Asking ‘is Fibromyalgia real?’ is a legitimate question. The medical community has no clear understanding of the processes that lead to this syndrome. Taken from a naturopathic and functional medicine perspective, there is far more light that can shine down on this all-too-misunderstood chronic condition.
In the conventional sense, fibromyalgia is a real syndrome. It is a collection of symptoms that occur collectively in the absence of any other well-understood clinical disease. So when no other ‘better understood’ medical diagnosis can be given, fibromyalgia is the name given. This is a called a ‘diagnosis of exclusion’. When every other possible diagnosis is proven negative, we’re left with a diagnosis of fibromyalgia.
Fibromyalgia has fascinated me since the early days of naturopathic medical school because it doesn’t neatly fit into any diagnostic category. There is a vagueness in fibromyalgia that suggests that a concrete understanding simply does not currently exist. Fibromyalgia is considered an ‘idiopathic pain syndrome’ and therefore, by definition, has no known cause.
In my years of studying functional medicine, I’ve learned one very important concept; that anything deemed ‘idiopathic’ must in fact be ‘multi-factorial’. Fibromyalgia is no exception.
Fibromyalgia is Real but There is No Single Cause
The most logical explanation for fibromyalgia is that there are multiple systemic problems occurring, which collectively increase toxins within the cell that ultimately decreases the cells energy production. This phenomena is well documented and is called ‘mitochondrial dysfunction’. The mitochondria are a part of each cell whose job is to produce the master energy molecule called ATP. When there is an impairment of mitochondrial activity, what follows is decreased ATP production which is experienced as muscle weakness, fatigue and pain (the hallmarks of fibromyalgia)
Until the actual causes of the mitochondrial dysfunction are explored and reversed, the symptoms of fibromyalgia will continue. The challenge is in uncovering what these deeper causative factors are, since not everyone with the classic fibromyalgia symptoms will have the same root causes.
Most know that fibromyalgia is commonly linked to chronic fatigue syndrome but a lesser-known fact is that fibromyalgia is also linked to:
- Irritable Bowel Syndrome (IBS)
- Small Intestinal Bacterial Overgrowth (SIBO)
- Chronic Migraines
- Autoimmune diseases
Other conditions that are not as commonly linked to fibromyalgia cases but should always be consider when there is no obvious diagnosis and where pain is a central feature include:
- Lyme disease or other chronic infections (esp. Chlamydia spp.)
- Heavy metal exposure (esp. lead and mercury)
- Iron overload
- Mold toxicity
Simply stated, the path to wellness is to start with the fundamentals. Assess each of these conditions listed above with an experienced naturopathic or functional medicine practitioner.
If Fibromyalgia is Real, How do we Test for it?
Classically, the common lab testing used to diagnose pain syndromes are negative in cases of fibromyalgia. The common tests are:
- C-Reactive Protein (CRP)
- Erythrocyte Sedimentation Rate (ESR)
- Anti-Cyclic Citrullinated Peptide (Anti-CCP)
- Anti Nuclear Antibody (ANA)
If any of these tests have come back positive, addition testing into autoimmune causes for your pain should be further explored.
Testing to uncover the underlying cause of any digestive symptoms is critical and ofter eye-opening for patients. A Comprehensive Digestive Stool Analysis (CDSA) measures bacterial, viral and fungal particles, it measures your ability to digest various types of foods and also inflammatory and immune markers within the digestive tract. Correcting these abnormalities alone can make considerable improvements for fibromyalgia patients, even those who have had pain for decades.
Testing for nutrient status is also a good idea. Specifically measuring Vitamin D, iron, B-12 and red blood cell magnesium (not serum magnesium) is a good starting point. Intravenous nutrient therapy is always prescribed to my fibromyalgia patients for two reasons.
- Most feel more energized, have less pain and sleep better with these treatments.
- The degree to which someone responds to an IV treatment is a good indicator of their nutrient status. For those who have very positive responses (suggesting serious nutrient deficiency), I will run more detailed nutrient testing, which allows me to customize IV treatments.
Can Fibromyalgia be Cured?
We started with the question ‘is fibromyalgia real?’ Now, when looking at this syndrome from a more wholistic perspective, we see that several other factors are at play which have eventually lead to the symptoms that match the ‘fibromyalgia’ diagnosis.
The best explanation of the cause of fibromyalgia is mitochondrial dysfunction. The causes are mitochondrial dysfunction are numerous and not all will apply to you, but all need to be considered.
Patients do get better when they focus on improving their mitochondrial health and the underlying factors that impact their functioning.
Treatment Options for the Most Stubborn Fibromyalgia Cases include:
1. Improve the Gut:
- Paleo Diet. No sugar. Emphasis on eating healthy fats, green leafy veggies, bone broth and collagen
- L-glutamine powder, probiotics, binders and potential antibiotics and/or anti-fungal medications
- Follow what has been discovered on CDSA test
2. Correct Nutrient Deficiencies
- IV nutrient therapy
- Additional Vitamin D and Magnesium
3. Correct Poor Sleep Patterns
- Melatonin and/or 5HTP (with magnesium)
- Herbs: Jamaican Dogweed, Passionflower, Valerian
4. Correct Thyroid Dysfunction
- Herbs or pharmaceuticals can be used, depending on lab results
5. Correct Mitochondrial Dysfunction
- CoQ10, B-vitamins and D-ribose powder
- Periodic/intermittent fasting and a higher-fat diet
- Balance light exercise with adequate rest
After treating many patients in chronic pain and helping many of them regain their lives, I would encourage anyone who has fibromyalgia to:
- Appreciate that it is a real condition with a known, multi-factorial cause
- Not settle for a non-descriptive diagnosis
- Not settle for a lifetime of taking pain medications, anti-depressants or muscle relaxants.
- Test for ALL of the conditions listed above. If it’s not feasible to do all the testing at first, start with the CDSA (stool test).
- Anticipate that your family doctor or rheumatologist will dismiss or discourage this approach to wellness.
- Be patient, healing takes time
- Find an experienced naturopathic or functional medical doctor near you to run the tests and guide you through the treatment process.