Fibromyalgia is characterized by a lack of energy, drive & motivation and a general lack of “get-up-and-go”. Mornings are pretty bad, you feel more tired than when you went to bed.
Cortisol levels in the mornings and also throughout the rest of the day are much lower than you need to get through the day’s stress, fatigue and pain.
Adrenal dysfunction is strongly responsible for this lack of restorative sleep or not feeling rested in the morning.
Cortisol is a key adrenal hormone that is essential to maintain healthy:
- Blood glucose levels
- Converting fat, protein and carbohydrate to maintain blood sugar
- Immune balance and healthy immune responses
- Endogenous anti-inflammatory [more allergies and inflammation when cortisol low]
- Blood Pressure
- Heart and blood vessel tone and contraction
- Central nervous system activation and motivation
- Healthy and happy optimistic mood
- Stress tolerance
- Sleep and day-night cycles
Just like thyroid hormone, it is very safe and easy to correct low cortisol levels.
Evaluation consists of symptomatic evaluation and laboratory investigation of cortisol levels at 4 different times of the day, or total cortisol production for a whole day.
Studies to read:
Comparison of the cortisol awakening response in women with shoulder and neck pain and women with fibromyalgia.
Fibromyalgia patients have lower cortisol levels than woman with shoulder and neck pain. Fibromyalgia patients have more symptom burden: pain levels, sleeping problems, perceived stress, and psychological problems related to their condition.
Fibromyalgia patients had significantly lower cortisol levels during the day, most pronounced in the morning . As expected, Fibromyalgia patients reported more pain, stress, sleeping problems, anxiety, and depression.
This confirms dysfunction in the hypothalamus-pituitary-adrenal axis in Fibromyalgia patients, with generally lower cortisol values, most pronounced upon awakening.
Delineating Psychological and Biomedical Profiles in a Heterogeneous Fibromyalgia Population Using Cluster Analysis
An analysis of various subgroups of Fibromyalgia patients indicated that the more symptomatic patients with more severe pain and disability had the lowest levels of cortisol.
Childhood abuse and family dysfunction is reported in 64% of fibromyalgia cases.
When present in the history, there was a greater tendency to a flattened day-night cortisol curve with lower cortisol production.