What Is Fibromyalgia?
Fibromyalgia is a disease that can have a lot of different symptoms. A major symptom is body-wide pain but patients can also have trouble sleeping, mood issues like anxiety and depression, low energy, poor digestion, and hormonal imbalances.
There are a few possible theories about how and why fibromyalgia develops. Fibromyalgia may develop due to trauma, chronic infections, chronic stress, autoimmune diseases, SIBO and heavy metal toxicity.
One explanation of what's happening in fibromyalgia is that pain perception within the nervous system is not working properly. People are able to feel pain more easily because their pain threshold is lowered and they have more of a pain promoting substance called substance P. Low serotonin levels may be responsible for this decreased pain threshold and also cause a decrease in our body's production of natural pain-relieving opiate compounds.
Many of the symptoms of fibromyalgia are similar to hypothyroidism so another thought is that fibromyalgia is due to cellular resistance to thyroid hormones. The active form of thyroid hormone, T3, is involved in the release of serotonin and pain relieving compounds. As the whole body's metabolism slows down it leads to a decrease in pain relieving compounds and an increase in pain stimulating ones.
Another explanation is that the issue arises in the brain at the hypothalamus, which controls many of our bodily functions like temperature, our sleep-wake cycle, the stress response and hormonal regulation. For one reason or another, the hypothalamus becomes dysfunctional and that's why so many body systems are affected.
How Do You Know You Have Fibromyalgia?
A major symptom of fibromyalgia is chronic, body-wide pain in multiple areas such as the neck, chest, arms, shoulders, hips, and back. There may be stiffness and swelling in these areas.
Other symptoms can include:
fatigue
coldness
sleep issues
brain fog
depression and anxiety
headache
digestive issues
nerve tingling or numbness
urinary issues
Patients usually have sleep issues, which just compounds their other symptoms. Because they can't get restful, restorative sleep, they feel worse overall. They feel tired, can't think, and don't have the energy to do the things they love. Poor sleep leads to more pain and their low quality of life may lead to feelings of depression and anxiety.
There aren't specific lab tests for fibromyalgia so it's more about ruling out other causes. Other possibilities can include thyroid disease, autoimmune disease, arthritis, polymyalgia rheumatica, and heart, lung or spinal issues.
I would also assess for Celiac disease, chronic viral diseases, food sensitivities and check adrenal, gut and hormonal function depending on the patient's symptoms.
There are also surveys and questionnaires asking about symptoms and activities of daily living that can help get a full picture of what someone is experiencing and to track treatment progress.
What Can You Do About Fibromyalgia?
The approach to fibromyalgia can look different for everyone depending on what we find in testing, and what the patient's lifestyle/diet is like.
We want to treat any underlying issues that were found during testing like hypothyroidism, viral infections, gut infections, or adrenal dysfunction.
Diet is always a foundation of any plan so cleaning up the diet, reducing refined carbs, addressing food sensitivities, staying hydrated, and eating regularly are all important.
Bodywork can help to relieve pain. If the patient can tolerate it, massage or myofasical release can be beneficial. Patients might be hesitant to exercise due to fatigue or pain but low-impact activity and stretching can really help.
Sleep is usually difficult and not restful so working on improving sleep is important. Rest becomes a priority and we go over sleep hygiene practices and making sure the bedroom is comfortable. Sleep aids like melatonin or herbs can help, too.
Other general support for improving metabolism, serotonin production and pain relief might include B complex, 5-HTP, SAM-e, magnesium and mitochondrial support.
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In health,
Dr. Jamie
Resources
Pizzorno, J. E., Murray, M. T., & Joiner-Bey, H. (2015). The Clinician's Handbook of Natural Medicine (3rd ed.). Churchill Livingstone.
Teitelbaum, J. (2007). From Fatigued to Fantastic (3rd ed.). Avery.
This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
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