Abstract
BackgroundAdynamia in fibromyalgia (FM) may be an expression of a functional deficit of the hypothalamic-pituitary-adrenal axis and be associated with below-normal levels of urinary cortisol. Our aim was to demonstrate that urinary cortisol was lower in patients with FM than in healthy subjects.FindingsWe measured urinary cortisol levels for a sample of 47 women aged 29 to 64 years (mean age 53 years), diagnosed with FM 2–3 years previously, and compared the results with those for a control sample of 58 healthy women of a similar age. Samples of 24-hour urine were appropriately collected and levels of urinary cortisol were measured using the fluorescence polarization immunoassay method. The mean cortisol value for the women with FM was 65.40 ± 27.10 μg/L, significantly lower than the mean cortisol level for the control group, at 90.83 ± 38.17 μg/L (p < 0.001).ConclusionOur study confirms that women with FM have significantly lower urinary cortisol levels than healthy women.
Highlights
Adynamia in fibromyalgia (FM) may be an expression of a functional deficit of the hypothalamic-pituitary-adrenal axis and be associated with below-normal levels of urinary cortisol
Our study confirms that women with FM have significantly lower urinary cortisol levels than healthy women
The values for 24-hour urinary cortisol depended on urine collection quality – a key factor in terms of obtaining reliable results, given that individual variations and metabolic or pharmacological interference may alter metabolism
Summary
Adynamia in fibromyalgia (FM) may be an expression of a functional deficit of the hypothalamic-pituitary-adrenal axis and be associated with below-normal levels of urinary cortisol. FM is influenced by factors such as stress, illness, and pain in some – but not all patients – as well as by certain neurotransmitter and neuroendocrine changes, including reduced biogenic amine levels, increased excitatory neurotransmitter concentrations and alterations in the hypothalamic-pituitary-adrenal axis and in autonomic nervous system activity [2,3,4]. Studies of cortisol levels and the hypothalamic-pituitary-adrenal axis are motivated by the (page number not for citation purposes). Studies have demonstrated a latent decrease in the level of certain hormones, such as the growth hormone, prolactin, adrenocorticotrophic hormone and cortisol [6,7]
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