Some researchers have proposed that fibromyalgia is a "stress-associated syndrome." This is based on the observation that the condition often seems to develop with-or become worsened by-hormonal imbalances that signal a disruption in the body's stress-response systems.1

The hypothalamic-pituitary-adrenal (HPA) axis is one of the major stress response systems in the body. It links our sense of perception via the brain with our nervous system and with the secretion pattern of powerful hormones. In response to chronic stress, poor diet, obesity, and other factors, this communication feedback system may go awry, causing a variety of hormonal imbalances. Many of these have been specifically linked with fibromyalgia.

Imbalances of the stress hormone cortisol have been reported in patients with fibromylagia. Secreted by the adrenal glands, cortisol helps prime the body's "flight or fight" response. Higher levels of this hormone can raise blood glucose levels, shift fat metabolism, dampen inflammatory response, and disrupt the sleep-wake cycle. One recent study reported higher baseline levels of cortisol, as measured in saliva, in patients with fibromyalgia compared to controls.2

Over time, excess cortisol would be likely to promote chronic anxiety, insomnia, high blood pressure, and increased fat deposits around the midsection of the body. Another study found higher cortisol released in patients with fibromyalgia in response to stimulation of the pituitary hormone, CRH (corticotropin-releasting hormone). This could be the body's way of responding to chronic pain and stress.3

High cortisol pushes the body to marshall its resources for the short term. The body cannot function well in "overdrive" for long periods of time, however. If chronic stress becomes a habitualized response, the adrenal glands may eventually begin to "wear down" and "burn out". This can result in adrenal exhaustion, a state in which the body no longer produces enough cortisol (or DHEA, another important adrenal hormone) to maintain adequate energy levels.

Chronic fatigue is a hallmark symptom of this type of adrenal imbalance. Based on this scenario, chronically low levels of cortisol have been cited as a link between fibromyalgia, traumatic stress disorder, and other stress-induced bodily disorders.4 In addition, low levels of the adrenal hormone DHEA have also been tied to poorer health status in patients with fibromyalgia.5

Since different types of adrenal imbalances can be involved in fibromyalgia, pre-testing patients is important in order to develop safe and effective clinical interventions. The Adrenocortex Stress Profile is an accurate, easy-to-take, noninvasive saliva test that measures the levels of both cortisol and DHEA, providing important clues for a holistic analysis and treatment.

Because it requires only timed saliva samples, the test is a convenient and noninvasive method for evaluating the circadian pattern of cortisol secretion in patients with fibromyalgia. This assessment also includes a DHEA/cortisol ratio to help evaluate the adaptive health of the adrenal stress response. Imbalances can point to important stress-related hormonal disruptions that may be exacerbating or contributing to symptoms.

References:

1 Leslie J. Crofford, M.D., et al. Neurohormonal Perturbations in Fibromyalgia. Baillieres Clin Rheumatology 1996; 10(2): 365-78.

2 Catley D, Kaell AT, Kirschbaum C, Stone AA. A naturalistic evaluation of cortisol secretion in persons with fibromyalgia and rheumatoid arthritis. Arthritis Care Res 2000 Feb;13(1):51-61.

3 Riedel W, Layka H, Neeck G. Secretory pattern of GH, TSH, thyroid hormones, ACTH, cortisol, FSH, and LH in patients with fibromyalgia syndrome following systemic injection of the relevant hypothalamic-releasing hormones.Z Rheumatol 1998;57 Suppl 2:81-7.

4 Heim C, Ehlert U, Hellhammer DH. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 2000 Jan;25(1):1-35.

5 Dessein PH, Shipton EA, Joffe BI, Hadebe DP, Stanwix AE, Van der Merwe BA. Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia. Pain 1999 Nov;83(2):313-9.

All lab tests can be done through the mail in the privacy of your own home, except blood tests, we send you to a lab to have your blood drawn for these. After you pay for the test we mail you the kit, the results take two weeks, the test results will be mailed to us and we will call you to go over the results, its that easy! All tests include the consultation for the report of findings.

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