Chronic fatigue syndrome: an endocrine disease off limits for endocrinologists?

Abstract

Endocrinologists were not included in the multidisciplinary working groups that prepared two recent reports on chronic fatigue syndrome, despite its unequalled clinical overlap with Addison's disease, which is a classic endocrine disorder. The failure to include at least one endocrinologist in those panels may explain why in their extensive reports there is not a single word about the 42 clinical features that chronic fatigue syndrome shares with Addison's disease, including all the signs and symptoms listed in the case definition of this syndrome.

Evaluation of antioxidant systems in pituitary-adrenal axis diseases

“…A significant increase in various oxidative stress parameters was showed: thiobarbituric acid reactive species, total radical-trapping antioxidant potential, and total antioxidant reactivity in plasma, as well as the activities of the antioxidant enzymes catalase, superoxide dismutase and glutathione peroxidase in erytrocytes and fibroblasts, and a higher susceptibility to oxidation of plasma low density lipoprotein was found [47]. Therefore, it can be hypothesized that some metabolic alterations in adrenal failure (surprisingly similar to those observed in chronic fatigue syndrome [48]) can be related to CoQ 10 deficiency.…”

Accountability in CMAJ

“…Given that hypocortisolism is one of the most frequently reported abnormalities of patients with chronic fatigue syndrome, 2-5 it is surprising that none of the available tests for assessing cortisol production 2-5 was included. 7 Although Cornuz and colleagues, in Table 1 of their paper, correctly mention Addison's disease as one of the major underlying causes of fatigue, they should have remarked that "pigmentation in skin creases, scars and buccal mucosa" 1 is far from being a constant feature of Addison's disease. 6 Another rationale for assessing cortisol production in patients with chronic fatigue is the fact that this condition shares 43 clinical features with Addison's disease, 7,8 including hypocortisolism, chronic fatigue, and all of the symptoms listed in the diagnostic criteria for chronic fatigue.…”

Dr Baschetti rides/writes again

“…In a more than two-page commentary 'Chronic fatigue syndrome: an endocrine disease off limits for endocrinologists' [1], Dr Baschetti claims to critically analyze the Australian and British reports on chronic fatigue syndrome (CFS) and to provide the medical community with a more complete picture of CFS. What he does, however, is to extensively reiterate his bias on the endocrinological basis of the syndrome.…”