Skip to main content

Advertisement

SpringerLink
Log in

Neuroendocrine abnormalities in fibromyalgia

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Fibromyalgia is a disorder of unknown etiology characterized by chronic, widespread musculoskeletal pain and symptoms such as fatigue, poor sleep, gastrointestinal complaints, and psychologic problems that are similar to those experienced by patients with hormone deficiencies. This review summarizes the available data on the neuroendocrine function in fibromyalgia, including data on hormone secretion, circadian phase, and autonomic nervous system function. Studies suggest that there may be lower activity of a number of hypothalamic-pituitaryperipheral gland axes and altered autonomic nervous system function in patients with fibromyalgia. These reductions in activity are mild to moderate and do not result from alterations in circadian rhythms. The reduced hormonal and autonomic responses appear to reflect an impairment in the hypothalamic or central nervous system response to stimuli rather than a primary defect at the level of the pituitary gland or the peripheral glands. A combination of multiple, mild impaired responses may lead to more profound physiologic and clinical consequences as compared with a defect in only one system, and could contribute to the symptoms of fibromyalgia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Wolfe F, Ross K, Anderson J, et al.: The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38(1):19–28.

    Article  PubMed  CAS  Google Scholar 

  2. Wolfe F, Smythe HA, Yunus MB, et al.: The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum 1990, 33(2):1600–172.

    Article  Google Scholar 

  3. Clauw DJ, Chrousos GP: Chronic pain and fatigue syndromes: Overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation 1997, 4:134–153.

    PubMed  CAS  Google Scholar 

  4. Goldenberg DL: Fibromyalgia syndrome a decade later. Arch Intern Med 1999, 159:777–785.

    Article  PubMed  CAS  Google Scholar 

  5. Weigent DA, Bradley LA, Blalock JE, Alarcon GS: Current concepts in the pathophysiology of abnormal pain perception in fibromyalgia. Am J Med Sci 1998, 315(6):405–412.

    Article  PubMed  CAS  Google Scholar 

  6. Reichlin S: Neuroendocrinology. In Williams Textbook of Endocrinology. Edited by Wilson, Foster, Kronenberg, Larsen.Philadelphia: W.B.Saunders Company; 1998:165–248.

    Google Scholar 

  7. Magiakou MA, Chrousos GP: Corticosteroid therapy, nonendocrine disease, and corticosteroid withdrawal. Curr Ther Endocrinol Metab 1994, 5:120–124.

    PubMed  CAS  Google Scholar 

  8. Adler GK, Kinsley BT, Hurwitz S, et al.: Reduced hypothalamicpituitary and sympathoadrenal responses to hypoglycemia in women with fibromyalgia syndrome. Am J Med 1999, 106:534–543.A hypoglycemic-hyperinsulinemic clamp technique was used to apply a precise graded-hypoglycemic challenge to 12 women with fibromyalgia and 13 healthy women. There was approximately a 30% reduction in the adrenocorticotropic and epinephrine responses to hypoglycemia in fibromyalgia. ACTH dose-response study showed normal adrenal sensitivity. These results suggest that there may be concomitant impairment of the HPA axis and the autonomic nervous system.

    Article  PubMed  CAS  Google Scholar 

  9. Maes M, Lin A, Bonaccorso S, et al.: Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia. Acta Psychiatr Scand 1998, 98:328–335.

    PubMed  CAS  Google Scholar 

  10. Crofford LJ, Pillemer SR, Kalogeras KT, et al.: Hypothalamicpituitary-adrenal axis perturbations in patients with fibromyalgia. Arthritis Rheum 1994, 37(11):1583–1592.

    Article  PubMed  CAS  Google Scholar 

  11. Lentjes EGWM, Griep EN, Boersma JW, et al.: Glucocorticoid receptors, fibromyalgia and low back pain. Psychoneuroendocrinology 1997, 22(8):603–614.

    Article  PubMed  CAS  Google Scholar 

  12. Catley D, Kaell AT, Kirschbaum C, Stone AA: A naturalistic evaluation of cortisol secretion in persons with fibromyalgia and rheumatoid arthritis. Arthritis Care Res 2000, 13(1):51–61.

    Article  PubMed  CAS  Google Scholar 

  13. Klerman EB, Goldenberg DL, Brown EN, et al.: Circadian rhythms of women with fibromyalgia. J Clin Endocrinol Metab 2001, 86(3):1034–1039.Ten women with fibromyalgia and 12 healthy women were observed using a 40-hour protocol to assess circadian phase in which subjects remained awake and factors known to alter circadian markers were minimized. Blood samples were collected for hormone analysis every 10 to 20 minutes. No significant difference was found in the circadian amplitude or phase of rhythms of melatonin, cortisol, and core body temperature, suggesting that the circadian rhythms in women with fibromyalgia are normal. Furthermore, cortisol and melatonin levels were similar in patients with fibromyalgia and in control groups.

    Article  PubMed  CAS  Google Scholar 

  14. Korszun A, Sackett-Lundeen L, Papadopoulos E, et al.: Melatonin levels in women with fibromyalgia and chronic fatigue syndrome. J Rheumatol 1999, 26:2675–2680.Cortisol levels were examined every 10 minutes in nine women with fibromyalgia and in nine healthy women over 24 hours. Waveforms fit to these data revealed similar cortisol rhythms, including similar amplitudes and acrophases, in the two subject groups, suggesting that plasma cortisol levels are similar in healthy subjects and in patients with fibromyalgia under controlled resting conditions.

    PubMed  CAS  Google Scholar 

  15. Griep EN, Boersma JW, Lentjes EGWM, et al.: Function of the hypothalamic-pituitary-adrenal axis in patients with fibromyalgia and low back pain. J Rheumatol 1998, 25:1374–1381.

    PubMed  CAS  Google Scholar 

  16. van Denderen JC, Boersma JW, Zeinstra P, et al.: Physiological effects of exhaustive physical exercise in primary fibromyalgia syndrome (PFS): Is PFS a disorder of neuroendocrine reactivity? Scand J Rheumatol 1992, 21:35–37.

    PubMed  Google Scholar 

  17. Gürsel Y, Ergin S, Ulus Y, et al.: Hormonal responses to exercise stress test in patients with fibromyalgia syndrome. Clin Rheumatol 2001, 20:401–405.

    Article  PubMed  Google Scholar 

  18. Griep EN, Boersma JW, de Kloet ER: Evidence for neuroendocrine disturbance following physical exercise in primary fibromyalgia syndrome. J Musculoskeletal Pain 1993, 1:217–222.

    Article  Google Scholar 

  19. Griep EN, Boersma JW, de Kloet ER: Altered reactivity of the hypothalamic-pituitary-adrenal axis in the primary fibromyalgia syndrome. J Rheumatol 1993, 20:469–474.

    PubMed  CAS  Google Scholar 

  20. Kirnap M, Colak R, Eser C, et al.: A comparison between lowdose (1 μg), standard-dose (250 μg) ACTH stimulation tests and insulin tolerance test in the evaluation of hypothalamopituitary-adrenal axis in primary fibromyalgia syndrome. Clin Endocrinol 2001, 55:455–459.

    Article  CAS  Google Scholar 

  21. Navarra P, Tsagarakis S, Faria MS, et al.: Interleukins-1 and -6 stimulate the release of corticotropin-releasing hormone-41 from rat hypothalamus in vitro via the eicosanoid cyclooxygenase pathway. Endocrinology 1991, 128(1):37–44.

    PubMed  CAS  Google Scholar 

  22. Torpy DJ, Dapanicolaou DA, Lotsikas AJ, et al.: Responses of the sympathetic nervous system and the hypothalamicpituitary-adrenal axis to interleukin-6: a pilot study in fibromyalgia. Arhritis Rheum 2000, 43(4):872–880.Adrenocorticotropic hormone (ACTH), cortisol, and catecholamines levels were measured in 13 patients with fibromyalgia and in eight healthy women before and after administration of interleukin-6. ACTH-release was significantly delayed, and norepinephrine and heart rate responses to interleukin-6 were exaggerated in patients with fibromyalgia compared with the control groups. These results suggest that there is altered hypothalamic corticotropin-releasing hormone-ACTH function and abnormal regulation of the autonomic nervous system in fibromyalgia.

    Article  CAS  Google Scholar 

  23. Riedel W, Kayka H, Neeck G: Secretory pattern of GH, TSH, thyroid hormones, ACTH, cortisol, FSH and LH in patients with fibromyalgia syndrome following systemic injection of the relevant hypothalamic-releasing hormones. Z Rheumatol 1998, 57(Suppl 2):81–87.Administration of hypothalamic releasing hormones (corticotropinreleasing hormone, thyroid-stimulating hormones, growth hormonereleasing hormone, gonadotropin-releasing hormone) to patients with fibromyalgia and healthy subjects showed increased ACTH, decreased TSH, increased prolactin, and blunted LH response in patients with fibromyalgia. These results support the idea of altered hypothalamic-pituitary regulation.

    Article  PubMed  CAS  Google Scholar 

  24. von Bardeleben U, Stalla GK, Muller OA, Holsboer F: Blunting of ACTH response to human CRH in depressed patients is avoided by metyrapone pretreatment. Biol Psychiatry 1988, 24(7):782–786.

    Article  Google Scholar 

  25. Maliszewski AM, Goldenberg DL, Hurwitz S, Adler GK: Regulation of the renin-angiotensin-aldosterone system in fibromyalgia. J Rheumatol 2002, in press.

  26. Russell IJ, Orr MD, Littman B, Vipraio GA, et al.: Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum 1994, 37(11):1593–1601.

    Article  PubMed  CAS  Google Scholar 

  27. Bradley LA, Sotolongo A, Alberts KR, et al.: Abnormal regional cerebral blood flow in the Caudate Nucleus among fibromyalgia patients and non-patients is associated with insidious symptom onset. J Musculosceletal Pain 1999, 7:285–292.

    Article  Google Scholar 

  28. Russell IJ, Vaeroy H, Javors M, Nyberg F: Cerebrospinal fluid biogenic amine metabolites in fibromyalgia/fibrositis syndrome and rheumatoid arthritis. Arthritis Rheum 1992, 35(5):550–556.

    Article  PubMed  CAS  Google Scholar 

  29. Legangneux E, Mora JJ, Spreux-Varoquaux O, et al.: Cerebrospinal fluid biogenic amine metabolites, plasma-rich platelet serotonin and [ 3H ] imipramine reuptake in the primary fibromyalgia syndrome. Rheumotology 2001, 40:290–296.

    Article  CAS  Google Scholar 

  30. Larsen PJ, Jessop D, Patel H, et al.: Substance P inhibits the release of anterior pituitary adrenocorticotrophin via a central mechanism involving corticotrophin-releasing factor-containing neurons in the hypothalamic paraventricular nucleus. J Neuroendocrinol 1993, 5(1):99–105.

    Article  PubMed  CAS  Google Scholar 

  31. Kageyama K, Tozawa F, Horiba N, et al.: Serotonin stimulates corticotropin-releasing factor gene expression in the hypothalamic paraventricular nucleus of conscious rats. Neuroscience Letters 1998, 243(1-3):17–20.

    Article  PubMed  CAS  Google Scholar 

  32. Singh A, Petrides JS, Gold PW, et al.: Differential hypothalamic-pituitary-adrenal axis reactivity to psychological and physical stress. J Clin Endocrinol Metab 1999, 84:1944–1948.

    Article  PubMed  CAS  Google Scholar 

  33. Kirschbaum C, Kudielka BM, Gaab J, et al.: Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus-pituitary-adrenal axis. Psychosomatic Medicine 1999, 61:154–162.

    PubMed  CAS  Google Scholar 

  34. Wittert GA, Livesey JH, Espiner EA, Donald RA: Adaptation of the hypothalamopituitary adrenal axis to chronic exercise stress in humans. Med Sci Sports Exerc 1996, 28(8):1015–1019.

    PubMed  CAS  Google Scholar 

  35. Laurent D, Schneider KE, Prusaczyk WK, et al.: Effects of caffeine on muscle glycogen utilization and the neuroendocrine axis during exercise. J Clin Endocrinol Metab 2000, 85(6):2170–2175.

    Article  PubMed  CAS  Google Scholar 

  36. Adler GK: Editorial: Exercise and fatigue: is neuroendocrinology an important factor? J Clin Endocrinol Metab 2000, 85(6):2167–2169.

    Article  PubMed  CAS  Google Scholar 

  37. Davis SN, Shavers C, Costa F, Mosqueda-Garcia R: Role of cortisol in the pathogenesis of deficient counter-regulation after antecedent hypoglycemia in normal humans. J Clin Invest 1996, 98(3):680–691.

    Article  PubMed  CAS  Google Scholar 

  38. Galassetti P, Mann S, Tate D, et al.: Effects of antecedent prolonged exercise on subsequent counter-regulatory responses to hypoglycemia. Am J Physical Endocrinol Metab 2001, 280:E908-E917.

    CAS  Google Scholar 

  39. Demitrack MA, Dale JK, Straus SE, et al.: Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab 1991, 73(6):1224–1234.

    PubMed  CAS  Google Scholar 

  40. Neeck G, Crofford LJ: Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome. Rheum Ids Cline North Am 2000, 26(4):989–1002.

    Article  CAS  Google Scholar 

  41. Yehuda R, Southwick SM, Nussbaum G, et al.: Low urinary cortisol excretion in patients with posttraumatic stress disorder. J Nerv Ment Dis 1990, 178(6):366–369.

    Article  PubMed  CAS  Google Scholar 

  42. Yehuda R, Kahana B, Binder-Brynes K, et al.: Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder. Am J Psychiatry 1995, 152(7):982–986.

    PubMed  CAS  Google Scholar 

  43. Kojima M, Hosoda H, Date Y, et al.: Ghrelin is a growthhormone-releasing acylated peptide from stomach. Nature 1999, 402:656–660.

    Article  PubMed  CAS  Google Scholar 

  44. Reiter EO, Rosenfeld RG: Normal and aberrant growth. In Williams Textbook of Endocrinology. Edited by Wilson, Foster,Kronenberg, Larsen. Philadelphia: W.B.Saunders Company;1998:1427–1507.

    Google Scholar 

  45. Bagge E, Bengtsson B, Carlsson L, Carlsson J: Low growth hormone secretion in patients with fibromyalgia: a preliminary report on 10 patients and 10 controls. J Rheumatol 1998, 25(1):145–148.

    PubMed  CAS  Google Scholar 

  46. Leal-Cerro A, Povedano J, Astorga R, et al.: The growth hormone (GH)-releasing hormone - GH -insulin-like growth factor-1 axis in patients with fibromyalgia syndrome. J Clin Endocrinol Metab 1999, 84(9):3378–3381.This study assessed spontaneous 24-hour growth hormone secretion measured every 20 minutes, and GH responses to exogenously administered growth hormone-releasing hormone in patients with fibromyalgia and in control groups. Compared with the control groups, patients with fibromyalgia showed a decrease in basal GH secretion, but had similar responses to GHRH. These results support the concept of an alteration at or above the level of the hypothalamus in the control of GH in patients with fibromyalgia.

    Article  PubMed  CAS  Google Scholar 

  47. Landis CA, Lentz MA, Rothermel J, et al.: Decreased nocturnal levels of prolactin and growth hormone in women with fibromyalgia. J Clin Endocrinol Metab 2001, 86:1672–1678.Assessment of serum growth hormone and prolactin levels every 60 minutes from 8 PM to 7 AM in 25 women with fibromyalgia and 21 healthy women revealed reduced GH and prolactin levels during the sleep period in the group with fibromyalgia. GH and prolactin were reduced in the patients with fibromyalgia despite similar sleep characteristics in the two subject populations, raising the possibility of altered hypothalamic-pituitary response to sleep in fibromyalgia.

    Article  PubMed  CAS  Google Scholar 

  48. Griep EN, Boersma JW, de Kloet ER: Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome. J Rheumatol 1994, 21(11):2125–2130.

    PubMed  CAS  Google Scholar 

  49. Dinser R, Halama T, Hoffmann A: Stringent endocrinologic testing reveals subnormal growth hormone secretion in some patients with fibromyalgia syndrome but rarely severe growth hormone deficiency. J Rheumatol 2000, 27:2482–2488.

    PubMed  CAS  Google Scholar 

  50. Bennett RM, Clark SR, Burckhardt CS, Campbell SM: Hypothalamic-pituitary-insulin-like growth factor-I axis dysfunction in patients with fibromyalgia. J Rheumatol 1997, 24(7):1384–1389.

    PubMed  CAS  Google Scholar 

  51. Buchwald D, Umali J, Stene M: Insulin-like growth factor-1 (somatomedin C) levels in chronic fatigue syndrome and fibromyalgia. J Rheumatol 1996, 23:739–742.

    PubMed  CAS  Google Scholar 

  52. Jacobsen S, Main K, Danneskiold-Samsoe B, Skakkebeck NE: A controlled study on serum insulin-like growth factor-1 and urinary excretion of growth hormone in fibromyalgia. J Rheumatol 1995, 22(6):1138–1140.

    PubMed  CAS  Google Scholar 

  53. Van Cauter E, Plat L, Copinschi G: Interrelations between sleep and the somatotropic axis. Sleep 1998, 21(6):553–566.

    PubMed  Google Scholar 

  54. Cordido F, Dieguez C, Casanueva FF: Effect of central cholinergic neurotransmission enhancement by pyridostigmine on the growth hormone secretion elicited by clonidine, arginine or hypoglycemia in normal and obese subjects. J Clin Endocrinol Metab 1990, 70(5):1361–1370.

    Article  PubMed  CAS  Google Scholar 

  55. Kato Y, Murakami Y, Sohmiya M, Nishiki M: Regulation of human growth hormone secretion and its disorders. Intern Med 2002, 41(1):7–13.

    PubMed  CAS  Google Scholar 

  56. Anderson SM, Shah N, Evans WS, et al.: Short-term estradiol supplementation augments growth hormone (GH) secretory responsiveness to dose-varying GH-releasing peptide infusions in healthy post-menopausal women. J Clin Endocrinol Metab 2001, 86(2):551–560.

    Article  PubMed  CAS  Google Scholar 

  57. Neeck G, Riedel W: Thyroid function in patients with fibromyalgia syndrome. J Rheumatol 1992, 19:1120–1122.

    PubMed  CAS  Google Scholar 

  58. Korszun A, Young EA, Engleberg NC, et al.: Follicular phase hypothalamic-pituitary-gonadal axis function in women with fibromyalgia and chronic fatigue syndrome. J Rheumatol 2000, 27:1526–1530.Estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone were examined in nine women with fibromyalgia and in nine healthy subjects. Blood was collected every 10 minutes over a 12-hour period. No significant differences in estradiol, progesterone, or FSH levels were detected between subject groups. In addition, the pulsatile secretion of LH was similar in the two populations. Thus, the functioning of the hypothalamic gonadotropin-releasing hormone-pituitarygonadal axis appears intact in fibromyalgia.

    PubMed  CAS  Google Scholar 

  59. Akkus S, Delibas N, Tamer MN: Do sex hormones play a role in fibromyalgia? Rheumatology 2000, 39:1161–1163.

    Article  PubMed  CAS  Google Scholar 

  60. Østensen M, Rugelsj/oen A, Wigers SH: The effect of reproductive events and alterations of sex hormone levels on the symptoms of fibromyalgia. Scand J Rheumatol 1997, 26:355–360.

    Article  PubMed  Google Scholar 

  61. Qiao ZG, Vaeroy H, Morkrid L: Electrodermal and microcirculatory activity in patients with fibromyalgia during baseline, acoustic stimulation, and cold pressor tests. J Rheumatol 1991, 18:1383–1389.

    PubMed  CAS  Google Scholar 

  62. Cohen H, Neumann L, Shore M, et al.: Autonomic dysfunction in patients with fibromyalgia: Application of power spectral analysis of heart rate variability. Semin Arthritis Rheum 2000, 29:217–227.Power spectrum analysis of heart rate variability was measured for 20 minutes in 22 awake, supine women who had fibromyalgia, and 22 awake, supine, healthy women. There was decreased heart rate variability with increased low-frequency and lower high-frequency components of power spectrum analysis in patients with fibromyalgia compared with the control group. These results suggest that there is increased sympathetic and decreased parasympathetic tones in fibromyalgia.

    Article  PubMed  CAS  Google Scholar 

  63. Martínez-Lavín M, Hermosillo AG, Rosas M, Soto MA: Circadian studies of autonomic nervous balance in patients with fibromyalgia: a heart rate variability analysis. Arthritis Rheum 1998, 41:1966–1971.Twenty-four hour ambulatory recording of heart rate variability, time-domain analysis of the accumulated 24-h R-R interval variations, and power spectral analysis were assessed in 30 patients with fibromyalgia and 30 healthy patients. There was an increase in lowfrequency band oscillations during the sleep period and a resultant decrease in 24-hour heart rate variability in patients with fibromyalgia. These results suggest that there is an increased sympathetic tone in fibromyalgia possibly related to alterations in the control of autonomic function during sleep.

    Article  PubMed  Google Scholar 

  64. Martínez-Lavín M, Hermosillo AG, Mendoza C, et al.: Orthostatic sympathetic derangement in subjects with fibromyalgia. J Rheumatol 1997, 24:714–718.

    PubMed  Google Scholar 

  65. Raj SR, Brouillard D, Simpson CS, et al.: Dysautonomia among patients with fibromyalgia: a noninvasive assessment. J Rheumatol 2000, 27:2660–2665.

    PubMed  CAS  Google Scholar 

  66. Bou-Holaigah I, Calkins H, Flynn JA, et al.: Provocation of hypotension and pain during upright tilt table testing in adults with fibromyalgia. Clin Exp Rheumatol 1997, 15:239–246.

    PubMed  CAS  Google Scholar 

  67. Czeisler CA, Winkelman JW, Richardson GS: Sleep disorders. In Harrison’s Principles of Internal Medicine. Edited by BraunwaldE, Fauci AS, Kasper D, et al. New York: McGraw-Hill;2001:155–163.

    Google Scholar 

  68. Nathan PJ, Burrows GD, Norman TR: The effect of dim light on suppression of nocturnal melatonin in healthy women and men. J Neural Transm 1997, 104:643–648.

    Article  PubMed  CAS  Google Scholar 

  69. Wikner J, Hirsch U, Wetterberg L, Rodjmark S: Fibromyalgia: a syndrome associated with decreased nocturnal melatonin secretion. Clin Endocrinol 1998, 49(2):179–183.

    Article  CAS  Google Scholar 

  70. Press J, Phillip M, Neumann L, Barak R, et al.: Normal melatonin levels in patients with fibromyalgia syndrome. J Rheumatol 1998, 25:551–555.

    PubMed  CAS  Google Scholar 

  71. Clark S, Tindall E, Bennett RM: A double blind crossover trial of prednisone versus placebo in the treatment of fibrositis. J Rheumatol 1985, 12(5):980–983.

    PubMed  CAS  Google Scholar 

  72. Cleare AJ, Heap E, Malhi GS, et al.: Low-dose hydrocortisone in chronic fatigue syndrome: a randomized crossover trial. Lancet 1999, 353:455–458.

    Article  PubMed  CAS  Google Scholar 

  73. McKenzie R, O’Fallon A, Dale J, et al.: Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized controlled trial. JAMA 1998, 280(12):1061–1066.

    Article  PubMed  CAS  Google Scholar 

  74. Bennett RM, Clark SC, Walczyk MS: A randomized, doubleblind, placebo-controlled study of growth hormone in the treatment of fibromyalgia. Am J Med 1998, 104(3):227–231.A randomized, double-blind, placebo-controlled study of growth hormone therapy in 50 women with fibromyalgia who had an insulin-like growth factor-1 of less than 160 ng/mL showed that growth hormone treatment, compared with placebo, had a moderate beneficial effect on fibromyalgia symptoms. None of the patients was cured and the positive effects appeared to wane after termination of growth hormone therapy.

    Article  PubMed  CAS  Google Scholar 

  75. Cryer PE: Hypoglycemia-associated autonomic failure in diabetes. Am J Physiol Endocrinol Metab 2001, 281(6):E1115-E1121.

    PubMed  CAS  Google Scholar 

  76. Lariviere WR, Melzack R: The role of corticotropin-releasing factor in pain and analgesia. Pain 2000, 84:1–12.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endocrine-Hypertension Division, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, 02115, Boston, MA, USA

    Gail K. Adler MD, PhD, Valdis F. Manfredsdottir MD & Katharine W. Creskoff BA

Authors
  1. Gail K. Adler MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valdis F. Manfredsdottir MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katharine W. Creskoff BA
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adler, G.K., Manfredsdottir, V.F. & Creskoff, K.W. Neuroendocrine abnormalities in fibromyalgia. Current Science Inc 6, 289–298 (2002). https://doi.org/10.1007/s11916-002-0050-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-002-0050-5

Keywords

Search

Navigation