Fibromyalgia rates are much higher in Hashimoto’s thyroiditis (HT) – about 31% and not higher in cases with subclinical hypothyroidism. This suggests a subgroup might be autoimmune.
Rheumatol Int. 2010 Nov 18. [Epub ahead of print]
Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia?
Bazzichi L, Rossi A, Zirafa C, Monzani F, Tognini S, Dardano A, Santini F, Tonacchera M, De Servi M, Giacomelli C, De Feo F, Doveri M, Massimetti G, Bombardieri S. abstract here
- Controls with subclinical hypothyroidism had a 0% FM rate
- Hashimoto’s Thyroiditis with subclinical hypothyroidism had a 28.5% FM rate
- Hashimoto’s Thyroiditis without subclinical hypothyroidism had a 33% FM rate
Thyroid antibodies levels in FM subjects were 10-20 times higher than normals or just subclinical hypothyroid cases.
Comment – I wrote previously about the association of thyroid antibodies and muscle pains – associated with dry eyes and mouth and throid antibodies:
Muscle-Joint Pains, Dry Mouth and Eyes? – Maybe You Have DEMS/SAPS with Thyroid Antibiodies
Those with dry eyes and dry mouth syndrome “DEMS” one has muscle aches and thyroid antibodies that no one could explain.
The fact that thyroid antibodies are higher in FM is not new – just forgotten by a generation of doctors who would like to assume FM is psychological. It has resurfaced now, and I hold better hope for the new generation of doctors not being as jaded.
Where will it end? check my FM subsection here:
http://painmuse.org/?cat=13
FM is a central sensitization disorder with excessive brain glutamate function
FM might be a viral disease
A FM subset has hypermobility syndrome
FM might be a mast cell disease with excessive amounts in skin and bowel
FM might be a sleep disorder with sleep genes found
FM in some cases is genetic
There appears an association with bipolar disease.
It is a small fiber neuropathy.
And now a subset might be an autoimmune disease
When it’s worked out, it will be a multitude of diseases using a similar pathway to disease…
The fact that subclinical hypothyroidism was not associated with FM was interesting.
ValerieLumleyI am a rercevoed I am a rercevoed fibromyalgic who left the care of medical profession to discover the cause and cure of this horrific condition, and I understand this condition from the inside and back out again. This is a good description of symptoms. Symptoms can often be mistaken for the cause, and treatments that help do not cure. Do not give up from failed hope. Keep going! See video: Curing Chronic Fibromyalgia Choosing What Works by author Valerie Lumley
————————–
Valerie:
I’m glad your case was a neck related and helped by working with the neck. Sorry I don’t know more but I’m not buying your book. Everything you see here is free without any advertising!
Sometimes neck sciatica (radiculopathy) is confused with FM:
C5/6 and C6/7 syndromes:
J Rheumatol. 1994 Aug;21(8):1520-6.
The C6-7 syndrome–clinical features and treatment response.
Smythe HA
http://www.ncbi.nlm.nih.gov/pubmed/7983658
I have written about cervical stenosis and went over it in detail here: I was lucky enough to talk with Dr. Heffez a couple times.
Fibromyalgia (FM) Tragic Misdiagnosis – Myotonic Dystrophy Type 2 and Cervical Spinal Stenosis – New Treatments as Result
http://painmuse.org/?p=143
Features that particularly suggest it include:
* Pain in neck and arm
* Gait instability – seen in 85%
* Weak hand grip – often in dominant hand
* hyper or hyposensitivy to shoulder glade levels posteriorly
* Pains and numbess or tingly sensations – particularly if in arms and legs.
* Aggravation of these symptoms with flexion or extension of your neck (usually extension)- this occurs rapidly and I have seen loss or exaggeration of ankle jerk within a minute of assuming aggravating posture.
* Most importantly, improvement in symptoms with use of a rigid cervical collar.
Examination would show alteration in ankle jerks with flexion and extension neck
Upright, high resolution, dye enhanced MRI’s done in flexion and extension should detect it if read by people who know how.
With C0/1 joint issues, there would be a lack of play moving the joint back and forth. The transverse processes of C1 can be felt just in front of the jaw underneath the bone behind the ear (the mastoid).
I have found mobilizing the bone is not all that difficult if you work it while going through its functional range = nodding.
I repeatedly press on the transverse process while simultaneously flexing the head until movement play is restored. Which side do you press on? – Well, sometimes it is obvious as the transverse process will be more prominent – overwise I’m not sure it matters as long as you can get the play restored – ie it is now loosely postioned so it can now move back and forth. I’m not sure if the NUCCA group would agree but I don’t think you need any specific hitting tool and I don’t think and actual maniputation would be wise.
People with actual chiari syndrome would find that manual cervical traction (done in a gentle myofascial approach) would give relief but there would be a violent return of pain when you release as cerebellar piece re-herniates (they won’t let you do that more than once and it is quite surprizing).
Sadly, I have found C0/1 work has helped occasionally with headaches but not given me any Fibromyalgia(FM) cures.
When the dust settles, FM will be found to be half a dozen or more diseases:
*a brain hypersensitivity:
High Brain Insula Glutamate Confirms Fibromyalgia Central Hypersensitivity Idea
http://painmuse.org/?p=199
*a Sleep disorder:
I am surprized how many FM cases have a dumbed down version of sleep apnea known as disordered breathing
A. Gold found it in 27/28 cases:
Sleep. 2004 May 1;27(3):459-66.
Inspiratory airflow dynamics during sleep in women with fibromyalgia.
Gold AR, Dipalo F, Gold MS, Broderick J.
http://www.ncbi.nlm.nih.gov/pubmed/15164899
Also many can carry a narcolepsy gene:
Do Some Victims with Fibromyalgia(FM) and Chronic Fatigue Syndrome(CFS) Have Sleep Genes?
http://painmuse.org/?p=294
Sleep disturbance has a big role in FM and resoluton of sleep issues is associated with resolution of FM
Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study
K. A. Davies,1 G. J. Macfarlane,2 B. I. Nicholl,1 C. Dickens,3 R. Morriss,4 D. Ray,5 and J. McBeth1
Rheumatology (Oxford). 2008 December; 47(12): 1809–1813
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582170/pdf/ken389.pdf
Sleep disordered breathing aggravates restless leg/periodic leg movement disease and visa versa
* a Peripheral Nerve Damage disease – small fiber neuropathy as bad as diabetic neuropathy has been found in FM
Is Fibromyalgia(FM) a Small Fiber Neuropathy?
http://painmuse.org/?p=810
and those with bad numb/paresthesias may have a disorder called Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The latter FM subgroup may respond to gamma globulin infusions:
A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg
X. J. Caro, E. F. Winter and A. J. Dumas
Rheumatology (2008) 47 (2): 208-211.
http://rheumatology.oxfordjournals.org/content/47/2/208.full.pdf
Those with significant paresthesias (numb feelings) or frank numbness need to have nerve studies and perhaps a skin biopsy done for nerve density
* a mast cell disease – people with FM have 5-15 times the amount of mast cells in the skin.
Is Fibromyalgia a Mast Cell Disease – like some “somatization diseases” such as migraine, TMJ, irritable bowel, and interstitial cystitis?
http://painmuse.org/?p=369
High mast cells are associated with irritable bowel, migraines and bladder spasm issues(IC). Individuals with chronic hives, where high mast cells are given, are 70% likely to have FM:
Acta Derm Venereol. 2009;89(4):389-92.
Chronic urticaria is usually associated with fibromyalgia syndrome.
Torresani C, Bellafiore S, De Panfilis G.
http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-0653
(can link for free full article)
* a Soft brain disease – that includes people with bipolar disease (1/4 of FM cases have bipolar symptoms)
Bipolar Disord. 2010 Aug;12(5):514-20.
Fibromyalgia and bipolar disorder: a potential problem?
Wilke WS, Gota CE, Muzina DJ.
http://www.ncbi.nlm.nih.gov/pubmed/20712752
And people with the APOE E4 gene have soft brains as well (more likely to get Alzheimer’s). Post traumatic FM cases are 7 times more likely to carry this gene.
Apolipoprotein E4 Genotype Increases the Risk of Being Diagnosed With Posttraumatic Fibromyalgia
Jonathan C. Reeser, MD, PhDa, , , Erin Payne, MPHb, Terrie Kitchnerc, Catherine A. McCarty, PhD, MPHd
PM&R Volume 3, Issue 3, March 2011, Pages 193–197
http://www.sciencedirect.com/science/article/pii/S1934148210013584
This has lead me to believe some brain damage is involved in FM and this is certainly seen – particularly in depressed FM cases
* a wounded wing disease – overwhelming stress from childhood trauma, office bullying, and serious life events damages people’s genes and the way they handle stress and among susceptible people, results in an 8 fold risk of developing FM:
Arthritis & Rheumatism; Volume 56, Issue 1, Pages 360-371, 2007; Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain : Findings of a population-based prospective cohort study J. McBeth et al
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927682/pdf/ard-69-03-0556.pdf
The body becomes stuck in fight or flight mode with evidence of hyper-sympathetic activity even during sleep. Relaxation training is useful and just listening to music twice daily for 20 min could reduce FM symptoms by 50%:
Music Therapy in Chronic Pain May Drop Pains by 50% 0ver 2 Months
http://painmuse.org/?p=459
People with deep emotional pain scars need to deal with it and a book with medication techniques has been put out just for that:
Unlearning Fibromylagia Pain
http://painmuse.org/?p=1283
And that’s just the start of issues involved:
* a hypermobility issues, a Cytokine disease, an autoimmune disease and so on
So you can see there are many different flavors of FM – you need to do a study on the neck and FM and see how common it is!