| | | | | diseases branch of the CDC, believes that most |
| People suffering from chronic fatigue syndrome (CFS) | | | | patients with CFS and fibromyalgia could benefit from |
| and fibromyalgia may feel better by boosting levels | | | | taking low-dose hydrocortisone, but he says the |
| of the stress hormone cortisol with low doses of | | | | treatment is not without risks. |
| hydrocortisone. According to Dr. Kent Holtorf, the | | | | Reeves and CDC colleagues recently published a |
| simple treatment carries significantly less risk and | | | | study showing that women with CFS symptoms |
| greater potential for benefit than widely accepted | | | | tend to have lower-than-normal cortisol levels upon |
| treatments for the two conditions. However, some | | | | waking in the morning, a time when levels typically |
| CFS and fibromyalgia experts were not so convinced. | | | | spike. |
| Chronic fatigue syndrome is a debilitating disorder of | | | | “It does appear that there is something different |
| uncertain cause which occurs mostly in women than | | | | in HPA axis function in these patients, but that |
| in men, and in adults between 40 to 50 years old. | | | | doesn't necessarily mean that this treatment is the |
| Fibromyalgia is a disorder characterized by the | | | | answer,” Reeves says. |
| presence of chronic widespread pain and debilitating | | | | He cites a 1998 study from the National Institutes of |
| fatigue. | | | | Health examining low-dose hydrocortisone for the |
| Holtorf believes the majority of CFS and fibromyalgia | | | | treatment of chronic fatigue syndrome. |
| patients have low levels of the steroid hormone | | | | Although the treatment was shown to have some |
| cortisol due to dysfunction in a brain system that | | | | benefit, a significant number of patients also exhibited |
| regulates response to stress, known as the | | | | a common side effect seen with higher steroid |
| hypothalamic-pituitary-adrenal (HPA) axis. The problem | | | | doses, such as adrenal suppression, a reduction in the |
| is that very sophisticated testing is needed to | | | | amount of hormones made by the adrenal glands. |
| identify this dysfunction. | | | | The researchers concluded that the degree of |
| As a result, while a number of studies have shown | | | | adrenal suppression precludes the steroid's practical |
| lower-than-normal cortisol levels to be common in | | | | use for CFS. |
| CFS and fibromyalgia patients, many others have | | | | Fibromyalgia researcher Dr. Lesley Arnold agrees. |
| failed to show the association. His review of the | | | | “The evidence in favor of using steroids to treat |
| research is published in the latest issue of the Journal | | | | these conditions just isn't there,” said the |
| of Chronic Fatigue Syndrome. | | | | University of Cincinnati associate professor of |
| Holtorf routinely treats patients with chronic fatigue | | | | psychiatry. “We just don't have enough |
| syndrome and fibromyalgia with low doses (5 to 15 | | | | consistent data about abnormalities in the HPA |
| milligrams a day) of the steroid hydrocortisone, in | | | | axis.” |
| addition to other treatments, to boost cortisol levels. | | | | Arnold points out that some studies in fibromyalgia |
| Of 500 consecutive patients treated with the steroid | | | | patients have shown the HPA axis activity to be |
| at his Torrance, Calif., clinic, Holtorf says 94% | | | | increased and some have shown it to be decreased. |
| showed some improvement and 62% showed | | | | “The only thing that has been consistent is that |
| substantial improvement by the fourth visit. | | | | there is usually some kind of abnormality in function. |
| Dr. William C. Reeves, director of the chronic viral | | | | |