Fibromyalgia affects an estimated five-million adults in the United States. Autoimmune diseases can, and frequently do, occur alongside it. Additionally, some autoimmune diseases, such as lupus, have symptoms that are strikingly similar to fibromyalgia.
Because fibromyalgia was once believed to be an arthritis-related condition, and many types of arthritis, such as rheumatoid arthritis (RA), are autoimmune diseases, the assumption used to be that fibromyalgia fit into this category. Research, though, has pointed in different directions.
However, we can’t definitively say fibromyalgia isn’t autoimmune since we still don’t know the underlying cause(s) of the condition. It’s possible that future studies may discover that autoimmunity plays a part in at least some cases.
Why Isn’t Fibromyalgia an Autoimmune Disease?
Some research suggests that the immune system in fibromyalgia may tend to have some irregularities, such as being chronically overactive. Some people believe that means it’s autoimmune, but in fact, these are two different types of immune dysfunction.
First, it’s important to understand what autoimmunity is.
In autoimmune disorders, the immune system mistakes a particular tissue or structure in the body for a dangerous invader, such as a virus or bacteria. It then attacks that tissue or structure in an attempt to destroy it. That process typically causes damage and inflammation at the site. (Inflammation is a normal and necessary part of the healing process, but it’s a problem when it becomes chronic.)
In laboratory tests, people with fibromyalgia typically have low inflammatory markers, while autoimmune diseases are associated with high inflammatory markers. So far, researchers haven’t found much evidence of damage, either. So that turns the tide of thought away from autoimmunity.
However, emerging research may re-focus the attention back in that direction. It shows that certain nerve structures, including the optic nerve, are sometimes damaged in fibromyalgia. So far, we don’t know why or how prevalent this damage is. That means we don’t yet know whether this is evidence of autoimmunity. It’s certain to be looked at as one possible cause, though.
Causes of Fibromyalgia
No particular trigger has been shown to spur the onset of fibromyalgia. Clinicians believe there are a variety of causes, including:
- Emotional trauma
- Viral infections
- Physical injuries
More and more, fibromyalgia is being called a neuroimmune disorder or a central sensitivity syndrome.
Brain Chemicals & Hormones
Fibromyalgia patients typically exhibit abnormalities in brain chemicals as well as hormonal abnormalities. At this point, though, no singular pattern has emerged among patients. While these imbalances are associated with fibromyalgia, there is no conclusive evidence they cause the disorder.
Brain chemical and hormonal imbalances common in fibromyalgia include:
- Reduced opioid receptor activity in the parts of your brain that regulate mood and the emotional aspects of pain
- Lower serotonin levels or activity
- Lower levels of the stress hormones norepinephrine and cortisol, which lead to inadequate responses to physical and psychological stresses
- Low levels of IFG-1, which promotes bone and muscle growth
- Up to three times the normal level of substance P, which is associated with increased pain perception
Other Common Symptoms of Fibromyalgia
As you now know, there is no singular pattern of symptoms for fibromyalgia. However, a group of symptoms is common in many patients and include:
- Aching, radiating, widespread pain and stiffness
- Pain from stimuli that don’t normally cause pain (i.e., light pressure)
- Pain that moves from one part of the body to another and isn’t associated with damage
- Sleep disorders (as overlapping conditions)
- Cognitive dysfunction (often called “fibro fog”)
- Unrefreshing sleep that leads to extreme fatigue
- Restless leg syndrome (as an overlapping condition)
- Irritable bowel syndrome (as an overlapping condition)
RA and lupus are two autoimmune diseases that can have symptoms similar to fibromyalgia. Others may be similar as well, depending on the particular fibromyalgia symptoms a person has.
Additionally, people with fibromyalgia may have overlapping autoimmune disease(s). A correct diagnosis is important to an effective treatment plan.
RA and lupus, however, do have diagnostic markers, including inflammation and damage, that doctors can look for when making a diagnosis.
A Word from Verywell
We’ll need a lot more research to determine whether fibromyalgia belongs in the autoimmune category. Until we know for sure, doctors are unlikely to prescribe common autoimmune treatments, such as drugs that suppress the immune system, for this condition.
As more research comes it, we’ll gain a clearer picture either way..