Ooh, this ties in to one of my personal pet hypotheses re CFS/ME.
SOMETHING... SOMEHOW... Has led to an insensitivity or even outright intolerance to cortisol level fluctuations in the body (or perhaps one of the other stress hormones/HPA axis etc).
This does not depend on "high levels" of cortisol, but merely changes above some "base level" idiopathic to each patient. This explains why some patients have high levels of cortisol in their tests, some are low and some are normal. The effect is seen as marginal.
What do exercise, stress and illness behaviour all have in common? They have all been measured to increase cortisol (and other stress hormones).
That is why some of us can walk for an hour before the onset of PEM, but others can barely manage 5 minutes. At some point, a threshold is crossed and the body starts responding to the presence of raised cortisol as a pathogen rather than a normal response. Immune response ensues.
The real question is why? How did the body learn to get this way?
Hi Skippa,
I often thought as cortisol influence as a major part of this enigma. When you live with something for so long you see all the small traits it throws at you and certain patterns emerge.
My reasoning for a circadian/cortisol influence was based on many small perceptions.
I think its a cortisol spike that is most dangerous to us for a crash....but its the constant cortisol is creating the constant autoimmune stress.
1. PWME mostly wake up worse and better at night - follow cortisol pattern.
2. Overnight flights etc help me....someone else here noticed that....a disrupted cortisol pattern is beneficial.
3. I improve more dramatically when i eat high carbs.....dropping cortisol via insulin release.
4. Women tend to suffer from stress more than men....possible link for the unbalanced male/female cfs ratio.
5. I can provoke a crash "on purpose" by forcing a stress surge on my body.
I think we ride close to the line all the time....and takes a little cortisol spike to tip us over.
I guess there is no real definitive way to test our theory....bar removing our adrenal glands
