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It is often critically important to evaluate adrenal status in the patient with chronic fatigue because adrenal and thyroid function are so interdependent, and because increases in catacholamines and up-regulation of the sympathetic nervous system have been implicated in FMS, as previously discussed

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The method differed due to differences in study design which include that the change in HbA1c was calculated from measurements taken at baseline and at 8 months