Fibromyalgia is a chronic health condition that involves widespread pain and fatigue. Typically, the pain is characterized by tenderness in many areas around the body, and it is accompanied by fatigue. In 2010, the American College of Rheumatology endorsed a new set of criteria for diagnosing fibromyalgia. The new criteria still recognize the identification of tender points in 19 areas of the body. However, they also check for symptoms in four categories unrelated to pain, including difficulty sleeping, fatigue, poor cognition, headaches, depression, and abdominal pain.
These symptoms are assigned a severity rating score. Finally, to be diagnosed with fibromyalgia the symptoms need to have been present at a similar level for at least three months. Most conventional tests are not useful for the diagnosis of fibromyalgia, but may be used to exclude other conditions, such as hypothyroidism, rheumatoid arthritis, lupus, polymyalgia rheumatic, other inflammatory or autoimmune disorders, and adverse medication reactions. Two tests have shown correlation with fibromyalgia: Anti-Polymer IgG Antibodies in the blood and reduced dermal unmyelinated nerve fiber bundles on punch skin biopsy.
About 5 million Americans have fibromyalgia. The condition affects women more often than men, and women may be more prone to develop fibromyalgia during menopause. Though it usually occurs in people ages 20-60 years, it can occur at any time. Triggering events may include physical injuries, emotional trauma, or viral infections such as the Epstein Barr virus. However, other factors play a role, including whether the person affected came from a very stressful culture or environment, whether they have a psychological vulnerability to stress, or had difficult experiences in childhood. Interestingly, about a third of children whose mothers have fibromyalgia also develop the disorder.
Presently, there are only a couple of medications approved for the treatment of fibromyalgia, and they are of limited benefit. Despite the medications, the person with fibromyalgia must endure their symptoms for their lifetime. Functional medicine, on the other hand, identifies the root causes of illness in the body and using the functional medicine toolbox aims to help the affected person change their disease trajectory. People who suffer from fibromyalgia have been found to have increased gut permeability, gut dysbiosis, small intestinal micro-organism (bacteria and yeast) overgrowth, mitochondrial dysfunction, hormone imbalance, toxin exposure, nutrigenomic vulnerabilities, chronic infection, and immune system dysfunction.
A functional medicine approach to fibromyalgia makes a lot of sense. To accomplish this goal the Functional Medicine operating system consists of the Functional Medicine Timeline, The Functional Medicine Matrix, and the Therapeutic Lifestyle Factors (Sleep & Relaxation, Movement & Exercise, Nutrition, Stress, and Relationships). Functional Medicine Matrix, based on a scientific framework known as “systems biology,” allows the practitioner to evaluate imbalances at the cellular level. This helps sort out why the disease has occurred in the first place. By understanding each of these imbalances the patient is empowered to make changes to correct them. Each part of the Matrix is called a “node,” and there are 7 nodes on the Functional Medicine Matrix. You can read about them here: Assimilation, Defense & Repair, Energy, Biotransformation & Elimination, Structural Integrity, Transport, and Communication.