Serotonin: A Cure for Fibromyalgia?

Fibromyalgia is a condition that has existed for many years, but doctors are just now uncovering the cause. In the past, fibromyalgia (FM or FMS), was even thought by many medical professionals to be a fake disease. According to a history report on FM reported by the University of Illinois College of Medicine at Peoria in 2004, the first recorded instance of FM was in 1904, when it was identified as fibrositis. However, it was not until the 1970s that FMS was identified as the condition known today. The first official medical treatments for FMS were not released until 1986, and included a combination of Serotonergic/norepinephric drugs.

Some people believe that doctors are more skeptical about the condition because it primarily affects women (up to 90 percent of cases are women, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases). To this day, many doctors still do not believe the condition actually exists. A 2008 article in the New York Times after the release of Lyrica as a treatment option for FMS explored the issue. According to Dr. Daniel Clauw, a professor of medicine at the University of Michigan, fibromyalgia is real, and it is possible to see the difference in how FM suffers process pain on brain scans.

However, many other doctors, including Frederick Wolfe who was the doctor originally responsible for quantifying the condition in 1990, do not believe the condition exists. These doctors believe that FM is simply a term for natural aches and pains that most other people tolerate without complaint. Many FM sufferers are labeled as “chronic complainers” by some doctors.

Despite this dissension in the medical community, FMS is a recognizable and real condition that is validated by many studies and much research. Although it affects mainly women, some men can also suffer from the condition. There are a variety of possible causes and conditions for the condition, outlined below.

What is Fibromyalgia?

According to the National Fibromyalgia Association, FM is a chronic pain disorder that affects an estimated 10 million Americans each year (of which 80 to 90 percent are women). It can strike any age, any gender, and any ethnic background. Severe cases can lead to an interference in daily activities, and FM sufferers must deal with chronic pain that most people can easily ignore.

FMS is diagnosed using guidelines from the American College of Rheumatology (ACR) in 1990. Criteria for the disorder include:

• Chronic pain in all four quarters of the body for at least 3 months
• Pain in at least 11 of the 18 tender points on the body
• Possible neuroendocrine physiological abnormalities

Diagnosis should be made only by a doctor familiar with the issue and only after other causes have been ruled out.

Symptoms of FM

Symptoms of FM can vary from patient to patient, according to the CFIDS Association of America. All patients, however, show signs of chronic pain unexplained by other conditions, medications, or illnesses. Symptoms for FMS can include:

Who Gets Fibromyalgia?

Fibromyalgia can affect anyone at any time. Children and adults, men and women, and persons from all ethnic backgrounds can get FM. However, there are some links between FM and other issues that may indicate a person’s chances of feeling the effects of the disorder at some point in their lifetime.

Possible Causes for Fibromyalgia 

According to the National Fibromyalgia Association and the CFIDS Association, there are several possible causes for the disorder. These possible causes include:

Genetics: Genetics may play a role in FMS symptoms. Studies about FM patients have shown that the disorder often appears in families. Siblings, and mothers and children, often have a history of sharing the same or similar symptoms of the disorder.

Emotional or physical trauma: Physical or emotional trauma may also contribute to the disorder. Trauma may act as a “trigger” for the disorder. Medical operations, car accidents, childbirth, or viral and bacterial infections may lead to the start of FM symptoms in some patients.

Nervous disorders: Research has shown that FM may be largely a central processing disorder with neuroendocrine/neurotransmitter dysregulation. This is a sensory processing issue, which can lead to an amplification of pain. Factors that can lead to FM may include: multiple physiological abnormalities, low blood flow to the thalamus region, HPA axis hypofunction, increased substance P in the spinal cord, and cytokine function abnormalities.

Reduced serotonin levels: According to some studies, low levels of serotonin and tryptophan may lead to an increased chance for FM symptoms. Many patients with FM symptoms show lowered serotonin levels, just like many patients with depressive symptoms, according to a 2007 study conducted by the Canadian Medical Association.

Other Risk Factors for FM

Recent studies have also shown that certain conditions and factors increase the chances for fibromyalgia symptoms to occur or flare-up. These factors include:

Obesity: A 2010 study by the American College of Rheumatology showed a surprising link between obesity, BMI, exercise levels, and FM. The study looked at over 18,000 women, 380 of which had fibromyalgia. The study showed that there is an association between how much leisure time someone has, how much physical exercise they engage in, and what weight a person is in regards to their risk for developing FMS symptoms. According to the study, women who exercised at least 4 times a week were 29 percent less likely to report any FM symptoms. Most patients reporting FM symptoms were overweight. The study concluded that frequent exercise and a healthy BMI may lead to a reduction in the risk for FM.

Stress: Web MD suggests there may be a link between stress and FM symptoms. Muscle microtrauma (slight damage to the muscles) may also lead to a cycle of FM symptoms, which can be brought on by stress. However, there are no studies that confirm the link between stress and FM.

Hormonal changes: Another possible theory outlined by Web MD is the theory of low human growth hormone production (HGH). Some sufferers of FM also have reduced levels of HGH in their blood. Other possible explanations relate to hormone changes (such as menopause) or other biochemical changes in the body.

Different Approaches to Helping FM

There are 4 main methods used to help FM and treat the issue so FM sufferers can live normal lives, according to Dr. Oz from a 2009 issue of Oprah Magazine. These treatment methods vary by treatment type and what they are used to treat.

The medical approach

Currently, there are several medications available to treat the condition. the U.S. Food and Drug Administration has approved 3 medications to help alleviate FM symptoms. These medications include Lyrica (pregabalin), Cymbalta (duloxetine HCl), and (milnacipran HCl). These medications have only been available since 2007 or later. These medications are designed to alter the nervous system and relieve pain symptoms or increase serotonin or tryptophan levels in the body, similar to antidepressant medication.

The energy-based approach

Since there is evidence to suggest that nerve disturbances are responsible for FM symptoms, treatments that help improve energy levels or reduce stress levels may also be effective. These treatments include chiropractic care, acupuncture, relaxation techniques, and massage. Exercise, including yoga and relaxation exercises are encouraged in this treatment method.

The nutritional approach

The nutritional approach looks at FM from a diet and health perspective. The treatment method will go through a series of testing to identify any possible food triggers for FM symptoms. A diet rich in foods that will boost nervous system function and serotonin and tryptophan levels naturally. Supplements may also be recommended to improve sleep and balance hormones.

The psychological approach

Depression has been linked to increased feelings of pain in the body. Improving mental health may lead to improved FM symptoms. Cognitive-behavioral therapy can help manage stress and depression levels in many FM patients.

The role of Serotonin in Fibromyalgia

Studies have shown that FM patients often have reduced serotonin and 5-Hydroxytryptamine levels. A 1993 study published in Mol Neurobiol Journal indicated that FM patients show reduced serotonin levels. A 2011 study conducted by the University of Sherbrooke studied 29 FM patients along with 17 patients with major depressive disorder (MDD) and 57 healthy individuals. The results of the study showed that the FM patients had reduced levels of the specific serotonin- 5-Hydroxytryptamine.

Serotonin is responsible for regulating many of the body’s systems, including the nervous system, memory, restful sleep, pain tolerance, and the mental health of a person- all systems affected in FM. These studies show that increasing serotonin levels in FM patients may reduce their symptoms and possibly even remove the condition altogether, although limiting treatment to one specific aspect of the disorder may not treat the entire condition, as it affects multiple parts of the body and has multiple causes and triggers unrelated to serotonin levels. However, increasing serotonin levels is likely to help in many cases, according to this data.

Theories Surrounding Serotonin and Its Role in Pain Management

Several studies have linked the role of serotonin with pain management. The basic premise is that serotonin can reduce inflammation, pain levels, and neuropathic hyperalgesia (nerve pain).

A 2009 study published in Curr Neuropharmacol indicated that serotonin can reduce chronic pain symptoms. The study concluded that serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective at reducing symptoms of chronic pain.

A 2010 study published in the Handbook of Behavioral Neuroscience indicated that, “Genetic alterations in the 5-HT system may influence the susceptibility to migraine and to other pain disorders. 5-HT is involved in descending inhibitory pathways in the CNS, and modulation of this system is the most likely mechanism of action of antidepressant drugs in analgesia.” This indicates that increasing serotonin levels can significantly cut down on the strength of pain disorders.

Natural Ways to Boost Serotonin Levels

There are actually several things you can do to naturally boost serotonin levels in your body without resorting to medications, which can often have unwanted side effects (like weight gain, depression, dizziness, and edema). Try these natural ways to book serotonin levels naturally without medication or supplements:

A 2007 study published in J Psychiatry Neuroscience outlined several things you can do to boost serotonin levels naturally. The study also found some surprising facts about foods containing serotonin. Common foods cited for their serotonin-containing properties – bananas and turkey- were found to not boost serotonin levels in the brain. The serotonin contained in these foods was filtered by the body and blocked from entering the bloodstream and reaching the brain. However, the study did find other methods that actually did improve serotonin levels in the brain. These methods included:

Exercise: Exercise has long been known to boost the mood and increase serotonin levels in the body. Moderate exercise at least 3-4 times a week can easily create tryptophan, which leads to the production of serotonin in the brain.

Light exposure: Bright light has long been a treatment method for depression. Exposure to bright light can increase serotonin levels in the body. According to the study, today’s people are light deprived. Most humans receive much less light even on a summer’s day than most humans did a few generations ago. According to the study, even the “summer bright light exposure was probably considerably less than the winter exposure of our agricultural ancestors.” Getting at least exposure of  1000 lux for at least 30 minutes a day is recommended to boost serotonin levels.

Mood improvement: Higher mood levels were associated with higher blood serotonin levels in the study. Positive moods lead to a higher serotonin level in the body. This can be done through therapy, reducing stress, and trying to engage in activities that are mood-boosting.

Diet: Eating foods high in serotonin that can be assimilated by the blood is important for increasing serotonin levels. Foods that include usable serotonin include dairy products and chickpeas.

Additional Help for FM Symptoms

If you want to reduce your FM symptoms, there are also a few other things you can try, according to Dr. Natasha Turner, a health professional from Canada. She recommends taking a variety of supplements and ensuring you get enough natural sources of select vitamins and minerals in your diet to improve tryptophan and serotonin levels in your blood.

Foods that May Reduce FM Symptoms

According to Dr. Natasha Turner, the best foods that will help reduce FM symptoms are foods that increase the serotonin levels in the body. Web MD also confirms this link. You may want to try adding these foods to your diet on a regular basis. All of the below foods contain high, absorbable forms of serotonin.

Supplements that Boost Serotonin Levels

In addition to eating serotonin-rich foods, taking additional supplements may help fight FM symptoms. Dr. Turner and Web MD recommend the following supplements to increase the immune system, lower inflammation, and increase serotonin levels in the body:

Will a Gluten-Free Diet Help FM Symptoms?

Some research has suggested that a gluten-free diet may help alleviate FM symptoms. Gluten is a known inflammatory food. However, a 2013 study conducted by F. Tovoli and published on ProHealth.com indicated that the rate of gluten sensitivity was the same for FM patients as for the normal populace (about 1 percent). In a group of 90 FM patients and 114 CD patients, 1 percent of FM patients showed gluten sensitivity, and 11 percent of CD patients met the criteria for FM.

There may be a link between gluten and FM symptoms, but the link is not strong enough to consider a cause. FM patients may want to try removing gluten from the diet for a few months to determine if their FM symptoms are affected.

Take These Steps to Reduce FM symptoms

Fibromyalgia is a frustrating condition that affects many more individuals than is known by the medical industry. In many cases, the medical industry dismisses FM symptoms and labels the individuals suffering from the condition as “complainers.” It can be extremely challenging trying to find a cure for a condition that many health professionals do not even believe exists.

Luckily, there are many natural steps you can take to reduce, and possibly eliminate FM symptoms. Make sure you get plenty of exercise and spend time in the sun frequently. Maintain a healthy weight, and fill your diet with serotonin-rich foods. Taking supplements to boost the immune system, reduce inflammation, and increase serotonin levels will also help you control any FM symptoms as well as your overall health. In many cases, you do not have to turn to the questionable treatment options for fibromyalgia available in the medical community.