Fludrocortisone

Fludrocortisone (brand name: Florinef) is a synthetic corticosteroid hormone used in treatment of postural hypotension and adrenal insufficiency, including Addison's disease. It is frequently used off-label as a treatment for postural orthostatic tachycardia syndrome (POTS) and orthostatic intolerance (OI). In adrenal insufficiency, it is generally taken together with hydrocortisone.

Fludrocortisone is mostly a mineralocorticoid, but it has very weak glucocorticoid effects. It mimics the function of aldosterone, increasing blood sodium levels and therefore, blood volume.

Use in chronic fatigue syndrome
* In 1998, a study by Phillip K. Peterson, et al, showed that low-dose fludrocortisone does not provide sufficient benefit to patients with chronic fatigue syndrome. Using the 36-Item Short-Form Health Survey, a reaction time test, and a treadmill exercise test, they found no observed improvement in the severity of any symptom. Likewise, blood pressure and heart rate readings were unaffected by treatment.

ME/CFS patients often have OI or POTS and these conditions could improve by taking fludrocortisone.

Side effects and drug interactions
It is important to discuss fludrocortisone's side effects and possible drug interactions with your doctor and pharmacist.

Notable studies

 * 1998, A preliminary placebo-controlled crossover trial of fludrocortisone for chronic fatigue syndrome. (Full Text)