Health rising blog post, by Cort Johnson, 30 July 2017: Epigenetics Study Highlights Metabolic Problems in Chronic Fatigue Syndrome (ME/CFS)
There was a time that the HPA axis was “it” in chronic fatigue syndrome. More studies have been done on the powerful glucocorticoid hormone cortisol than other factor in ME/CFS, and it’s not hard to understand why. Cortisol not only plays a major role in the stress response and getting the body the energy it needs, but it’s also an important immune regulator. The low cortisol levels in ME/CFS seemed to fit it perfectly: not only did people with ME/CFS report feeling both wired and tired, but their immune systems seemed to be shifted in just the direction one would expect.
The cortisol levels turned out to be only mildly low, though, and then only in the morning, suggesting that cortisol by itself was not “it” for a disease as disabling as chronic fatigue syndrome. Other studies suggested, however, that other problems might exist in the fantastically complex HPA axis. One study showing a reduced responsiveness to cortisol suggested that cortisol levels might not need to be low for significant problems to show up.
Then Broderick’s model suggested that HPA axis issues probably played a major role in this disease. As with most measures in ME/CFS, it seems that crude measures like cortisol levels just don’t work well. You have to stimulate something, or see how it interacts, or see how the network it’s embedded with is doing to get the real story. In other words, you have to dig deeper.
O Canada
That’s exactly what Patrick McGowan has done. McGowan is from Canada – yet another country with a kind of Dr. Jekyll and Mr. Hyde-like history with ME/CFS. Canada, of course, birthed the Canadian Consensus Criteria – the most influential criteria in ME/CFS’s recent history, and the first to make post-exertional malaise a hallmark symptom. (Bruce Carruthers, the lead author of the Criteria, recently died.)
Canada has also given ME/CFS some notable researchers including Patrick McGowan, Lasker Award winner Mark Houghton, the data miners and modelers Gordon Broderick and Travis Crawford of Dr. Klimas’ Institute for Neuroimmune Studies, David Patrick as well as some prominent MD’s; Dr. Byron Hyde, Dr. Bested, Dr. Kerr, Dr. Eleanor Stein and others.
Canada also had its Dr. Jekyll and Mr. Hyde-ish side. British Columbia produced one of the rare centers for ME/CFS (good) which Dr. Bested rather quickly resigned from (bad). Canada also opened up a grant package for ME/CFS (good) and then put someone who didn’t believe ME/CFS was a disease in charge of its application review (bad).
Introduced to ME/CFS via the Solve ME/CFS Initiative grant, McGowan’s earlier epigenetics study highlighted immune changes. Then McGowan scored a big private foundation grant. Now he, his University of Toronto PhD student, Wilfred de Vega, and Suzanne Vernon (who introduced McGowan to ME/CFS) have produced a fascinating study: Epigenetic modifications and glucocorticoid sensitivity in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS)
