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HPA axis and Fibromyalgia

Aug 2011

One of the biggest struggles for those suffering from Fibromyalgia (FMS) is the difficulty in receiving a proper diagnosis. Since the cause of the disorder is unknown, doctors have always been hesitant to diagnose it. But there’s good news. Recent studies may have found the disorders source: an abnormality in the hypothalamus-pituitary-adrenal gland (HPA) axis.

What the HPA Axis Is: A system of interactions between the hypothalamus, pituitary gland, and adrenal gland.

  • Hypothalamus: Located in the middle of the base of the brain, the hypothalamus controls the pituitary gland, as well as body temperature, hunger, thirst, mood, sleep, sex drive
  • Pituitary gland: A pea-sized gland at the base of the brain, it controls metabolism, blood pressure, sexuality, reproduction, and stress response.

Adrenal gland: These are triangular-shaped glands located on top of the kidney. They produce cortisol, epinephrine (adrenalin), and norepinephrine, as well as small amounts of estrogens and androgens.

The HPA Axis coordinates the physical and physiological response to external and internal stimuli, including stress. Since those with FMS process pain differently than the average person, it is a logical hypothesis that abnormalities in the HPA axis could be the cause of FMS.

The Connection Between HPA Abnormalities and FMS

  • Cortisol: when imbalanced, this can result in a lowered tolerance for pain, as well as fatigue, trouble with concentration, and other complications. These are common amongst those with FMS. Since the release of the hormone cortisol is controlled by the pituitary gland and the hypothalamus, irregular levels of cortisol suggest that irregularities in the HPA axis and FMS are related.
  • Serotonin: helps deliver the sensation of pain to the brain. It appears in insufficient levels in those who suffer from FMS.
  • Substance P: a neurotransmitter associated with increased pain perception in the cerebrospinal fluid. Increased levels of substance P increase sensitivity, or heighten awareness of pain. Substance P has been found at three times the normal levels in people who suffer from FMS.
  • Insulin-Like Growth Factor-1 (IGF-1): Some studies have reported low levels of IGF-1 in about a third of fibromyalgia patients. IGF-1 is a hormone that promotes bone and muscle growth. Low levels of growth hormone may lead to impaired thinking, lack of energy, muscle weakness, and intolerance to cold — all symptoms of FMS. While a direct link between IGF-1 levels and FMS has yet to be found, growth hormone levels in the blood may be an indicator of the disorder.

While these hormone indicators may not be exclusive to those suffering from FMS, the correlation between the symptoms of those with FMS and the HPA abnormalities cannot be ignored. Once thought to be an imaginary disease, new studies are bringing us closer to understanding the nature of the Fibromyalgia syndrome. The more we learn about the nature of the disorder, the easier it will be able to treat and perhaps one day cure fibromyalgia.

Definition: The hypothalamic-pituitary-adrenal axis is a complex set of interactions between the hypothalamus (a part of the brain), the pituitary gland (also part of the brain) and the adrenal or suprarenal glands (at the top of each kidney.) The HPA axis helps regulate things such as your temperature, digestion, immune system, mood, sexuality and energy usage. It’s also a major part of the system that controls your reaction to stress, trauma and injury.

Research links fibromyalgia and chronic fatigue syndrome with abnormalities in genes involved in the HPA axis. (Primarily the hypothalamus in fibromyalgia and primarily the adrenals in chronic fatigue syndrome.)

The HPA axis also is involved in anxiety disorder, bipolar disorder, post-traumatic stress disorder, clinical depression, burnout and irritable bowel syndrome.

Also Known As: hypothalamic-pituitary-adrenal axis
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THIS INFORMATION IS NOT INTENDED TO SUBSTITUTE FOR A MEDICAL PHYSICIANS ADVICE. AS WITH ANYTHING, PLEASE CONSULT YOUR HEALTH CARE PROVIDER BEFORE STARTING ANY NEW VITAMINS, SUPPLIMENTS, DIETS OR EXERCISES.

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