Fibromyalgia Or Adrenal Fatigue?

When I started practice 25 years ago, I’m not sure I’d ever heard of Fibromyalgia. Now it seems as though everyone and their mother is being diagnosed. What gives? Is Fibromyalgia a real disease?   Or is it simply a “bucket diagnosis” —- a manufactured health problem to which doctors attribute all sorts of things they do not really understand?  You know —– not really sure what it is?   Just throw it in the bucket labeled “Fibromyalgia” — sort of how they used to do with ARTHRITIS. 

Unfortunately, Fibromyalgia is real —- all too real for those people whom it has clamped in its jaws.  But Fibromyalgia is probably not what you think it is — or what you have been told it is.  My goal is to not only show you what Fibromyalgia really is, but educate you about what it takes to manage this problem effectively. Be aware that dealing with FIBROMYALGIA effectively, is going to require you to step outside of the box you have been living in.  You know; the one full of JUNK FOOD, BAD HABITS, and all sorts of PRESCRIPTION MEDS — most of which are suppressing your immune system (see link).

You cannot continue to live like you have been living and have any hope of MANAGING this problem effectively.  It is going to require some effort on your part if you want to have any hope of success — it’s not something your doctor can do for you.  If you are not willing to at least contemplate life outside “The Box,” read no further.  But, if you are interested in finding out what Fibromyalgia really is, as well as creating a plan to defeat it —- read on.

WHAT IS FIBROMYALGIA?

Fibromyalgia
FIBRO (FIBROUS or KNOTTED)MY or MYO (MUSCLES or FASCIA)  ALGIA (PAIN)

Ask any doctor about Fibromyalgia, and you’re sure to get a plethora of answers —- each one different from the last.  However, a quick review of the Medical Literature tells us that the symptoms of Fibromyalgia have been around a very long time.  In fact, there are those who believe that Job was afflicted with Fibromyalgia. 

“I, too, have been assigned months of futility, long and weary nights of misery. When I go to bed, I think, ‘When will it be morning?’ But the night drags on, and I toss till dawn…  And now my heart is broken. Depression haunts my days. My weary nights are filled with pain as though something were relentlessly gnawing at my bones.”    – Job 7:3 & 4; 30:16 & 17

DIAGNOSING FIBROMYALGIA

As you may have figured out from the header to this section, Fibromyalgia is currently named according to its symptoms instead of according to its cause.  Because standard medical testing (IMAGING, Blood Work (FM/a, ANEMIA, SED Rate, ANA, BLOOD SUGAR), etc) does not provide a ready diagnosis, the following are the only diagnostic criteria that are considered when doctors determine whether or not a person has Fibromyalgia. I have simplified some of the verbiage and added some of my own links:

History of widespread pain that has been present for at least three months.  Note that pain is considered “widespread” when all of the following are present:

Official Definition of Fibromyalgia: Pain on palpation with the fingers, must be present in at least 11 of the following 18 tender point sites (these are not necessarily TRIGGER POINTS): Note that the points listed are shown in the diagram at the top of the page or just below this list.

Finger tip palpation should be performed with an approximate force of 10 pounds. To be diagnostic for fibromyalgia, points must be painful at palpation, not just “tender”. 

IS FIBROMYALGIA A ‘REAL‘ DISEASE?

Years ago, when I first learned about the way that doctors diagnose Fibromyalgia, I asked myself where such an absurdly simplistic (downright vague) set of diagnostic criteria came from?  With a little bit of digging, I found out.  In 1976, a group of Rheumatologists (arthritis specialists) had a meeting in Tampa, Florida to discuss the rising epidemic of patients that had both CHRONIC PAIN and CHRONIC FATIGUE. Not too much came of the meeting other than naming this dual set of symptoms “Fibromyalgia“.  But this presented its own unique problem.

Like all of us, doctors like to get paid.  In order to have a ‘disease’ whose diagnosis and treatment is found in the ICD-10 BOOK and reimbursable by the health insurance industry, there has to be a specific set of symptoms that define and characterize the said disease.  So, in 1990, The American College of Rheumatology stepped in and saved the day with the diagnostic criteria listed previously.

This allowed for more tax dollars to be spent doing Fibromyalgia research, more people to be diagnosed with Fibromyalgia, and best of all for the HMO’s, and PPO’s that employ almost 100% of today’s medical community (try finding a self-employed doctor today), the chance to make way more dollars treating Fibromyalgia.  Oh, as you can imagine; BIG PHARMA was thrilled as well.  Learn more about Lyrica (Pregablin) and Neurontin (Gabapentin) HERE.

DIAGNOSTIC DIFFICULTIES

Fibromyalgia is considered a controversial diagnosis for good reason.  Most of this has to do with of the lack of scientific consensus concerning its cause. There is actually a tremendous debate over using the current diagnostic criteria —— and even over whether objective diagnosis is possible at all.   Why is this?  Why doesn’t the doctor just take an x-ray or order a blood test?  With the severity of symptoms that most people suffer with, it seems like it should be so simple.

With Fibromyalgia; although there are frequently any number of comorbites, standard laboratory testing and diagnostic imaging typically appear normal. Other than the tender points listed above, there is usually little evidence of objective diagnostic findings (fatigue is considered a subjective finding).   This is why many members of the medical community question whether Fibromyalgia is a disease at all.  On top of this, many of the symptoms of Fibromyalgia mimic those of other conditions (ARTHRITIS, DEPRESSION, joint pain, impaired memory, fatigue, ENDOCRINE PROBLEMS, etc). 

Please note that I am not for one moment insinuating that Fibromyalgia is not real. For many people Fibromyalgia is all too real —- a living, breathing, nightmare. However, due to lack objective findings, Fibromyalgia is easily faked, becoming, along with spinal pain, the disease du jour for America’s rapidly expanding I-don’t-want-to-work crowd.    FYI: The American Medical Association (AMA) first recognized the symptoms of Fibromyalgia as a disability-causing illness in 1987.  People have figured this out, and gaming the system has become an easy thing for those who understand the diagnostic criteria, which can be found all over the internet (including this post). 

Before you fly off the handle and accuse me of calling people with Fibromyalgia, “fakers,” let me reassure you that Fibromyalgia is real.  It’s just that it is not what you think it is, or what your doctor has told you it is.  Speaking of doctors, let’s take a look at the opposite ends of the spectrum as far as what the medical profession saying about Fibromyalgia.

WHAT ARE MEDICAL EXPERTS
SAYING ABOUT FIBROMYALGIA?

“There’s an extremely wide range of opinions of physicians, ranging from it doesn’t exist at all to it’s a true illness. At a guess I’d say it’s probably no better than fifty-fifty.  In fact I was at a dinner with two other nerve-and-muscle neurologists and one was a believer and the other was what you could call an ‘eye roller.” John Kincaid, Neurology Professor at the Indiana University School of Medicine, and a former board member of the American Association of Neuromuscular and Electrodiagnostic Medicine. Taken from Why Fibromyalgia has a Credibility Problem. 

“The diagnosis of fibromyalgia itself worsens the condition by encouraging people to think of themselves as sick and catalog their pain.  These people live under a cloud, and the more they seem to be around the medical establishment, the sicker they get.” Dr. Nortin Hadler, a Rheumatologist and professor of medicine at the University of North Carolina Taken from a 2008 article in the New York Times called, Drug Approved. Is Disease Real ?  Dr. Hadler is right on the money with his second sentence. Shortly, I will show you how popular medical treatment actually makes fibromyalgia worse.

“Some of us in those days thought that we had actually identified a disease, which this clearly is not.  To make people ill, to give them an illness, was the wrong thing.” Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for Fibromyalgia.  He says he has become cynical and discouraged about the diagnosis, and now considers the condition a physical response to stress, depression, and economic and social anxiety. Taken from a 2008 article in the New York Times called, Drug Approved. Is Disease Real?

If I wanted to, I could have given you dozens — probably hundreds — of quotes on both sides of the argument.  Although the vast majority of the medical community has not realized it yet, understanding Fibromyaliga is simple. Fixing it is another matter altogether.  And you cannot even begin to grasp what it really is or how to effectively manage it without first understanding Adrenal Fatigue.

ADRENAL FATIGUE

WARNING:  Adrenal Fatigue is NOT Addison’s disease; a condition where the Adrenal Glands completely shut down Cortisol Production. Despite sub-clinical hypo-adrenia with its various stages being recognized as a distinct clinical syndrome since the turn of the 20th century, most doctors are unfamiliar with this condition for the simple reason that it is almost impossible to diagnose via traditional blood tests or diagnostic imaging.

Normal blood tests are designed to detect pathological processes — i.e. a severe and absolute deficiency of adrenal hormone.  Addison’s Disease afflicts only 1 in 25,000 people. Although adrenal hormones are low in the case of Adrenal Fatigue, they are still within the “normal” range and not low enough to warrant the diagnosis of any specifically named disease.

For over forty years now, the medical community has been playing a game with those who truly suffer from Fibromyalgia.  How so?  Any time a disease is named according to its symptoms as opposed to being named according to its cause, you automatically create tremendous confusion.  Again, how so?  You see, Fibromyalgia has been around as a medical diagnosis for decades.  

However, it was known by several different names — names that almost always pointed to the offending culprit —– fatigued, overworked, or burned out Adrenal Glands.  Thus, the problem was named according to cause, and not symptoms: Adrenal Fatigue, Adrenal Stress, Adrenal Insufficiency, Adrenal Exhaustion, Sub-clinical Hypoadrenia, etc, etc, etc.

About four decades ago, the medical community started noticing an exponential increase in patients with the symptoms of Adrenal Fatigue.  They had a big meeting.  They changed the name of this group of symptoms from Adrenal Fatigue to Fibromyalgia. 

This in itself begs the question of why — why would the medical and pharmaceutical communities feel that it was absolutely imperative to change the name of this health problem from Adrenal Fatigue to Fibromyalgia?  Part of the problem had to do with what we talked about above; the fact that there were and still are no standard medical tests that can definitively (key word here is definitively) diagnose Fibromyalgia.

But let’s think about this situation a different way.  If your doctor said to you, “Mrs. Smith, you have Adrenal Fatigue,” what are the first two questions you would ask?  Think for a moment —- we would all ask the same two questions.

Plainly stated, if your doctor cannot provide objective tests to accurately measure adrenal function, or if your doctor has no real idea how your adrenal glands became fatigued in the first place.  Or if your doctor is unsure about how to go about ‘unfatiguing’ the adrenal glands, or if your doctor is one of those who denies that Adrenal Fatigue / Fibromyalgia even exists at all; can he / she really help you?  Of course not! 

However, if the medical / pharmaceutical communities can create a paradigm shift so that people think differently about the disease, they can then convince patients that they have a handle on this health problem —- even though they haven’t a clue.

The Medical / Pharmaceutical community realized that if they could simply change the name of the disease from something describing underlying cause, and shift it to something that instead described the symptoms (painful knotted muscles), they could convince millions of patients that no one really understands this mysterious illness that’s sweeping America in epidemic fashion. 

Oh, and by the way, because there are no objective findings, the only hope as far as treatment is concerned is to address the symptoms with drugs — LOTS OF DRUGS — for the rest of your life.  And don’t even bother looking for a cure, because there is none.   Thus the birth of Fibromyalgia / Chronic Fatigue Syndrome (these are often used together or interchangeably).

What was the payoff?  Far fewer people ultimately ask their doctors those pesky questions that cannot be answered simply by pulling out a pen and writing a prescription for MUSCLE RELAXERS, PAIN KILLERS, NSAIDS, ANTI-DEPRESSANTS, NERVE PILLS, SLEEPING PILLS, CORTICOSTEROIDS, or who knows what the latest Fibromyalgia drug du jour is.   And don’t kid yourself. The Pharmaceutical Industry is specifically targeting you!  Long ago, they realized that if they could play this thing right, they were sitting on a gold mine. 

Oh, I see.  You’re one of those people who still believe in Santa Clause, the Tooth Fairy, and a Pharmaceutical Industry that puts your health and well being ahead of profits. You probably also believe in the veracity of “EVIDENCE-BASED MEDICINE” as well.

To truly grasp the intensity that Big Pharma is trying to separate you from your hard earned dollars, and the fact that they will go to any length to do so, read the story of Pfizer’s nearly 3 billion dollar fine (yes, billion with a “b”) for fraudulently touting two of their drugs (Neuronitin and Lyrica) for, among other things, Fibromyalgia (HERE).  When I first heard of this, I figured that a fine of this magnitude would bankrupt the company.  That is, until I found out that Pfizer brought in over 70 billion dollars that year. Three billion was just the price of doing business.

When a person is stressed, the body reacts by mounting a response through the stimulation of the SYMPATHETIC NERVOUS SYSTEM. As we have discussed already, this is also called the “fight or flight” response as the body arms itself to face what it perceives as danger.

When this happens, epinephrine (adrenaline) is secreted by the adrenal medulla, and the hypothalamus-pituitary axis is stimulated to release ACTH, which in turn causes the adrenal cortex to increase production of the anti-stress hormone cortisol.  In small amounts, Cortisol is fabulous stuff.  However, when you get overstressed (emotional stress, mental stress, physical stress, dietary stress, etc), your cortisol-making machinery kicks into high gear.

When a person experiences chronic stress, the cortisol level may rise to such a high level that its production diminishes as the Adrenal Glands fatigue, and eventually become exhausted.   With chronic stress, there is decrease in DHEA levels with a rise in cortisol. As a result, the ratio of cortisol to DHEA increases.  As with most hormonal systems, there is a negative feedback loop that limit the production of each hormone once it hits its target level. The same occurs in the case of cortisol, with one exception. 

During prolonged or acute stress when the body perceives that its survival is at stake, the excessive cortisol output actually diminishes the feedback response. In other words, instead of the feedback loop shutting down cortisol production when the levels get high, the body reacts 180 degrees opposite.  Because cortisol is the body’s primary anti-stress hormone, it will interpret a very high cortisol level as impending and life-threatening danger. When this happens, there is actually a blunting effect on the feedback loop allowing it to spin increasingly out of control.  More cortisol will therefore be produced even though your body becomes increasingly’ resistant’ to it.

This is the body’s way to ensure that we can cope with the on-going stress that threatens its survival.  This is OK for brief times of very acute stress.  But if it goes on very long, the body (including the Adrenal Glands) begins to fatigue.  The result of Chronically High Cortisol Levels include……

IMPORTANT NOTE: Rarely are we talking about full-blown Cushing’s Syndrome here — a diagnosis that is easily made via standard blood tests.  Cushing’s Syndrome is a condition caused by dramatically elevated Cortisol levels in the blood, whose symptoms are similar to those seen above and include elevated blood pressure, Diabetes, pink / purple stretch marks on the abdomen, Fatigue, Depression, Moodiness, and accentuated fatty tissue on the face and upper back (the dreaded “hump”). Women with Cushing’s Syndrome may develop irregular menstrual periods and develop new facial hair growth, as well as a decrease in sex drive.  Sometimes the line between Adrenal Fatigue and Cushing’s Syndrome is very thin.

As Cortisol levels continue to rise, a tolerance to the hormone (‘resistance’, similar to INSULIN RESISTANCE) begins to take place.  Although there are increasingly high Cortisol levels circulating in the bloodstream, it does not work as effectively.  Thus, the body calls for even more Cortisol to be produced.  This vicious cycle causes things like:
 

WHY DO I HAVE FIBROMYALGIA

Why do I have Fibromyalgia?  It’s a great question.  I would suggest that you first ask your doctor and see what kind of response you get.  More than likely there will be some stuttering and stammering, and then some explanations about how no one really knows what Fibromyalgia really is, what causes it, or how to cure it.  In fact, most doctors tell their patients that there is no hope of actually finding an answer for their Fibromyalgia.  The only hope is possibly getting some symptomatic relief.  You know — better living via pharmacy.  I’ve said it before, but if you want solutions to managing your Fibromyalgia, you will have to step outside the box.

The Adrenal Glands are two small glands that sit on top of the kidneys. Each adrenal gland has two compartments. The smaller inner compartment (medulla) affects the SYMPATHETIC NERVOUS SYSTEM (the fight or flight response).  It is responsible for producing two hormones, epinephrine and norepinephrine (aka adrenaline and noradrenaline). They play an important role in helping cope with physical and emotional stress.

The larger outer compartment (cortex) is responsible for producing more than 50 different hormones in three major classes – glucocorticoids, mineralcorticoids and sex hormones. The most important glucocorticoid hormone is cortisol. When cortisol output is too low, then the body is unable to appropriately deal with stress.  In fact, Cortisol is the single most important stress hormone in the body. We learned earlier what high cortisol levels do.  However, cortisol is not bad in and of itself.  It performs numerous vital functions in the body, including……..

Interestingly enough, cortisol regulates the immune system in two different ways.  Firstly, it activates the immune system by its release.  Secondly, it suppresses the immune system as more of it is released.  It is a delicate feedback loop, which, when damaged, can cause multiple body systems to spiral out of control.  And although you might be diagnosed with some sort of BLOOD SUGAR METABOLISM PROBLEM (Diabetes, METABOLIC SYNDROME, HYPOGLYCEMIA, etc), THYROID PROBLEMS, female issue, etc; your Adrenal Hormones will almost certainly remain normal on the blood tests.  It is rare that these ranges to fall into the area where they indicate full-blown Addison’s Disease or Cushing’s Syndrome.  This is why the best Adrenal Testing uses saliva instead of blood.

Yes, that’s right.  Adrenal Glands can be tested.  Even though I have been telling you that there are no objective medical tests that will show Fibromyalgia, this does not mean that there are no tests that show Adrenal Fatigue.  Although Europe grasped this fact long ago, unfortunately, the American medical community has been ignoring some of the new Adrenal Testing that is done in the same manner as DNA Testing is done (saliva testing).  Hair mineral analysis is another way (albeit not as good as saliva) to evaluate adrenal function.

In a word, the reason that you have Fibromyalgia is “stress”.  I realize that this sounds like a huge cop out.  It’s not.  Although mental or emotional stress can certainly be a large part of the picture, this “stress” can come in many other forms as well.  What about the physical stress caused by burning the candle at both ends or an incredibly physical job?  What about dietary stress?   Like I showed you earlier, it is all but impossible to find a person who suffers with Fibromyalgia / Adrenal Fatigue who is not seriously and pathologically addicted to sugar, SODA, junk food, fast food, refined / processed carbs, etc.  But that is not all.

One of the chief ways that the human body and immune system are stressed, is by Gut Dysfunction. Because 80% of the immune system is found in the Gut / Intestines (HERE), it is impossible to be healthy while dealing with a DYSFUNCTIONAL GUT.  It’s why if you have Fibro, you likely have a serious case of “THE LEAKIES” — something else that is easily tested for.

FIBRO FACTS

CHRONIC FATIGUE
Detailed interviews of 40 Fibromyalgia patients from three countries (United States, Germany and France) showed that with Fibromyalgia, fatigue is the second most severe symptom after pain.  The interviews were conducted with non-leading queries, such as “Tell me about your experience of having fibromyalgia?” The average duration of Fibromyalgia symptoms for the 40 participants was 6.6 years, the average age was 49, and 70 percent were female. When asked about their experiences with Fibromyalgia, these were their reported symptoms:

The participants then described their fatigue as follows:

MORE THINGS TO KNOW ABOUT FIBROMYALGIA

Fibromyalgia is associated with additional symptoms which seem distinct themselves but are actually included in “Fibromyalgia Syndrome “. Other than muscle pain and fatigue, fibromyalgia patients also may struggle with:

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