Westropp, Jodi L, Welk, Kristin A, Buffington, C A Tony · The Journal of urology · 2003 · DOI
This study found that cats with a painful bladder condition called feline interstitial cystitis had smaller adrenal glands (organs that make stress hormones) and produced less cortisol when stimulated compared to healthy cats. The researchers suggest this might indicate a mild form of adrenal insufficiency, similar to what has been observed in some people with chronic fatigue syndrome.
This study is relevant to ME/CFS because it demonstrates a potential neuroendocrine dysfunction in a chronic pain/inflammatory condition with overlapping features. The authors explicitly note that decreased adrenal size has been observed in chronic fatigue syndrome patients and that IC can be comorbid with ME/CFS, suggesting a shared pathophysiological mechanism involving hypothalamic-pituitary-adrenal axis dysfunction.
This study does not prove that humans with interstitial cystitis or ME/CFS have the same adrenal abnormalities as cats—the findings are in a feline model and require human validation. It does not establish causality or determine whether adrenal changes are primary or secondary to the underlying disease. The study cannot establish whether hormone replacement therapy would be beneficial without clinical trials.
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
Westropp, Jodi L, Welk, Kristin A, & Buffington, C A Tony (2003). Small adrenal glands in cats with feline interstitial cystitis.. The Journal of urology. https://doi.org/10.1097/01.ju.0000095566.63870.66
BibTeX
@article{mecfsatlas-westropp-2003-small-adrenal,
author = {Westropp, Jodi L and Welk, Kristin A and Buffington, C A Tony},
title = {Small adrenal glands in cats with feline interstitial cystitis.},
journal = {The Journal of urology},
year = {2003},
doi = {10.1097/01.ju.0000095566.63870.66},
note = {PubMed: 14634458},
url = {https://www.mecfsatlas.com/evidence/westropp-2003-small-adrenal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/westropp-2003-small-adrenal
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