A recent study has suggested that cortisol could help alleviate suffering for those with chronic fatigue syndrome (CFS) and fibromyalgia (FM), both of which currently have only limited treatment options.

Based on an extensive review of more than 50 published studies that assessed adrenal function in CFS and FM patients, researchers in Torrance, California, found that the majority of patients had low levels of the steroid hormone cortisol, due to a dysfunction in the brain stem, which regulates the response to stress.

The comprehensive review also showed that patients who were given 5–15 mg a day of cortisol as an early part of a multi-system treatment plan experienced significant improvement in their symptoms and quality of life.

This research was further confirmed in an observational study following the conditions of 500 patients from one clinic, where all were given cortisol as part of their treatment protocol. In this case, 94% showed some improvement and 62% showed substantial improvement by the fourth visit.
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While a number of other studies have also shown lower-than-normal cortisol levels to be common in CFS and FM patients, many have failed to show this association, and some experts are hesitant about using cortisol to treat these conditions.

William C Reeves, MD, director of the chronic viral diseases branch of the US Centers for Disease Control and Prevention, agrees that CFS/FM patients do appear to have an abnormality of hormonal function, and that most might benefit from taking low-dose hydrocortisone (cortisol), but stresses that the treatment is not without risks.

He cites a 1998 study from the National Institutes of Health, examining low-dose hydrocortisone for the treatment of chronic fatigue syndrome, in which benefit was seen, but in which a significant number of patients also exhibited a side effect which is common with higher steroid doses – suppression of the adrenal glands' normal hormone production.
For Reeves and others, the degree of adrenal suppression precludes the practical use of steroids for CFS.

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First Published in June 2008

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