Presentation6 signs
- 01Profound fatigue lasting 6+ months
- 02Post-exertional malaise
- 03Unrefreshing sleep
- 04Cognitive impairment (brain fog)
- 05Orthostatic intolerance
- 06Immune dysfunction
A constellation, not a disease.
HHHC · clinical index
Nº 03.6Hormone-related conditions
Chronic fatiguesyndrome & ME.
ME/CFS carries documented hormonal abnormalities — blunted HPA axis, low DHEA-S, subclinical thyroid dysfunction. We look carefully for the treatable endocrine drivers inside a genuinely complex condition.
The pathway
How we work with you, from first visit onwards.
Stage · 01
Consult
60-minute in-person assessment with your doctor.
Stage · 02
Test
Full hormone panel, thyroid, metabolic markers.
Stage · 03
Protocol
Bioidentical prescription tuned to your results.
Stage · 04
Follow up
Monitored adjustments as your body responds.
The Hormonal Dimension
Understanding ME/CFS
Myalgic encephalomyelitis/chronic fatigue syndrome is a systemic neuroimmune condition characterised by profound fatigue, post-exertional malaise, and cognitive dysfunction. While the full pathophysiology remains under investigation, multiple studies have documented significant endocrine abnormalities in ME/CFS patients.
These include a blunted cortisol awakening response, reduced DHEA-S levels, impaired pregnenolone synthesis, and subclinical hypothyroidism with poor T4-to-T3 conversion. Neuroinflammation — microglial activation in the brain — has been demonstrated on PET imaging and provides a rationale for low-dose naltrexone therapy.
We do not claim to cure ME/CFS, but by identifying and correcting the hormonal and nutritional deficiencies that are common in this condition, many patients experience meaningful improvements in energy, cognition, and quality of life.
Diagnostic Criteria
Common Symptoms
Based on IOM 2015 and NICE 2021 diagnostic frameworks.
Core Symptoms
- Profound fatigue lasting more than 6 months
- Post-exertional malaise (crash after activity)
- Unrefreshing sleep despite adequate hours
- Cognitive dysfunction (brain fog)
- Reduced activity tolerance
Neuroimmune
- Recurrent sore throats
- Tender lymph nodes
- New-onset headaches
- Orthostatic intolerance (dizziness on standing)
- Temperature dysregulation
Hormonal Signs
- Morning cortisol blunting
- Poor stress recovery
- Low DHEA-S for age
- Subclinical thyroid dysfunction
- Menstrual irregularities
Evidence-Based Approach
Treatment Options
Targeting the treatable hormonal and neuroimmune components of ME/CFS.
HPA Axis Assessment & Support
4-point salivary cortisol mapping to document cortisol rhythm abnormalities. Targeted support with DHEA, pregnenolone, and adaptogenic strategies where deficiency is documented.
Low-Dose Naltrexone (LDN)
1.5-4.5mg nightly for neuroinflammation modulation. Emerging case series data showing improvement in fatigue, cognitive function, and quality of life in ME/CFS.
Thyroid Optimisation
Comprehensive panel including reverse T3 and TPO antibodies. T3 combination therapy for documented poor T4-to-T3 conversion. Many CFS patients have subclinical thyroid dysfunction.
Nutritional & Mitochondrial Support
Targeted repletion of iron (ferritin >70), vitamin D, B12, magnesium, and CoQ10. Addressing the nutritional deficiencies that impair energy metabolism.
Hormone-Related Conditions Service
Learn more about our comprehensive approach to hormone-driven conditions.
Next step
Struggling with Chronic Fatigue?
Book a consultation to explore whether hormonal factors are contributing to your exhaustion.