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Cortisol
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'''Cortisol''' is a steroid [[hormone]] released by the adrenal glands which sit upon the kidneys. It is the main stress hormone in the human body.<ref name="webmd">{{Cite web | url = https://www.webmd.com/a-to-z-guides/what-is-cortisol | title = What Is Cortisol? | website = WebMD|language=en|access-date=2021-02-16}}</ref> Release of cortisol is controlled by the [[hypothalamus]], a part of the [[brain]].<ref name="webmd" /> Cortisol has several known roles in the human body: aiding in [[Metabolic|metabolism]], reducing [[inflammation]], assisting electrolyte balance, stimulating gastric-acid secretion and controlling one's sleep/wake cycle.<ref name=hhn>{{Cite web | url = https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/cortisol | title = Cortisol | last = | first = | authorlink = | date = | website = Hormone Health Network| archive-url = | archive-date = |url-status = | access-date=2021-02-16}}</ref><ref name="webmd" /> Cortisol given as a medicine is known as [[hydrocortisone]]. Normal blood level of cortisol vary throughout the day, with the highest level in the morning upon awakening and lowest level around midnight. Levels can also rise in reaction to stress or low blood sugar. Some health conditions can cause an increase in cortisol, such as [[depression]]<ref name="Scott, 1998" /> and Cushing syndrome.<ref name="webmd" /> Other health conditions can cause a decrease, such as [[Addison's disease]]<ref name=nadf>{{Cite web | url = https://www.nadf.us/primary-adrenal-insufficiency-addisonrsquos-disease.html | title = Primary Adrenal Insufficiency (Addison's Disease) | website = National Adrenal Diseases Foundation|language=en|access-date=2021-02-16}}</ref> and [[ME/CFS]].<ref name=Addington>{{Cite journal | last = Addington | first = John W. | authorlink = | date = 2000-01-01 | title = Chronic Fatigue Syndrome | url =https://doi.org/10.1300/J092v07n02_06|journal=Journal of Chronic Fatigue Syndrome|volume=7 | issue = 2 | pages = 63–74|doi=10.1300/J092v07n02_06|issn=1057-3321|pmc=|pmid=|access-date=|quote=|via=}}</ref> ==ME/CFS== === Findings === Hypocortisolism (a low cortisol level) frequently occurs in patients with [[ME/CFS]], confirmed by studies measuring cortisol levels and in urine<ref name="Scott, 1998" /> and saliva.<ref name="Schmaling, 2015" /><ref name="Nijhof, 2014" /> In addition to general hypocortisolism, [[ME/CFS]] patients have a decreased cortisol awakening response, ie, morning cortisol levels peak later compared to healthy controls.<ref name="Roerink, 2018" /> In 2018, Roerink, et al, studied hair cortisol concentrations in [[Chronic fatigue syndrome|CFS]] patients to assess if hypocortisolism was a prolonged phenomenon. They found that there was a trend of lower hair cortisol concentrations in [[Chronic fatigue syndrome|CFS]] patients, thus suggesting that hypocortisolism was long-term in [[ME/CFS]].<ref name="Roerink, 2018" /> As people with [[ME/CFS]] improved, their hypocortisolism improved.<ref name="Nijhof, 2014" /> === Clinical trials === A 1998 double-blind, randomized, placebo-controlled trial found that low dose hydrocortisone led to a statistical improvement in one subjective score, the Wellness scale. No statistical evidence of improvement was seen with the other self-rating scales. The authors concluded that: although hydrocortisone treatment was associated with some improvement in symptoms of CFS, the degree of adrenal suppression precludes its practical use for CFS.<ref>{{Cite journal | last = McKenzie | first = R | date = Sep 1998 | title = Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized controlled trial | url = https://www.ncbi.nlm.nih.gov/pubmed/9757853|journal=JAMA|volume=280 | issue = 12 | pages = 1061-6|via=}}</ref> In 1999, the Institute of Psychiatry, London, did a randomized crossover trial, in which [[Simon Wessely]] was an author, where low dose hydrocortisone treatments given to patients with [[chronic fatigue syndrome]] were found to reduce [[fatigue]] scores and that 28% of patients in the treatment group had reductions in scores that brought them to or close to normal in the short term.<ref>{{Cite journal | last = Cleare | first = AJ | date = February 1999 | title = Low-dose hydrocortisone in chronic fatigue syndrome: a randomised crossover trial | url = https://www.ncbi.nlm.nih.gov/pubmed/9989716|journal=Lancet|volume=353 | pages = 455-8|via=}}</ref> A 2003 double-blind, randomized, placebo-controlled trial of hydrocortisone in combination with [[fludrocortisone]] found no difference in self-reported outcomes from when patients received the placebo vs. the medication.<ref>{{Cite journal | last = Blockmans | first = D | date = Jun 2003 | title = Combination therapy with hydrocortisone and fludrocortisone does not improve symptoms in chronic fatigue syndrome: a randomized, placebo-controlled, double-blind, crossover study | url = https://www.ncbi.nlm.nih.gov/pubmed/12829200|journal=Am J Med|volume=114 | issue = 9 | pages = 736-41|via=}}</ref> ==Notable studies== *1998, Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers<ref name="Scott, 1998" /> [https://www.ncbi.nlm.nih.gov/pubmed/9476743 (Abstract)] *2000, Review article - Chronic Fatigue Syndrome: A Dysfunction of the Hypothalamic-Pituitary-Adrenal Axis<ref name="Addington, 2000" /> [http://dx.doi.org/10.1300/J092v07n02_06 (Abstract)] *2014, The role of hypocortisolism in chronic fatigue syndrome<ref name="Nijhof, 2014" /> [https://www.ncbi.nlm.nih.gov/pubmed/24636516 (Abstract)] *2015, Salivary cortisol responses to household tasks among couples with unexplained chronic fatigue<ref name="Schmaling, 2015" /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388037/ (Full Text)] *2018, Hair and salivary cortisol in a cohort of women with chronic fatigue syndrome<ref name="Roerink, 2018" /> [https://www.sciencedirect.com/science/article/pii/S0018506X1730569X (Abstract)] *2018, A State-Space Investigation of Cortisol Alterations in Chronic Fatigue Syndrome<ref>{{Cite journal | last = Hua | first = Huy | authorlink = | last2 = Amin | first2 = Rafiul | authorlink2 = | last3 = Wickramasuriya | first3 = Dilranjan S. | author-link3 = | last4 = Faghih | first4 = Rose T. | author-link4 = | last5 = | author-link5 = | date = 2018 | title = A State-Space Investigation of Cortisol Alterations in Chronic Fatigue Syndrome | url =https://uh-ir.tdl.org/handle/10657/3725|journal=Undergraduate Research Day Summer Undergraduate Research Fellowship (SURF) Projects - University of Houston|language=en-US|volume= | issue = | pages=|quote=|via=}}</ref> == See also == *[[Hydrocortisone]] *[[Hormone]] ==Learn more== *[https://www.webmd.com/a-to-z-guides/what-is-cortisol What is cortisol? - WebMD] *[https://selfhacked.com/2016/04/12/need-know-cortisol-health-effects/ All You Need to Know About Cortisol and Its Health Effects] *[https://www.healthrising.org/blog/2014/08/04/cortisol-postexertional-malaise-stress-management-collide-mecfs-study/ The Cortisol, PEM and Stress Management Link in Chronic Fatigue Syndrome] by [[Cort Johnson]] in [[Health Rising]] ==References== <references> <ref name="Addington, 2000">{{Citation | last1 = Addington | first1 = John W. | author-link1 = | title = Chronic Fatigue Syndrome: A Dysfunction of the Hypothalamic-Pituitary-Adrenal Axis | journal = Journal of Chronic Fatigue Syndrome | volume = 7 | issue = 2 | page = 63-74 | date = 2000 | pmid = | doi = 10.1300/J092v07n02_06 }}</ref> <ref name="Nijhof, 2014">{{Citation | last1 = Nijhof | first1 = SL | author-link1 = | last2 = Rutten | first2 = JM | authorlink2 = | last3 = Uiterwaal | first3 = CS | author-link3 = | last4 = Bleijenberg | first4 = G | author-link4 = | last5 = Kimpen | first5 = JL | author-link5 = | last6 = Putte | first6 = EM | author-link6 = | title = The role of hypocortisolism in chronic fatigue syndrome | journal = Psychoneuroendocrinology | volume = 42 | issue = | page = 199-206 | date = 2014 | pmid = | doi = 10.1016/j.psyneuen.2014.01.017 }}</ref> <ref name="Roerink, 2018">{{Citation | last1 = Roerink | first1 = Megan E. | author-link1 = | last2 = Roerink | first2 = Sean H.P.P. | authorlink2 = | last3 = Skoluda | first3 = Nadine | author-link3 = | last4 = van der Schaaf | first4 = Marieke E. | author-link4 = | last5 = Hermus | first5 = Ad R.M.M. | author-link5 = | last6 =van der Meer | first6 = Jos W.M. | author-link6 = Jos van der Meer | last7 = Knoop | first7 = Hans | author-link7 = | last8 =Nater | first8 = Urs M. | author-link8 = | title = Hair and salivary cortisol in a cohort of women with chronic fatigue syndrome | journal = Hormones and Behavior | volume = 103 | issue = | page = 1–6 | date = 2018 | pmid = | doi = 10.1016/j.yhbeh.2018.05.016 }}</ref> <ref name="Schmaling, 2015">{{Citation | last1 = Schmaling | first1 = K.B. | author-link1 = | last2 = Romano | first2 = J.M. | authorlink2 = | last3 = Jensen | first3 = M.P. | author-link3 = | last4 = Wilkinson | first4 = C.W. | author-link4 = | last5 = McPherson | first5 = S. | author-link5 = | title = Salivary Cortisol Responses to Household Tasks among Couples with Unexplained Chronic Fatigue | journal = Journal of Family Psychology : JFP : Journal of the Division of Family Psychology of the American Psychological Association (Division 43) | volume = 29 | issue = 2 | page = 296–301 | date = 2015 | pmid = | doi = 10.1037/fam0000074 }}</ref> <ref name="Scott, 1998">{{Citation | last1 = Scott | first1 = LV | author-link1 = | last2 = Dinan | first2 = TG | authorlink2 = | title = Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers | journal = J Affect Disord | volume = 47 | issue = 1-3 | page = 49-54 | date = 1998 | pmid = 9476743 | doi = }}</ref> </references> [[Category:Neurotransmitters and hormones]] [[Category:Hormones]] [[Category:Adrenal glands]] [[Category:Adrenal hormones]]
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