While the abstract referenced below is short, it makes mention of a number of key points, each suggesting that an inflammatory process may be at work in fibromyalgia:
- The cerebro-spinal fluid (CFS) of those with fibromyalgia has been shown to contain higher than normal levels of substance P and corticotropin releasing hormone (CRH).
- The blood (serum) of fibromyalgia patients contains higher than normal levels of two pro-inflammatory cytokines (IL-6 and IL-8) as well as substance P.
- Higher than normal levels of mast cells are found in the skin of those with fibromyalgia.
- Fibromyalgia is associated with numerous other conditions.
Although the author does not (at least in the abstract) describe a comprehensive theory by which to explain the various findings in fibromyalgia, a suggestion is put forth that fibromyalgia is a neuro-immunoendocrine disorder where increased release of CRH and substance P by muscle neurons triggers the production of pro-inflammatory cytokines by mast cells.
It’s an interesting theory because it takes into account that while fibromyalgia does not evidence classic inflammation, it is increasingly clear that some type of inflammatory process is critical in the onset and progression of fibromyalgia (and that there is local activity, in the skin, muscles, etc. – not just in the brain and spinal cord.)
Does fibromyalgia result from an inflammatory process?
Science: Increased mast cells, pro-inflammatory cytokines, CRH and substance P all suggest an inflammatory process.
Conclusion: Fibromyalgia is not an inflammatory condition in the classic sense, but must involve an inflammatory process.
Fibromyalgia is associated with increased levels of corticotropin-releasing hormone.
Fibromyalgia is associated with increased levels of substance P, a pro-inflammatory mediator and pain causative agent.
The association of fibromyalgia with inflammation is further evidenced by the frequent occurrence of other inflammatory conditions in those with fibromyalgia, and by the observation that pro-inflammatory cytokines are found at higher levels in the blood and cerebro-spinal fluid (CSF) of fibromyalgia patients.
The author of the study briefly summarized below suggests the use of the anti-inflammatory supplement quercitin, noting that such a supplement can be safely combined with other treatments.
The use of other natural products to reduce inflammation might also be of benefit.
Fibromyalgia–new concepts of pathogenesis and treatment.
Summary of the abstract
Fibromyalgia is a debilitating disorder characterized by chronic diffuse muscle pain, fatigue, sleep disturbance, depression and skin sensitivity.
Patients with fibromyalgia often have other conditions, including migraines, interstitial cystitis and irritable bowel syndrome.
The cause of fibromyalgia remains unknown, but there is evidence of increased corticotropin-releasing hormone (CRH) and substance P in the crebro-spinal fluid of those with fibromyalgia. There is also evidence of increased substance P in the serum, as well as increased serum concentrations of two major pro-inflammatory cytokines (IL-6 and IL-8.)
Increased numbers of activated mast cells have also been found in skin biopsies of fibromyalgia patients.
It is suggested that fibromyalgia is a neuro-immuno-endocrine disorder where neurons in specific muscle sites trigger mast cells to release CRH, substance P and pro-inflammatory cytokines.
Nutraceutical formulations containing the natural anti-inflammatory and mast cell inhibitory flavonoid quercetin hold promise, especially because these can be used along with other treatments.