Zarković, Milos, Pavlović, Milorad, Pokrajac-Simeunović, Ana et al. · Srpski arhiv za celokupno lekarstvo · 2003 · DOI
This study tested how well the adrenal glands (which produce stress hormones) respond to a small dose of ACTH hormone in people with ME/CFS, compared to healthy people and those with adrenal problems from steroid use. The researchers found that some people with ME/CFS had a slower initial hormone response similar to adrenal insufficiency, but the response eventually caught up. This suggests ME/CFS patients may have a subtle problem with how quickly their adrenal glands respond to signals.
This research addresses a longstanding question about whether ME/CFS involves abnormalities in the hormonal stress-response system, which could explain fatigue and other symptoms. Finding that some ME/CFS patients have reduced early adrenal responsiveness, even if not universally present, supports a biological basis for the illness and could guide future treatment research.
This study does not prove that adrenal dysfunction causes ME/CFS, nor does it establish that all ME/CFS patients have the same degree of adrenal impairment. The cross-sectional design cannot determine if adrenal changes precede symptom onset or result from the illness. Small sample size (n=9) limits generalizability.
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
Zarković, Milos, Pavlović, Milorad, Pokrajac-Simeunović, Ana, Cirić, Jasmina, Beleslin, Biljana, Penezić, Zorana, et al. (2003). [Disorder of adrenal gland function in chronic fatigue syndrome].. Srpski arhiv za celokupno lekarstvo. https://doi.org/10.2298/sarh0310370z
BibTeX
@article{mecfsatlas-zarkovi-2003-disorder-adrenal,
author = {Zarković, Milos and Pavlović, Milorad and Pokrajac-Simeunović, Ana and Cirić, Jasmina and Beleslin, Biljana and Penezić, Zorana and Ognjanović, Sanja and Savić, Slavica and Poluga, Jasmina and Trbojević, Bozo and Drezgić, Milka},
title = {[Disorder of adrenal gland function in chronic fatigue syndrome].},
journal = {Srpski arhiv za celokupno lekarstvo},
year = {2003},
doi = {10.2298/sarh0310370z},
note = {PubMed: 15058215},
url = {https://www.mecfsatlas.com/evidence/zarkovi-2003-disorder-adrenal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/zarkovi-2003-disorder-adrenal
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