Miwa, Kunihisa · Journal of cardiology · 2017 · DOI
This study found that ME/CFS patients have smaller hearts and lower levels of certain hormones that control blood volume and fluid balance compared to healthy people. When researchers gave half the ME/CFS patients a synthetic hormone called desmopressin for five days, about half of them felt better, with less dizziness when standing and improved ability to do daily activities.
This research suggests ME/CFS may involve dysregulation of the body's fluid and blood pressure control systems, offering a potential physiological mechanism for orthostatic intolerance—a common and debilitating symptom. The positive response to desmopressin in some patients points to a possible targeted treatment avenue that warrants further investigation.
This study does not prove that low hormone levels cause ME/CFS, only that they are associated with it. The 50% response rate to desmopressin means this treatment does not work for all patients and does not establish it as a standard cure. The small sample size and lack of a placebo control mean results cannot be generalized to all ME/CFS patients.
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
Miwa, Kunihisa (2017). Down-regulation of renin-aldosterone and antidiuretic hormone systems in patients with myalgic encephalomyelitis/chronic fatigue syndrome.. Journal of cardiology. https://doi.org/10.1016/j.jjcc.2016.06.003
BibTeX
@article{mecfsatlas-miwa-2017-down-regulation,
author = {Miwa, Kunihisa},
title = {Down-regulation of renin-aldosterone and antidiuretic hormone systems in patients with myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Journal of cardiology},
year = {2017},
doi = {10.1016/j.jjcc.2016.06.003},
note = {PubMed: 27401397},
url = {https://www.mecfsatlas.com/evidence/miwa-2017-down-regulation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/miwa-2017-down-regulation
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