Having followed all the research that has been looking at both immune system activation and low levels of cortisol in ME/CFS, I was wondering if a course of high dose steroids might be a useful form of treatment. Is there any evidence that supports the use of steroids in ME?
No proper clinical trials have ever been carried out involving higher doses of steroids in ME/CFS and anecdotal reports (including a small trial in Glasgow some years ago) suggest that steroids such as prednisone are not of any overall benefit. There have been some small clinical trials using much lower doses of steroids (in the form of hydrocortisone). However, the results from these small trials suggest that the potential to cause long-term problems outweighs any possible short-term benefits. Setting up a clinical trial of high-dose steroid treatment would require a lot of thought from the ethical and side-effect point of view and would not be regarded as a high priority.
- The ME Association Clinical and Research Guide (‘The Purple Book') summarises and references these trials in the Treatment section.
Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.