Medscape article: 'Just a Myth'? It May Be Time to Take Adrenal Fatigue Seriously, 2019, by John Watson

One of the Drs in the UK who flirts with adrenal fatigue is Sarah Myhill.

http://www.drmyhill.co.uk/wiki/Common_Hormonal_Problems_in_CFS_-_Adrenal

As the Medscape article above says, researchers into ME/CFS have long looked at the HPA axis but not found anything particularly conclusive.

Interestingly Myhill quotes a study from KCL to justify prescribing hormones & steroids.

https://www.ncbi.nlm.nih.gov/m/pubmed/9989716/

The authors are none other than Simon Wessely & Anthony Cleare!

 

From “Magical Medicine: How to make a disease disappear” by Professor Malcolm Hooper -

http://www.margaretwilliams.me/2010/magical-medicine_hooper_feb2010.pdf

Page 12 - there is evidence of abnormality of adrenal function, with the size of the glands being reduced by 50% in some cases

Page 110 - adrenal insufficiency with subsequent low cortisol levels (Addington 2000)

Page 136 - According to Cheney, it is difficult to talk about a low cardiac output without talking about the involvement of the brain and the adrenal glands.

If the cardiac output goes down, in order not to die, there is a rise in noradrenergic tone (also involving the adrenal glands) to bring the output back up. In ME/CFS, this is a serious problem, because when the adrenals are exhausted, there will be low cardiac output.

There is no such thing as an ME/CFS patient who is NOT hypothyroid: this has nothing to do with thyroid failure, but everything to do with matching metabolic demand and cardiac output.

Page 148 - We suggest that the hyper‐responsiveness of the adrenal cortex to ACTH in patients with (ME)CFS reflects a secondary adrenal insufficiency in which adrenal receptors have become hyper‐responsive to inadequate levels of ACTH. (Mark A Demitrack et al. Journal of Clinical Endocrinology and Metabolism 1991:73:6:1224‐1234).

Page 149 - In a study examining abnormality of adrenal function, Japanese researchers found that “these abnormalities are quite different from those found in patients with mental or physical diseases reported previously” (Yamaguti K et al. JCFS 1996:2:2/3:124‐125).

Page 149 - The cardinal findings include attenuated ACTH responses to CRH and low 24‐hour urinary cortisol. These are compatible with a mild central adrenal insufficiency. ” (LV Scott TG Dinan. JCFS 1996:2:4:49‐59).

Page 150 - “The right and left adrenal gland bodies were reduced by over 50% in the (ME)CFS subjects, indicative of significant adrenal atrophy in a group of (ME)CFS with abnormal endocrine parameters” (Scott LV et al. Psychoneuroendocrinology 1999:24:7:759‐768).

Page 151 - reduced adrenal responsiveness to ACTH exists in (ME)CFS (Srp Arh Celok Lek 2003:131:9‐10:370374).

 

If you want an introduction to the HPA axis and the stress response, try this article.

https://www.integrativepro.com/Resources/Integrative-Blog/2016/The-HPA-Axis