Cleare, A J, O'Keane, V, Miell, J P · Psychoneuroendocrinology · 2004 · DOI
This study looked at stress hormone levels in people with ME/CFS, specifically a hormone called DHEA that affects mood, memory, and sleep. Researchers compared 16 ME/CFS patients to 16 healthy controls and tested how their bodies responded to a hormone challenge. They also gave some patients a low-dose steroid medication for a month to see if it helped. The findings suggest that DHEA levels are higher in ME/CFS and may relate to how disabled patients feel, and that low-dose steroid treatment can lower these levels and improve symptoms in some patients.
Understanding hormone abnormalities in ME/CFS is crucial because the condition involves dysregulation of the stress-response system; this study provides evidence that normalizing DHEA levels through low-dose hydrocortisone may reduce fatigue in responsive patients. These findings support further investigation of steroid therapy as a targeted biomarker-informed treatment approach for ME/CFS.
This study does not prove that elevated DHEA *causes* ME/CFS or disability; it only shows a correlation. The small sample size (n=16 per group) limits generalizability, and the lack of a standardized ME/CFS case definition (e.g., no explicit post-exertional malaise criteria) means the patient cohort may not be fully representative of the broader ME/CFS population. The modest sample size also means the trend toward increased DHEA responsiveness after hydrocortisone (P=0.053) did not reach statistical significance in the full group.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Cleare, A J, O'Keane, V, & Miell, J P (2004). Levels of DHEA and DHEAS and responses to CRH stimulation and hydrocortisone treatment in chronic fatigue syndrome.. Psychoneuroendocrinology. https://doi.org/10.1016/S0306-4530(03)00104-5
BibTeX
@article{mecfsatlas-cleare-2004-levels-dhea,
author = {Cleare, A J and O'Keane, V and Miell, J P},
title = {Levels of DHEA and DHEAS and responses to CRH stimulation and hydrocortisone treatment in chronic fatigue syndrome.},
journal = {Psychoneuroendocrinology},
year = {2004},
doi = {10.1016/S0306-4530(03)00104-5},
note = {PubMed: 15110921},
url = {https://www.mecfsatlas.com/evidence/cleare-2004-levels-dhea},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/cleare-2004-levels-dhea
Contribute
Private, reviewed by a human. Not a public comment thread.