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Mild adrenocortical deficiency, chronic allergies, autoimmune disorders & the Chronic Fatigue Syndrome (CFS): a continuation of the cortisone story

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The possibility that patients with disorders that improve with

administration of large, pharmacologic dosages of

glucocorticoids, such as chronic allergies and autoimmune

disorders, might have *mild deficiency of cortisol production

or utilization* has received little attention. Yet evidence

that patients with rheumatoid arthritis improved with small,

physiologic dosages of cortisol or cortisone acetate was

reported over 25 years ago, and that patients with chronic

allergic disorders or unexplained chronic fatigue also

improved with administration of such small dosages was

reported over 15 years ago, suggesting that these disorders

might be associated with mild adrenocortical deficiency. The

apparent reasons for the failure of these reports to be

confirmed or mentioned in medical textbooks and the facts

needed to restore perspective are reviewed, and the need for

further studies of the possible relationship of a mild

deficiency of the production or utilization of cortisol and

possibly other normal adrenocortical hormones to the

development of these disorders is discussed.

Jefferies WM

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