Petrescu, Anca D, Kain, Jessica, Liere, Victoria et al. · Frontiers in endocrinology · 2018 · DOI
This review examines how the stress hormone system (HPA axis) works and what happens when it breaks down in people with liver disease. The HPA axis is like your body's control center that manages stress responses and many other important functions. The authors explain how inflammation in the liver can disrupt this system, potentially leading to the fatigue and other symptoms seen in both liver disease and chronic fatigue syndrome.
HPA axis dysfunction is a recognized feature in ME/CFS, and this review provides mechanistic insight into how chronic inflammation disrupts the stress hormone system—a pathway potentially relevant to ME/CFS pathology. Understanding how inflammatory states suppress HPA axis function could inform therapeutic strategies for both liver disease and post-infectious fatigue syndromes like ME/CFS.
This review does not directly study ME/CFS patients or prove that HPA axis dysfunction in cholestatic liver disease is identical to that in ME/CFS. It does not establish causation—the correlation between liver inflammation and HPA suppression does not prove which causes which. The findings in liver disease models may not fully translate to ME/CFS mechanisms without direct comparative studies.
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Primary citation
Petrescu, Anca D, Kain, Jessica, Liere, Victoria, Heavener, Trace, & DeMorrow, Sharon (2018). Hypothalamus-Pituitary-Adrenal Dysfunction in Cholestatic Liver Disease.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2018.00660
BibTeX
@article{mecfsatlas-petrescu-2018-hypothalamus-pituitary,
author = {Petrescu, Anca D and Kain, Jessica and Liere, Victoria and Heavener, Trace and DeMorrow, Sharon},
title = {Hypothalamus-Pituitary-Adrenal Dysfunction in Cholestatic Liver Disease.},
journal = {Frontiers in endocrinology},
year = {2018},
doi = {10.3389/fendo.2018.00660},
note = {PubMed: 30483216},
url = {https://www.mecfsatlas.com/evidence/petrescu-2018-hypothalamus-pituitary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/petrescu-2018-hypothalamus-pituitary
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