Research has shown that, among people with fibromyalgia, some important body chemicals are significantly lower than normal, while others are significantly higher. For example, a 2006 study published in the Journal of Psychiatric Research compared the levels of brain-derived neurotrophic factor (BDNF) in people with FMS and people without fibromyalgia. (BDNF is a protein in the central nervous system.) The researchers found that BDNF concentrations in the blood were significantly higher in the 41 patients with fibromyalgia than in the 45 patients without fibromyalgia. However, why the BDNF levels were higher in patients with fibromyalgia is unknown, and further research is still needed.
Some experts believe that the cause of excessive or deficient levels of body chemicals is due to a brain abnormality related to the interaction between important organs that regulate body chemicals, such as the hypothalamus, pituitary gland, and adrenal glands. What is generally accepted is that excessive or deficient levels of certain hormones from the hypothalamus, thyroid, pituitary, and adrenal glands could contribute to or cause fibromyalgia-type symptoms.
Impairments in these glands that cause deviations from the normal level of body chemicals can lead to troublesome difficulties with sleep, an increased risk for pain, and greater degrees of muscle pain, especially morning stiffness They may also cause other symptoms that are commonly associated with fibromyalgia, such as fatigue and brain fog, and hormonal abnormalities may worsen other medical conditions.
No one knows for sure what causes fibromyalgia, although a wide array of theories abound. Evidence is mounting, however, for profound central nervous system abnormalities in FMS. Much of the scientific data strongly implicate stress-related factors that result in abnormalities of the autonomic nervous system as well as neuro-endocrine axes (brain-hormone axes include the pituitary-adrenal gland connection) of FMS patients. Fibromyalgia is not just an extreme form of chronic musculoskeletal pain in the general population. For people with fibromyalgia, speculating on why they've developed FMS is certainly an interesting topic — but it isn't as important as actively working with doctors and other health-care providers on a good plan to minimize the pain, fatigue, and other symptoms.
Substance P = Pain
Substance P is a brain/pain neurochemical with the main purpose of sending pain messages to the body. "It's time to hurt! Say 'ouch!'" Normally, this pain message isn't a bad thing, because people need to feel pain when they experience harm, so that they can take the appropriate action to resolve the situation. The problem with fibromyalgia, however, is that the pain signal that the individual feels is way out of proportion to minor injuries or illnesses. (Read more about pain in Chapter 4.)
Researchers have demonstrated that people with FMS generate abnormally high levels of Substance P. In fact, studies have shown that some people with fibromyalgia have as much as three times the levels of Substance P in their cerebrospinal fluid (a special fluid found in the backbone) than is found in people who don't have fibromyalgia.
Experts don't know whether excessive levels of Substance P are the cause of fibromyalgia symptoms or the result of them. And, actually, experts don't even know if Substance P is either the cause or the result of FMS at all. The high amount of Substance P could just be a by-product of other biochemical processes. (Yes, I know that trying to categorize the cause of this elusive fibromyalgia syndrome can be very frustrating — sort of like trying to nail down Jell-O. Just when you think you have it figured out, it slips away.)
Everyone's body releases some amount of Substance P as a normal course of events when painful stimuli occur. But you certainly don't want to have excessive levels of Substance P in your body. Unfortunately, you can't flip a "halfway" or a "low" switch in your brain to scale things down if your body is churning out too much of this chemical. For now, your brain's control panel is currently inaccessible. Instead, medications and treatments must be used to counteract the effects of Substance P and the accompanying array of symptoms that are associated with fibromyalgia.
This chapter focuses on possible causes of fibromyalgia, but you should also know some basics about what can aggravate an existing case of FMS in many people. So here's a quick list of watch-out-for items for you to consider:
I Consuming copious quantities of alcohol:
You may think that alcohol will help you fall asleep, so why not have a few drinks before going to bed? The reality is that you may pass out from drinking, but you'll usually wake up in the middle of the night feeling awful. (Read more about alcohol and fibromyalgia in Chapter 15.)
I Staying up very late and skimping on your sleep time: In fact, some experts believe that inadequate sleep can actually cause FMS, not just worsen it. (When you read Chapter 14, you find out why sleep deprivation is so bad. But the short answer is that inadequate sleep can really worsen existing fibromyalgia for most people.)
I Stressing out in a major way about your personal, work, or family problems:
Stressing out on just about anything, in fact, can really aggravate your symptoms, making it important for FMS sufferers to figure out how to relax. (Read more about depressurizing yourself in Chapter 13.)
Ouch! You're going to regret it when the pain kicks in. (Chapter 15 offers good advice on good foods and bad foods.)
I Experiencing changing weather conditions: You can try to wish bad weather away, but it won't work. However, you can anticipate its effects on you. (See Chapter 2 for more information on weather sensitivity.)
Neurochemically affecting your pain or symptomatic levels
Some studies of people with fibromyalgia have indicated that other neuro-chemicals, in addition to Substance P, may be possible causes or contributors to the problem. Thyroid hormone is a critically important hormone that regulates the body's energy expenditure and metabolism. Some people who suffer from chronic fatigue, wide-ranging muscle pain, and sleep disturbances are ultimately found to have elevated or depressed levels of circulating thyroid hormone. This can occur for many reasons, but, in most instances, can be appropriately controlled, leading to improvement in symptoms.
Cortisol is an important hormone that's secreted by the adrenal glands in a circadian rhythm. Most of your cortisol is produced early in the morning (around 3 a.m.), but dips to low levels in the evening. It maintains blood pressure, blood sugar, and other important biological functions that help people cope with stress. Studies indicate that some people with FMS have abnormal circadian rhythms of cortisol secretion resulting in low levels of cortisol during daytime (making them feel fatigued) and too much cortisol at night (causing insomnia).
People with fibromyalgia sometimes experience below-normal levels of brain chemicals, such as serotonin, a calming brain chemical. Also, some people with fibromyalgia have below-normal levels of growth hormones, which are hormones that even adults have that perform basic repair work at the cellular level. Insufficient growth-hormone levels may mean that damaged cells stay damaged longer, causing pain and other symptoms.
Was this article helpful?