Craddock, Travis J A, Fritsch, Paul, Rice, Mark A et al. · PloS one · 2014 · DOI
This study explored how the body's stress-response system (the HPA axis) may become stuck in a dysfunctional state in ME/CFS and Gulf War Illness, interacting with sex hormones and immune function. Using computer models based on known biology, researchers found that men with Gulf War Illness showed a pattern of high cortisol and low testosterone, while women with ME/CFS showed low cortisol and high estradiol—suggesting the body gets trapped in alternate 'stuck' settings. These findings suggest that treatments might work by helping the body escape these abnormal states.
This study provides a theoretical framework explaining why ME/CFS and Gulf War Illness are so difficult to treat—the body's regulatory systems may be locked into abnormal but stable states. Understanding these alternate homeostatic states could guide development of targeted treatments that reset dysregulated systems rather than treating isolated symptoms. The sex-specific patterns identified may explain why ME/CFS presentation and severity differ between men and women.
This study is based on a theoretical model, not direct measurement of live human physiology, so it does not definitively prove causation or establish these mechanisms as the primary driver of disease perpetuation. The model predictions require validation in larger patient cohorts with comprehensive longitudinal endocrine-immune profiling. The study does not establish whether the alternate homeostatic states are initiating causes or consequences of chronic illness.
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
Craddock, Travis J A, Fritsch, Paul, Rice, Mark A, del Rosario, Ryan M, Miller, Diane B, Fletcher, Mary Ann, et al. (2014). A role for homeostatic drive in the perpetuation of complex chronic illness: Gulf War Illness and chronic fatigue syndrome.. PloS one. https://doi.org/10.1371/journal.pone.0084839
BibTeX
@article{mecfsatlas-craddock-2014-role-homeostatic,
author = {Craddock, Travis J A and Fritsch, Paul and Rice, Mark A and del Rosario, Ryan M and Miller, Diane B and Fletcher, Mary Ann and Klimas, Nancy G and Broderick, Gordon},
title = {A role for homeostatic drive in the perpetuation of complex chronic illness: Gulf War Illness and chronic fatigue syndrome.},
journal = {PloS one},
year = {2014},
doi = {10.1371/journal.pone.0084839},
note = {PubMed: 24416298},
url = {https://www.mecfsatlas.com/evidence/craddock-2014-role-homeostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/craddock-2014-role-homeostatic
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