Cortisol and hypothalamic–pituitary–gonadal axis hormones in follicular-phase women with fibromyalgia and chronic fatigue syndrome and effect of depressive symptoms on these hormones

Abstract

We investigated abnormalities of the hypothalamic-pituitarygonadal axis and cortisol concentrations in women with fibromyalgia and chronic fatigue syndrome (CFS) who were in the follicular phase of their menstrual cycle, and whether their scores for depressive symptoms were related to levels of these hormones. A total of 176 subjects participated -46 healthy volunteers, 68 patients with fibromyalgia, and 62 patients with CFS. We examined concentrations of follicle-stimulating hormone, luteinizing hormone (LH), estradiol, progesterone, prolactin, and cortisol. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Cortisol levels were significantly lower in patients with fibromyalgia or CFS than in healthy controls (P < 0.05); there were no significant differences in other hormone levels between the three groups.Fibromyalgia patients with high BDI scores had significantly lower cortisol levels than controls (P < 0.05), and so did CFS patients, regardless of their BDI scores (P < 0.05). Among patients without depressive symptoms, cortisol levels were lower in CFS than in fibromyalgia (P < 0.05). Our study suggests that in spite of low morning cortisol concentrations, the only abnormalities in hypothalamic-pituitary-gonadal axis hormones among follicular-phase women with fibromyalgia or CFS are those of LH levels in fibromyalgia patients with a low BDI score. Depression may lower cortisol and LH levels, or, alternatively, low morning cortisol may be a biological factor that contributes to depressive symptoms in fibromyalgia. These parameters therefore must be taken into account in future investigations.

Higher Perceived Stress but Lower Cortisol Levels Found among Young Greek Adults Living in a Stressful Social Environment in Comparison with Swedish Young Adults

“…The basic mechanism of the HPA axis is that stress first leads to hyperactive functioning, but if the stress exposure is longstanding and individuals are no longer able to cope with this exposure, a state of exhaustion is reached and the system turns to hypoactive functioning. This tendency of hypocortisolism has been reported for patients with a variety of stress-related disorders such as chronic fatigue syndrome, fibromyalgia, lower-back pain, post-traumatic stress disorder, and burnout [33], [43], [44], [45].…”

“…Swedish and Greek translations were used for both PSS and HAD. The scales HAD depression and HAD anxiety were respectively divided into three groups and illustrated in table 1, following the established clinical cut-offs [33]. PSS was for illustrative purposes in table 1, divided into three groups (0–10p, 11–20p, 21–40p), as it has no established clinical cut-offs.…”

Nitric Oxide, Inflammation, Lipid Profile, and Cortisol in Normal- and Overweight Women With Fibromyalgia

“…In accord with several previous studies (Freitas, Lemos, Spyrides, & Sousa, 2012;Lentjes, Griep, Boersma, Romijn, & de Kloet, 1997), we did not find any significant differences in cortisol levels between the FM patients and the healthy controls. Conversely, investigators have reported both reduced (Gur et al, 2004) and elevated (Bote et al, 2012;Crofford et al, 2004) levels of cortisol in earlier studies in patients with FM versus controls. Research has shown that patients with FM have normal morning, afternoon, and evening serum cortisol levels compared to healthy subjects but elevated night levels (Fatima et al, 2013).…”

“…NO may also influence the HPA axis by neutralizing norepinephrine activity (Esch et al, 2002). Though investigators have observed alterations in the HPA axis along with altered response to stress in FM (Crofford et al, 2004;Gur et al, 2004), presently there are conflicting data as to the activity of the HPA axis in these patients.…”

Human Serum Albumin Structure in Presence of Different Concentrations of Cortisol and Glucose: An In Vitro Modeling Under Normal and Hyperglycemic Conditions

“…Irreversible complications of diabetes are caused by changes in the structure of biomolecules such as albumin, collagen, and hemoglobin; these changes favor the development of complications such as atherosclerosis, nephropathy, and retinopathy (13,14). Cortisol, also called hydrocortisone, is a steroid hormone or glucocorticoid that is secreted by the adrenal glands and its release is controlled by the hypothalamus (15). It is responsible for several stress-related changes in the body, and is known as the stress hormone.…”