Fibromyalgia

Fibromyalgia is a functional diagnosis, for which conventional medicine has identified no causative mechanism; its cause may be multifactorial, with multiple contributing factors. It may have an auto-immune component [Lelu2011  🕮 ].

Although Fibromyalgia and chronic fatigue syndrome appear to share many of the same symptoms and causative factors, they appear to be distinct disorders with different treatments. Hence, careful differential diagnosis based on history, signs, and symptoms is necessary for effective treatment [Liptan2016].

It is also possible that a patient may present with diagnoses of both Fibromyalgia and chronic fatigue syndrome.

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complimentary and Alternative treatments that may be considered include:

The cause of Fibromyalgia is unknown, but among the theories that have been advanced, post traumatic-stress reaction [Liptan2016] appears most credible. In a nutshell, psychological or physical trauma induces a self-perpetuating cycle of sympathetic nervous system arousal ('fight-or-flight') that triggers and sustains prolonged abnormal muscle contraction. This prolonged elevated muscle tone in turn depletes muscle-mitochondrial energy stores, resulting in increased levels of lactic acid being produced. Lactic acid is responsible for the characteristic "burn" an athlete normally feels after a set of strength-training exercises. But whereas in normal athletic training, the lactic acid dissipates after the workout, in the case of Fibromyalgia, the muscle tension never relaxes, and the lactic acid can never dissipate. Unfortunately, the pain causes a reflex feedback cycle in which the neurological system is driven further into sympathetic arousal, and muscle tension is further increased.

In addition to driving painful muscle contractions, the elevated sympathetic nervous system arousal also disrupts the Fibromyalgia-sufferer's sleep, resulting in a hypervigilance that has been characterized as "sleeping with one eye open." This state prevents the patient from achieving the deep sleep state necessary for physical and mental repair. The end result of this unrestful sleep is daytime fatigue and mental fog.

Other contributing factors may include mitochondrial dysfunction. Note that Dr. Weyrich has argued that mitochondrial dysfunction may be secondary to overgrowth with yeasts and fungi, and [Shaw2008] has pointed out that elevated urinary levels of tartaric acid and other markers of overgrowth with yeasts and fungi are associated with Fibromyalgia [Dr. Weyrich: however, it is not clear that these findings are not better associated with a diagnosis of chronic fatigue syndrome].

• Widespread muscle pain.
• Fatigue.
• Brain-fog.

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  Organic Acid Test (elevated markers for
gut dysbiosis).
• Basal Body Temperature (depressed if hypothyroid or mitochondrial dysfunction)
• Heavy metal urinalysis with provocation (possible cause of mitochondrial dysfunction).
• Measures of inflammation, such as Erythrocyte Sedimentation Rate, High Sensitivity C Reactive Protein, and Homocysteine.

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  chronic fatigue syndrome [Liptan2016].
• Vitamin B12 deficiency [Pacholok2011].
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  Lyme Disease .

Conventional Treatments

Naturopathic, Complimentary and Alternative Treatments

• Elevated levels of tartaric acid (3-hydroxymalic acid or 2,3-hydroxy-succinic acid) are associated with Fibromyalgia. Tartaric acid is an analog of the Krebs cycle intermediate malic acid that inhibits the Krebs cycle enzyme fumarase that converts fumaric acid to malic acid [Shaw2008], [Russell1995  🕮 ].
• Pain Is Real; Fibromyalgia Isn't [Ehrlich2003  🕮 ]
• Stop using the American College of Rheumatology criteria in the clinic [Wolfe2003]
• Fibromyalgia Among Friends [Smythe2004]
• Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) [Holtorf2008]
• Secretory pattern of GH, TSH, thyroid hormones, ACTH, cortisol, FSH, and LH in patients with Fibromyalgia syndrome following systemic injection of the relevant hypothalamic-releasing hormones [Riedel1998]
• Thyroid Functions in Patients with Fibromyalgia Syndrome [Neeck1992  🕮 ]
• Neuromediator and hormonal perturbations in Fibromyalgia syndrome: results of chronic stress? [Neeck1994  🕮 ]
• Health status and disease severity in Fibromyalgia: results of a six-center longitudinal study [Wolfe1997  🕮 ]
• Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) [Holtorf2007]
• Fibromyalgia: a clinical review [Clauw2014  🕮 ]
• AAPT Diagnostic Criteria for Fibromyalgia [Arnold2019  🕮 ]
• Low Dose Naltrexone in the Treatment of Fibromyalgia [Metyas2018  🕮 ]