Cortisol and hypothalamic-pituitary-gonadal axis hormones in follicular-phase women with fibromyalgia and chronic fatigue syndrome and effect of depressive symptoms on these hormones
Open accessAbstract
We investigated abnormalities of the hypothalamic-pituitary-gonadal axis and cortisol concentrations in women with fibromyalgia and chronic fatigue syndrome (CFS) who were in the follicular phase of their menstrual cycle, and whether their scores for depressive symptoms were related to levels of these hormones. A total of 176 subjects participated - 46 healthy volunteers, 68 patients with fibromyalgia, and 62 patients with CFS. We examined concentrations of follicle-stimulating hormone, luteinizing hormone (LH), estradiol, progesterone, prolactin, and cortisol. Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Cortisol levels were significantly lower in patients with fibromyalgia or CFS than in healthy controls (P < 0.05); there were no significant differences in other hormone levels between the three groups. Fibromyalgia patients with high BDI scores had significantly lower cortisol levels than controls (P < 0.05), and so did CFS patients, regardless of their BDI scores (P < 0.05). Among patients without depressive symptoms, cortisol levels were lower in CFS than in fibromyalgia (P < 0.05). Our study suggests that in spite of low morning cortisol concentrations, the only abnormalities in hypothalamic-pituitary-gonadal axis hormones among follicular-phase women with fibromyalgia or CFS are those of LH levels in fibromyalgia patients with a low BDI score. Depression may lower cortisol and LH levels, or, alternatively, low morning cortisol may be a biological factor that contributes to depressive symptoms in fibromyalgia. These parameters therefore must be taken into account in future investigations.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
One case of ME/CFS associated with membranous dysmenorrhea spontaneously resolved after discontinuation of hormonal contraceptive treatment.
“one case of ME/CFS associated with membranous dysmenorrhea spontaneously resolved after the discontinuation of hormonal contraceptive treatment53”
From Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically-relevant Phenotyping of Women with Chronic Fatigue Syndrome (2019) · cites this paper as [53]
The Materials and methods section says participants were not taking contraceptive pills, while the Discussion addresses hormone levels and hormone treatment in CFS. Neither section reports a case of membranous dysmenorrhea or ME/CFS resolving after contraceptive discontinuation. Searches for those terms and for a case of CFS resolving after contraceptive discontinuation found no such report in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603 · see citing works
The american college of rheumatology 1990 criteria for the classification of fibromyalgia
Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., Tugwell, P., Campbell, S. M., Abeles, M., Clark, P., et al. (1990) · Arthritis & Rheumatism · doi:10.1002/art.1780330203 · Cited by 9,563 · see citing works
The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G., Komaroff, A., & and International Chronic Fatigue Syndrome Study Group. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-121-12-199412150-00009 · Cited by 4,969 · cited 1× · see citing works
“The diagnosis of fibromyalgia was based on the 1990 American College of Rheumatology criteria [15] and CFS was diagnosed according to the International CFS Definition Criteria [16].”
MethodComprehensive Textbook of Psychiatry
Freedman, A. M., & Kaplan, H. I. (1967) · The American Journal of the Medical Sciences · doi:10.1097/00000441-196712000-00052 · Cited by 3,825 · see citing works
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822 · cited 1× · see citing works
“Moreover, decreased activity of the HPA axis was reported in some stress-related states such as CFS and atypical and seasonal depression [40].”
BackgroundThe prevalence and characteristics of fibromyalgia in the general population
Wolfe, F., Ross, K., Anderson, J., Russell, I. J., & Hebert, L. E. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1780380104 · Cited by 2,394 · see citing works
The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders
Heim, C., Ehlert, U., & Hellhammer, D. H. (2000) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(99)00035-9 · Cited by 1,688 · see citing works
Comprehensive Textbook of Psychiatry
Schwab, J. J. (1968) · Psychosomatics · doi:10.1016/s0033-3182(68)71813-2 · Cited by 1,291 · see citing works
Prins, J. B., van der Meer, J. W., & Bleijenberg, G. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68073-2 · Cited by 974 · see citing works
Demitrack, M. A., Dale, J. K., Straus, S. E., Laue, L., LISTWAK, S. J., Kruesi, M. J. P., Chrousos, G. P., & Gold, P. W. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-73-6-1224 · Cited by 727 · see citing works
Hypothalamic–pituitary–adrenal axis perturbations in patients with fibromyalgia
Crofford, L. J., Pillemer, S. R., Kalogeras, K. T., Cash, J. M., Michelson, D., Kling, M. A., Sternberg, E. M., Gold, P. W., Chrousos, G. P., & Wilder, R. L. (1994) · Arthritis & Rheumatism · doi:10.1002/art.1780371105 · Cited by 508 · see citing works
Glucocorticoids and the Genesis of Depressive Illness a Psychobiological Model
Dinan, T. G. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.3.365 · Cited by 338 · see citing works
(1993) · PubMed · Cited by 324 · see citing works
Bansell, J. C., & Valtueña, J. P. (2020) · Nursing Management · doi:10.1097/01.numa.0000719220.85627.ef · Cited by 276 · see citing works
(1998) · PubMed · Cited by 260 · see citing works
Contrasting neuroendocrine responses in depression and chronic fatigue syndrome
Cleare, A. J., Bearn, J., Allain, T. J., McGregor, A. M., Wessely, S. C., Murray, R. M., & O’Keane, V. (1995) · Journal of Affective Disorders · doi:10.1016/0165-0327(95)00026-j · Cited by 255 · see citing works
The neuroendocrinology of chronic fatigue syndrome and fibromyalgia
PARKER, A. J. R., Wessely, S. C., & Cleare, A. J. (2001) · Psychological Medicine · doi:10.1017/s0033291701004664 · Cited by 205 · see citing works
Diurnal hormone variation in fibromyalgia syndrome: a comparison with rheumatoid arthritis.
McCain, G. A., & Tilbe, K. S. (1989) · PubMed · Cited by 199 · see citing works
Relationship of clinical features with psychological status in primary fibromyalgia
Yunus, M. B., Ahles, T. A., Aldag, J. C., & Masi, A. T. (1991) · Arthritis & Rheumatism · doi:10.1002/art.1780340104 · Cited by 184 · see citing works
NEUROENDOCRINE PERTURBATIONS IN FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME
Neeck, G., & Crofford, L. J. (2000) · Rheumatic Disease Clinics of North America · doi:10.1016/s0889-857x(05)70180-0 · Cited by 158 · see citing works
Hypothalamic-pituitary-insulin-like growth factor-I axis dysfunction in patients with fibromyalgia.
Bennett, R. M., Cook, D. M., Clark, S. R., Burckhardt, C. S., & Campbell, S. M. (1997) · PubMed · Cited by 154 · see citing works
Cytokines and depression in cases with fibromyalgia.
Gür, A., Karakoç, M. A., Nas, K., Remzi, Cevik, Denli, A., & Saraç, A. J. (2002) · PubMed · Cited by 146 · see citing works
Self-citationBiological Markers for Depression in Chronic Pain
Blumer, D. P., Zorick, F. J., Heilbronn, M., et al. (1982) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198207000-00010 · Cited by 140 · see citing works
Ferraccioli, G., Cavalieri, F., Salaffi, F., Fontana, S., Scita, F., Nolli, M., & Maestri, D. (1990) · PubMed · Cited by 125 · see citing works
Epidemiology of Chronic Fatigue Syndrome: The Centers for Disease Control Study
Gunn, W. J., Connell, D. B., & Randall, B. (2007) · Novartis Foundation symposium · doi:10.1002/9780470514382.ch6 · Cited by 122 · see citing works
Adrenocortical activity and some clinical findings in acute and chronic fatigue
Poteliakhoff, A. (1981) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(81)90095-7 · Cited by 118 · see citing works
Scott, L. V., & Dinan, T. G. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00101-8 · Cited by 110 · see citing works
Scott, L. V., Medbak, S., & Dinan, T. G. (1998) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1998.tb10030.x · Cited by 107 · see citing works
Riedel, W., Layka, H., & Neeck, G. (1998) · Zeitschrift für Rheumatologie · doi:10.1007/s003930050242 · Cited by 105 · see citing works
Neurohormonal perturbations in fibromyalgia
Crofford, L. J., Engleberg, N. C., & Demitrack, M. A. (1996) · Baillière s Clinical Rheumatology · doi:10.1016/s0950-3579(96)80022-7 · Cited by 95 · see citing works
Melatonin levels in women with fibromyalgia and chronic fatigue syndrome.
Korszun, A., Sackett-Lundeen, L. L., Papadopoulos, E., Brucksch, C. B., Masterson, L., Engelberg, N. C., Haus, E. L., Demitrack, M. A., & Crofford, L. J. (1999) · PubMed · Cited by 84 · see citing works
The hypothalamic-pituitary-adrenal stress axis in fibromyalgia and chronic fatigue syndrome
Crofford, L. J. (1998) · Zeitschrift für Rheumatologie · doi:10.1007/s003930050239 · Cited by 80 · see citing works
Chronic pain and depression: a clinical and family history survey
Schaffer, C. B., Donlon, P. T., & Bittle, R. M. (1980) · American Journal of Psychiatry · doi:10.1176/ajp.137.1.118 · Cited by 78 · see citing works
Xiao, E., Luckhaus, J., Niemann, W. H., & Ferin, M. (1989) · Endocrinology · doi:10.1210/endo-124-4-1632 · Cited by 77 · see citing works
Neeck, G. (2000) · Scandinavian Journal of Rheumatology · doi:10.1080/030097400750001743-1 · Cited by 75 · see citing works
Glucocorticoids and the genesis of depressive illness
Mitchell, A. J. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.6.853b · Cited by 70 · see citing works
The differential impact of age on the phenomenology of melancholia
Parker, G. B., Roy, K. T., Hadži-Pavlović, D., Wilhelm, K. A., & Mitchell, P. B. (2001) · Psychological Medicine · doi:10.1017/s0033291701004603 · Cited by 69 · see citing works
Waxman, J., & Zatzkis, S. M. (1986) · Postgraduate Medicine · doi:10.1080/00325481.1986.11699544 · Cited by 66 · see citing works
Pathogenic mechanisms of fibromyalgia
Neeck, G. (2002) · Ageing Research Reviews · doi:10.1016/s1568-1637(01)00004-6 · Cited by 65 · see citing works
Korszun, A., Young, E. A., Engleberg, N. C., Masterson, L., Ec, D., Spindler, K. P., McClure, L. A., Brown, M. B., & Crofford, L. J. (2000) · PubMed · Cited by 62 · see citing works
Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome.
Griep, E. N., Boersma, J. W., & de Kloet, E. R. (1994) · PubMed · Cited by 60 · see citing works
Salivary Cortisol Profiles in Chronic Fatigue Syndrome
Wood, B. L., Wessely, S. C., Papadopoulos, A. S., Poon, L., & Checkley, S. A. (1997) · Neuropsychobiology · doi:10.1159/000026469 · Cited by 56 · see citing works
Contrasting neuroendocrine responses in depression and chronic fatigue syndrome
Cleare, A. J., Bearn, J., McGregor, A., Allain, T. J., Wessely, S. C., Murray, R. M., & O’Keane, V. (1995) · Biological Psychiatry · doi:10.1016/0006-3223(95)94634-9 · Cited by 29 · see citing works
Do sex hormones play a role in fibromyalgia?
Akkuş, S., Delibaş, N., & Tamer, M. N. (2000) · Lara D. Veeken · doi:10.1093/rheumatology/39.10.1161 · Cited by 22 · see citing works
David, A. S., & Wessely, S. C. (1996) · The Lancet · doi:10.1016/s0140-6736(05)65451-7 · Cited by 20 · see citing works
Rheumatologists and neck pain: IN MY OPINION II
SMYTHE, H. A. (2000) · Scandinavian Journal of Rheumatology · doi:10.1080/030097400750001743 · Cited by 14 · see citing works
Studd, J. W. W., & Panay, N. (1996) · The Lancet · doi:10.1016/s0140-6736(05)65448-7 · Cited by 13 · see citing works
Macintyre, A., & Hume, M. C. (1993) · Postgraduate Medical Journal · doi:10.1136/pgmj.69.808.164 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Wolfe F Smythe HA Yunus MB Bennett RM Bombardier C Goldenberg DL Tugwell P Campbell SM Abeles M Clark P The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee Arthritis Rheum 1990 33 160 72 2306288
Cited by
Sorted by citations
Evaluating psychosocial contributions to chronic pain outcomes
Meints, S. M., & Edwards, R. R. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.01.017 · Cited by 719 · see citing works
Pain, catastrophizing, and depression in the rheumatic diseases
Edwards, R. R., Cahalan, C., Mensing, G., Smith, M., & Haythornthwaite, J. A. (2011) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2011.2 · Cited by 596 · see citing works
Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome
Papadopoulos, A. S., & Cleare, A. J. (2012) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2011.153 · Cited by 280 · see citing works
Executive functions, self-regulation, and chronic pain: a review
Solberg Nes, L., Roach, A. R., & Segerstrom, S. C. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9096-5 · Cited by 242 · see citing works
Tak, L. M., Cleare, A. J., Ormel, J., Manoharan, A., Kok, I. C., Wessely, S., & Rosmalen, J. G. M. (2011) · Biological Psychology · doi:10.1016/j.biopsycho.2011.02.002 · Cited by 230 · see citing works
Fibromyalgia syndrome is associated with hypocortisolism
Riva, R., Mork, P. J., Westgaard, R. H., Rø, M., & Lundberg, U. (2010) · International Journal of Behavioral Medicine · doi:10.1007/s12529-010-9097-6 · Cited by 143 · see citing works
Voellmin, A., Winzeler, K., Hug, E., Wilhelm, F. H., Schaefer, V., Gaab, J., La Marca, R., Pruessner, J. C., & Bader, K. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.09.008 · Cited by 144 · see citing works
Faresjö, Å., Theodorsson, E., Chatziarzenis, M., Sapouna, V., Claesson, H.-P., Koppner, J., & Faresjö, T. (2013) · PLoS ONE · doi:10.1371/journal.pone.0073828 · Cited by 74 · see citing works
Cevik, R., Gur, A., Acar, S., Nas, K., & Sarac, A. J. (2004) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-5-47 · Cited by 39 · see citing works
Self-citationMorris, M. C., Cooney, K. E., Sedghamiz, H., Abreu, M., Collado, F., Balbin, E. G., Craddock, T. J. A., Klimas, N. G., Broderick, G., & Fletcher, M. A. (2019) · Clinical Therapeutics · doi:10.1016/j.clinthera.2019.03.002 · Cited by 14 · see citing works
- Authors
- Gur, A., Cevik, R., Nas, K., Colpan, L., & Sarac, S.
- Affiliations
- Dicle University (TR)
- ORCID
- Nas, Kemal
- Venue
- Arthritis Res Ther
- Published
- 2004-03-15
- Volume
- 6
- Issue
- 3
- Pages
- R232-8
- ISSN
- 1478-6354 (ISSN-L)
- PMC
- PMC416440
- OpenAlex
- W1941295057
- Cited by
- 88
- References
- 49
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 6 · 2021: 1 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 4 · 2015: 6 · 2014: 4 · 2013: 4 · 2012: 1
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Arthritis Research & Therapy (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- fibromyalgia, chronic fatigue syndrome, hypothalamic-pituitary-gonadal axis, cortisol, follicular phase, luteinizing hormone, depressive symptoms, depression, menstrual cycle, estradiol, progesterone, prolactin
- MeSH terms
- Adult, Depression, Estradiol, Female, Fibromyalgia, Follicular Phase, Follicle Stimulating Hormone, Hormones, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Luteinizing Hormone, Pituitary-Adrenal System, Progesterone, Fatigue Syndrome, Chronic, Comorbidity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
