HPA Axis Role in Fibromyalgia & ME/CFS

The hypothalamus and pituitary are highlighted in blue. Dorling Kindersley/Getty Images

HPA axis is an abbreviation for the hypothalamic-pituitary-adrenal axis. It describes a complex set of interactions between two parts of the brain—the hypothalamus and the pituitary gland—and the adrenal or suprarenal glands that are located at the top of each kidney.

The HPA axis is a major part of the system that controls your reaction to stress, trauma, and injury.

It also helps regulate a lot of other things in your body, such as your temperature, digestion, immune system, mood, sexuality, and energy usage.

Given that list of functions, and comparing to the known list of dysfunctions and symptoms of fibromyalgia and chronic fatigue syndrome, it's not surprising that research links these conditions with abnormalities in the HPA axis.

HPA Axis and Its Role in Central Sensitivity Syndromes 

In fact, some research suggests that the HPA axis plays a role in all central sensitivity syndromes, the family of illnesses fibromyalgia, chronic fatigue syndrome, and several other conditions that are believed to be in. All of these illnesses are related to hyper-sensitivities of the central nervous systems (brain and spinal cord.)

The role of the HPA axis in these disorders isn't fully understood, but so far, research suggests it plays an underlying role. Studies suggest:

  • Decreased HPA-axis activity leads to a lowered cortisol response to stress in chronic fatigue syndrome
  • Lower cortisol reactivity is tied to more severe chronic fatigue syndrome symptoms (Kempke)
  • Childhood stressors may lead to HPA-axis dysfunction, which may contribute to the development of these conditions

Some researchers have called for new treatment strategies that target the dysfunctional HPA axis in these conditions.

The HPA axis also is involved in anxiety disorder, bipolar disorder, post-traumatic stress disorder, clinical depression, burnout, and irritable bowel syndrome.

Source:

Borsini A, et al. Psychological medicine. 2014 Jul;44(9):1809-23. Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research.

Genc A. Journal of physical therapy science. 2015 Jul;27(7):2225-31. Does aerobic exercise affect the hypothalamic-pituitary-adrenal hormonal response in patients with fibromyalgia syndrome?

Gracely RH, Schweinhardt P. Current rheumatology reviews. 2015;11(2):116-30. Programmed symptoms: disparate effects united by purpose.

Kempke S, et al. Health psychology. 2015 Dec 21. [Epub ahead of print] Self-critical perfectionism predicts lower cortison response to experimental stress in patients with chronic fatigue syndrome.

Liptan GL. Journal of bodywork and movement therapies. 2010 Jan;14(1):3-12. Fascia: A missing link in our understanding of the pathology of fibromyalgia.

Tomas C, Newton J, Watson S. ISRN neuroscience. 2013 Sep 30;2013:784520. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome.