IMAGE DESCRIPTION: An image of building blocks with letter spelling Cortisol. The title of the blog (top left) and the ME Association logo (bottom right)

BLOOMBERG: Striking Drop in Stress Hormone Predicts Long Covid in Study: Cortisol

Long Covid causes low levels of Cortisol

MEA Comment

Dr Charles Shepherd, Honorary Medical Adviser to the ME Association comments:

I was at the IACFS conference when this interesting new research on low cortisol levels in Long Covid was presented two weeks ago.

It is an important research finding because:

1. Dysfunction of the hypothalmic-pituitary-adrenal (HPA) axis – which controls the output of the hormone cortisol from the adrenal glands – also occurs in ME/CFS.

In fact, this is the commonest and most consistent research abnormality involving neuroendocrine (brain-hormone) dysfunction to be found in ME/CFS.

All the ME/CFS research into HPA dysfunction and low cortisol is summarised and referenced in the Research section of the ME Association Clinical & Research Guide 2022 Edition (also known as the ‘purple book')

The 2022 Clinical & Research Guide (The ‘Purple Book’) is now available to order! 

2. Treating low levels of cortisol with a steroid hormone (such as hydrocortisone) seems a sensible thing to do.

However, several clinical trials that have assessed this intervention in ME/CFS have concluded that any minor benefits are outweighed by the potential to cause side-effects and further disruption of the hormonal control mechanisms.

So, steroid replacement is not a form of treatment that is prescribed in the UK or recommended in the new NICE guideline.

All the clinical trials involving steroid treatment for ME/CFS are summarised and referenced in the Treatment section of the ME Association's/ Clinical & Research Guide 2022 Edition (also known as the ‘purple book')

Finally, it is interesting to note that HPA dysfunction and low cortisol levels were also reported in a previous outbreak of coronavirus (SARS) infection:

Dr Charles Shepherd,
Trustee and
Hon. Medical Adviser
to the ME Association.

Dr Charles Shepherd
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