Fibro Facts 2: The Immune System and Fibromyalgia

One of the reasons I want to do this daily blog is to increase understanding and awareness about fibromyalgia syndrome. So today, we’re going to talk about fibromyalgia and the immune system.

The first point we need to get out of the way: Fibromyalgia is not considered an autoimmune disorder.

However, I’ve recently wondered, does that mean fibromyalgia has no impact on our immune systems?

I have heard everything from, “Yes it does, and that’s why overlapping illness is so common,” to, “No it doesn’t and thinking so is ignorant,” and pretty much everything in the middle.

So today I decided to choose two articles from the search engine that meet my requirements for reliable sourcing and reporting and see what I can find.

1. Fibromyalgia: Is It an Autoimmune Disease? - Healthline Media.

2. Cytokine and Immune System Abnormalities in Fibromyalgia and Other Central Sensitivity Syndromes - PubMed National Library of Medicine | National Center for Biotechnology Information.

Autoimmune or not autoimmune? What experts say

According to Healthline, the number one digital health publisher, some medical experts believe, “fibromyalgia could be classified as an autoimmune disease because many of the symptoms overlap with those of autoimmune disorders.”

However, the medical community does not have sufficient evidence to prove this claim, and this is where issues begin to arise with understanding what is - and isn’t - fibromyalgia.

There’s a distinct lack of evidence showing that fibromyalgia produces autoantibodies or causes harm to surrounding tissues, says Healthline.

So we know our bodies are not actually on the attack. This is supposed to calm us. Nothing is really happening inside us, it just feels that way.

When I was going through the diagnosis process, I had ultrasounds and X-rays and blood tests, nothing.

There is no damage to my joints, despite the reality of them getting red and swollen and hot and stabby and things going numb. My white blood cells are within normal range. And so, this is where the idea comes from that, if there is no physical evidence of the chronic pain we feel, it is in our heads.

Invisible. Untraceable. Ignorable.

Here’s what I learned from the next article, the study on cytokines and central sensitivity syndromes.

What are cytokines?

Our immune system uses signals. These signals require receptors to transmit and receive messages. These receptors come in sets, one of which are cytokines. We have these cytokine receptors throughout our entire body, and they allow discussion between the immune system and the nervous system.

Some of the most important clinical interactions between these two systems are associated with the ‘sickness response’ as well as pain and analgesia,” says the study.

“This ‘sickness response’ which has been frequently attributed to inflammatory cytokines, strongly resembles the core symptoms of fibromyalgia and other Central Sensitivity Syndromes (CSS).”

The study conclusion was that a lack of consistent associations was observed between CSS symptoms and peripheral cytokines which seem to suggest that maybe cytokines abnormalities of the central nervous system contribute to the pathogenesis of these illnesses.

In everyday terms, this means there isn’t strong evidence to associate fibromyalgia-like syndromes to peripheral cytokines, suggesting perhaps a central nervous system component whereby those cytokine receptors are abnormal.

Breaking it down further, it sounds like this is explaining the misfiring or miscommunication issue between our bodies and brains we keep hearing about. While it is not related directly to our immune system, it is related to our nervous system.

In fact, in case I haven’t mentioned this yet, fibromyalgia is categorized as a neurological health problem. This is confirmed by the rheumatology community and the American College of Rheumatology. But do you have a clear understanding of how this affects immunity? No, me neither.

Fibro in the time of COVID-19

Actually, it’s the coronavirus that really made me think of this in the first place. Never had I before wondered about my immune system in relation to fibromyalgia.

I came across a third article today because I wasn’t satisfied to leave things here. It’s called, “Does Fibromyalgia Make You at a Higher Risk for Coronavirus?” on Creaky Joints. They interviewed experts to get the story straight.

According to Petros Efithimiou, MD, FACR, rheumatologist, it depends whether the fibro is primary or secondary.

Efithimiou says, “Primary fibromyalgia, which is the most common form, is a chronic pain syndrome in which the body and brain process pain and stimuli differently.
There is no immunosuppression."

This group is not at any increased risk for COVID-19.

However, if you have secondary fibro, the answer changes.

“Secondary fibromyalgia, on the other hand, often occurs in patients with conditions that can affect the immune system, such as lupus, rheumatoid arthritis, or axial spondyloarthritis,” states Creaky Joints.

“In this case, your immune system may be suppressed and you could be considered at a higher risk for COVID-19, especially if you have additional co-occurring health conditions, such as heart disease, lung disease, or diabetes.”

And, for anyone about to go down the rabbit hole of whether any potential medications for fibro decrease or impact our immune system, the answers from the experts are reassuring. Antidepressants don’t compromise our immune system and neither do the common NSAIDs prescribed.

The small spoon scoop

Can’t get through the whole article? No problem. Basically, if you have fibromyalgia as a primary condition, rather than as an onset or prompt of another illness, the research I reviewed says you are not immunosuppressed.

It does not impact our immune system, but it does impact our central nervous system.

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