This study explored hormonal differences in 67 adolescents with chronic fatigue syndrome (CFS) compared with 55 healthy controls. CFS can cause severe reduction in quality of life among patients, yet the pathophysiology of CFS remains uncertain. Lately, it has been proposed that CFS is a result of dysfunction of brain stem areas controlling endocrine and autonomic effector systems, possibly reflecting a state of permanent stress responses or sustained arousal. If this is true, one would expect to find changes in endocrine axes, especially those affected by the autonomic nervous system, including renin and ADH.
Among patiens, antidiuretic hormone (ADH) was significantly decreased (p=0,000), while osmolality and renin was significantly increased (p=0,000 and p=0,001). To our knowledge, these findings are novel. Increased renin may be a result of increased sympathetic nervous cell activity. Decreased ADH synthesis has previously been reported in rats exposed to chronic stress. Together these findings support a theory of central dysregulation, possibly reflecting a state of sustained arousal, as the pathophysiology behind CFS. The cause of increased osmolality is uncertain, but could be secondary to decreased ADH or a result of altered set-point for osmolality regulation. Further studies in this field is warrented.