Hendrix, Jolien, Fanning, Lara, Wyns, Arne et al. · European journal of clinical investigation · 2025 · DOI
Researchers analyzed 37 studies comparing how the bodies of ME/CFS and fibromyalgia patients handle stress hormones compared to healthy people. They found that ME/CFS patients have higher levels of adrenaline at rest and unusual responses to exercise and position changes—suggesting their nervous system doesn't regulate stress hormones normally. These findings point to a specific biological problem in ME/CFS that might be treatable.
This study identifies specific biological markers of adrenergic dysfunction in ME/CFS that are distinct from fibromyalgia, supporting the concept that ME/CFS involves genuine neurobiological abnormalities rather than being psychosomatic. These findings suggest potential therapeutic targets—such as adrenergic regulation—that could lead to new treatments tailored specifically to ME/CFS pathophysiology.
This study does not prove that adrenergic dysfunction causes ME/CFS or explain why these abnormalities develop. It cannot establish whether correcting these adrenergic abnormalities will improve patient symptoms, nor does it identify which specific adrenergic interventions would be beneficial. Correlation between biomarkers and disease mechanisms does not necessarily indicate causation.
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
Hendrix, Jolien, Fanning, Lara, Wyns, Arne, Ahmed, Ishtiaq, Patil, Madhura Shekhar, Richter, Emma, et al. (2025). Adrenergic dysfunction in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and meta-analysis.. European journal of clinical investigation. https://doi.org/10.1111/eci.14318
BibTeX
@article{mecfsatlas-hendrix-2025-adrenergic-dysfunction,
author = {Hendrix, Jolien and Fanning, Lara and Wyns, Arne and Ahmed, Ishtiaq and Patil, Madhura Shekhar and Richter, Emma and Van Campenhout, Jente and Ickmans, Kelly and Mertens, Rembert and Nijs, Jo and Godderis, Lode and Polli, Andrea},
title = {Adrenergic dysfunction in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and meta-analysis.},
journal = {European journal of clinical investigation},
year = {2025},
doi = {10.1111/eci.14318},
note = {PubMed: 39319943},
url = {https://www.mecfsatlas.com/evidence/hendrix-2025-adrenergic-dysfunction},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/hendrix-2025-adrenergic-dysfunction
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