Which neuroendocrine abnormalities are associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Some authors have noted that 5 main measurable neuroendocrine abnormalities are associated with dysfunction of the HPA axis. [39] These are as follows:

  • Low free cortisol levels in 24-hour urine samples

  • Loss of the normal circadian rhythm, with an elevated evening cortisol level (when it should be at its lowest level)

  • Insulin-induced hypoglycemia associated with an overproduction of ACTH

  • Low levels of growth hormone

  • Stimulated ACTH secretion leading to insufficient adrenal release of glucocorticoids

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