McKenzie, R, Reynolds, J C, O'Fallon, A et al. · The Journal of rheumatology · 2000
This study tested whether a low dose of the steroid medication hydrocortisone affected bone density in people with ME/CFS over 12 weeks. Researchers found that patients taking the steroid experienced a slight decrease in bone mineral density in their spine, while those taking a placebo did not. This suggests that even low doses of steroids may weaken bones over time.
This study is important because some ME/CFS patients have been treated with low-dose steroids, and understanding their bone health effects is critical for safe treatment decisions. The finding that even low steroid doses reduce bone density suggests clinicians and patients should carefully weigh risks and benefits and consider bone-protective interventions during glucocorticoid therapy for ME/CFS.
This study does not establish that low-dose hydrocortisone causes clinically significant fractures or long-term bone damage in ME/CFS patients, nor does it prove that steroid treatment is contraindicated for all patients. The 12-week timeframe is relatively short, and bone density changes may not fully predict fracture risk. The study was conducted in ambulatory patients and may not generalize to more severely affected individuals.
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
McKenzie, R, Reynolds, J C, O'Fallon, A, Dale, J, Deloria, M, Blackwelder, W, et al. (2000). Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial.. The Journal of rheumatology. https://pubmed.ncbi.nlm.nih.gov/10990237/
BibTeX
@article{mecfsatlas-mckenzie-2000-decreased-bone,
author = {McKenzie, R and Reynolds, J C and O'Fallon, A and Dale, J and Deloria, M and Blackwelder, W and Straus, S E},
title = {Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial.},
journal = {The Journal of rheumatology},
year = {2000},
note = {PubMed: 10990237},
url = {https://www.mecfsatlas.com/evidence/mckenzie-2000-decreased-bone},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/mckenzie-2000-decreased-bone
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