Newton et al A Review of Hypothalamic-Pituitary-Adrenal Axis Function in CFS

[bertiedog]

From reading the paper I suspect that the proposed dysregulation of the Hypothalamic-Pituitary-Adrenal Axis is likely a consequence of the ongoing disease process and is not causative. The link with POTS appears to be a standout point made by the paper, from a personal view I suspect that the vascular issues in ME are likely much more central than this. Still, an interesting hypothesis and could be a potential target for some symptomatic relief.


As I say this is a personal view for the disease I myself experience and is unlikely to be universal given the numerous diseases likely under the heading of ME/CFS. For me too much exercise gives me awful dizziness and nausea along with the PEM for a few days later. I remember when I was withdrawing from university I had to walk half a mile from the finance office back to my halls of residence, it was a relatively warm day and by the time I got back I was dizzy, disorientated and felt nauseous. It took a good hour before the room stopped spinning and I could even sit up without vomiting. To me, this experience cemented in my mind that the problem for me lies with vascular problems and is supported by my low blood pressure at every reading (Strangely last time I had it taken it was 120:55 which the doctor thought nothing of.) Thankfully mu POTS type symptoms are barely noticeable so long as I pace myself although it means i'm housebound for 5-6 days a week.

I had all of the above symptoms but now that I take a full replacement amount of steroid every day ie 6mg Prednisolone I don't have any of these symptoms anymore. My case is likely to be different because I likely have a Sheehan's Syndrome which causes hypo pituitary problems but I so often recognise the symptoms that fellow ME/CFS sufferers have as pure adrenal /possible thyroid symptoms which would likely go away with the correct low dose steroid/thyroid regime which they don't get.

Nowadays I am doing almost 6000 steps daily and yet I used to suffer in the way that you mention above. The huge problem is doctors don't recognise it just as Ema was stating.

Pam

 

[roxie60]

tomorrow I find out my latest test results. Been waiting a week. Really feeling out of it tonight. I am curious what the Cortisol AM and ACTH is going to show. It was a different lab doing the tests this time because doctor wanted CD8-CD57 test and only Lab Corp available to do that so I had all the tests so not sure how they will turn out.

I need to put together my typical list of symps, supps and synopsis of life since last visit. I cant even think clearly tonight to think about all I want to ask her......going to bed, hopefully I wont just lay there awake but will rest and this fuzzy brain will be clearer in the AM for me to put together my thoughts and plan and questions.

 

[August59]

To clarify my point further, I don't think that measuring cortisol (alone) is a good marker of anything in particular.

I agree that the level of cortisol may not be so important, but the circadian rhythm of cortisol is extremely important. The rhythm of cortisol controls many things especially the thyroid. Without the peak of cortisol in the morning which is going to help usher more T3 into the cells and give you that wake up feeling. My cortisol is above 8 am levels from 12pm to 12 and never drops till 8 am. At 8am when it is suppose to be at it's highest, mine is lower than it is suppose to be at 12 am.

 

[peggy-sue]

If you have to get a list together, it is a good idea to keep a pen and a bit of of paper on you at all times,

- in case something pops into your head - so you can write it down immediately, before you forget.

Unless you are permanently attached to some computery way of having a document you can put notes in.

In the past, I've spent up to a week compiling a list to print out and take to my gp.

(it wasn't that long - just difficult to put together.)

The easiest way to make your brain go blank is to "sit down" to put your list together.....

 

[WillowJ]

my cortisol is not low, and I understand low cortisol is not a universal finding in us.

 

[Snow Leopard]

my cortisol is not low, and I understand low cortisol is not a universal finding in us.

The standard range quoted for most regular panel tests is fairly wide, most of us will be on the low side of the standard range. This is why I insist that cortisol alone isn't really indicative of anything.

It is a funny thing to say, but the 'statistically significant' lower cortisol levels than controls (when testing blood serum in the morning) doesn't necessarily mean that the cortisol levels of many patients will be below the quoted standard range.

But then again statistics are often taken out of context.

 

[maryb]

can't read all of this too fogged - on recent testing my cortisol was higher than the range at all of the 4 times of the day.