Back in 2017, Lady Gaga shared on Twitter she has fibromyalgia and « wished to raise awareness, » for the debilitating condition. Since then she’s rescheduled tours due to the severe nerve pain she suffers from fibromyalgia and revealed to Vogue, « I get so irritated with people who don’t believe fibromyalgia is real, » the singer said. « For me, and I think for many others, it’s really a cyclone of anxiety, depression, PTSD, trauma, and panic disorder, all of which sends the nervous system into overdrive, and then you have nerve pain as a result. » And she’s not alone. According to the Centers for Disease Control and Prevention, fibromyalgia affects roughly four million American adults–an estimated 2 percent of the U.S. population and at times it can be hard to diagnose because its symptoms mimic other diseases. Fibromyalgia is a chronic condition that causes sleep problems and widespread pain throughout the body that can severely interrupt a person’s daily activities and lifestyle and Eat This, Not That! Health spoke with experts who explained what to know about it and signs that indicate you could have it. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.
Dr. Jacob Hascalovici, the Chief Medical Officer with Clearing, a telehealth platform for chronic pain patients says, « Some people who develop fibromyalgia may have experienced a physically or emotionally traumatic event. For others, fibromyalgia may appear without any discernible ‘trigger’ event. Previous infections appear to increase the risk of developing fibromyalgia, and the risk may also be higher when the body becomes very sensitized to pain and to having to deal with pain triggers and memories of pain. »
Board certified internist Dr. Jacob Teitelbaum, MD, bestselling author of From Fatigued to Fantastic! says, « CFS, and it’s painful cousin fibromyalgia (CFS/FMS), represent an energy crisis that trips a key circuit breaker in the brain called the hypothalamus. This controls sleep, hormones, and autonomic function, so the circuit breaker going off-line causes widespread dysfunction and is often crippling. Anything that causes people to spend more energy than they can make (including viral and other infections, including COVID) can trip the hypothalamic circuit breaker and trigger CFS/FMS. »
Dr. Andrew Neville, ND, one of the top experts in fibromyalgia and Adrenal Fatigue explains, « Ultimately, it’s a dysfunction of the Stress Response System, and it starts in the adrenals. Cortisol, your main stress hormone, serves as your body’s primary anti-inflammatory function. Your adrenal glands produce that cortisol. If the adrenals are taxed, and you cannot produce adequate anti-inflammatory cortisol, you will be overly inflamed. Inflammation causes pain. Chronic inflammation also acts as an additional biochemical stress, which perpetuates the entire body’s dysfunction and causes it to over-perceive its environment. This is called ‘Central Sensitization.’ If this continues to occur over time, it develops into chronic pain and/or chronic fatigue for others. This is often diagnosed as Fibromyalgia. »
Megan Anderson, APN Nurse Practitioner at The California Center for Functional Medicine says, « A lot of newer research has shown that many of the symptoms in fibromyalgia syndrome (FMS) are caused by antibodies that increase the activity of pain-sensing nerves throughout the body. The results show that fibromyalgia is a disease of the immune system, rather than the currently held view that it originates in the brain. One study published in the Journal of Clinical Investigation, demonstrated that the increased pain sensitivity, muscle weakness, reduced movement, and reduced number of small nerve-fibers in the skin that are typical of FMS, are all a consequence of patient antibodies. From a functional medicine lens, we tend to view it as a syndrome that falls somewhere along the autoimmune spectrum and likely has multiple triggers, and therefore multiple ways to potentially address it. »
« Fibromyalgia is characterized by widespread musculoskeletal pain, so you might have fibromyalgia if you’re suffering from widespread muscular pain, » says Dr. Hascalovici.
Dr. Teitelbaum says, « Most of you have likely noticed that after a workout, when energy levels in the muscles are low, your muscles go tight rather than loose and limp. This is because it takes more energy to relax a muscle than to contract it. The energy crisis in fibromyalgia causes chronic muscle shortening and secondary widespread pain. When the muscle pain becomes long-term, it triggers secondary brain pain (called central sensitization and nerve pain. »
Gita Castallian, MPH Public Health Analyst at The California Center for Functional Medicine states, « The main sign of fibromyalgia is pain and tenderness in muscles and joints throughout the body, often ranging and roaming over time. This is an indicator of fibromyalgia when the pain lasts for three months or longer and typically becomes chronic. It is often described as a constant, dull and widespread ache and often worsens after too much activity, poor sleep, not enough exercise, stress and weather changes. Some people with fibromyalgia describe the pain as stabbing, shooting, throbbing or aching. »
Dr. Hascalovici shares, « You may have fibromyalgia if the pain makes it difficult to concentrate. This symptom is known as ‘fibro-fog.' »
Dr. Teitelbaum adds, « Difficulty with short-term memory and word finding and substitution can be quite severe. This has been labeled the brain fog, and is caused by numerous factors. These include inadequate energy in the brain cells, decreased blood flow to the parts of the brain responsible for speech (temporal lobe), chronic infections because of the immune dysfunction CFS and fibromyalgia (people have experienced brain fog when they have the flu), and numerous other contributing factors. »
Castallian says, « Brain fog, sometimes called ‘fibrofog’ in this context, is common for people with fibromyalgia, making it hard to focus and concentrate on mental tasks, a lack of mental clarity and affects memory. They particularly have issues with memory when dealing with complex tasks while multitasking or having divided attention. One study showed that fibromyalgia patients have memory impairments mimicking about 20 years of aging. Since there are many causes for brain fog, it is important to rule out other causes (like B12 deficiency or iron-deficiency anemia) before pinning it on fibromyalgia. »
Dr. Teitelbaum says, « Normally with severe fatigue, people can sleep all weekend. But because the hypothalamic circuit breaker which controls sleep malfunctions in CFS/FMS, severe insomnia accompanies the fatigue. When both of these are present for over three months, I would presume a CFS/FMS -related process is present until proven otherwise. Even if other conditions are present. »
Castallian adds, « A common sign of fibromyalgia is waking up tired, even after a full night’s sleep. There is often severe and chronic fatigue. Other sleep issues are also associated with fibromyalgia, including restless leg syndrome, insomnia and sleep apnea. Additionally, because lack of sleep can decrease your ability to process pain, insomnia and other sleep issues can aggravate and intensify fibromyalgia symptoms. Therapies that are targeted toward managing the pain can help with sleep and vice versa – working to improve sleep can help to make the pain more manageable. Chronic pain can be exhausting in many ways. »
« Pain from fibromyalgia may shift locations or have an erratic pattern, so it could be affecting different areas of your body at different times, » states Dr. Hascalovici.
Dr. Neville states, « With an unregulated nervous system and a trigger-happy limbic system, sensory nerves connected to smell are always on high alert. »
« Stress tolerance bottoms out with fibromyalgia, making even simple decision-making stressful and sometimes even impossible, » says Dr. Neville.
Dr. Neville shares, « This is due to Central Sensitization, the phenomenon of an unregulated nervous system and an overactive limbic system. »
According to Dr. Neville, « The heightening of senses that results from Fibromyalgia tends to put patients on high-alert. The slamming of a door may feel like an earthquake. The phone ringing makes the heart race. »
According to Dr. Hascalovici. « Fibromyalgia can cause widespread and often disruptive pain throughout the body, often in your muscles and soft tissues. Difficulty sleeping, pronounced fatigue, and memory issues like trouble concentrating frequently characterize fibromyalgia as well. It’s not uncommon for people with a challenging or traumatic background to develop fibromyalgia, and the condition is often also accompanied by depression, anxiety, TMJ, and IBS. »
Dr. Teitelbaum says, « Although some people are able to continue working, they are usually able to do little else. More severe cases often leave the person crippled and even bedbound. »
Castallian explains, « Fibromyalgia is a complex, chronic and painful syndrome affecting the musculoskeletal system that can result in widespread pain throughout the body, extreme fatigue, brain fog, sleep disorders and other physical and cognitive issues. These symptoms can be debilitating, keeping some with FMS from maintaining their ability to work or do normal daily functions of life. Additionally, it is considered an invisible illness because it is not readily visible from the outside. It is not easily recognized that someone may be suffering or in pain just by looking at them. Because of this, there is an added layer of stress to the impact that fibromyalgia already has on the quality of day to day life. Invisible illnesses often do not receive the empathy or credibility that readily visible illnesses do, often fueled by doubt, denial, stigma and feelings of isolation. Additionally, because the symptoms of fibromyalgia are common in many other conditions, receiving an accurate diagnosis can be a challenging and frustrating process, taking many years of searching for answers for most people with this chronic illness. »
Dr. Neville explains, « There are many ways a chronically active stress response, such as occurs in Adrenal Fatigue, can cause pain. The main stress hormone, cortisol, is also our main anti-inflammatory molecule in the body. When this hormone is out of balance, a variety of inflammatory—hence painful—physiologic conditions can arise. Excess cortisol and adrenaline also « hyper-sensitize » peripheral nerves, which basically turns up the volume on the nervous system, creating a situation where patients ‘feel’ all bodily sensations at a higher level. This is a process called introception. Last but certainly not least, the excess stress hormone ‘sensitizes’ the brain, including the limbic system (the CEO of the stress response system). This phenomenon is called Central Sensitization. This also occurs in the sensory nerves, so that many of my patients with Adrenal Fatigue are also overly sensitive to bright lights, loud sounds, and harsh chemicals and smells. Even touch sensation has its volume cranked up; someone could simply touch one of my patients, and the patient’s brain registers that as pain. We know from functional MRI studies that the PTSD notably originates in the amygdala, which is part of one’s limbic system. As I mentioned earlier, the limbic system is the CEO of the stress response system.
As we only have one stress response system dealing with any and all stress, I compare it to a bucket. All stress in our lives—past and present—is in the bucket, including past trauma and abuse. It is well documented that past trauma and abuse of any kind predisposes someone to stress-related diseases in adulthood, such as anxiety, depression, insomnia, and even fibromyalgia and Chronic Fatigue Syndrome.
When we take this into context, Lady Gaga is absolutely correct in that her fibromyalgia was triggered by her PTSD. (The singer told TODAY she has PTSD from being sexually assulated by a producer when she was 19.)
Adrenal Fatigue, as well as fibromyalgia, can be effectively treated when we look at it in terms of an overactive stress response system. Comprehensive holistic treatment can desensitize the system, creating space in one’s stress bucket so that the system becomes less and less trigger-happy. As that happens, we turn off the chronic stress response—or fight or flight—which perpetuates chronic wear and tear in the body. During treatment, we’re also turning on the healing and repair mechanisms in our bodies. As this occurs, the symptoms of an overactive stress response (such as fatigue, pain, anxiety, depression, and insomnia) gradually decrease over time in intensity, frequency, and duration, until they finally fade away completely. »
Dr. Hascalovici states, « Fibromyalgia doesn’t necessarily shorten your life expectancy. With treatment, you can maintain your mobility, manage your symptoms and practice healthy ways to change the way your body perceives pain. People with fibromyalgia can experience the best of what life has to offer, with the proper treatment and support. Having a strong support system is important and may be one of the biggest indicators of how successful your treatment could be. You can take control of your pain by educating yourself and by building a team of friends and medical professionals who can support you. »
Dr. Neville says, « Fibromyalgia is medical jargon for chronic transient pain of unknown cause with no known effective treatment. Doctors recommend general health advice and pain killers. You’ll have good days and bad, and you’re told that you need to learn to live with it. After years of research and treating patients with fibromyalgia, and dealing with it myself, I’ve found that the cause of chronic pain is a dysfunction of your stress response system, commonly known as Adrenal Fatigue. Adrenal Fatigue can be properly treated, effectively ridding your body of fibromyalgia., »
Dr. Teitelbaum reveals, « I had CFS/FMS myself back in 1975 which knocked me out of medical school and left me homeless for a year. I have dedicated the last 45 years to researching and teaching about effective treatments. Anything that triggers an energy crisis in the body can cause fibromyalgia. For example, about 11 – 30% of people with lupus, rheumatoid arthritis, and multiple sclerosis will have a secondary fibromyalgia. »
Dr. Teitelbaum also shared his additional thoughts about fibromyalgia.
« Lady Gaga has been blessed with finding excellent physicians familiar with the illness, which is part (along with being so determined) of what allows her to continue. But as I mentioned, fibromyalgia occurs along a wide spectrum of severity. Some, like Lady Gaga, are among the « walking wounded » that are still able to function. Where others are house or bed bound. But having treated thousands of people with these conditions successfully, the vast majority of people can benefit with proper treatment and support. Often dramatically. The problem is that the treatments tend to be low cost (relative to patentable medications), and therefore nobody is teaching physicians about them. There are literally dozens of treatments that are very effective. Most fall under the SHINE acronym as discussed earlier. It is important to start by addressing sleep. This can be done with a host of natural and prescription therapies, usually in low-dose and in combination, until the person is getting their eight hours of sleep nightly.
Nutritional support is critical for optimizing energy. This begins by eliminating sugar and increasing salt and water intake. Then adding a high dose B complex vitamin along with magnesium 200 mg a day. Our published research has shown that Ribose 5 g 2 to 3 times a day, red ginseng, Ashwagandha, Rhodiola, and other herbal support can be very helpful as well.
If the person is getting hangry (irritable when hungry) then adrenal support is helpful. Cold intolerance and weight gain suggestive thyroid support may be needed despite normal testing. Worsening of fatigue and insomnia around the menses suggested bioidentical estrogen and progesterone may be needed. It is helpful to remember that the hypothalamic circuit breaker that goes off-line controls virtually the entire hormonal system. Resulting in hormonal deficiencies despite normal blood tests. There are countless other treatments that need to be considered, but the above gives a good start. »