Phoenix Rising - Cort Johnson's Column
...Presenting complex chronic fatigue syndrome (ME/CFS) research in a way we can all understand.
Thursday, March 29th, 2012:
A Biological Cause of ‘Poor Stress Management’ Found in ME/CFS?
Dr. Ronald Glaser - Chronic Fatigue Syndrome and the Pathophysiology of EBV Infection
by Cort Johnson
Brain Behav Immun. 2012 Mar 6. Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome. Lattie EG, Antoni MH, Fletcher MA, Penedo F, Czaja S, Lopez C, Perdomo D, Sala A, Nair S, Fu SH, Klimas N.
It's certainly not clear that everyone with ME/CFS reacts poorly to stress but anecdotal reports suggest that many people with ME/CFS are more vulnerable to stressors after getting the disorder than they were before they had it. Noting that stress often worsens symptoms this study looked for physiological components that might be able to explain part of the stress response problem in ME/CFS. In this study these Miami researchers looked at self-report measures of fatigue, emotional distress and their ability to manage their stress and sought to link them to cytokine and cortisol measures.
They found that patients with better ‘perceived stress management skills’, not surprisingly, tended to be less fatigued and have less emotional distress and have a greater cortisol fluctuations over the day and lower levels of Il-2. The lower levels of diurnal cortisol in the more stressed out patients suggested a less ‘dynamic’ stress response system was present and brought into question whether damage to HPA axis was responsible for some of the difficulties some people have in handing stress.
Low diurnal cortisol levels have been found in rheumatoid arthritis but have mostly been studied, not surprisingly, since cortisol is a ‘stress hormone’ in stress disorders They’ve been found in fibromyalgia, post traumatic stress disorder, RA and other disorders.
One ME/CFS study found that behavioral therapies could return cortisol levels to normal in some patients while another suggested that those types of therapies didn’t work as well in people with low cortisol levels.
The fact that patients with high levels of IL-6 tended to rate themselves as being poor at stress management and suffered from increased fatigue suggested that high levels of this cytokine, long known to be associated with increased pain levels, may result in increased distress and inhibit an individuals ability to manage stress.
This study suggested that problems in two areas, the HPA axis and the immune system exacerbate symptoms and may impact the ease with one deals with stress.
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