Connecting post-viral fatigue with hormones

Written by: Dr Paul Jenkins
Edited by: Karolyn Judge

Recognising the signs and symptoms and signs of post-viral fatigue is a step towards relief from a condition that can severely affect your quality of life. Renowned consultant physician and endocrinologist Dr Paul Jenkins details what people should look out for, its relation to hormone conditions and how post-viral fatigue is diagnosed.


Woman lying on a sofa with post-viral fatigue


What are the signs of post-viral fatigue?

The terms post viral fatigue syndrome (PVFS), chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME) describe a devastating and complex disorder. Long Covid is another form of this disease albeit with a few specific nuances.



Symptoms include:

  • Extreme fatigue – the likes of which people cannot understand until they have experienced it. It is an overwhelming fatigue, which patients describe ‘like the plug being pulled out’. Patients may not even have energy to get up or wash their hair, or go shopping.
  • Post exertional fatigue
  • Shortness of breath
  • Chest pains
  • Headaches
  • Tinnitus
  • Muscle and joint aches
  • Brain fog and reduced ability to concentrate
  • Poor sleep
    • Difficulty getting off to sleep
    • Disturbed sleep
    • Waking unrefreshed
  • Pins and needles
  • Palpitations and dizziness especially on standing or sitting upright
  • Anxiety and depression


However, these are the symptoms and there can be a number of hormonal disorders which can also cause similar symptoms or worsen them.



How are hormones and post-viral fatigue related?

The main hormonal disorders which can exaggerate or mimic some post-viral symptoms are those of:

An underactive thyroid gland causes low levels of thyroid hormone resulting in slowing of the body’s metabolism. It is characterised by fatigue, weight gain, feeling cold, sluggish, hair loss, dry skin and poor memory.

The adrenal glands produce the critical hormone, cortisol, which is our main stress hormone and allows us to respond to physical stress. Failure of the adrenals to produce enough cortisol is a rare but potentially catastrophic disease and requires urgent assessment and treatment. Patients often complain of ‘adrenal fatigue’ - a term which encompasses many of the symptoms of post-viral fatigue and which is usually the underlying illness. 

  • Menopause

The onset of menopause can also result in fatigue, temperature fluctuations and poor memory. It can certainly worsen post-viral fatigue.

Vitamin D is critical to many of the body’s functions including the immune system. We obtain most of our vitamin D through exposure of skin to sunlight, and therefore living in the UK, as well as those of darker skin pigmentation are very prone to having low levels. Deficiency is also characterised by fatigue, weak muscles, brain fog as well as impaired recovery from illnesses especially viral infections.



Can post-viral fatigue affect anyone?

Yes, it can affect anyone but is more common in

  • Women
  • Patients with hypermobility
  • Those who have suffered severe glandular fever (infectious mononucleosis) in the past.
  • People under a lot of stress, whether that be working very long hours, doing a lot of strenuous exercise or under severe psychological stress
  • There is a hereditary component and not infrequently there is a family history of similar symptoms



How do endocrinologists diagnose post-viral fatigue?

The diagnosis is made on the basis of a compatible clinical history and exclusion of other hormonal causes.

  • How do endocrinologists treat post-viral fatigue?
  • The key is to treat other conditions, if relevant
  • Clear explanation to the patient of the diagnosis and the need to reduce all their activities and pace themselves



Can HRT cure post-viral fatigue?

No, but it certainly can help relieve some of the symptoms.


Dr Paul Jenkins can provide expert, highly-skilled endocrinology services if you’re looking for assistance. Visit his Top Doctors profile to get in touch.

By Dr Paul Jenkins
Endocrinology, diabetes & metabolism

Dr Paul Jenkins is an extensively trained and highly skilled consultant physician and endocrinologist based in London. Private patients can access his first-rate professional and individualised care at the renowned clinics of The London Endocrine Centre and BMI The London Independent Hospital.

His areas of specialist expertise include the diagnosis and management of thyroid disorders, hypothyroidism, T3 treatment, post-viral fatigue, Long Covid, polycystic ovaries syndrome, pituitary disease and diabetes mellitus.

Dr Jenkin's medical studies took place at Cambridge University. After qualifying with a degree in medical sciences, he underwent clinical training at the prestigious Royal London Hospital followed by training at the internationally renowned Department of Endocrinology at St Bartholomew’s Hospital, where he gained tremendous experience in clinical endocrinology.

Dr Jenkins is also a keen researcher. He led an active research group into the interactions between hormones and cancer, and he has published over 80 peer-reviewed scientific papers, 4 books and 17 book chapters. Furthermore, he has been invited to lecture at over 90 national and international conferences.

After 20 years in practice, he established The London Endocrine Centre, where he is the senior consultant. Dr Jenkins firmly believes in a holistic approach to his patients' care. In all his consultations, he allows plenty of time for patients to discuss all of their concerns and wishes before fully involving them in a shared approach to their optimum management.

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