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Hormonal Replacement Therapy in CFS

Suppression of the HPA Axis is common in CFS, and results in reduced hormonal output from both the thyroid gland and the gonads.  Low thyroid output may result in weight gain, feeling cold all the time, thickening and dryness of the skin, brittle hair, and other symptoms. The TSH, a test typically used to screen for low thyroid, is unreliable in the face of HPA Axis suppression, so physicians should check specific hormone levels (triiodothyronine, or T3, and free T4) and supplement accordingly.  Women with reduced gonadal may experience hot flushes, sweats, stiffness in joints, sleep disruption, light or irregular menses, vaginal dryness, and other symptoms.   Men with gonadal insufficiency may experience achy or stiff joints, temperature sensitivity, and increased fatigue. Both men and women experience reduced libido, and may put themselves at higher risk for osteoporosis (softening of the bones that may lead to fractures). 

 

Bottom line:  Thyroid and sexual hormones (estradiol, testosterone, and FSH or LH) should be checked in persons with CFS.  Supplements should be prescribed based on symptoms and FDA Guidelines in order to assure optimal health and function.