Fibromyalgia may be due to low DHEA.
Pain. 1999 Nov;83(2):313-9.
Hyposecretion of adrenal androgens and the relation of serum
adrenal steroids, serotonin and insulin-like growth factor-1
to clinical features in women with fibromyalgia.
Dessein PH, Shipton EA, Joffe BI, Hadebe DP, Stanwix AE, Van
der Merwe BA.
Rheumatology Unit, Milpark Hospital, Johannesburg,
South Africa.
Neuroendocrine deficiencies have been implicated in
fibromyalgia (FM). In the present study, adrenal androgen
metabolites and their relationship with health status in FM
were investigated. For comparison, serum levels of other
implicated neuroendocrine mediators were correlated with
health status. Fifty-seven consecutive women with FM
completed the Fibromyalgia Impact Questionnaire (FIQ).
Fasting blood samples were taken for measurement of
dehydroepiandrosterone sulphate (DHEAS), free testosterone
(T), cortisol, serotonin and insulin-like growth factor-1.
Normal value for DHEAS and T were obtained from 114
controls. DHEAS levels were decreased significantly in pre-
and postmenopausal patients (P<0.0001 and P<0.0005,
respectively). T levels were decreased significantly in
premenopausal and insignificantly in postmenopausal patients
(P<0.0001 and P=0.06, respectively). The following
correlations between neurohormonal levels and FIQ scores
were found: DHEAS (after adjustment for age) vs. pain
(P<0.001) and T (after adjustment for age) versus physical
functioning (P=0.002). None of the other neurohormonal
levels correlated significantly with any of the FIQ scores.
IGF-1 levels were lower in the obese patients as compared to
those who were non-obese (P=0.03). The BMI correlated
positively with pain (P<0. 001) and inversely with DHEAS
levels (P=0.006). After further adjustment for BMI, the
correlation between age adjusted DHEAS and pain was no
longer significant. Hyposecretion of adrenal androgens was
documented in FM. This was more pronounced in obese
patients. Low serum androgen levels correlated with poor
health status in FM. Longitudinal studies are needed to
elucidate whether these are cause and/or effect
relationships.