Fibromyalgia and the Hypothalamic Pituitary Adrenal Axis

HYPOTHALAMIC PITUITARY ADRENAL AXIS (HPA)

Perturbations of components of the HPA occur in patients with FMS. 47 These observations may reflect centrally induced changes to major modulatory peptides such as corticotrophin-releasing hormone. Although such changes may lead to better understanding of some of the clinical features of FMS such as fatigue, at this stage, they remain as a research tool. Measurement of various hormone levels in FMS is not yet useful in the clinical situation. The finding of lowered somatomedin-C in FMS subjects compared to controls is possibly related to the just described changes through alterations in growth hormone secretion. pathophysiological implications of this observation remain unclear and these measurements thus remain in the research area, but it is possible that somatomedin-C levels may act as a marker of an individual's overall condition. This has not yet been shown to be the case.

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