I often get the question “Is fibromyalgia an autoimmune disease?”
The answer is no, fibromyalgia is not an autoimmune disease.
An autoimmune disease is when the body erroneously attacks itself. We see that with rheumatoid arthritis or lupus where the body attacks the joints. Fibromyalgia is not an autoimmune disease. Rheumatologists who specialize in autoimmune diseases and who treat fibromyalgia, the few who still do, will tell you fibromyalgia isn’t an autoimmune disease.
Why isn’t fibromyalgia an autoimmune disease?
I’ve specialized in treating fibromyalgia for almost twenty years, and I can tell you that most fibromyalgia patients don’t have inflammatory markers show up in their blood work that signify autoimmune disease.
Yes, some will have an elevated CRP (C-reactive protein is a substance produced by the liver in response to inflammation), but they don’t have an elevated SED (Sedimentation) rate or other markers like ANA (Antinuclear Antibodies) or RA factor, which you’d see in an autoimmune disease.
Understanding fibromyalgia and inflammation
Fibromyalgia patients can still have inflammation. But it is not due to an autoimmune disease. The inflammation can be caused by food allergies, leaky gut, yeast overgrowth, osteoarthritis, past injuries, poor diet, or poor health habits.
And yes, fibromyalgia patients can have an autoimmune disease. Hashimoto’s thyroiditis is common, and Sjogren’s, rheumatoid, or even Lupus can coexist with fibromyalgia. But again these conditions don’t cause fibromyalgia.
The pain is magnified by a condition known as allodynia (see below).
A large number of rheumatologists who are autoimmune disease specialists are now electing not to see or treat fibromyalgia patients. If they do treat them, after diagnosing them, they just refer them out to a pain specialist. More and more rheumatologists, doctors who are supposed to be fibromyalgia specialists, are choosing to not treat fibromyalgia. Many simply don’t believe it exists and others have come to the conclusion that drug therapy alone is a dead end, at least long term.
Is fibromyalgia a nerve disease?
No, fibromyalgia is not a neurological disease. Fibromyalgia is a breakdown in the hypothalamus-pituitary-adrenals (HPA axis)—a reduction in your pain threshold called allodynia. When that happens, pain is magnified, but fibromyalgia is not a neurological disease.
Can you have neuropathy, polyneuropathy or some type of nerve involvement with fibromyalgia? You can, but that’s not the cause of fibromyalgia. It certainly can be part of the syndrome, but not everybody who has fibromyalgia has a problem with a neurological ailment.
Understanding fibromyalgia and central sensitivity syndrome
Many chronic conditions such as tension headaches, fibromyalgia, IBS, migraines, and myofascial pain may be a result of central sensitivity syndrome (CSS). In patients with CSS, the central nerve system becomes hypersensitive to pain stimuli in a condition called hyperalgesia. It can also cause widespread and persistent pain and pain from touching (allodynia).
In an individual without chronic pain, receptors in ligaments, muscles, skin, and joints detect tissue damage. This damage can be from inflammation, injury, or disease. Numerous neurotransmitters that exist in each cell send electrical impulses from the pain receptor, through the peripheral nerve, up the spinal cord, finally ending at your brain. Your brain then interprets and processes the signals.
When you suffer an injury, you may develop acute or “short-term” pain from inflammation or damage. Eventually, the acute pain subsides, though the length of time it takes to heal varies based on your injury. The cause of acute pain is known and, therefore, the course it will take is usually predictable. If you think about a needle pricking your finger, you can see that the sensation is always the same. The pain goes from your finger, up your arm, and to your brain in relatively the same way. This is not the case with chronic pain.
If you have chronic inflammation, or suffer from repetitive injuries your brain is receiving continuous electrical impulses. Over time, pain signals become amplified because your brain stays hyper-excited. Even when pain signals should not be present, your brain still believes that they are, frequently amplifying them in the process. It becomes automatic and lasts long after the original injury is healed.
A low pain threshold from allodynia, and depleted stress coping chemicals, poor sleep, excess weight, and poor diet, causes pain to be magnified. Doesn’t matter if pain is being triggered from fibromyalgia, past surgeries, scar tissue, osteoarthritis (wear and tear arthritis), old injury, or other pain triggering condition. When the pain threshold is low, pain no matter from where is more pronounced!
In fibromyalgia patients, this method of abnormal pain processing can be seen. Fibromyalgia symptoms including hyperalgesia, CFS, IBS, muscle pain, headaches, and allodynia are frequent even though there is no inflammation or damage present.
Achieving deep restorative sleep will often dramatically reduce pain. Taking the right combination of high dose vitamins, minerals, essential fatty acids, and amino acids to build up your stress coping chemicals and raise your pain threshold will combat allodynia, and will often reduce pain by 50-60 percent.
You can read more about how a disruption in the HPA axis leads to and aggravates fibromyalgia, in my 5th edition book Treating and Beating Fibromyalgia www.getfibrobooks.com or by watching my free video series, www.drmvideos.com