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

Abstract

To study the hormonal perturbations in FMS patients we injected sixteen FMS patients and seventeen controls a cocktail of the hypothalamic releasing hormones: Corticotropin-releasing hormone (CRH), Thyrotropin-releasing hormone (TRH), Growth hormone-releasing hormone (GHRH), and Luteinizing hormone-releasing hormone (LHRH) and observed the hormonal secretion pattern of the pituitary together with the hormones of the peripheral endocrine glands. We found in FMS patients elevated basal values of ACTH and cortisol, lowered basal values of insulin-like growth factor I (IGF-I) and of triiodothyronine (T3), elevated basal values of follicle-stimulating hormone (FSH) and lowered basal values of estrogen. Following injection of the four releasing-hormones, we found in FMS patients an augmented response of ACTH, a blunted response of TSH, while the prolactin response was exaggerated. The effects of LHRH stimulation were investigated in six FMS patients and six controls and disclosed a significantly blunted response of LH in FMS. We explain the deviations of hormonal secretion in FMS patients as being caused by chronic stress, which, after being perceived and processed by the central nervous system (CNS), activates hypothalamic CRH neurons. CRH, on the one hand, activates the pituitary-adrenal axis, but also stimulates at the hypothalamic level somatostatin secretion which, in turn, causes inhibition of GH and TSH at the pituitary level. The suppression of gonadal function may also be attributed to elevated CRH by its ability to inhibit hypothalamic LHRH release, although it could act also directly on the ovary by inhibiting FSH-stimulated estrogen production. We conclude that the observed pattern of hormonal deviations in FMS patients is a CNS adjustment to chronic pain and stress, constitutes a specific entity of FMS, and is primarily evoked by activated CRH neurons.

Metabolic and hormonal acclimation to heat stress in domesticated ruminants

“…Corticotropinreleasing hormone stimulates somatostatin; possibly a key mechanism by which heat-stressed animals have reduced GH and thyroid levels (Riedel et al, 1998). In dairy cattle, the glucocorticoids decrease during acclimation at 358C (Alvarez and Johnson, 1973) and are lower in thermal-acclimated animals compared with controls (Ronchi et al, 2001).…”

Cerebrospinal Fluid Corticotropin-Releasing Factor Concentration is Associated with Pain but not Fatigue Symptoms in Patients with Fibromyalgia

“…The principal components of the human stress response are the hypothalamic-pituitary-adrenocortical (HPA) axis and locus ceruleus/norepinephrine-sympathetic (LC-NE) system (Chrousos and Gold, 1992). Results of studies examining HPA axis function in patients with FM are inconsistent, with both HPA axis hypoactivity and hyperactivity identified (McCain and Tilbe, 1989;Griep et al, 1993;Crofford et al, 1994;Riedel et al, 1998;Catley et al, 2000). Autonomic nervous system function in patients with FM, reflected in both heart rate variability (HRV) and plasma catecholamine levels, suggests a central hypernoradrenergic state (Martinez-Lavin et al, 1998;Stein et al, 2004).…”

Inhibition of cortisol production by metyrapone enhances trace, but not delay, eyeblink conditioning

“…Furthermore, it may suggest a hampered re-learning of classically conditioned symptoms in patient groups characterized by relative hypocortisolism. Thus, our data have theoretical and clinical significance, especially for stress-sensitive syndromes such as fibromyalgia, which have been shown to be associated with HPA axis perturbation in terms of a sensitized pituitary with adrenal insufficiency (Griep et al 1998;Griep et al 1993;Riedel et al 1998). Although some authors have assumed cerebellar mechanisms (e.g., interpositus nucleus) in both acquisition and extinction of eyeblink conditioning (Hardiman et al 1996;Krupa et al 1993;Krupa and Thompson 1997), several other studies have proposed the activity of different brain areas as well, including the hippocampus, in these conditioning processes (Akase et al 1989;Clark et al 1997;Krupa et al 1996;Krupa and Thompson 2003).…”