scholarly journals Salivary cortisol response to awakening in chronic fatigue syndrome

2004 ◽  
Vol 184 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Amanda D. L. Roberts ◽  
Simon Wessely ◽  
Trudie Chalder ◽  
Andrew Papadopoulos ◽  
Anthony J. Cleare
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Hpa Axis ◽  
Salivary Cortisol ◽  
Area Under The Curve ◽  
Chronic Fatigue ◽  
Cortisol Response ◽  
Non Invasive ◽  
Fatigue Syndrome ◽  
Invasive Test ◽  
Response To Stress

BackgroundThere is accumulating evidence of hypothalamic–pituitary–adrenal (HPA) axis disturbances in chronic fatigue syndrome (CFS). The salivary cortisol response to awakening has been described recently as a non-invasive test of the capacity of the HPA axis to respond to stress. The results of this test correlate closely with those of more invasive dynamic tests reported in the literature; furthermore, it can be undertaken in a naturalistic setting.AimsTo assess the HPA axis using the salivary cortisol response to awakening in CFS.MethodWe measured salivary cortisol upon awakening and 10, 20, 30 and 60 min afterwards in 56 patients with CFS and 35 healthy volunteers.ResultsPatients had a lower cortisol response to awakening, measured by the area under the curve.ConclusionsThis naturalistic test of the HPA axis response to stress showed impaired HPA axis function in CFS.

scholarly journals Analysis of Gender Differences in HRV of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Using Mobile-Health Technology

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3746
Author(s):  
Lluis Capdevila ◽  
Jesús Castro-Marrero ◽  
José Alegre ◽  
Juan Ramos-Castro ◽  
Rosa M Escorihuela
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Autonomic Dysfunction ◽  
Mobile Health ◽  
Health Technology ◽  
Chronic Fatigue ◽  
Gender Effects ◽  
Non Invasive ◽  
Fatigue Syndrome ◽  
Mhealth Technology ◽  
Hrv Analysis

In a previous study using mobile-health technology (mHealth), we reported a robust association between chronic fatigue symptoms and heart rate variability (HRV) in female patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study explores HRV analysis as an objective, non-invasive and easy-to-apply marker of ME/CFS using mHealth technology, and evaluates differential gender effects on HRV and ME/CFS core symptoms. In our methodology, participants included 77 ME/CFS patients (32 men and 45 women) and 44 age-matched healthy controls (19 men and 25 women), all self-reporting subjective scores for fatigue, sleep quality, anxiety, and depression, and neurovegetative symptoms of autonomic dysfunction. The inter-beat cardiac intervals are continuously monitored/recorded over three 5-min periods, and HRV is analyzed using a custom-made application (iOS) on a mobile device connected via Bluetooth to a wearable cardiac chest band. Male ME/CFS patients show increased scores compared with control men in all symptoms and scores of fatigue, and autonomic dysfunction, as with women in the first study. No differences in any HRV parameter appear between male ME/CFS patients and controls, in contrast to our findings in women. However, we have found negative correlations of ME/CFS symptomatology with cardiac variability (SDNN, RMSSD, pNN50, LF) in men. We have also found a significant relationship between fatigue symptomatology and HRV parameters in ME/CFS patients, but not in healthy control men. Gender effects appear in HF, LF/HF, and HFnu HRV parameters. A MANOVA analysis shows differential gender effects depending on the experimental condition in autonomic dysfunction symptoms and HF and HFnu HRV parameters. A decreased HRV pattern in ME/CFS women compared to ME/CFS men may reflect a sex-related cardiac autonomic dysfunction in ME/CFS illness that could be used as a predictive marker of disease progression. In conclusion, we show that HRV analysis using mHealth technology is an objective, non-invasive tool that can be useful for clinical prediction of fatigue severity, especially in women with ME/CFS.

scholarly journals Persistent burnout theory of chronic fatigue syndrome

2015 ◽  
Author(s):  
David Jameson
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Stress ◽  
Hpa Axis ◽  
Chronic Fatigue ◽  
Stress System ◽  
Occupational Burnout ◽  
Fatigue Syndrome ◽  
Growing Body ◽  
Physiological Abnormalities ◽  
Behavioural Factors

There is no agreement on the etiology of chronic fatigue syndrome (CFS), and the main theories (behavioural and viral/immune) do not satisfactorily explain all findings. A growing body of evidence shows that CFS appears to be a dysfunction of the stress system—and the hypothalamic–pituitary–adrenal (HPA) axis in particular—as a result of chronic stress. CFS shares many similarities to occupational burnout, including similar symptoms, physiological abnormalities and triggers. After a review of the available evidence, I hypothesize that CFS is a state of persistent burnout that remains after the initial stressors have been removed. This persistence may be due to a combination of a dysregulation of the HPA axis and behavioural factors.

Alterations in Diurnal Salivary Cortisol Rhythm in a Population-Based Sample of Cases With Chronic Fatigue Syndrome

2008 ◽  
Vol 70 (3) ◽  
pp. 298-305 ◽  
Author(s):  
Urs M. Nater ◽  
Laura Solomon Youngblood ◽  
James F. Jones ◽  
Elizabeth R. Unger ◽  
Andrew H. Miller ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Salivary Cortisol ◽  
Chronic Fatigue ◽  
Population Based ◽  
Fatigue Syndrome

Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome?

2009 ◽  
Vol 40 (3) ◽  
pp. 515-522 ◽  
Author(s):  
A. D. L. Roberts ◽  
M.-L. Charler ◽  
A. Papadopoulos ◽  
S. Wessely ◽  
T. Chalder ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Psychotropic Medication ◽  
Salivary Cortisol ◽  
Poor Response ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Free Cortisol

BackgroundThere is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. The clinical significance of this is unclear. We aimed to determine whether hypocortisolism exerted any effect on the response of CFS to cognitive behavioural therapy (CBT).MethodWe measured 24-h urinary free cortisol (UFC) in 84 patients with Centers for Disease Control and Prevention (CDC)-defined CFS (of whom 64 were free from psychotropic medication) who then received CBT in a specialist, tertiary out-patient clinic as part of their usual clinical care. We also measured salivary cortisol output from 0800 to 2000 h in a subsample of 56 psychotropic medication-free patients.ResultsOverall, 39% of patients responded to CBT after 6 months of treatment. Lower 24-h UFC output was associated with a poorer response to CBT but only in psychotropic medication-free patients. A flattened diurnal profile of salivary cortisol was also associated with a poor response to CBT.ConclusionsLow cortisol is of clinical relevance in CFS, as it is associated with a poorer response to CBT. Hypocortisolism could be one of several maintaining factors that interact in the persistence of CFS.

scholarly journals The Associations Between Basal Salivary Cortisol and Illness Symptomatology in Chronic Fatigue Syndrome

2008 ◽  
Vol 13 (3) ◽  
pp. 157-180 ◽  
Author(s):  
Susan Torres-Harding ◽  
Matthew Sorenson ◽  
Leonard Jason ◽  
Nadia Reynolds ◽  
Molly Brown ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Salivary Cortisol ◽  
Chronic Fatigue ◽  
Fatigue Syndrome

scholarly journals The Neuroendocrinology of Chronic Fatigue Syndrome

2003 ◽  
Vol 24 (2) ◽  
pp. 236-252 ◽  
Author(s):  
Anthony J. Cleare
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Hpa Axis ◽  
Psychiatric Comorbidity ◽  
Chronic Fatigue ◽  
Functional Importance ◽  
Prospective Cohort Studies ◽  
Fatigue Syndrome ◽  
Cortisol Responses ◽  
The Many

Abstract Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin, the nature of the pathophysiological components remains unclear. There has been a wealth of interest in the endocrinology of this condition, which will be reviewed in this article. Most studied has been the hypothalamic-pituitary-adrenal (HPA) axis; although the quality of many studies is poor, the overall balance of evidence points to reduced cortisol output in at least some patients, with some evidence that this is linked to symptom production or persistence. There is evidence for heightened negative feedback and glucocorticoid receptor function and for impaired ACTH and cortisol responses to a variety of challenges. However, there is no evidence for a specific or uniform dysfunction of the HPA axis. Given the many factors that may impinge on the HPA axis in CFS, such as inactivity, sleep disturbance, psychiatric comorbidity, medication, and ongoing stress, it seems likely that HPA axis disturbance is heterogeneous and of multifactorial etiology in CFS. Studies assessing GH, dehydroepiandrostenedione and its sulfate, melatonin, leptin, and neuroendocrine-monoamine interactions are also reviewed. There is some evidence from these studies to suggest alterations of dehydroepiandrostenedione sulfate function and abnormal serotonin function in CFS, but whether these changes are of functional importance remains unclear. To obtain a clearer assessment of the etiological and pathophysiological relevance of endocrine changes in CFS, 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.

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