Today, we are pleased to share a new publication, Steroid Dynamics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Case-Control Study using Ultra Performance Supercritical Fluid Chromatography Tandem Mass Spectrometry.
The Heart of the Matter
- OMF’s research centers in Uppsala and Melbourne published a study of steroid hormones—molecules that control a lot of important systems in the body—using an advanced technique called ultra-performance supercritical fluid chromatography tandem mass spectrometry (UPSFC-MS/MS).
- The team looked at individual hormones as well as how the hormones interact with each other, or the hormone networks. They found that the networks were particularly important for finding differences between people with ME/CFS and healthy controls.
- The differences they found in the networks indicate that the hypothalamic-pituitary-adrenal (HPA) axis function and progestogen pathways aren’t working correctly in ME/CFS.
- This paper is part of a larger project tracking hormone fluctuations in ME/CFS and Long COVID (the MELLOW study), which is in the “Recruitment, Data Collection” stage of the research process.
Steroid Dynamics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome:
A Case-Control Study using Ultra Performance Supercritical Fluid Chromatography Tandem Mass Spectrometry

OMF’s Collaborative Center at Uppsala and Melbourne ME/CFS Collaboration—directed by Drs. Jonas Bergquist and Chris Armstrong, respectively—recently published a study looking at differences in the steroid metabolome between ME/CFS and controls. Steroid hormones are of interest in ME/CFS because they are known to regulate immune, nervous, metabolism, and endocrine systems, which are dysfunctional in the disease.
In this study, the team quantified steroid levels using ultra-performance supercritical fluid chromatography tandem mass spectrometry (UPSFC-MS/MS). With this technique, the molecules are separated based on physical and chemical properties (the supercritical fluid chromatography) and identified and quantified based on mass to charge ratio (the mass spectrometry). On top of individual steroid hormone levels, the team also evaluated structural differences in the hormone networks, which shows how steroids interact with each other.
No individual steroid showed significant differences after statistical corrections, but the team’s network analysis showed some notable changes in steroid-steroid relationships. They found that cortisone is highly central in ME/CFS networks, but peripheral in control networks. They also saw less integration of progesterone in ME/CFS than controls. When evaluating ratios of steroids, the team found that cortisol:pregnanolone and pregnanolone:progesterone were altered in ME/CFS (not significantly after statistical correction).
Overall, this study shows that the balance (homeostasis) of steroid hormones is disrupted in ME/CFS, so hormone network dynamics is important in understanding ME/CFS pathophysiology. The particular changes found in the network and ratio-based analyses point to a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function and progestogen pathways.
This manuscript underwent the peer review process and you can now read the full publication in the Journal of Translational Medicine.
The paper is part of a larger project tracking hormone fluctuations in ME/CFS and Long COVID: the MELLOW study. This larger study is in the “Recruitment, Data Collection” stage of the research process.
