Hormonal pertubations in fibromyalgia (FM) syndrome

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The symptomatology characterizing fibromyalgia (FM) comprises three

systems: the musculoskeletal system with widespread muscular

pain, neuroendocrine disorders, and psychological distress

including depression. Though the most prominent symptom of FM

is pain in defined points of the musculoskeletal system, the

numerous other somatoform and psychological disorders suppose

a common primary disturbance which we consider to originate

within higher levels of the central nervous system.

Recent

studies of the entire endocrine profile of FM patients

following a simultaneous challenge of the hypophysis with

corticotropin-releasing hormone (CRH), thyrotropin-releasing

hormone, growth hormone-releasing hormone, and luteinizing

hormone-releasing hormone support the hypothesis that an

elevated activity of CRH neurons determines not only many

symptoms of FM but may also cause the deviations observed in

the other hormonal axes. Hypothalamic CRH neurons thus may

play a key role not only in “resetting” the various endocrine

loops but possibly also nociceptive and psychological

mechanisms as well.

Neeck G, Riedel W

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