Study Shows Low Cortisol in Women with CFS

In December 2007, the Journal of Clinical Endocrinology & Metabolism published a study by researchers from the Centers for Disease Control and Prevention (CDC) and Emory University examining morning cortisol concentrations in people with CFS. This study received attention from the New York Times (January 29, 2008) and other news outlets.

Cortisol is a naturally occurring hormone produced by the body. It helps increase blood sugar and blood pressure, and it has an immunosuppressive effect by modulating inflammatory activity. Some people refer to it as a “stress hormone” because it’s involved in the stress response and in bringing the body back to balance (homeostasis).

Unlike in clinical depression, where there can be too much cortisol being produced, some CFS studies have shown low cortisol levels compared to healthy control subjects. Atypical cortisol production is also an indicator of HPA-axis dysfunction—long implicated in CFS—since the HPA axis regulates cortisol.

In this study, researchers measured the morning cortisol levels of 75 people with CFS and 110 healthy control subjects by taking saliva samples from them immediately upon awakening and at 30 and 60 minutes thereafter. While levels were only slightly different upon awakening, people with CFS—particularly women—showed lower cortisol levels at 30 minutes and at 60 minutes after awakening. In fact, while there was significant difference in morning cortisol levels between healthy women and women with CFS, cortisol measurements were similar between men with CFS and without. This suggests that something about the biology of being female is affecting cortisol levels.

Because cortisol affects the function of many cells, including immune cells, low cortisol may help explain CFS symptoms. Other conditions with low cortisol, like Addison’s disease, manifest similar symptoms as CFS.

Nater UM, Maloney E, Boneva RS, Gurbaxani BM, Lin JM, Jones JF, Reeves WC, Heim C. Attenuated morning salivary cortisol concentrations in a population-based study of persons with chronic fatigue syndrome and well controls. J Clin Endocrinol Metab Dec 26 2007; doi:10.1210/jc.2007-1747

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