More and more evidence has come to light showing that the primary cause of Fibromyalgia is a malfunction of the nervous system.  Chemical imbalances have been found and an abnormality in the brains pain receptors causing heightened sensitivities and stronger reactions to pain signals.

 

Unfortunately, much as this is recognised, there is no known cure.  There are, however, different treatments that can help.

 

One chemical imbalance that I’m aware of is low levels of serotonin along with high levels of substance P.

 

Serotonin is a neurotransmitter produced in the brain and the gastrointestinal tract and is involved in the regulation of a number of processes including sleep cycles, appetite, memory, mood, pain perception, immune system and emotions.  Interestingly, women have a lower capacity for producing serotonin than men which may help explain why the majority of people with Fibro are female.

 

The regulation of serotonin metabolism occurs during the very deep stages of sleep, and serotonin actually helps induce deep sleep in the first place as it converts to melatonin (a vital hormone for regulating sleep patterns).  So when serotonin levels are low – as is very common in Fibro – disruptions to sleep patterns occur and the metabolism of serotonin is disrupted, further aggravating problems and causing serotonin levels to spiral down.

 

Low levels of serotonin can result in depression, exhaustion (despite getting adequate rest), anxiety or panic attacks, irritability, obesity, insomnia or disturbed sleep (due to your mind racing, or the inability to fall/stay asleep).  It has also been attributed to low self-esteem, paranoia, obsessive thoughts and behaviour, IBS, chronic pain, headaches and migraines, hot flushes and changes in body temperature.  

 

It can make you far more emotionally sensitive, result in frequent sadness and crying episodes and cause you to withdraw socially.  It may also make it difficult to focus attention on any one thing, and you may find your mind wandering a lot.  

 

Serotonin levels can be lowered by a number of factors including environmental toxins, alcohol, caffeine, aspartame, nicotine, hormonal imbalances, a lack of exercise, inflammation, digestive disorders, chronic stress and anger.  A diet lacking adequate levels of vitamins, minerals, fatty acids and amino acids can also adversely affect the regulation of neuro-transmitters.

 

A number of the B vitamins are very important, such as vitamin B6 which helps ensure the proper functioning of the nervous system and the production of neuro-transmitters, and vitamins B1 and B3 which are essential for nerve health.

 

Despite the natural serotonin in food, it can be very hard to raise your serotonin levels by food alone and supplementation is generally required to address a deficiency.  Your GP may recommend an anti-depressant medication such as citalopram or amitriptyline.

 

Other changes you can make to help increase serotonin levels include making sure you get regular exercise (at least 30 minutes three times per week), getting plenty of natural sunlight and making sure you set time aside for ‘fun’ activities, along with time to relax and meditate.  

 

Substance P is a neurotransmitter responsible for sending pain impulses to the brain and the spinal cord.  It works together with serotonin and low serotonin levels can cause elevated levels of substance P which leads to an increase in pain perception.

 

Signs of high levels of substance P include restless legs, muscular tightness or achiness, digestive disturbances, anxiousness, sleep disturbances, random pains that move around and vaginal discomfort.  You may also experience generalised itching as substance P is released through the nerve endings (in extreme cases you may feel excess sensitivity towards touching your skin, making physical touch very uncomfortable).

 

Your GP can prescribe either Pregabalin or Gabapentin, both of which are primarily used to control epilepsy but have also been proven to help regulate the nervous system and reduce chronic pain levels.  They reduce the activity of over-stimulated nerve cells and chemicals in the brain which control the communication of pain signals in the body.

 

Your GP may refer you to either a rheumatologist or a neurologist for further support. If Pregabalin or Gabapentin don’t work then medications such as Duloxetine can be prescribed. Lidocaine is also used - either as an injection or infusion - which is believed to calm the nervous system and thereby reduce random pains.

 

To go down a more natural route, supplements such as quercetin (especially with bromelain) have been suggested as helping reduce high levels of substance P, as well as Acetyl L-Carnitine and cayenne (which contains the active compound capsaicin found in some topical creams).

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Massage and yoga exercises can also help.  Meditation is also an important tool because it helps to regulate the nervous system, encouraging a balance between the sympathetic (“fight or flight”) and the parasympathetic nervous system which encourages relaxation and lower stress levels.