A comparison of salivary cortisol in Chronic Fatigue Syndrome (CFS), community depression & healthy controls

BACKGROUND: Previous studies reporting cortisol hyposecretion

in chronic fatigue syndrome may have been confounded by

venepuncture, fasting and hospitalisation.

METHODS: Morning

and evening salivary cortisol were obtained on consecutive

days in the first 3 days of the menstrual cycle and compared

in three samples of women taking no medication and matched for

age: 14 patients with chronic fatigue syndrome, 26 community

cases of ICD-10 current depressive episodes and 131 healthy

community controls.

RESULTS: The mean evening cortisol was

significantly lower in the chronic fatigue syndrome patients

compared to controls with depression (P = 0.02) and healthy

controls (P = 0.005). Chronic fatigue syndrome patients

without psychiatric disorder had significantly lower morning

salivary cortisols compared to controls (P = 0.009).

CONCLUSION: Chronic fatigue syndrome patients display cortisol

hyposecretion in saliva as well as plasma compared to patients

with depression and healthy controls.


samples of female patients with cortisol estimated at only two

time points in the day. Cortisol secretion may be secondary to

other neurotransmitter abnormalities or other physiological or

lifestyle factors in chronic fatigue syndrome patients.

CLINICAL RELEVANCE: Chronic fatigue syndrome is biochemically

distinct from community depression.

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