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This work on the part of the body is thought to cause dysregulation of the autonomic nervous system (ANS) and the hypothalamic-pituitary axis (HPA), leading to elevated cortisol and immune suppression.[69] James Pennebaker, a leading researcher in this area, demonstrated this by monitoring the physiologic effects of disclosure in individuals connected to polygraphs

TMAO levels were reduced in individuals who improved with treatment, underscoring the importance of monitoring PH severity and prognosis [17]

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This limitation underscores that GDF15, despite its high sensitivity (96.7%), should not be used alone as a definitive diagnostic marker for FM