Disturbed adrenal function in adolescents with chronic fatigue syndrome

J Pediatr Endocrinol Metab. 2005 Mar;18(3):295-301. doi: 10.1515/jpem.2005.18.3.295.


Objective: To investigate adrenal function in children and adolescents with chronic fatigue syndrome (CFS) compared with age-matched controls.

Methods: Case-control study of low dose (500 ng/m2) synacthen tests (LDST) in 23 adolescents with CFS and 17 age-matched controls. Serum cortisol concentrations were measured at 5-min intervals from 10 to 45 minutes. Peak serum cortisol concentration, time to peak, rise in cortisol and area under the curve (AUC) were derived.

Results: Patients with CFS had significantly lower mean cortisol levels during the LDST (p <0.001), lower peak cortisol (p <0.025), reduced cortisol AUC (p <0.005) and longer time to peak cortisol (p <0.05). Abnormalities were seen in both sexes but were more pronounced in females. Unstimulated adrenal androgen and 17-hydroxyprogesterone concentrations were normal.

Conclusions: Adolescents with CFS have subtle alterations in adrenal function suggesting a reduction in central stimulation of the adrenal glands. The more pronounced effects in females may reflect differential central effects of stress on hypothalamic-pituitary-adrenal axis regulation between the sexes.

MeSH terms

  • Adolescent
  • Adrenal Gland Diseases / etiology*
  • Adrenal Glands / physiology*
  • Case-Control Studies
  • Fatigue Syndrome, Chronic / complications*
  • Fatigue Syndrome, Chronic / physiopathology*
  • Female
  • Humans
  • Hydrocortisone / blood*
  • Hypothalamo-Hypophyseal System / physiology
  • Male
  • Pituitary-Adrenal System / physiology
  • Sex Factors


  • Hydrocortisone