COVID-19 and Chronic Fatigue Syndrome: An Endocrine Perspective, 2021, Bansal et al

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ola_cohn

Established Member (Voting Rights)
Abstract
Patients recovering from COVID-19 may have persistent debilitating symptoms requiring long term support through individually tailored cardiopulmonary and psychological rehabilitation programs. Clinicians need to be aware about the likely long-term complications and their diagnostic assessments to help identify any occult problems requiring additional help. Endocrinological evaluations should be considered as part of the armamentarium in the management of such individuals with diligent cognizance about the involvement of the hypothalamo-pituitary-adrenal (HPA) axis, adrenals, and thyroid.

Keywords
Long Covid, COVID-19, Chronic Fatigue Syndrome, Endocrinopathy, adrenal function, thyroid, pituitary, pain

Authors: Rashika Bansal, Sriram Gubbi Christian A. Koch

Open access full text
https://www.sciencedirect.com/science/article/pii/S2214623721000363
 
Its an interesting video but alas if any of this is the root cause its not a hopeful outcome really. If the pituitary gland is under producing due to damage and disrupting the HPA axis as a secondary adrenal insufficiency there isn't a whole lot to do. If the glands are damaged a top of the kidneys as it appears then that is not recoverable either, both are damage. Potentially if its auto antibodies that are binding the ACTH and disrupting communication from Pituitary to the kidneys then there is some chance to recover from that but its an auto immune condition. Finally if its damage to the pancreas that too is unlikely to recover. Its interesting but given people do spontaneously recover I would assume its more the inflammation of the Hypothalamus or auto immune but if the Post Covid condition is a mix of all of these then only some people are going to recover and I presume the same would be true for ME/CFS.

Surely some ME/CFS patients have had their endocrine system probed extensively? If this was a common thread through all patients we would know that as would doctors.
 
BrightCandle said:
Surely some ME/CFS patients have had their endocrine system probed extensively?
Click to expand...

Not sure if this qualifies as extensively but I've had a workup that included thyroid tests, and two stimulation tests to see if the pituitary and adrenal gland were responsive. A cortisol curve over the day, 24 hour catecholamines, pituitary homones. MRI of the head which found a flattened pituitary. The flattened pituitary can be inborn or the result of autoimmune disease and probably other things. In my case it seemed to be inborn.

If I remember right, the cortisol curve was abnormal, flatter and with much less of a morning peak. Morning cortisol was a bit low at times but total amount over the course of the day was normal. Sometimes my ACTH is mildly elevated. The pituitary homones FSH and LH were below normal which seems to indicate hypogonadism (in a male). But the doctors didn't suggest any treatment. So things are not normal here but apparently also not abnormal enough to explain much.
 
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BrightCandle said:
Surely some ME/CFS patients have had their endocrine system probed extensively? If this was a common thread through all patients we would know that as would doctors.
Click to expand...

I’ve been documenting adrenal adventures (phaeochromocytoma and cortisol insufficiency) in this thread, which I will update with anything of endocrinological interest. Occam’s razor suggests that the endocrine issues were, at the very least, implicated in triggering ME/CFS mode. I doubt that the endocrinologists looking after me will welcome the discussion, though.

https://www.s4me.info/threads/phaeochromocytoma-and-adrenalectomy.29026/#post-434920

There are good threads elsewhere on small adrenal glands as a possible indicator of ME/CFS, and on hydrocortisone as a dubious remedy.
 
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