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Evidence for an altered tryptophan metabolism in fibromyalgia

Fibromyalgia (FM) is a prevalent syndrome with chronic pain and a hypothesized underlying disturbance of the tryptophan (TRP) metabolism.

We performed a tryptophan depletion (TD) test in 17 FM patients and 17 controls. TRP, 5-hydroxyindoleacetic acid (5-HIAA), kynurenine (KYN), and interleukin-6 (IL-6) were measured. Additionally pain perception was monitored in the FM patients.

FM patients and controls exhibited a decrease of TRP and KYN during TD. 5-HIAA levels also decreased in all controls and in 11 FM patients, but showed a marked increase in 6 FM patients. IL-6 significantly increased during TD in the patients, but not in the controls. Pain perception was not affected in the FM patients.

These data demonstrate an altered TRP metabolism in a subgroup of FM patients, where the TD seems to activate 5-HT metabolism. Our findings may have diagnostic as well as therapeutic implications in the field of fibromyalgia.

About the Authors

Schwarz MJ, Offenbaecher M, Neumeister A, Ewert T, Willeit M, Praschak-Rieder N, Zach J, Zacherl M, Lossau K, Weisser R, Stucki G, Ackenheil M. (2002) Evidence for an altered tryptophan metabolism in fibromyalgia . Neurobiol Dis. 2002 Dec;11(3):434-42. Psychiatric Hospital, University of Munich, D-80336, Munich, Germany.

Comments

NAD_Blood_Tests

  • Posted on 05/09/2010 08:22 am
It is known that dietary tryptophan can be converted to nicotinamide nucleotides in the body. Both the level of tryptophan and the energy content of the diet have been shown to influence the efficiency of conversion. The rate at which tryptophan is converted to nicotinamide nucleotides in the body may be expected to be influenced by the activities of the enzymes concerned with the tryptophan-NAD pathway.

NAD_Blood_Tests

  • Posted on 04/29/2010 04:02 am
The ratio of lactate to pyruvate reflects the NAD/NADH ratio and is useful in distinguishing primary defects. Measured enzymatically in blood or CSF as an index of defects of glucose oxidation (fed state) or gluconeogenesis (fasted). (Center Inherited Disorders Energy Metabolism at CWR University School of Medicine, Cleveland, Ohio).

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