Abstract
Objective: Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain, fatigue, disrupted sleep, depression, and physical deconditioning. In this article, we review the literature on the normal activity of the hypothalamic-pituitary-growth hormone-insulin-like growth factor-1 (HP-GH-IGF-1) axis and its perturbations in FM subjects. Methods: Studies included in this review were accessed through an English language search of Cochrane Collaboration Reviews. Keyword MeSH terms included "fibromyalgia," "growth hormone" (GH), or "insulin-like growth factor-1" (IGF-1). Results: Twenty-six studies enrolling 2006 subjects were reviewed. Overall, low levels of IGF-1 were found in a subgroup of subjects. Growth hormone stimulation tests often revealed a suboptimal response, which did not always correlate with IGF-1 levels. No consistent defects in pituitary function were found. Of the 3 randomized placebo controlled studies, only 9 months of daily injectable recombinant GH reduced FM symptoms and normalized IGF-1. Conclusions: These studies suggest that pituitary function is normal in FM and that reported changes in the HP-GH-IGF-1 axis are most likely hypothalamic in origin. The therapeutic efficacy of supplemental GH therapy in FM requires further study before any solid recommendations can be made.
Original language | English (US) |
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Pages (from-to) | 357-379 |
Number of pages | 23 |
Journal | Seminars in Arthritis and Rheumatism |
Volume | 36 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2007 |
Keywords
- fibromyalgia
- growth hormone (GH)
- growth hormone releasing hormone (GHRH)
- hypothalamus
- insulin-like growth factor-1 (IGF-1)
- pituitary
- somatostatin
ASJC Scopus subject areas
- Rheumatology
- Anesthesiology and Pain Medicine