Pipper, Cornelia, Bliem, Linda, León, Luis E et al. · Journal of endocrinological investigation · 2024 · DOI
Researchers measured hormone levels in the blood of ME/CFS patients and compared them to healthy people. They found that certain hormones—including cortisol-related compounds and progesterone—were different in people with ME/CFS, and the differences varied depending on whether patients had mild/moderate or severe disease and their sex. These hormone patterns might help doctors better identify and categorize ME/CFS in the future.
Steroid hormone abnormalities may represent objective biomarkers for ME/CFS diagnosis and disease severity stratification, addressing a critical clinical need in a disease lacking definitive diagnostic tests. Sex-specific hormone patterns suggest that biological mechanisms and disease expression differ between males and females, which could inform more personalized treatment approaches and improve understanding of why ME/CFS disproportionately affects women.
This study does not establish whether hormone abnormalities cause ME/CFS or result from it—the cross-sectional design prevents causal inference. It does not prove these hormones alone can reliably diagnose ME/CFS in clinical practice, as external validation in larger, independent populations is needed. The modest sample size, especially for males (n=6-8), limits generalizability of sex-specific findings.
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
Pipper, Cornelia, Bliem, Linda, León, Luis E, Mennickent, Daniela, Bodner, Claudia, Guzmán-Gutiérrez, Enrique, et al. (2024). Sex and disease severity-based analysis of steroid hormones in ME/CFS.. Journal of endocrinological investigation. https://doi.org/10.1007/s40618-024-02334-1
BibTeX
@article{mecfsatlas-pipper-2024-sex-disease,
author = {Pipper, Cornelia and Bliem, Linda and León, Luis E and Mennickent, Daniela and Bodner, Claudia and Guzmán-Gutiérrez, Enrique and Stingl, Michael and Untersmayr, Eva and Wagner, Bernhard and Bertinat, Romina and Sepúlveda, Nuno and Westermeier, Francisco},
title = {Sex and disease severity-based analysis of steroid hormones in ME/CFS.},
journal = {Journal of endocrinological investigation},
year = {2024},
doi = {10.1007/s40618-024-02334-1},
note = {PubMed: 38724880},
url = {https://www.mecfsatlas.com/evidence/pipper-2024-sex-disease},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/pipper-2024-sex-disease
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