Young, A H, Sharpe, M, Clements, A et al. · Biological psychiatry · 1998 · DOI
This study tested whether people with ME/CFS have abnormal levels of cortisol, a stress hormone, by measuring it in saliva and urine over 24 hours. The researchers found no difference in cortisol levels between people with ME/CFS and healthy controls, suggesting that the baseline cortisol system may not be impaired in this condition.
Understanding HPA axis function is crucial because abnormalities in stress hormone regulation have been proposed as a potential mechanism underlying ME/CFS symptoms. This study contributes to clarifying whether basal cortisol dysregulation is a consistent feature of the condition or whether findings from earlier studies may reflect methodological differences.
This study does not prove that the HPA axis is completely normal in ME/CFS, as it only measured basal (resting) activity—not how the system responds to stress or other challenges. The small sample size and potential differences in patient selection criteria between this and previous studies mean a single negative finding does not definitively rule out HPA dysfunction in ME/CFS subtypes.
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
Young, A H, Sharpe, M, Clements, A, Dowling, B, Hawton, K E, & Cowen, P J (1998). Basal activity of the hypothalamic-pituitary-adrenal axis in patients with the chronic fatigue syndrome (neurasthenia).. Biological psychiatry. https://doi.org/10.1016/S0006-3223(97)00404-6
BibTeX
@article{mecfsatlas-young-1998-basal-activity,
author = {Young, A H and Sharpe, M and Clements, A and Dowling, B and Hawton, K E and Cowen, P J},
title = {Basal activity of the hypothalamic-pituitary-adrenal axis in patients with the chronic fatigue syndrome (neurasthenia).},
journal = {Biological psychiatry},
year = {1998},
doi = {10.1016/S0006-3223(97)00404-6},
note = {PubMed: 9494707},
url = {https://www.mecfsatlas.com/evidence/young-1998-basal-activity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/young-1998-basal-activity
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