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Pituitary gland
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== ME/CFS == Dysfunction of the endocrine system, with a focus on [[hypothalamic-pituitary-adrenal axis]] (HPA axis) hypofunction, has been reported in individuals with ME/CFS.<ref>{{Cite journal | last = Nijhof | first = Sanne L. | last2 = Rutten | first2 = Juliette M. T.M. | last3 = Uiterwaal | first3 = Cuno S. P.M. | last4 = Bleijenberg | first4 = Gijs | last5 = Kimpen | first5 = Jan L.L. | last6 = Putte | first6 = Elise M. van de | date = Apr 2014 | title = The role of hypocortisolism in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/24636516|journal=Psychoneuroendocrinology|volume=42|pages=199β206|doi=10.1016/j.psyneuen.2014.01.017|issn=1873-3360|pmid=24636516}}</ref><ref>{{Cite journal | last = Papadopoulos | first = Andrew S. | last2 = Cleare | first2 = Anthony J. | date = 2011-09-27 | title = Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/21946893|journal=Nature Reviews. Endocrinology|volume=8|issue=1|pages=22β32|doi=10.1038/nrendo.2011.153|issn=1759-5037|pmid=21946893}}</ref><ref>{{Cite journal | last = Heim | first = Christine | last2 = Nater | first2 = Urs M. | last3 = Maloney | first3 = Elizabeth | last4 = Boneva | first4 = Roumiana | last5 = Jones | first5 = James F. | last6 = Reeves | first6 = William C. | date = Jan 2009 | title = Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction|url=https://www.ncbi.nlm.nih.gov/pubmed/19124690|journal=Archives of General Psychiatry|volume=66|issue=1 | pages = 72β80|doi=10.1001/archgenpsychiatry.2008.508|issn=1538-3636|pmid=19124690}}</ref><ref name="Morris">{{Cite journal | last = Morris | first = Gerwyn | last2 = Anderson | first2 = George | last3 = Maes | first3 = Michael | date = 2016-10-20 | title = Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways|url=https://link.springer.com/article/10.1007/s12035-016-0170-2|journal=Molecular Neurobiology|language=en|volume=54|issue=9 | pages = 6806β6819|doi=10.1007/s12035-016-0170-2|issn=0893-7648}}</ref>. It has been suggested that HPA axis hypofunction in ME/CFS is caused by chronic activation of the inflammatory and oxidative and nitrosative stress pathways<ref name="Morris" />. However, this area of research continues to lack studies with direct measures of pituitary function. Some patients report that there seems to be a period of pituitary/HPA axis hyperfunction in the earlier stage of ME/CFS, whereas later in disease progression there's a switch to hypofunction. This could perhaps explain some of the wide variation across studies (e.g.,<ref>{{Cite journal | last = DEMITRACK | first = MARK A. | last2 = DALE | first2 = JANET K. | last3 = STRAUS | first3 = STEPHEN E. | last4 = LAUE | first4 = LOUISA | last5 = LISTWAK | first5 = SAM J. | last6 = KRUESI | first6 = MARKUS J.P. | last7 = CHROUSOS | first7 = GEORGE P. | last8 = GOLD | first8 = PHILIP W. | date = Dec 1991 | title = Evidence for Impaired Activation of the Hypothalamic-Pituitary-Adrenal Axis in Patients with Chronic Fatigue Syndrome|url=https://academic.oup.com/jcem/article-abstract/73/6/1224/2653522|journal=The Journal of Clinical Endocrinology & Metabolism|language=en|volume=73|issue=6|pages=1224β1234|doi=10.1210/jcem-73-6-1224|issn=0021-972X}}</ref><ref>{{Cite journal | last = Di Giorgio | first = Annabella | last2 = Hudson | first2 = Marina | last3 = Jerjes | first3 = Walid | last4 = Cleare | first4 = Anthony J. | date = May 2005 | title = 24-hour pituitary and adrenal hormone profiles in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/15911907|journal=Psychosomatic Medicine|volume=67|issue=3 | pages = 433β440|doi=10.1097/01.psy.0000161206.55324.8a|issn=1534-7796|pmid=15911907}}</ref><ref>{{Cite journal | date = 2004-07-01 | title = Basal circadian and pulsatile ACTH and cortisol secretion in patients with fibromyalgia and/or chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/pii/S0889159104000212|journal=Brain, Behavior, and Immunity|language=en|volume=18|issue=4|pages=314β325|doi=10.1016/j.bbi.2003.12.011|issn=0889-1591}}</ref>). Patients with ME have also reported other problems with the pituitary, such as [[empty sella syndrome]] and [[pituitary adenoma]]. These may be of note to guide future research.{{citation needed | date = Nov 2021}}
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