May 12th is National Fibromyalgia Awareness Day. The founders chose this date to honor the founder of modern nursing, Florence Nightingale, who was born on that date in 1820. This day is also celebrated as International Nurses Day. Nightingale is thought to have suffered from Fibromyalgia, based on notes she made in her diary about chronic widespread pain, fatigue, and mental cloudiness.
According to the Centers for Disease Control (CDC), Fibromyalgia affects about 2% of the United States population, about 4 million adults. Women are twice as likely to suffer from the condition compared to men, and age increases your likelihood of a Fibromyalgia diagnosis. This chronic illness is often diagnosed alongside chronic fatigue syndrome (CFS), so you’ll often see literature referring to Fibromyalgia Syndrome and Chronic Fatigue: FMS/CFS.
Other common conditions that accompany Fibromyalgia include anxiety, depression, temporomandibular joint disorder (TMJ), chronic migraines or headaches, and irritable bowel syndrome (IBS).
What is Fibromyalgia?
By definition, fibromyalgia is pain (-algia) that occurs in the muscle (myo) fibers. According to the Mayo Clinic, the most common symptoms of fibromyalgia include:
- Widespread pain – A constant dull ache that occurs on both sides of the body and both above and below the waist. The pain must have gone on for at least three months.
- Fatigue – Unrefreshing sleep, despite sometimes sleeping longer times than normal. Pain often keeps patients from sleeping, but they may also be diagnosed with other sleep disorders, like restless leg syndrome (RLS) and sleep apnea.
- Cognitive difficulties – “Brain fog,” making it difficult to focus or concentrate.
Dr. Flynn will tell you that Fibromyalgia is an “end-stage diagnosis.” By the time your doctor has diagnosed you with Fibromyalgia, you’ve been dealing with pain for a long time. The diagnostic criteria are all based on pain; there’s no lab finding that distinguishes fibromyalgia from other conditions or symptoms. The doctor will just rule out other serious conditions, like rheumatoid arthritis, and then you’re left with a “Fibro” diagnosis.
Imbalances Found in Fibromyalgia
However, there’s one thing that doctors and researchers know is the case in fibromyalgia patients, which is that the immune system is overactive. Fibromyalgia is an autoimmune process affecting the soft tissue and smooth muscle. Now, the immune system is not somehow “making a mistake” in attacking itself; it’s simply overactive, which then affects the soft tissue.
This overactivity can happen when toxins like mercury attach to receptors on the cells and change the DNA of those cells. Then they are no longer recognized as part of the body but as a foreign substance. Hence, the immune system goes to work attacking those foreign substances.
Researchers have also found that pain-related neurotransmitters, glutamate and substance P, are elevated in fibromyalgia patients. Glutamate, like the food additive MSG (monosodium glutamate), is stimulating to the brain and can make it difficult to sleep.
What Really Goes Wrong in Fibromyalgia?
As is the case in so many chronic illnesses, Fibromyalgia is a state of chronic inflammation and being stuck in “stress mode.” The trick is finding out what’s causing the body to stay in that state.
One theory is the Cell Danger Response theory, as outlined by Dr. Robert Naviaux. His theory is that chemical, physical, or biological threats trigger a stress response in the body that throws it out of homeostasis. Responding to the threat (thinking quickly, running away, etc.) requires extra resources, so the body ramps things up to meet the demand. That leads to all kinds of changes in the body that need to happen for survival. That’s the Cell Danger Response (CDR).
After the threat is gone, there should be a sequence of events that reverse the CDR, lowering inflammation and activating healing. However, sometimes that doesn’t happen, and the body keeps the CDR going. That creates imbalance throughout the body, including the gut microbiome, multiple organs, and even changes in behaviors. The body is now in a state of chronic illness.
What are those chemical, physical, or biological threats?
Trauma, Toxins, and Thoughts
While the concept of the three Ts comes from chiropractic care, it applies to chronic illness. The three factors cause distress to the nervous system and translate throughout the body. Here’s how trauma, toxins, and thoughts contribute to fibromyalgia.
Trauma and Fibromyalgia
Fibromyalgia is often initially triggered by a traumatic event of some kind. This trauma can even be an infection, which puts a huge amount of stress on the body. The CDC lists stressful or traumatic events, including adverse childhood experiences (ACEs), car accidents, illness or infections, and a diagnosis of post-traumatic stress disorder (PTSD) as potential risk factors for Fibromyalgia.
Other types of traumas that may lead to a Fibromyalgia diagnosis include:
- Physical trauma to the spine
- Sexual assault/Rape
- Traumatic loss
- Being a victim of violence
- Being a witness to violence or a natural disaster
- Having a baby – A major stress on the body
An initial physical trauma to the spine may create a chronic spinal misalignment that leads to Fibromyalgia. Whiplash in particular can lead to cervical trauma fibromyalgia, and adults with neck injuries had 10 times the risk of developing fibromyalgia in the following year compared to those with injuries farther down.
Wellness Way doctors have seen a correlation between loss of curvature in the neck and a Fibromyalgia diagnosis.
The trauma of a major toxic exposure, like mold, a chemical leak, or new construction products, like carpet glue, could also trigger Fibromyalgia.
Toxins and Fibromyalgia
Smaller chronic exposure to toxins, both internally and externally, can also contribute to Fibromyalgia. For example, mold sickness may be misdiagnosed as Fibromyalgia. According to mold expert, Neil Nathan, MD, treating mold toxicity often clears up Fibromyalgia symptoms.
Exposure to other toxins in the surrounding environment can also lead to Fibromyalgia. Some doctors might acknowledge this as Sick Building Syndrome (SBS), when a toxic exposure in the building leads to chronic inflammation and illness.
Toxins set off an immune response in the body as it deals with foreign substances. It may result in inflammation, pain, or other nervous system-related symptoms, like mood disorders or sleep issues.
Thoughts and Fibromyalgia
Chronic stress is a major contributor to Fibromyalgia. Stress impacts our thoughts and the subsequent hormones (like cortisol) and neurotransmitters (like histamine and adrenalin) that our body produces. This impacts inflammation, pain, and sleep.
Here are some things that serve as emotional stressors and create inflammation in the body:
- Emotional stress from marriage, financial, or other issues
- Watching the news (fear/worry)
- Overwhelm from major life changes, such as marriage, a new baby, graduation, divorce, or even moving to a new city.
- Pent up anger
- Grief/feelings of loss
When we talk about trauma, toxins, and thoughts, the main point is that everything is connected. The trauma that impacts our brain and spine, the toxins affecting our liver, and the thoughts that make our hearts race… are all interconnected.
The Swiss Watch and Fibromyalgia
The systems of your body work together like the gears of a Swiss Watch. Each of the gears affects all the others. If something is out of balance in one area of the body, it will have consequences for other areas. That’s exactly the case in Fibromyalgia.
If the body is stuck in stress mode and is pouring out inflammatory chemicals, it’s pretty hard to get back into repair mode. As a result, the muscles suffer, the brain suffers, and sleep suffers. You can’t keep using pain cream or pills, or sleep medications and expect to feel better.
Subluxations are misalignments in the spine that cause interference with the nervous system. When the spine is out of alignment, the misaligned vertebrae can irritate the surrounding nerves and cause a sympathetic (“fight-or-flight”) response. The body then responds by releasing inflammatory chemicals, which may cause pain.
Immune Responses to Food
One common cause of chronic inflammation is unknown food allergies. Eating foods that you’re sensitive to creates an immune response and the inflammation that goes along with it. That can stimulate the brain, causing wakefulness or leading to pain throughout the body. One of the foods that can trigger an immune response in fibromyalgia patients is gluten.
Dietary & Nutritional Factors
A 2020 study published in the journal Nutrients found that several dietary interventions reduced Fibromyalgia symptoms, including pain, sleepiness, fatigue, and cognitive symptoms. These interventions included:
- The addition of olive oil
- Replacing modern grain with ancient grains like Kamut
- Mediterranean diet
- Low-calorie diets
- Vegetarian diets
- Low FODMAPs diet
- Gluten-free diet
- MSG- and aspartame-free diet
Interestingly, all these interventions lighten the toxic load and/or lower inflammation in the body.
Gut Dysbiosis and Fibromyalgia
Addressing gut dysbiosis may be an important part of resolving Fibromyalgia. A 2019 study published in The Lancet’s journal, EBioMedicine, found that fibromyalgia patients tended to have a reduced diversity of bacteria, especially in those involved in neurotransmitter metabolism.
Higher diversity in the gut microbiome is associated with good health, and a lower diversity in the gut is linked to a high refined sugar, low fiber, and high fat diet; essentially, a diet of processed foods.
Scientists proposed a new hypothesis, “The Dysbiotic March,” which they published in 2020 in the journal, Medical Hypotheses. This hypothesis states that digestive symptoms are often associated with chronic fatigue and pain like Fibromyalgia. The dysbiotic march is starts with excessive antibiotic use during childhood. That leads to digestive complaints, like IBS. Finally, it develops into chronic fatigue syndrome (CFS), fibromyalgia (FMS), and/or myalgic encephalitis (ME) years later.
The Wellness Way Approach to Fibromyalgia
The Wellness Way does a deep dive into the unique causes behind your fibromyalgia pain and symptoms. Since there are so many contributing factors, it’s impossible to know what’s going on behind the scenes. We don’t guess; we test! We’ll start by listening to your health history and your current symptoms. From there, we’ll do specialized testing to learn what factors within the three Ts are affecting you and how. These tests could include x-ray imaging, food allergy testing, gut testing, hormone testing, and more.
- Fibromyalgia | CDC
- Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis – PMC (nih.gov)
- Fibromyalgia – Symptoms and causes – Mayo Clinic
- Treatment of fibromyalgia – PMC (nih.gov)
- Metabolic features of the cell danger response – PubMed (nih.gov)
- Fibromyalgia, chronic fatigue syndrome, and myofascial pain – PubMed (nih.gov)
- Trauma and fibromyalgia: is there an association and what does it mean? – PubMed (nih.gov)
- Why Fibromyalgia Patients Should Consider Mold Toxicity as a Cause of Their Illness | Vitality 101
- [Environmental medical syndromes] – PubMed (nih.gov)
- Neurobiological basis of chiropractic manipulative treatment of the spine in the care of major depression – PMC (nih.gov)
- Food Allergies: The Basics – PMC (nih.gov)
- Nutritional Interventions in the Management of Fibromyalgia Syndrome – PMC (nih.gov)
- Gut microbiome and serum metabolome analyses identify molecular biomarkers and altered glutamate metabolism in fibromyalgia – PubMed (nih.gov)
- The healthy human microbiome – PMC (nih.gov)