viruses may well be connected to all sort of subtle abnormal and subnormal behaviors and mental states, not just CFS.

The connection between neurological pathogens and mental heath is very well established as regards to curable bugs like toxoplasma and syphilis, simply because mental state problems caused by these tend to resolve when the people are given the cure (antibiotics), thus proving the connection. Once effective antivirals are developed, the same will almost certainly be found true for CFS.

In summary: although people with full CFS might be the worst off in terms of mental state changes, these same neurological viruses that cause CFS (which are very commonly found in the general population) may be responsible for many more mental state aberrations other than just those of chronic fatigue syndrome.

December 11, 2009 at 5:35 pm
(8) Kat says:

As someone who has had more stress in less than half a lifetime than all the stresses together experienced by 25 people who live into their late 90s, I could have told the CDC years ago about cortisol in severe CFIDS and fibromyalgia, both of which I am now disabled by. Over the years, I felt more and more drained, with an excruciating pain in my lower back, around the area just above my kidneys. Tests have shown my cortisol function is only half. But my doctor will not prescribe cortisol for me without me paying thousands of dollars to a special “non-profit” foundation in my state. So I get worse and without anyone to help me I go for weeks without being able to eat and days without being able to bathe. I now understand why so many like me wind up committing suicide. I’m not depressed, but I’ve had no energy and have felt like the walking dead for so many years, and my ability to function is so non-existent, I see myself starving to death just laying in bed, and dying alone.

December 28, 2009 at 6:32 pm
(9) Rainlee says:

You know Kat, I want to say, your writing is eloquent, and I feel you have a lot of brain cells left. But I know what you mean, only you know what your normal was. I also have had tons of stress and loss and grief, and it all happened clumped together instead of over years, on top of many physical illnesses and injuries, mold illness, and mononucleosis, and an unknown illness for 3 mos when I was 6 yrs old with a 101 fever, and had to stay out of school. Then later, car accidents, etc. So it is hard to say. I am sure I had congenital weaknesses, and then many triggers, and even though they say me/cfs is not progressive, it certainly seems like all of us get much worse as time goes by. It could just be it wears down our immune system and we are getting older, and like any virus , it gets stronger without anything to fight it off. I feel, even if not proven, we should at least be on valtrex every day, as at least it is an anti viral, and then if they find a cause and effect with the xmrv virus, hopefully they will put their pharma billions to good use for a change. I realize that pain meds and stimulants are bandaids, but until they can “cure” this, we are all too young to be bedridden. One year ago I was working full time, and the year before that, I worked full time and took care of my dad with lung cancer, huge toll, and then my moms stroke. I did take pain meds but I could tell how I felt, and I had no flares, my weight was good, appetite good, sleep good. Then this year after horrific psychological stress, and then physical stress, I did not recover. In June, the fatigue became one big flare of exhaustion, and the pain in my arms, legs, back, and feet became so severe. I could not take the trash out, walk the dog.. Everything felt like moving through mud. For the first time my brain was not sharp, and I would get narcol type sx while on computer, or at anytime. Then, just a month ago, severe bladder pain. It has taken urology a long time, and I finally got a cat scan, and will see them for a cystoscopy in 4 days. But all of that in one year, including job and income loss, foreclosure, a move, and loss of my provider, so my meds were changed, which I feel unbalanced my system. Do you have a protocol you are following? Like the guafenesin one by Dr Armand in LA at the Fibro treatment cente? Or just take supplements. I had been a runner and hiker, and did aerobics, and an ER nurse before. It seems most people were very active, and that just makes this so much harder.

I have a question, why cant you get cortisol, which is basically hydrocortisone, and very cheap? What I cannot get is growth hormone. I am very low in it, and the insurance will pay for it, but the doctor has to write why you need it, and there have been studies that not only do most people with fibro run low, it improved pain by 65%. If you dont have enough growth hormone, besides the fatigue, you cannot build muscle back up when you exercise, instead of getting flares, and exhaustion. I also would like Ritalin, as it helped me a lot with energy, and being able to work, and get things doneTake care of yourself, hugs, Rain.

February 12, 2011 at 11:22 pm
(10) Peggy Baxter says:

I have had fibro & cf for over 25yrs. In 1/10, I spent close to a week in the hospital 4 a severe intestinal infection. I wrote to the Dr. Oz show asking where I could get REAL HELP! I got a reply recommending The Fibromyalgia and Fatigue Centers. I had never heard of them but this was going to be my last effort to get well. I was done, I just couldn’t take it anymore, the10+ pain with 3-4 migraines/week,ect. With no insurance & no saving left I was forced to sell my home. I had enough money to move closer to my daughter & pay for the Fibromyalgia & Fatigue Center program. I was still recovering from the IG infection from Jan 2010. I had to wait until I was strong enough to make the flight, in 10/10 I went to Fort Worth. At that time I needed a wheel chair to get to & from the plane & to the taxicab. I was late to my appointment, tired & in so much pain I was barely coherent. Dr. Boulden & her staff went out of their way to help me. I started The Fibromyalgia & Fatigue Center’s Treatment 11/10. I’m in my 4th month & I have aways to go. Now Instead of 24/7 pain I now only have real pain 1st thing in the mornings, this is such a great relief. I have only had 2 migraines both were in 11/2010. None since then! I’m getting better! Please listen to me, if I can be helped so can u. There is Hope, there is true Help! It’s real, it’s not a gimmick and it works! I am part of the proof, that this treating the whole body concept program works. I’ve even started an exercise program after having done nothing but lie in bed for the last 10 yrs. I gave up, I let the pain take over,it ruled me. No more! Thanks to Dr K. Boulden, her wonderful staff and of course The Fibromyalgia and Fatigue Center of Fort Worth Texas. There are 12, F & F Center’s in the US. I’m a patient there I have no other connection. My whole reason for writing this is to give other FM & CFsufferers true info. so u can get help like I have.
Good Health to all,Peggy C. Baxter

February 15, 2011 at 10:18 pm
(11) Angela says:

Peggy, thrilled that you have had so much improvement and wish you all the best for health.
I am a CFS and FM sufferer and have been for 22years. Have really struggled over the years to find doctors who will take my illness seriously and thankfully recently found one who does. She uses the Pfeiffer Protocol. I’ve really only just started seeing her and have not progressed very far so not sure how effective that treatment is but, from what I can gather, it involves a lot of vitamin supplementation.
Anyway, I am in Australia so do not have access to any of the F&F Centers you spoke of. We have nothing of the sort here, unfortunately, and so I was wondering what your treatment involved. Do they look at the state of the gut? Does it involve the use of probiotics? Is the treatment lifelong or a once off? Would love to know how they tackle this illness.
Many thanks and kind regards, Angela

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