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:

  • Childhood stressors may lead to HPA-axis dysfunction, which may contribute to the development of these conditions
  • Regular mild exercise, such as stretching, may improve HPA-axis function in fibromyalgia
  • HPA-axis dysfunction may impair function of the fascia (a body-wide network of connective tissues) in fibromyalgia

    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.


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