Chronic Fatigue Syndrome and Low Cortisol
Chronic fatigue syndrome (CFS) has become a pervasive medical problem affecting up to 5 percent of patients, primarily women. There is no effective treatment for this condition, perhaps because in nearly all cases, there is an underlying cause that has not been properly identified.
What is Chronic Fatigue Syndrome?
Symptoms of Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS) is defined as clinically unexplained, persistent, or relapsing fatigue of at least six month’s duration and the presence of at least four of these symptoms:
• Sore throat
• Tender, enlarged lymph nodes in neck or under arm region
• Muscle pain
• Pain in multiple joints
• Fatigue after exercise
• Non-refreshing sleep
• Headaches
• Impaired memory/concentration
You may find it interesting to know that all of the symptoms of chronic fatigue syndrome are also symptoms of hypocortisolism! And again, the key question to ask is WHY? Some key causes of chronic fatigue syndrome AND low cortisol include: sleep disorders, immune system dysfunction, chronic infections, gastrointestinal problems, and abnormal function of the mitochondria (power houses of our cells).
Numerous studies have confirmed that patients with CFS have:
• Reduced baseline HPA (hypothalamus-pituitary-adrenal) axis function
• Decreased function or abnormal regulation of HPA axis
• Flattened daytime cortisol levels
• Inappropriately low cortisol levels upon exposure to a known stressor
• Excessive inflammation
And yet again, the majority of the medical evidence does not find primary adrenal gland failure to be the cause of low cortisol in CFS patients. A 2008 issue of the Journal of Chronic Fatigue Syndrome published an evidence based review of CFS and fibromyalgia which specifically states:
“… A more important fact is that a multitude of studies have demonstrated the HPA axis dysfunction in these conditions [CFS and fibromyalgia] is central (hypothalamic or pituitary), not a primary adrenal insufficiency.”

