Hi Lisa and everyone,

I've been lurking for a while not really well enough to post but i just had
to jump in when i saw this posting.

>Thought this might be of interest to those battlng CFS, and also because of
>recent comments re:excess cortisol and its effects on emotions. This
<snip>
>Comorbidities are common in chronic fatigue syndrome
>(CFS), with up to 50% of patients also having major
>depression. Reports of mild hypocortisolism in CFS
>prompted researchers to look into similarities between the
>disease and Addison's disease to evaluate whether low-dose
>hydrocortisone therapy may be an effective treatment.
>Patients who fulfilled criteria for both conditions were
>randomized to receive low-dose hydrocortisone or placebo
>for 1 month each. Self-rated fatigue and disability were
>significantly reduced in about one-third of the patients
>while on hydrocortisone, although pretreatment endocrine
>evaluation could not have predicted this response.

what this doesn't mention is that a signifacant (sorry cant recall how
much) number of sufferers actually got WORSE after the hydrocortisone, so
it has been more or less abandoned, unless anyone wants to take the risk of
trying it.  (There's also a risk that taking long term hydrocortisone can
lead to the body becomeing dpeendant on it).  It is true that it is a
common pathological feature though (unlike clinical depression).  Also this
abstract fails  to distinguish between causal and reactive depression.  I
will paste here what i already wrote once for another list:
>As in Dr Strauss' trial
>(see below), there was an adrenal imbalance created by taking
>hydrocortisone (the adrenals secrete cortisone and tons of other hormones).
> Hydrocortisone is another name for natural cortisol, cortisone and
>prednisone are synthetic ones, although sometimes (according my prehistoric
>family medicine encyclopeadia) cortisone is used to mean either.  Cortisol
>has something to do with the way the body uses carbohydrates, starches and
>sugars and connective tissue maintenance, so I assume this is how it
>affects the bodies' energy absorption (as will a lot of factors).
>
>At least one study has been done comparing CFS/ME to Addison's desease
>(AD), in which the sufferer has underactive adrenal glands.  There are so
>many simularities, it may actually be some cases of AD are being mistaken
>for CFS/ME (although haven't we heard this before, with hypothyroidism et
>al).  AD features fatigue, weakness, bowel problems, joint pain, cognitive
>difficulties, and a decrease in blood volume. Such are the symptomatic
>likenesses between the two illnesses it is all the more scandalous that
>attitudes to CFS/ME are such as they are.  It's one rule for one illness,
>one rule for another (and because of lack of "aetiology" and "evidence").
>It has to be said though that PWADs are subjected to the same sort of
>stigma, from laypeople anyway, because they don't "look" ill.
>
>My advice if you can call
>it that, would be to proceed with extreme caution, better IMO to look at a
>more fundemental systems in the body, preferably together, holistically, or
>in such a way that as many systems as appropriate are treated alongside
>each other (but that's easier said than done!)  It's all so interconnected
>that it's too easy to create an imbalance somewhere else by fixing up just
>one part.  The pituitary controls the adrenals and just about everything
>else, but that isn't much help either especially as I don't know much about
>it except it regulates growth hormone production, another thing which has
>in the past been posited as a factor in CFS).  The hormone the pituitary
>produces to control the adrenals is called ACTH which sounds familiar too.
>(NY Times - "Normally, the hypothalmus in the brain produces CRH, or
>corticotropin releasing hormone, which stimulates the pituitary gland in
>the brain to
>produce ACTH, or adrenocorticotropin hormone.  ACTH, in turn, stimulates
>produciton of cortisol in the adrenal gland, which is next to the
>kidney...doctors have long linked deficits of cortisol to lethargy and
>fatigue.")
>
>If nothing else, it's proof CFS/ME is definitely not depression, as
>depressives tend to have normal or high (can't recall which #-/) cortisol
>levels.  That begs the question, do those unfortunate enough to suffer from
>both have neutral/normal or nearer normal levels of cortisol?  If so, then
>cortisol depletion can't be that central to CFS/ME or otherwise depressives
>wouldn't be able to get CFS/ME too.

I should aslo point out why i changed the subject header for this is that
there is a world of difference vbteeen CFS and CF which mayy not be
apparent to the non PWC, and we PWCs can be very tetchy about this!  But
for good reason, CF is usually treatable and less severe illness than
CFS/ME, the latter having fatigue as only one of it's symptoms (50 symtpoms
recognised world wide) since it is a ssyndrome -- CF is only a symptom
(albeit a very unpleasant one).  Because of the different management
indicated for these two and the medical establishment's censorship of
research by using populatuion samples just based on CF (too broad), this
has led to much bitterness and ill feeling in the CFS community.

Anyway just thought i'd make this clear - i'm by no means meaning to sound
as if i am attacking anyone, and it was thoughtful of you to post this
Lisa. :)   Now I think i will have to return to my lurking mode!

Best wishes
Mike
P.S. sorry about typos - not a good day/week/month
PPS. please don#'t ask me questions as i am nt really up to posting just
now, not that i don't want to be friendly.  hope it's okay for me to just
"listen in". :)


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     My judgement may be impaired but don't use
          that to judge my impairment :)
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