What are the symptoms of fibromyalgia?
Fibromyalgia is a chronic condition that causes pain and tenderness all over the body. As it features a collection of symptoms it is referred to as a syndrome. [Ref]
For people with fibromyalgia, widespread pain and a heightened pain response are common. Also fibromyalgia syndrome (FMS) is often accompanied by chronic fatigue and insomnia, as well as brain fog and poor cognition. Many FMS sufferers experience:
- Trouble sleeping
- Restless Legs Syndrome
- Irritable Bowel Syndrome and bladder issues
- Tingling of hands and feet
- Sensitivity to noise, lights or temperature
- Morning stiffness
- Fatigue (possibly Chronic Fatigue Syndrome)
Adults with fibromyalgia are more than 3 times more likely to suffer from major depression than non-sufferers. [Ref]
However, unlike arthritis FMS does not relate to problems in joints, bones or muscles. In fact, patients with fibromyalgia have abnormalities in central pain-processing, and in the release of neurotransmitters. This often leads to lower pain thresholds for people with fibromyalgia.
There may be periods when fibromyalgia symptoms get better or worse. This variability can depend on individual levels of stress. Equally weather conditions can also a determinant in how strongly certain fibromyalgia pain is felt.
How is fibromyalgia diagnosed?
It’s estimated that somewhere between 1.8 million and 2.9 million people in the UK have fibromyalgia. It generally affects people between the ages of 30 and 50. Also patients with fibromyalgia are 7 times more likely to be women than men. [Ref]
As well as those fibromyalgia symptoms itemised above, the underlying symptoms experienced will include a lack of energy, drowsiness and muscle stiffness.
Doctors may look for tenderness to pressure or tender points at a specific number of certain spots before diagnosing fibromyalgia. But on physical examination such tender areas are generally not swollen or displaying other external signs.
The most commonly used criteria for diagnosis are whether (1) severe pain is experienced in three to six different areas of the body or (2) multiple areas are experiencing a consistent level of pain. Clearly the diagnosis will explore if other explanations of the pain have been previously identified.
A physical exam can be helpful to detect tenderness and to exclude other causes of muscle pain. Widespread body pain is the main feature of fibromyalgia, so health care providers will ask you to describe your pain. This may help tell the difference between fibromyalgia and other diseases with similar symptoms.
Other conditions which have similar symptoms include:
- hypothyroidism (under active thyroid gland)
- polymyalgia rheumatica
Sometimes fibromyalgia is confused with rheumatoid arthritis or lupus. But unlike fibromyalgia, these rheumatic diseases cause inflammation in the joints and tissues. Blood tests (see below) can detect the difference. However FMS is often an accompanying issue for sufferers of rheumatic or spinal disorders.
What causes fibromyalgia?
The causes of fibromyalgia syndrome are unclear and may differ. Fibromyalgia is not from an autoimmune, inflammation, joint, or muscle disorder. Indeed sometimes there is no obvious trigger to the condition.
Current research points to the nervous system, particularly the central nervous system. Scientists believe that injury, or viruses that change the way the brain perceives pain, may be causal, and certainly seem to have a triggering factor for FMS. The condition may also be triggered by a physical or emotionally stressful event, or heightened levels of anxiety.
Abnormally high levels of Substance P in spinal fluid or other neurotransmitters might be a cause, as they transmit and amplify pain signals to and from the brain.
Also research is trying to identify whether there is a gene or genes that make a person more likely to have FMS and the other health problems that can occur with it. Scientists believe that the condition may be due to injury, emotional distress, or viruses that change the way the brain perceives pain, but the exact cause is unclear. People with rheumatoid arthritis, lupus, and spinal arthritis are more likely to have the illness.
Although Fibromyalgia can affect quality of life, it is still considered medically benign. It does not cause any heart attacks, stroke, cancer, physical deformities, or loss of life.
Treatment of Fibromyalgia
With appropriate treatment people with mild or moderate fibromyalgia syndrome can live a normal life. Most treatment options aim at pain reduction with simple analgesics (like paracetamol), however non steroid based anti-inflammatory drugs can also be effective. Antidepressants or prescription medication that affects the levels of neurotransmitters are also prescribed for some people. Opioid analgesics such as tramadol are also used for pain management. But a number of these types of medication come with side effects.
Combatting sleep disorders with re-programming around bedtime can also be effective in re-discovering restorative sleep. Avoiding eating, drinking alcohol and exercise near bedtime will generally help.
Rheumatologists and physiotherapists, and other specialists can also bring effective treatment for differing fibromyalgia symptoms. Actually exercise generally and aerobic exercise particularly is commonly recommended treatment for fibromyalgia, as pain allows. Additionally acupuncture has been tracked as offering relief of pain for some patients. Also cognitive behavioral therapy can be effective for sufferers of disrupted sleep patterns, and for addressing any emotional symptoms.
Other therapies that can be successful as part of an approach to FMS include working with an occupational therapist, a tailored exercise program, massage therapy and tai chi. Indeed a program of physical activity is often a central component in addressing fibromyalgia symptoms.
There have been successful studies of the adoption of a vegan diet to reduce fms symptoms. Additionally personalised elimination diets have been shown to decrease pain and stiffness for fms patients, indeed food intolerance can also be a symptom of fms. Indeed gluten intolerance can also develop in fms sufferers. Therefore the advice and management of diet by a specialist nutritional therapist is strongly recommended.
Non-medication therapies are the cornerstone of treatment for fibromyalgia. Many people improve with them and never require medications. Moreover, without focusing on sleep hygiene, stress reduction and exercise, it is difficult to improve, even with medication.
As a general background we advise:
- Try to eat whole foods (preferably organic)
- Prioritise plant-based food (organic whenever possible)
- Avoid sugar
- Avoid additives such as aspartame and monosodium glutamate
- Drink water and tea
- No caffeine
- No tobacco
- Cut down or cut-out alcohol
Some supplements can be highly effective, but there is a long list to choose from, so here are a few common and readily available supplements for fibromyalgia sufferers to consider:
- probiotics ( like some yoghurts, kimchee, miso)
- iron ( found in egg yolk, dried beans and fruit
- vitamin B1 (from peas, black beans, lentils, soybeans, oat bran, asparagus, sesame seeds)
- vitamin D (from sunlight or tablet supplements
- zinc ( from mushrooms, spinach, sesame seeds, pumpkin seeds, green peas, baked beans, cashews, whole grains, oats, oysters, and chicken)
We would be very happy to engage in a free 15 minute call, at your request to discuss your fibromyalgia symptoms. We can also talk through these foods and supplements with you.
However there is no overall cure for fibromyalgia. Equally a single therapy can’t address multiple symptoms. A GP can though play an important role in treatment and care, as symptoms vary among patients, treatment. So, programmes need to be individualised. A managed range of medical, exercise and complementary treatments can be effective in treating particular aspects of fms, and in improving quality of life for sufferers.
There are currently no conventional diagnostic tests to detect fibromyalgia although individuals can be test for inflammation via a blood-based CRP test, and generally doctors use bold tests to eliminate other possible causes before a diagnosis on fibromyalgia is made. These blood tests may include:
- Complete blood count
- Thyroid hormone
- Antinuclear antibody
- C-Reactive Protein
- Erythrocyte sedimentation rate
The IBS Clinics (IBSC) approach to Fibromyalgia
Functional medicine seeks to find the root cause of addressing the problem to help restore a person’s health. Our process is based upon these sound principles.
The contributing factors to Fibromyalgia are many and varied and may include some or all the following:
Chronic pain acts as a stressor to the adrenal glands. Although it is not usually the initial stressor as that could be any number of things including food intolerances, Candida, mercury toxicity, vitamin deficiencies, or mould toxins.
Candida is a fungus or yeast, which when overgrown breaks down the intestinal lining and penetrates the bloodstream, releasing toxic by-products into the body which causes brain fog, fatigue, digestive issues, and pain.
Heavy metal toxicity:
Heavy metals such as Mercury and lead (omnipresent in our environment) contribute to our toxic burden and suppress our immune system function. This can promote inflammation and autoimmunity.
Glutathione is a key component of our detoxification system without it we are unable to adequately detoxify, and as oxidative stress occur. Oxidative stress is increased patients with FM. Furthermore, total antioxidant capacity or antioxidant enzymes such as superoxide dismutase (SOD) and catalase are decreased in the plasma of patients with FM.
Antioxidant therapies have proven effective in many pathological processes in which oxidative stress plays an important role both primarily as secondarily. CoQ10, Vitamin E or alpha-tocopherol, vitamin C or ascorbic acid, melatonin, SOD, vitamin A or retinol, glutathione, N-acetylcysteine, etc., are some of the antioxidants used in randomised trials of patients with a variety of diseases including fibromyalgia.
Gluten is often called “the great masquerader” and as such has been associated with over 50 different diseases. It seems likely that whilst gluten is often considered to cause gut issues it is much more likely to cause neurological issues such as pain, cognitive problems, disrupted sleep, fatigue and depression.
Mould or Mycotoxins:
Mycotoxins are toxic substances produced by toxic moulds. Whilst 75% of the population can handle such toxins effectively, up to 25% of us carry genetic mutations which affect our ability to clear these toxins from our body.
Small Intestine Bacterial Overgrowth (SIBO) and Leaky Gut:
Bacterial overgrowth in the small intestine can promote a leaky gut. Gluten reactions also promote SIBO and a leaky gut, in fact there is an inter-relationship between these conditions and the result is widespread low-grade inflammation in the body.
Over 50% of individuals with a thyroid issue have no idea they have one and 90% of these have hypothyroidism (underactive) thyroid gland. Your GP will be assessing your thyroid function using a set of standard reference ranges which are very broad, and it is possible that this range, may not be optimal for you. IBSC nutritionists use functional medicine ranges to assess the thyroid and can help you to optimise your thyroid function.
Magnesium, vitamin D and B12 deficiency are common vitamin deficiencies in people with fibromyalgia. Magnesium especially is often very deficient and quickly helps improve health when levels are increased with the consumption of magnesium rich foods and supplements.
As you can see from the above list, many of these causes are interrelated and often there is no one single root cause to fibromyalgia or any chronic illness. It is a combination of several or possibly all the above.
Getting to the root cause can be complex and lengthy process and IBSC are on hand to help you navigate your way through the process of regaining your health.