title: Growth hormone perturbations in fibromyalgia: a review.
abstract: OBJECTIVE
  Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain, fatigue, disrupted sleep, depression, and physical deconditioning. In this article, we review the literature on the normal activity of the hypothalamic-pituitary-growth hormone-insulin-like growth factor-1 (HP-GH-IGF-1) axis and its perturbations in FM subjects.
  
  
  METHODS
  Studies included in this review were accessed through an English language search of Cochrane Collaboration Reviews. Keyword MeSH terms included "fibromyalgia," "growth hormone" (GH), or "insulin-like growth factor-1" (IGF-1).
  
  
  RESULTS
  Twenty-six studies enrolling 2006 subjects were reviewed. Overall, low levels of IGF-1 were found in a subgroup of subjects. Growth hormone stimulation tests often revealed a suboptimal response, which did not always correlate with IGF-1 levels. No consistent defects in pituitary function were found. Of the 3 randomized placebo controlled studies, only 9 months of daily injectable recombinant GH reduced FM symptoms and normalized IGF-1.
  
  
  CONCLUSIONS
  These studies suggest that pituitary function is normal in FM and that reported changes in the HP-GH-IGF-1 axis are most likely hypothalamic in origin. The therapeutic efficacy of supplemental GH therapy in FM requires further study before any solid recommendations can be made.
authors.affiliation: Division of Arthritis & Rheumatic Diseases, School of Medicine, Oregon Health & Science University School of Nursing, 3455 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA.
authors.forename: Kim D
authors.initials: KD
authors.lastname: Jones
authors.forename: Parimal
authors.initials: P
authors.lastname: Deodhar
authors.forename: Ashley
authors.initials: A
authors.lastname: Lorentzen
authors.forename: Robert M
authors.initials: RM
authors.lastname: Bennett
authors.forename: Atul A
authors.initials: AA
authors.lastname: Deodhar
mesh_terms: D005260:Female; D005356:Fibromyalgia / Q000378:metabolism*; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I