CFS Fibromyalgia and Low Cortisol

This is from http://www.bellaonline.com/articles/art45203.asp


For more than ten years, researchers studying Chronic Fatigue Syndrome (CFS) and Fibromyalgia Syndrome, have conducted studies in regard to adrenal function in patients with these syndromes and have concluded that patients are found to be experiencing “low adrenal function" as one of the features of these syndromes. This co-existing condition is also called “adrenal fatigue", “adrenal exhaustion" and “low adrenal reserve". Reputable medical sources also state that patients with Thyroid Disease are at more risk than the general population, for also having co-existing CFS and/or Fibromyalgia.

Through testing of a patient’s adrenal hormones, it can be determined if that person has low-functioning adrenals. In addition to blood testing, saliva tests are also accurate for testing the “free levels" of the adrenal hormones, the main ones being DHEA and cortisol. A “24 hour urinary cortisol test", can also be done, to test adrenal-cortisol levels.

Another major adrenal function blood test is also available, called the “ACTH Stimulation Test". This one is designed to confirm or rule out true “adrenal insufficiency" (full blown). Most CFS and Fibromyalgia patients do not have true, full blown adrenal insufficiency but a milder form of adrenal fatigue/exhaustion.

Research conclusions by major Medical Research groups, including the NIH, state that low cortical levels, are found to be a contributing factor in CFS/FMS, due to dysfunction of the HPA Axis (Hypothalamus-Pituitary-Adrenal Axis). It is my opinion because of this, that CFS/FMS has as one of its features, a form of adrenal fatigue, that does not meet the definition for true “adrenal insufficiency" and because of this, it cannot be medically treated the same. With full blown Adrenal Insufficiency, the low adrenal hormones must be replaced through steroid treatment (cortisone-steroid/hydrocortisone). With lesser forms of low adrenal function, such as adrenal fatigue, steroid treatment can possibly worsen the adrenal problem because the steroids may cause “adrenal suppression", which means the patient may have to take the steroids, the rest of their life because anything less than very short-term use of the steroids, can cause this suppression.

This milder form of low adrenal function, many times is treated with supplements such as DHEA, Adrenal Glandulars and multi-vitamins that contain those that help boost adrenal function, as well as B-12 shots. These are all over-the-counter supplements, with the exception of B-12 shots but you can also get B-12 in oral form that is over-the-counter. All of these supplements have been found to be helpful in resolving adrenal fatigue conditions.

Some of the other things Medical Researchers have studied in regard to CFS and Fibromyalgia, is the fact that these syndromes can have different triggers for different patients but with many, it is an underlying viral, autoimmune, bacterial etc…, type infection in the body, that causes chronic activation of the immune system and over time, this uses up some of the adrenal reserves because the adrenals have a major role in releasing cortisol, the body’s natural anti-inflammatory, attempting to ward off inflammation. Cortisol (also called “cortical"), is also the “stress hormone", that helps the body to deal with stresses of all kinds, without it, even the smallest stressor would cause shock and death (adrenal crises). It, along with adrenaline, are “fight or flight" hormones and help protect the body from the effects of stress, from minor emotional stress, to major ones, such as a car accident or serious disease.

This in my opinion is why persons with CFS/FMS have such low tolerance for stressors both emotional and physical. With low adrenal function, even mild emotional and physical stressors result in major fatigue, couple this with the immune system dysfunction that CFS/FMS patients also have and you have syndromes with serious symptoms! It may be that the immune deficiency found in both CFS and Fibromyalgia is also a type of burn-out of that system, due to constant, ongoing activation of it, that the body eventually loses the ability to continue.

As with all other opinions about CFS and Fibromyalgia, we have to consider all of the above, as some of the many theories that are out there however, I feel the evidence of low adrenal function in CFS and Fibromyalgia, is overwhelming. What I have described, is what I feel connects these syndromes to a form of adrenal fatigue.