Seventy-five percent of FM patients reported exhaustion following minimal activity. Microtrauma caused by or resulting from hypoxia, ischemia, stress, prolonged muscle spasm,local muscle abnormalities was suggested after studies showed nonspecific ultrastructure changes in the muscles of fibromyalgia patients. Muscle energy depletion can occur. Thus postural abnormalities and muscle imbalances can result in microtrauma and eventually pain. These findings may indicate the influence of posture on fibromyalgia syndrome.
Growth hormone is critical in maintaining and repairing muscle.
The secretion of growth hormone occurs primarily during stage 4 sleep and this in turn results in a rise in somatomedin C. Serum levels of somatomedin C were found to be significantly lower in 70 fibromyalgia patients compared to 55 healthy controls. A tryptophan-serotonin deficiency has been proposed. Tryptophan is a precursor to the neurotransmitter serotonin. A lack of serotonin or its precusor could account for many of the symptoms reported by FM patients. Serum serotonin and tryptophan were significantly lower in FM patients than matched controls.