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NIH CFS Workshop Report: Firdhaus Dhabhar on Stress & the Immune System in Chronic Fatigue Syndrome

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By Rich Van Konynenburg, Ph.D.

Firdhaus Dhabhar is an Associate Professor at Ohio State University. His talk (at the NIH Workshop on CFS on June 12, 2003 at Bethesda, MD) had one central message, which was that under normal circumstances the effect of stress on the immune system is beneficial, not detrimental.

In conditions of short-term or acute stress, the response of the HPA axis is to raise the output of glucocorticoids for a short time, and this actually mobilizes the immune system to be better able to cope with incoming threats. For example, under these circumstances the white blood cell count in the peripheral blood decreases, but this does not mean that these cells have been destroyed. Rather, the white cells are moved out of the blood into the tissues to be ready to fight injuries or infections that may occur. Prof. Dhabhar used the picturesque language of warriors moving from their barracks to the boulevards, and from there to their battle positions.

He noted that the problems with stress and the immune system occur when the stress situation is long-term, as in weeks, months, or years. If the glucocorticoid output is maintained at a high level for such long times, the immune system is suppressed, as was discussed by Esther Sternberg.

I think that the significance of this talk for CFS is that while it appears that a history of high stress is important in bringing about the onset of CFS in many PWCs, this stress must be of long duration in order to have this effect. I think this is fully consistent with the stress history reported by many PWCs.

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