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Integrity of Growth Hormone/Insulin-Like Growth Factor System Maintained in Chronic Fatigue Syndrome (CFS)

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By Cleare AJ, Sookdeo SS, Jones J, O'Keane V, Miell JP • • April 19, 2000

SUMMARY: The study finds that, despite similarities between CFS and growth hormone (GH) deficiency, it doesn't necessarily follow that someone with CFS has a GH deficiency. The conclusion is drawn from data collected from 37 CFS patients (not taking medication) and 37 healthy volunteers. The study measured their GH functions, and then treated them with hydrocortisone (shown to relieve CFS fatigue), measuring GH function before and after the administration. In addition to measuring GH urinary excretion, researchers also recorded the behavior of their insulin-like growth factors. After performing these tests with a variety of measurement types, they found little difference between those with CFS and those without. Hydrocortisone did not create any difference between the groups, having little effect on GH function. The only noteworthy exception was that CFS patients exhibited some suppression of one of the insulin-like growth factors during the insulin stress test.

ABSRACT: GH deficiency states and chronic fatigue syndrome (CFS) share several characteristics, and preliminary studies have revealed aspects of GH dysfunction in CFS. This study assessed indexes of GH function in 37 medication-free CFS patients without comorbid psychiatric illness and 37 matched healthy controls. We also assessed GH function before and after treatment with low dose hydrocortisone, which has been shown recently to reduce fatigue in CFS. We measured basal levels of serum insulin-like growth factor I (IGF-I), IGF-II, IGF-binding protein-1 (IGFBP-1), IGFBP-2 and IGFBP-3 together with 24-h urinary GH excretion. We also performed 2 dynamic tests of GH function: a 100-microg GHRH test and an insulin stress test using 0.15 U/kg BW insulin. There were no differences between patients and controls in basal levels of IGF/IGFBP or in urinary GH excretion. GH responses to both the GHRH test and the insulin stress test were no different [between] patients and controls. CFS patients did have a marginally reduced suppression of IGFBP-1 during the insulin stress test. Hydrocortisone treatment had no significant effect on any of these parameters. There is no evidence of GH deficiency in CFS. At the doses used, hydrocortisone treatment appears to have little impact on GH function.

Source: Cleare AJ, Sookdeo SS, Jones J, O'Keane V, Miell JP, "Integrity of the growth hormone/insulin-like growth factor system is maintained in patients with chronic fatigue syndrome," J Clin Endocrinol Metab 2000 Apr;85(4):1433-9, Department of Psychological Medicine, Guy's King's and St. Thomas' School of Medicine, and the Institute of Psychiatry, London, United Kingdom,, PubMed.

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