In addition to lower cortisol levels in the morning and throughout the day [in patients who really need higher levels to support them through their daily stress and pain], Fibromyalgia patients demonstrate decreased cortisol receptor sensitivity. This adds insult to the injury.

To achieve the same cortisol-mediated stress, blood sugar and energy metabolism support, fibromyalgia patients need higher levels of circulating cortisol than average patients. Lower cortisol levels plus compromised cortisol receptor sensitivity accounts for much of the symptom load exhibited by fibromyalgia patients, esp as relates to day-night rhythm problems, increased perceptions of stress and decreased stress tolerance with anxiety during stressful situations.

Yet again, this situation need not be an obstacle to better health. Moderately increasing cortisol levels through micro-dosing with appropriate hormone therapy makes the world of difference with anxiety, sleep and day-to-day function.

 

Evidence for an association between an enhanced reactivity of interleukin-6 levels and reduced glucocorticoid sensitivity in patients with fibromyalgia.

Reduced and disturbed glucocorticoid sensitivity was observed in fibromyalgia patients. The very interesting observation in this study, in addition to the disturbed cortisol receptor function, that fibromyalgia patient’s ACTH did not increase during pain pressure point threshold testing: cortisol did increase 3 times [from the pain of the test] and IL-6 increased 4 times [an inflammatory hormone that is problematic in FMS].

Glucocorticoid sensitivity in fibromyalgia patients: decreased expression of corticosteroid receptors.

Fibromyalgia patients exhibited changes in glucocorticoid receptor (GR) affinity and disturbances associated with loss of hypothalamic-pituitary-adrenal (HPA) axis resiliency. There is a lower expression of corticosteroid receptors  in FM patients when compared to healthy controls.

Changes in salivary cortisol and corticosteroid receptor-alpha mRNA expression following a 3-week multidisciplinary treatment program in patients with fibromyalgia. 

“…..Increased resiliency and sensitivity of the stress system is probably related to stimulation of Glucocorticoid Receptor-alpha synthesis by the components of the treatment.”     The conclusion of this study is that due to changes in cortisol receptor sensitivity, Fibromyalgia patients improved in many respects, including pain threshold and resilience of the stress system.

 

Werner Vosloo ND, MHom