Hormonal problems in CFS - a clinical picture - the ectomorph

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Update November 2023

Since first writing this page, I have added much to my knowledge concerning hormonal issues in CFS sufferers. Without wishing to overwhelm the reader, I list these new pages below, but first, please see my new book, which contains the whole picture, regarding the thyroid, adrenal and pineal glands:

See also Our Book Green Mother - families fit for the future for the full picture regarding female sex hormones.

I now recommend the use of thyroid and adrenal glandulars to resolve these issues but I am including pages below that describe prescription medications also, by way of completeness.

The pages referred to above are as below:







It is now quite clear that there is a distinct hormonal disturbance in CFS sufferers with abnormalities in the hypothalamic-pituitary-adrenal axis. There is plenty of evidence to suggest abnormalities of the thyroid glands. Two papers in the Journal of Environmental and Nutritional Medicine clarified my thinking in this area - please see the section immediately below. More recent papers have confirmed these hormonal disturbances - for example, see A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome which lists a further 101 studies.

CFS sufferers are often Ectomorphs

The first is a paper from an Australian psychiatrist Paul Holman, who noticed that very slim individuals seem particularly prone to chronic fatigue, anxiety and environmental sensitivity. He then reviewed the literature and discovered reports from doctors who tried to classify people in terms of their constitution.

Of most interest was that done by Sheldon in 1940 when he published The Varieties of Human Physique, where he described three dominant types - the endomorph, the mesomorph and the ectomorph.

It is the ectomorph who interests us because he/she seems susceptible to CFS. Sheldon noted ectomorphs were introverts under 'strong inhibitory control'. They tend to be extremely sensitive to noise and 'distractions'. They usually revealed histories of allergies, skin complaints, chronic fatigue and insomnia. They needed to eat more and oftener than other types, needed protein in 'large quantities' and had difficulty adjusting to changes in climatic conditions.

A similar description is given by Tintera, who described a group of 200 patients whom he characterised as having suboptimal adrenal cortical function. These individuals showed an asthenic habitus, crowded lower incisors, cold extremeties, postural hypotension and tenderness in the adrenal angle. Their commonest complaints were anxiety, depression, headaches, salt and sugar craving, drug reactions, allergies, pre-menstrual syndrome, gastrointestinal problems (particularly alternating constipation and diarrhoea) and dermatoses. Laboratory findings included a flat glucose tolerance test, eosinophilia and low urinary 17-ketosteroids. Tintera hypothesised that the main problem for these people rested in a constitutional adrenal weakness which expressed itself in symptoms when the person was chronically stressed. His treatment was a high protein diet, low refined carbohydrates, more salt, hydrochloric acid (to help protein digestion), B vitamins, vitamin C and whole adrenal gland injections.

The ectomorph has a constitution associated with anxiety and insomnia. These people are more 'aroused' and have a higher demand for nutrients, energy requirements and repair of body tissues. Normally the body repairs damaged tissues during sleep. Hormonally this is marked by a switch from cortisol and adrenalin in the day to testosterone and growth hormone at night, catabolic or breaking down by day to anabolic or building up by night.

We know that carbohydrates (such as sugar, wheat, potato etc), stimulate the thyroid gland, reduce pain thresholds, and elevate mood in the sort term (combating anxiety and depression) and so the ectomorph is likely to be tired and stressed, likely craves sweet foods in an attempt to attain calmer alertness. However excess carbohydrate in the long term raises metabolic rate, is stimulating, depletes nutrients (vitamins and minerals) and eventually damages the body resulting in chronic fatigue.

Treatment for Ectomorphs

Holman's advice to ectomorphs is that prevention is better than cure. He suggests:

  • Ectomorphs learn the virtues of relaxation, regularity and stress management at an early age.
  • Maintain good regular sleep. This is of paramount importance and insomnia should be seen as an early warning sing of hyperarousal.
  • Protein in the middle of the day is essential to prevent the 'catabolic run down of mid to late afternoon'. Animal protein in stews or casseroles is best as ectomorphs are poor digesters. Vegetarians should supplement their diet routinely with amino acids.
  • Ectomorphs should be wary of food sensitivity, especially to wheat and legumes.
  • Ectomorphs need more of everything - food, vitamins, minerals, antioxidants (i.e. vitamins A,C,E and selenium), water (they tend to dehydrate readily), amino acids. (To this I would add essential fatty acids and salt). Modest exercise to build muscle mass is helpful. Avoid refined carbohydrate, and alcohol.

The way in which I implement these suggestions is:

In general, see Overview of CFS/ME protocol

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