Neuroendocrine disorder in chronic fatigue syndrome

Neuroendocrine disorder in chronic fatigue syndrome

Background/aim: Neuroendocrine disorders are considered a possible pathogenetic mechanism in chronic fatigue syndrome (CFS). The aim of our study was to determine the function of the hypothalamic pituitary adrenal axis (HPA) and thyroid function in women of reproductive age suffering from CFS. Materials and methods: The study included 40 women suffering from CFS and 40 healthy women (15 45 years old). Serum levels of cortisol (0800 and 1800 hours), ACTH, total T4, total T3, and TSH were measured in all subjects. The Fibro Fatigue Scale was used for determination of fatigue level. Results: Cortisol serum levels were normal in both groups. The distinctively positive moderate correlation of morning and afternoon cortisol levels that was observed in healthy women was absent in the CFS group. This may indicate a disturbed physiological rhythm of cortisol secretion. Although basal serum T4, T3, and TSH levels were normal in all subjects, concentrations of T3 were significantly lower in the CFS group. Conclusion: One-time hormone measurement is not sufficient to detect hormonal imbalance in women suffering from CFS. Absence of a correlation between afternoon and morning cortisol level could be a more representative factor for detecting HPA axis disturbance.

___

  • 1. Prins JB, van der Meer JWM, Bleijenberg G. Chronic fatigue syndrome. Lancet 2006; 367: 346-355.
  • 2. Nijhof LS, Rutten JMTM, Uiterwaal CSPM, Bleijenberg G, Kimpen LLJ, van de Putte EM. The role of hypocortisolism in chronic fatigue syndrome. Psychoneuroendocrinology 2014; 42: 199-206.
  • 3. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med 1994; 121: 953-959.
  • 4. Jason LA,  Porter N,  Herrington J,  Sorenson M, Kubow S. Kindling and oxidative stress as contributors to myalgic encephalomyelitis/chronic fatigue syndrome. J Behav Neurosci Res 2009; 7: 1-17.
  • 5. Bains W. Treating chronic fatigue states as a disease of the regulation of energy metabolism. Medical Hypotheses 2008; 71: 481-484.
  • 6. Cleare JA. The neuroendocrinology of chronic fatigue syndrome. Endocrine Reviews 2003; 24: 236-252.
  • 7. Brkic S, Tomic S, Maric D, Novakov-Mikic A, Turkulov V. Lipid peroxidation is elevated in female patients with chronic fatigue syndrome. Med Sci Monit 2010; 16: CR628-632.
  • 8. Smirnova IV, Pall LM. Elevated levels of protein carbonyl in sera of chronic fatigue syndrome patients. Mol Cell Biochem 2003; 248: 93-95.
  • 9. Cleare AJ. The HPA axis and the genesis of chronic fatigue syndrome. Endocrinol Metab 2004; 2: 55-59.
  • 10. Papadopoulos AS, Cleare AJ. Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome. Nature Rev Endocrinol 2012; 8: 22-32.
  • 11. Jones FJ. An extended concept of altered self: chronic fatigue and post-infection syndromes. Psychoneuroendocrinol 2008; 33: 119-29.
  • 12. Jerjes WK, Peters TJ, Taylor NF, Wood PJ, Wessely S, Cleare AJ. Diurnal excretion of urinary cortisol, cortisone andcortisol metabolites in chronic fatigue syndrome. J of Psych Res 2006; 60: 145-153.
  • 13. Lorusso L,  Mikhaylova SV,  Capelli E,  Ferrari D,  Ngonga GK,  Ricevuti G. Immunological aspects of chronic fatigue syndrome. Autoimm Rev 2009; 8: 287-291.
  • 14. Cleare AJ, Blair D, Chambers S, Wessely S. Urinary free cortisol in chronic fatigue syndrome. Am J Psychiatry 2001; 158: 641- 643.
  • 15. Maes M, Mihaylova I, Kubera M, Leunis JC. An IgM-mediated immune response directed against nitro-bovine serum albumin (nitro-BSA) in chronic fatigue syndrome (CFS) and major depression: evidence that nitrosative stress another factor underpinning the comorbidity between major depression and CFS. Neuroendocrinol Lett 2008; 29: 1-5.
  • 16. García-Campayoa J, Pascuala A, Aldaa M, Marzob J, Magallonc R,  Fortes S. The Spanish version of the fibro fatigue scale: validation of a questionnaire for the observer’s assessment of fibromyalgia and chronic fatigue syndrome. Gen Hosp Psych 2006; 28: 154-160.
  • 17. Ablin JN, Odes L, Neumann L, Buskila D. The Hebrew version of the fibro fatigue scale: validation of a questionnaire for assessment of fibromyalgia and chronic fatigue syndrome. Rheumatol Int 2009; 30: 1173-1176.
  • 18. Gabb J, Engert V, Hetz V, Schard T, Schurmeyer TH, Elhert U. Associations between neuroendocrine responses to the Insulin Tolerance test  and patient characteristics in chronic fatigue syndrome. J Psychosom Res 2004; 56: 419-414.
  • 19. ter Wolbeek M, von Doornen Lj, Coffeng LE, Kavellars A, Heijnen CJ. Cortisol and severe fatigue: a longitudinal study in adolescent girls. Psychoneuroendocrinology 2007; 32: 171- 182.
  • 20. Wyller VB, Vitelli V, Sulheim D, Fagermoen E, Winger A, Godang K, Bollerslev J. Altered neuroendocrine control and association to clinical symptoms in adolescent chronic fatigue syndrome: a cross-sectional study. J Transl Med 2016; 14: 121.
  • 21. Christley Y, Duffy T, Everall IP, Colin RM. The neuropsychiatris and neuropsychological features of chronic fatigue syndrome: revisiting the enigma. Curr Psychiatry Rep 2013; 15: 353.
  • 22. Cleare AJ, Miell J, Heap E, Sookdeo S, Young L, Malhi GS, O’Keane V. Hypothalamo-pituitary-adrenal axis function in chronic fatigue syndrome, and the effects of low-dose hydrocortisone therapy. J Clin Endocrinol Metab 2001; 86: 3545-3554.
  • 23. Altemus M, Dale JK, Michelson D, Demitrack MA, Gold PW, Straus SE. Abnormalities in response to vasopressin infusion in chronic fatigue syndrome. Psychoneuroendocrinology 2001; 26: 175-188.
  • 24. Mommersteeg PM, Heijnen CJ, Kavelaars A, van Doornen LJ. The HPA axis and immune function in burnout. Prog Brain Res 2007; 167: 281-285.
  • 25. Torres-Harding S,  Sorenson M,  Jason L,  Maher K, Fletcher MA, Braun M. The associations between basal salivary cortisol and illness symptomatology in chronic fatigue syndrome. J Appl Biobehav Res 2008; 13: 157-180.
  • 26. Rajeevan MS,  Smith AK,  Dimulescu I,  Unger ER,  Vernon SD,  Heim C,  Reeves WC. Glucocorticoid receptor polymorphisms and haplotypes associated with chronic fatigue syndrome. Genes Brain Behav 2007; 6: 167-176.
  • 27. Xu G, Wenjun Y, Li J. An update for the controversies and hypotheses of regulating nonthyroidal illness syndrome in chronic kidney diseases. Clin Exp Nephrol 2014; 18: 837-843.
  • 28. Wang B, Liu S, Li L, Yao Q, Song R, Shao X, Li Q, Shi X, Zhang JA. Non-thyroidal illness syndrome in patients with cardiovascular diseases: a systematic review and meta-analysis. Int J Cardiol 2017; 226: 1-10.
  • 29. Moorkens G, Berwaerts J, Wynats H, Abs R. Characterisation of pituitary function with emphasis on GH secretion in the fatigue chronic syndrome. Clin Endocrinol 2000; 53: 99-106.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK