Prolonged or chronic critical illness – a term applied to patients that survive severe injury or infection, but fail to start recovering after a few days – is characterized by low levels of peripheral hormones (including T3, IGF-1, cortisol and testosterone). This pattern is increasingly recognized as a neuroendocrine dysfunction inhibiting patients’ recovery, requiring treatment independent of the initial illness or trauma.
The same pattern of altered hormone levels has been documented in ME/CFS and fibromyalgia, suggesting that the research into the mechanisms and treatments from the field of critical illness may be relevant for ME/CFS and fibromyalgia.
Pro-inflammatory cytokines play a role in inducing and maintaining the uniform suppression of the neuroendocrine axes — predominantly at the level of the hypothalamus — during prolonged critical illness irrespective of the initial injury or infection.
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