Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity
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A 2026 meta-analysis of 46 independent ME/CFS case-control datasets (1388 patients and 1349 controls) reported selected HPA-axis and cortisol differences. ME/CFS is a distinct syndrome, not proof that general chronic stress exhausts adrenal glands or validates an adrenal-fatigue diagnosis.