Key Benefits

• Map key fatigue drivers: stress hormones, inflammation, nutrient status, and protein reserves.
• Spot HPA-axis imbalance with morning cortisol to clarify stress-driven fatigue and sleep issues.
• Guide next steps if cortisol is abnormal by ruling adrenal insufficiency or Cushing’s.
• Flag silent inflammation and heart risk with hs-CRP to prioritize recovery strategies.
• Explain muscle aches and low resilience by detecting vitamin D deficiency and correcting.
• Support bone strength and pregnancy needs by optimizing vitamin D per guideline targets.
• Clarify nutrition and recovery with albumin, best read with CRP and organ tests.

What are CFS/ME

CFS/ME biomarkers are objective signals from the body that translate the illness’s hidden biology into measurable patterns. They reflect how the immune system, energy production, brain–body communication, and stress responses are behaving at rest and after exertion—the phase when symptoms typically flare (post-exertional malaise). These signals can include shifts in immune messengers (cytokines), changes in cellular energy pathways (mitochondrial bioenergetics), altered autonomic balance (sympathetic–parasympathetic activity), and markers of brain–immune inflammation (neuroinflammation and glial activation). By capturing these patterns, biomarker testing can help distinguish CFS/ME from conditions with similar fatigue, identify biological subtypes, and track how the illness changes over time or with treatment. In short, biomarkers turn subjective experience into biological evidence, revealing the body’s operating state in CFS/ME and its response to physical or cognitive stress. While no single blood test defines the condition, a thoughtful panel can map the networks that drive symptoms and point toward targeted care and research.

Why are CFS/ME biomarkers important?

Biomarkers in CFS/ME are snapshots of whole‑body regulation—how the stress axis, immune signaling, nutrient status, and protein balance are coping with persistent energy strain. They do not “diagnose” the illness, but they help map physiology, clarify contributors, and track change over time.

Cortisol should follow a diurnal curve, higher in the morning and lower at night; feeling best usually aligns with values sitting mid‑range for the time of day. High‑sensitivity CRP is ideally at the low end of its reference interval. Vitamin D tends to support function best in the mid‑to‑upper part of its range. Albumin, a marker of protein status and inflammation, is healthiest steady in the middle of normal.

When these run low, each tells a different story. A low or flattened cortisol pattern suggests reduced HPA‑axis drive, often mirroring unrefreshing sleep, post‑exertional worsening, lightheadedness, and brain fog. Very low hs‑CRP usually means little overt systemic inflammation; in CFS/ME, symptoms can persist even with normal CRP, pointing to nonclassical immune signaling. Low vitamin D reflects limited reserves for muscle, bone, and immune modulation, linking to achiness, fatigue, and in children or teens, growth and bone concerns. Low albumin can reflect inflammation, poor intake, or dilution, and correlates with edema, slower recovery, and frailty risk; pregnancy naturally lowers albumin via hemodilution and raises total cortisol due to binding proteins.

The big picture: these markers connect stress physiology, immune tone, and tissue resilience. Together they help rule out mimics, illuminate comorbid risks—cardiometabolic load (hs‑CRP), bone health (vitamin D), nutritional and hepatic status (albumin), and neuroendocrine balance (cortisol)—and frame long‑term health trajectories in CFS/ME.

What Insights Will I Get?

CFS/ME affects how the body generates energy, regulates stress hormones, and coordinates immune responses. Biomarker testing maps these systems so symptoms can be understood in context of metabolism, cardiovascular tone, cognition, and recovery. At Superpower, we test these specific biomarkers: Cortisol, hs-CRP, Vitamin D, Albumin.

Cortisol is the primary stress hormone (HPA-axis output); in CFS/ME, altered daily patterns or lower overall levels are reported in some people. hs-CRP is a sensitive marker of systemic inflammation; it is often normal in CFS/ME, but elevations point to concurrent inflammatory activity. Vitamin D is a secosteroid that modulates immunity and muscle function; low status is common and may correlate with pain or fatigue severity in some studies. Albumin is the major plasma protein and a negative acute-phase reactant; lower values reflect inflammation, reduced hepatic synthesis, losses, or dilution.

Together, these markers indicate system stability. Cortisol profiles reflect circadian integrity, stress resilience, and glucose regulation that underpin energy and cognition. hs-CRP gauges inflammatory steadiness that can shape autonomic balance, vascular function, and post-exertional symptom amplification. Vitamin D signals immune set-point and musculoskeletal capacity relevant to infection susceptibility and recovery. Albumin tracks protein reserve, oncotic pressure, and transport capacity, informing fluid balance and tissue repair potential.

Notes: Interpretation is context-dependent. Cortisol is time-of-day sensitive. Acute illness or flares raise CRP and lower albumin; dehydration raises albumin. Pregnancy, age, adiposity, and smoking affect CRP; estrogen or glucocorticoids alter cortisol-binding and CRP. Season, latitude, skin pigmentation, and assay variability influence vitamin D.