Increased baseline ACTH and increase in response to stress have been observed, hypothesized to be a result of decreased negative feedback. Immune system
Inflammation has been suggested to have a role in the pathogenesis of fibromyalgia. People with fibromyalgia tend to have higher levels of inflammatory cytokines IL-6, and IL-8. There are also increased levels of the pro-inflammatory cytokines IL-1 receptor antagonist. Increased levels of pro-inflammatory cytokines may increase sensitivity to pain, and contribute to mood problems. Anti-inflammatory interleukins such as IL-10 have also been associated with fibromyalgia.A repeated observation shows that autoimmunity triggers such as traumas and infections are among the most frequent events preceding the onset of fibromyalgia. Neurogenic inflammation has been proposed as a contributing factor to fibromyalgia. Digestive system
Gut microbiome
Gut bacteria may play a role in fibromyalgia. People with fibromyalgia are more likely to show dysbiosis, a decrease in microbiota diversity. There is a bidirectional interplay between the gut and the nervous system. Therefore, the gut can affect the nervous system, but the nervous system can also affect the gut. Neurological effects mediated via the autonomic nervous system as well as the hypothalamic pituitary adrenal axis are directed to intestinal functional effector cells, which in turn are under the influence of the gut microbiota. Gut-brain axis
The gut-brain axis, which connects the gut microbiome to the brain via the enteric nervous system, is another area of research. Fibromyalgia patients have less varied gut flora and altered serum metabolome levels of glutamate and serine, implying abnormalities in neurotransmitter metabolism.
This can be done by eating a sufficient volume of sufficiently calorie-dense foods. Body weight may also be increased through the consumption of liquid nutritional supplements. Exercise
Another way for underweight people to gain weight is by exercising, since muscle hypertrophy increases body mass. Weight lifting exercises are effective in helping to improve muscle tone as well as helping with weight gain. Weight lifting has also been shown to improve bone mineral density, which underweight people are more likely to lack.Exercise is catabolic, which results in a brief reduction in mass. However, during recovery, anabolic overcompensation causes the muscles to grow, which results in an overall increase in mass. This can happen through an increase in muscle proteins, or through enhanced storage of glycogen in muscles. Exercise can also help stimulate the appetite of a person who is not inclined to eat. Appetite stimulants
Certain drugs may increase appetite either as their primary effect or as a side effect. Antidepressants, such as mirtazapine or amitriptyline, and antipsychotics, particularly chlorpromazine  and haloperidol, as well as tetrahydrocannabinol (found in cannabis), all present an increase in appetite as a side effect. In states where it is approved, medicinal cannabis may be prescribed for severe appetite loss, such as that caused by cancer, AIDS, or severe levels of persistent anxiety. Other drugs or supplements which may increase appetite include antihistamines (such as diphenhydramine, promethazine or cyproheptadine). See also
Essential nutrient
List of phytochemicals in food
Body image
Emaciation
Malnutrition
Stunted growth

References


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