Growth Hormone Perturbations in Fibromyalgia: A Review

Kim D. Jones, Parimal Deodhar, Ashley Lorentzen, Robert M. Bennett, Atul A. Deodhar

Research output: Contribution to journalArticle

52 Scopus citations

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 languageEnglish (US)
Pages (from-to)357-379
Number of pages23
JournalSeminars in Arthritis and Rheumatism
Volume36
Issue number6
DOIs
StatePublished - Jun 1 2007

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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

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