Low-dose hydrocortisone in chronic fatigue syndrome: a randomised crossover trial

摘要: Summary Background Reports of mild hypocortisolism in chronic fatigue syndrome led us to postulate that low-dose hydrocortisone therapy may be an effective treatment. Methods In a randomised crossover trial, we screened 218 patients with fatigue. 32 met our strict criteria for without co-morbid psychiatric disorder. The eligible received consecutive treatment (5 mg or 10 daily) 1 month and placebo month; the order was randomly assigned. Analysis by intention treat. Findings None dropped out. Compared baseline self-reported scores (mean 25·1 points), score fell 7·2 points on 3·3 those (paired difference mean 4·5 [95% CI 1·2‐7·7], p=0·009). nine (28%) hydrocortisone, reached predefined cut-off value similar normal population score, compared three (9%) (Fisher’s exact test p=0·05). degree disability reduced treatment, but not placebo. Insulin stress tests showed endogenous adrenal function suppressed hydrocortisone. Minor side-effects were reported after one patient Interpretation some syndrome, reduces levels short term. Treatment longer time follow-up studies are needed find out whether this effect could clinically useful.