Fibromyalgia
Fibromyalgia has strong hormonal associations including HPA axis dysfunction, thyroid abnormalities, and neuroinflammation. We investigate the treatable hormonal drivers that standard care often misses.
Book ConsultationThe Hormonal Connection
Understanding Fibromyalgia
Fibromyalgia is a chronic widespread pain condition with a striking 7:1 female-to-male ratio and peak onset during perimenopause — both pointing to significant hormonal involvement. Research has documented multiple endocrine abnormalities in fibromyalgia patients, including blunted cortisol responses, low DHEA-S, subclinical thyroid dysfunction, and impaired growth hormone secretion.
Central sensitisation — the amplification of pain signals in the spinal cord and brain — is now understood to involve neuroinflammation mediated by microglial activation. Low-dose naltrexone targets this mechanism directly by modulating toll-like receptor 4 (TLR4) on microglia, reducing pro-inflammatory cytokine release and resetting pain processing.
Our approach combines comprehensive hormonal and neuroimmune assessment with targeted treatments including LDN, HPA axis support, thyroid optimisation, and neurosteroid restoration — addressing the systemic drivers rather than masking symptoms.
What Patients Experience
Common Symptoms
Fibromyalgia is a multi-system condition. Symptoms vary but commonly include pain, fatigue, and cognitive difficulties.
Pain Symptoms
- Widespread musculoskeletal pain
- Tender points and trigger areas
- Morning stiffness
- Heightened pain sensitivity (central sensitisation)
- Headaches and jaw pain
- Joint pain without swelling
Fatigue & Sleep
- Profound exhaustion unrelieved by rest
- Post-exertional malaise
- Unrefreshing sleep
- Difficulty maintaining activity levels
Cognitive & Mood
- Brain fog (fibro fog)
- Difficulty concentrating
- Word-finding problems
- Short-term memory issues
- Anxiety and depression
- Irritability and mood swings
Evidence-Based Approach
Treatment Options
Targeted hormonal and neuroimmune interventions for fibromyalgia.
Low-Dose Naltrexone (LDN)
1.5-4.5mg nightly — modulates TLR4 on microglia, reducing neuroinflammation and central sensitisation. RCTs show ~30% pain reduction vs placebo (Younger et al., 2013).
HPA Axis & Adrenal Support
Cortisol rhythm mapping with targeted support for blunted HPA axis. DHEA and pregnenolone replacement where documented deficiency exists.
Thyroid Optimisation
Comprehensive thyroid panel including free T3, reverse T3, and TPO antibodies. T3 combination therapy if poor T4-to-T3 conversion is documented.
Sleep & Neurosteroid Support
Progesterone for GABA-mediated sleep quality, melatonin for circadian rhythm restoration, and targeted magnesium supplementation.
Hormone-Related Conditions Service
Learn more about our comprehensive approach to hormone-driven conditions.
Living with Fibromyalgia?
Book a consultation to explore whether hormonal factors are contributing to your pain and fatigue.