Just before Christmas a friend of mine shared a Facebook post from a news website that discussed some newly published research about Fibromyalgia syndrome (FMS). Initially I intended to just share this directly to my own Facebook page, but I wanted to see if I could find the published study first to check what I was sharing. As anyone who reads medical journal articles knows, getting more than just the abstract for free for a recent article is about a rare as hen’s teeth, so when I found that Elsevier had made it available in full, I was over the moon. I printed it out and sat down with my yellow highlighter and started to go through the article.
It would be fair to say that my first reaction was an emotional one. Here, in front of me, was more evidence that fibromyalgia syndrome had a physical manifestation that could actually be measured and was the possible reason for the symptoms experienced. For years people diagnosed with FMS have had to rely on whether or not their physicians “believed” in FMS – and let me tell you from experience, many didn’t. So, it has taken me a little while to get over the “wow, no way!” reaction and get to writing the blog post 😊!
The journal article is titled “Brain glial activation in fibromyalgia – A multi-site positron emission tomography investigation” Albrecht, D., Forsberg, A., Sandstrom, A., et al (2018). I know that sounds like a load of medical jargon. In plain English it means that a type of brain scan using positron emission tomography (PET) found that cells called glial cells are more active in people with fibromyalgia.
Although this is a relatively small study with 31 participants with FMS and 27 healthy participants, there are two things that I like about it:
Now before I lose part of my audience, here are some definitions for my non-medical readers:
An equally interesting and earlier study by Kosek, K., Martinsen, S., Gerdle, B., et al (2016), also from the Karolinska Institute and on 126 real live people, found a link between some of the polymorphisms, of the gene that codes for TSPO, and the level of pain experienced by people with FMS. It found that people with FMS who had a genotype for high affinity binding TSPO reported greater severity of symptoms, including pain, than those with mixed and low affinity TSPO binding. They also looked at serotonin transporter 5-HTT polymorphisms and found that people who had high levels of TSPO expression AND had high levels of 5-HTT expression (leading to higher levels of serotonin) reported the highest levels of pain.
In a “things that make you go hmmm” kind of way I wonder if the reason that the popular supplement 5-HTP is helpful for some people with fibromyalgia and also anxiety, but causes increased levels of anxiety in others, is related to the 5-HTT polymorphism that people carry.
There was also a comment that TSPO upregulation has an association with higher levels of another inflammation indicator interleukin 8 (IL-8), which has also been recorded as elevated in cerebral spinal fluid in FMS people.
As usual, more research is required, but this is great to know and means that there is tangible evidence to start working with.
How can we make this knowledge work for us?
Did you know that cortisol hormone levels can have a significant impact on your health and wellbeing by influencing both the way your other hormones e.g. oestrogen, progesterone and testosterone, are produced and metabolised?
Cortisol levels are generally driven by our brain’s stress response as a part of the Hypothalamic/Pituitary/Adrenal (HPA) axis.
Originally designed to be of short duration to give us a quick burst of adrenaline to escape from danger (lions and tigers and bears – oh my!), these days our stress response is often in a constant state of overload from work, family and lifestyle commitments.
This puts our HPA axis into overdrive and we find it harder to maintain quality sleep, get grumpy and tired, find that it gets harder to lose weight, are injured more easily when exercising or playing sports and find it harder to fight off or recover from illnesses and strenuous exercise. As time moves on the body can struggle to make enough cortisol hormones through its normal pathways, so it starts diverting the progesterone and testosterone precursor hormone to try and make cortisol in what is called the “pregnenolone steal”. This can be tragic for people trying to become pregnant as it can lead to fertility issues for both men and women. It can also lead to oestrogen dominance in women since there is a reduced amount of progesterone to balance out oestrogen putting us at risk of PMS, fibroids and oestrogen driven cancers. The extra hormonal complication for women is what makes it harder for us to lose weight.
And even the blokes can’t escape from this one! Cortisol mobilises fat stores in the body to become belly fat in both women and men. Constant stress also puts us at risk of systemic inflammation which increases the risk of heart disease, diabetes and cancers. We have all heard of people burning out and many will have heard of adrenal fatigue syndrome that occurs as a result of too much stress.
Stress does not even need to be real to have an impact – just imagining or anticipating a situation is enough to elicit a stress response.
Here are some simple things that you can do about it before you get to the point that you cannot raise enough energy to even get out of bed: