Neuroendocrine Findings in Patients with Fibromyalgia

SUMMARY

Objectives. Fibromyalgia [FMS] remains a poorly understood disorder characterized by a number of symptoms [pain, fatigues, sleep disturbance and psychological distress], but few physical findings and normal routine laboratory tests. Many of the most important symptoms of FMS are shared by other syndromes such as chronic fatigue syndrome, irritable bowel syndrome, chronic headaches, pelvic pain syndromes, and temporomandibular disorders. These syndromes fall into the spectrum of “stress-related illnesses” by virtue of the clinical observation that the onset of the disorder often coincides with physical or psychological stress, and because the course of the symptoms is strongly influenced by the perceived level of life stress. The physiologic stress response systems interact with other neuroendocrine axes, particularly those that affect growth and reproduction. We will review research supporting an association between FMS and perturbed function of stress response systems and other neuroendocrine axes.

Conclusions. Currently available research indicates that multiple neuroendocrine pathways are disturbed in patients with FMS. It is not clear whether these disturbances render patients vulnerable to the development of FMS, develop as a consequence of the disorder, or are consequent to other neurochemical disturbances. Further research is needed to clarify the role of neuroendocrine axes in FMS.