A New Clue in Understanding the Cause of Fibromyalgia
A new study found a link between the bacteria that populate the digestive tract (called the gut microbiome) and this chronic pain condition. Here’s what that could mean.by Stephanie Stephens Health Writer
For the more than 10 million Americans who have fibromyalgia, a new study from Canada provides valuable information about this often-mystifying condition whose cause is still mostly undetermined.
Fibromyalgia causes widespread body pain, sleep problems, and fatigue, among other symptoms. To wit, it can take months or several years to diagnose, contributing to the emotional and mental distress that is also common with this condition.
But the new research, published in the journal PAIN, is the first of its kind to investigate variations in the makeup of the gut microbiome—basically, the trillion or so bacteria that inhabit your digestive system—between patients with fibromyalgia and healthy control participants. Could these bacteria differences hold the clues to why people get fibromyalgia in the first place? Here’s what you should know.
A Link Between Your Microbiome and Fibromyalgia?
Researchers determined that significant differences exist in the bacteria found in the gastrointestinal tracts of people with fibromyalgia when compared with healthy people. Specifically, they found that people with the disease had different amounts (either more or less than healthy controls) of 19 specific species of bacteria in their bodies. The study also controlled for other variables that can affect the gut microbiome, like diet, physical activity level, medications, and age.
The study looked at 77 women with fibromyalgia and 79 without the disease—fibromyalgia is most than twice as common in women than in men, per the Centers for Disease Control and Prevention. Study participants submitted stool, urine, blood, and saliva samples to be analyzed next to those of the control subjects. Some controls shared a home with the fibromyalgia patients or were related to them.
"The diagnosis of fibromyalgia and its clinical features (pain, fatigue, and cognitive symptoms) explained more microbiome variance" in the gut bacteria of those with fibromyalgia, the authors wrote.
Another surprising finding from the study: The severity of patient symptoms correlated directly with either an increased presence or more pronounced absence of certain bacteria, according to study author Amir Minerbi, M.D., of the Alan Edwards Pain Management Unit at the McGill University Health Centre. However, key questions remain, he said.
For example: Are changes in the gut bacteria of fibromyalgia patients' actual markers of disease? Are they responsible for causing fibromyalgia and the pain associated with it? If so, could they be the pathway to a cure and faster diagnosis?
To answer these questions and hopefully improve diagnosis and treatment for fibromyalgia patients, the research team hopes to expand research by utilizing another cohort, perhaps internationally, or to do animal studies.
Tracking the Cause of Fibromyalgia
More accurate and timely information about fibromyalgia is always welcomed by the community, for the exact cause of this disease remains a mystery. In a late 2018 British study of almost 950 participants, published in Health Psychology Open, a few "themes" emerged as potential causes:
bodily assault or trauma, ill health, and change
emotional trauma and distress
stress and vulnerability
They also noted that those with the disease spend a lot of time convincing other people that they actually have it and that it is real—which can be exhausting and disheartening in its own right.
The National Arthritis Foundation adds the following to the list of possible causes: abnormal levels of chemicals in blood, or in brain or spinal fluid that transmit and intensify pain signals, lack of exercise and changes in muscle metabolism—consumption of energy by all cells, including the ones in muscle tissue to perform work—as well as muscle overuse, sleep disturbance, and depression.