Exploring Associations Between Metabolites and Symptoms of Fatigue, Depression and Pain in Women With Fibromyalgia

Biol Res Nurs. 2021 Jan;23(1):119-126. doi: 10.1177/1099800420941109. Epub 2020 Jul 17.


Fibromyalgia (FM) is a chronic noncommunicable disorder characterized by a constellation of symptoms that include fatigue, depression and chronic pain. FM affects 2%-8% of the U.S. population, 2% of the global population, with 61%-90% of FM diagnoses attributed to women. Key causal factors leading to the development and severity of FM-related symptoms have not yet been identified. The purpose of this article is to report relationships among identified metabolites and levels of fatigue, depression, pain severity, and pain interference in a sample of 20 women with FM. In this secondary analysis, we conducted global metabolomic analysis and examined the data for relationships of metabolite levels with self-reported symptoms of fatigue, depression, pain severity, and pain interference. Results revealed six metabolites (6-deoxy-hexose; pantothenic acid; ergothioneine; l-carnitine; n-acetylserotonin; butyrobetaine) and their associated metabolic pathways such as carnitine synthesis, lipid oxidation, tryptophan metabolism, beta-alanine metabolism and pantothenic and Coenzyme-A biosynthesis that were either positively or inversely related to pain severity, pain interference, or both. The preliminary data presented suggest that metabolites representing energy, amino acid, or lipid classification may be associated with pain symptom severity and interference in women with FM. Future work will confirm these findings in a large, comparative cohort, targeting metabolites and metabolite pathways to better understand the relationships of metabolites and symptomology.

Keywords: depression; fatigue; fibromyalgia; metabolites; metabolomics; pain.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Pain / etiology
  • Chronic Pain / metabolism*
  • Cohort Studies
  • Depression / etiology
  • Depression / metabolism*
  • Fatigue / etiology
  • Fatigue / metabolism*
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / metabolism
  • Fibromyalgia / physiopathology
  • Humans
  • Metabolic Networks and Pathways
  • Metabolomics
  • Middle Aged
  • Pain Measurement
  • Quality of Life
  • Self Report