Hormones and Fibromyalgia, Part 2.
Mark Pellegrino, MD posted:
Thank you for your great responses to the discussion on hormone problems with FM . I wanted to summarize what may be some specific neuroendocrine dysfunctions that contribute to so many of our unique symptoms. Briefly, I'll name the gland, it's implicated dysfunctional hormone(s), and specific fibro symptoms that may result. I think it's best to think of a dysfunctional hormone in FM as a deficient hormone. This means that our body acts like we do not have enough of a particular hormone even if, technically, the hormone levels are not measured to be "too low." Many hormones have been measured to be too low, but some are considered "low normal" and others may be defective in some way, or unable to bind properly with the hormone receptors, so the end result is: "deficient."

Hypothalamus: Specialized neuroendocrine brain area that produces releasing hormones that signal specific glands. These "releasing hormones" may be defective, dysfunctional, deficient for us and thus not able to properly signal our glands to function properly.

Pineal gland: melatonin. May play role in our poor nonrestful sleep.

Pituatary: growth hormone, thyroid stimulation hormone. Deficiencies of both, esp growth hormone, can lead to fatigue, cognitive dysfunction, cold hands and feet, poor recovery from activity/exercise, immune dysfunctions, decreased tissue repair etc.

Thyroid: thyroxine. Often low and can mimic FM, or become low in those with FM and cause worsening fatigue, slowed metabolism, weight gain, pain.

Liver: insulin-like growth factor-1, or somatomedin C, is produced by the liver in response to stimulation by our growth hormone. Low growth hormone levels equals low IGF-1 levels.

Pancreas: insulin. Probably plays role in our FM-related hypoglycemia symptoms (lightheaded, dizzy, fatigue, "crashing"). In FM, the insulin seems to become more sensitive in its action, thus it acts like there is too much instead of too little as with the other hormones.

Adrenal gland: glucocorticoids (steroid hormones) These are our "stress hormones" which may start off being overstimulated due to the stress of chronic pain but ultimately probably become deficient. Can lead to immune dysfunction (ie frequent infections), fatigue, cognitive dysfunctions, metabolism changes, chronic anxiety etc.

Adrenal medulla: epinephrine, norepinephrine, dopamine. Play major role in our PAIN via complex interactions with our central and peripheral nervous systems. These 3 key hormones are also important in mood, anxiety, congnition, focusing, motivation and more. All are "deficient" in FM.

Ovary/Testes: estrogen, androgen, testosterone. Can lead to problems with libido, sexual function, weakness, fatigue etc.

Skin: vitamin D. Don't forget about this important compound which is felt to be more of a hormone than a vitamin.

This is a lot of info but it may help you see the bigger hormone picture a little better and appreciate how complicated all the hormone interactions and feedback loops are. Also, it may remind you that all your unique fibro symptoms have an actual biological "cause," invariably within our dysfunctional neuroendocrine system.

Disclaimer: The above is for your information only. I don't pretend to really understand any of it!!

Dr. P
Booch007 responded:
Dear Dr. P,

Well we are just a sack of chemistry and interactions of the same.........GI once said a TUBE within a TUBE....and all that goes on between the two. !! .

Don't think for a minute that we believe your disclaimer**.....

I just saw a parathyroid patient who's calcium wasn't so bad..if that was the marker to look at the PTH. Geez, her PTH was off the roof, but her repetative kidney stones I think is what was saving her from high chemistry finding. IT is the look of the overall that helps these poor docs to figure you out. Drawing labs is only a part of the picture.

Thanks for the class again. CUT and PASTED in your file... (it is getting big!). Thank you again, Nancy B
1wareaglefan responded:
Thank you so much for your expert information, Dr. P.! Why can't all our doctors be like you? I just wondered then, if in the future you think endocrinologists will be the ones to diagnose and treat fibro?

Thank you again for keeping us informed!

Bless you....ELizabeth
xperky responded:
Wow. No wonder we are difficult to treat.
With Compassion,
Booch007 replied to xperky's response:
Wish there was a LIKE button on this website.....Margaret I would LIKE you...........see how challenging it is to get us balanced, and why once out...the mission is so daunting, they just fail at the answers....it is so complicated and all different.

It really is many things happen to get us here and in my own path to figure me* out...I am twisted in the mess of chemistry I am in. Then once here, your brain chemistry is actively changing thinking it is in warfare....so you end up on a SNRI or similar to help with that......we are a mess....

My new mantra "I am held together by duct tape and Plummers putty"...........Don't mess with me!....Nancy B
husband0 responded:
I am wondering if other FM sufferers have violently abusive verbal outbreaks against their spouses during or before flares???
missshortyd replied to husband0's response:
Dear husbandO
I'm sorry you are dealing with this.Sometimes when we don't feel good we might be a little cranky but violently abusive is a bit much.Maybe you should talk to her doctor.I hope others on here can offer more advice.

Hang in there
angelswife responded:
Thanks for the great info, Dr. P!

From reading this, I feel I've probably had Fibro since my early 20s. Just never got the right dx...As an aside, wouldn't it be funny if Fibro turned out to be a protective measure against getting diabetes? Our family is loaded with diabetics; but I and my mom have always been hypoglycemic, and we both have Fibromyalgia. Wonder if there's a connection somewhere....?
glad2bhere65 replied to angelswife's response:
Hi, well, I've had Type I diabetes for over 30 years and was just diagnosed with fibro last fall, so maybe there isn't a connection. I hope all of you have a good day.

Wolfsong452 responded:
thinking I"m going to go back and reread this,

I'm having a bad day thinking things through, I can't make any sense of this.

Sorry Doctor P.
An_241175 responded:
Do you know a doctor in the Philadelphia area that uses hormone studies to help peoplewith FMS?
I am desperate and dealing with this for 20 years and still I cannot find a doctor confident in treating this condition.
Caprice_WebMD_Staff replied to An_241175's response:
Hi An_241175,

I'm afraid doctor recommendations cannot be made on our boards, by our experts or other members.

I hope you find what you're looking for.
We must let go of the life we have planned, so as to accept the one that is waiting for us. ~Joseph Campbell
Anon_175628 responded:
Great info.. I have night sweats and bad out breaks during the day. My Dr suggested I may need to see a hormone spec. This answers a lot of questions for me. I've had hypoglycemia for years. I lost weight when I first got sick even though I was on 300mg of Lyrica. I had to stop taking it because it started making me swell up. Low vit D and my last urine test said high protein levels, now what is that? Does anyone have any info. on that? I've not been back to the Dr for another test so I don't have any idea what it means. Any help????????????????????
glad2bhere65 replied to Anon_175628's response:
The high protein can mean kidney problems I think. I'm diabetic, so I take a med to keep my kidneys from excreting protein, so you will want to discuss this with your doctor.

mcd1956 replied to husband0's response:
Dear husband, I am new to this website, however, I am embarrassed to say that I have had those same feelings.I am re-married and the "psyco-ness" continued. It always happened around the time I would ovulate. I could feel the changes inside but couldn't control them. I would get extremely angry over things that I know wouldn't normally bother me and lash out at the ones I loved the most. My ex-husband said all he ever wanted was to find someone who didn't have PMS. My own mother said she could see the change in my eyes! I felt possessed! I ended up going to the gynocologist and begging for a hysterectomy when I was 42 hoping that would stop the madness and I could save my marriage. The doctor told me I had "toxic" hormones and I believed him. I received a total hysterectomy and that has helped tremendously. I know what you are going thru and I feel so sorry for you and your wife. It is extremely hard on everyone. I was beginning to think I should be committed somewhere because I had so much to be grateful for but acted so ungrateful and angry. The doc couldn't guarantee that anything would change after the surgery because a woman's body can still cycle.....but it has helped me tremendously. God bless you and your family.