Fibromyalgia (fibro) is a condition that has become more common in the last 10-20 years. It used to be thought that fibro was a made-up condition. While we don’t necessarily know exactly what causes fibro, we do know that there are several factors that can play a role in its progression.
Diagnosis and symptoms
Currently fibro is a diagnosis of exclusion. This means that other conditions have be ruled out before a diagnosis is made. There are also no lab markers or testing that can be done to confirm fibro. Symptoms on the other hand though can point you in the right direction.
Recent research has shown that fibro is a multi-system disease. This means that it affects many different areas of the body at once. The most common areas affected in fibro include the nervous system, the musculoskeletal system and the immune system. This can lead to symptoms like fatigue, brain fog, muscle pain and weakness, sleep difficulties and many others.
Nervous system and Serotonin
One of the main theories around the causes of fibro is that the nervous system doesn’t work quite as right. In those with fibromyalgia, there can be pathways in the brain and spinal cord that do not turn off pain signals when they would do so otherwise. This can lead to improper firing of nerves that cause continuous pain in people.
When nerves send signals in the body, including pain signals, they do so with molecules called neurotransmitters (NTs). The body makes several NTs including serotonin, norepinephrine, dopamine and GABA. In relation to fibro, serotonin is the most important NT. Those with fibro often have low serotonin levels. This can lead to not only pain but depression and anxiety as well.
It’s not surprising then that the most common medications used for fibro are anti-depressants that can increase serotonin levels. Medications like Cymbalta, which are SNRI’s (serotonin, norepinephrine reuptake inhibitors), will increase the amount of serotonin that stimulates the nerves. These medications have proven to be successful for some people with fibro.
Alternative Treatments for Fibromyalgia
Serotonin can also be increased naturally. Supplements like 5-HTP or St. John’s Wort can increase serotonin levels. Care needs to be taken with these things though. They have to be increased and decreased slowly and should be monitored by a health care provider. Caution should also be used when taken in combination with other medications (especially anti-anxiety or antidepressant medications).
Other calming herbs and supplements like melatonin, valerian and GABA can help reduce some of the increased nerve stimulation. They also help to improve sleep which greatly improves fibro symptoms.
Treating low serotonin doesn’t work for every patient with fibro. There are other factors that can play a role in symptom aggravation. Hormone imbalances, increased stress responses and mitochondrial dysfunction can also aggravate fibro symptoms.
NTs can be tested for to see if they are low or high, and a good physician can help you figure out the best treatment for you. If you are interested in meeting with one of our physicians to discuss diagnosis and treatment options for fibroa, call our office today at 206-588-1227.