Fibromyalgia: Yet Another Biome Related Illness

I’ve written before about recent findings that alterations in the gut bacteria are associated with chronic fatigue syndrome (CFS), which is closely related to fibromyalgia.  For those of you unfamiliar, the symptoms of fibromyalgia include wide spread body pain, fatigue, impaired sleep, potentially cognitive difficulties and irritable bowel symptoms.  It affects mostly women (75-90% of people with fibro are women).  In CFS, the main symptom tends to be the fatigue; in fibro, it’s pain.  But there is huge overlap in the illnesses.

So much more work needs to be done, especially considering the staggering numbers of people affected:  2-4% of the world’s population (and some information points to that number being closer to 3-6%)![i]

A paper just published last week in the journal, Pain,[ii] is the first showing alterations in gut bacteria are associated with fibro:  19 different species, in fact (some greater than normal, some less). The study involved a total of 156 people, 77 of whom had fibromyalgia (and all of whom were women).  The scientists used multiple techniques to confirm the findings, and were definitively able to establish that these alterations were not the result of diet, medication, age, physical activity, but purely connected to the illness. In fact, based on the pattern of differences, the researchers could predict whether or not someone has fibromyalgia with 87.8% accuracy.

Says the lead researcher, “We found that fibromyalgia and the symptoms of fibromyalgia—pain, fatigue, and cognitive difficulties—contribute more than any of the other factors to the variations we see in the microbiomes of those with the disease.”[iii]

Two more points of particular interest to me:

Firstly, the severity of the symptoms directly correlated with the degree of bacterial variance.  Secondly, the researchers also found alterations in the levels of butyrate and proprionate, two of the three major anti-inflammatory short chain fatty acids produced by gut bacteria.  The cause of fibro is unknown at present, and those afflicted do not show signs of inflammation in blood tests. However, last year, research at Massachusetts General (Harvard’s teaching hospital) showed that glial cells (the immune cells of the central nervous system and brain) are activated in people with fibro.  That is, their brains are inflamed.  Several years before, in fact, pro-inflammatory cytokines were isolated in the cerebral spinal fluid of sufferers.  Again though – the cause of this inflammation is still unknown.[iv] This new information may have pin pointed the source of that inflammation.

Whether the changes are the cause, or an effect, of the disease is also unknown.  Further studies are planned, thank goodness.  So, as I always say…stay tuned!

_____________________________________________________

[i] http://www.fmaware.org/about-fibromyalgia/prevalence/

[ii] Minerbi, A, et. al. Altered microbiome composition in individuals with fibromylgia. Pain. 2019.  10.1097/j.pain.0000000000001640

[iii] https://www.futurity.org/fibromyalgia-gut-bacteria-microbiome-2085822-2/

[iv] https://medicalxpress.com/news/2018-09-people-fibromyalgia-inflammation-brain.html