Just before Christmas a friend of mine shared a Facebook post from a news website that discussed some newly published research about Fibromyalgia syndrome (FMS). Initially I intended to just share this directly to my own Facebook page, but I wanted to see if I could find the published study first to check what I was sharing. As anyone who reads medical journal articles knows, getting more than just the abstract for free for a recent article is about a rare as hen’s teeth, so when I found that Elsevier had made it available in full, I was over the moon. I printed it out and sat down with my yellow highlighter and started to go through the article.
It would be fair to say that my first reaction was an emotional one. Here, in front of me, was more evidence that fibromyalgia syndrome had a physical manifestation that could actually be measured and was the possible reason for the symptoms experienced. For years people diagnosed with FMS have had to rely on whether or not their physicians “believed” in FMS – and let me tell you from experience, many didn’t. So, it has taken me a little while to get over the “wow, no way!” reaction and get to writing the blog post!
The journal article is titled “Brain glial activation in fibromyalgia – A multi-site positron emission tomography investigation” Albrecht, D., Forsberg, A., Sandstrom, A., et al (2018). I know that sounds like a load of medical jargon. In plain English it means that a type of brain scan using positron emission tomography (PET) found that cells called glial cells are more active in people with fibromyalgia.
- It is on living humans (in vivo), not mice or rats and not on cells in a lab (in vitro).
- The Massachusetts General Hospital, USA and the Karolinska Institute, Sweden collaborated on the study with groups of people from both countries.
Now before I lose part of my audience, here are some definitions for my non-medical readers:
- Glial cells are a group of cell types found in association with nerve cells, but are not nerve cells and do not make synaptic connections. They provide support to the nervous system. The studies discussed here refer to microglia – which are part of the body’s clean-up crew, aka macrophages. They are attracted to and remove debris created by injuries, inflammation or general cell renewal.
- Translocator Protein (TSPO) – is a protein that is found on the membrane of the mitochondria inside your cells. It is involved in a number of processes that I won’t go into here, and is also expressed/activated when inflammation is present, so is a good indicator of an inflammatory process going on in areas of the body where it is active in high densities. TSPO activity is also implicated in heart disease and, most importantly for FMS people, the production of neuroactive and reproductive steroid hormones which impact on mood, pain and cognition – starting to sound familiar anyone? It can also be easily scanned in PET imaging, as was done in these studies.
- Serotonin Transporter 5-HTT – aka SERT is a protein that regulates the amount of serotonin that is available for nerve cells to use by releasing it into the gap between cells (synaptic cleft) and then recycling (reuptaking) it. The way this functions is related to the genetic polymorphism, or variant, of the gene that codes for 5-HTT that you carry.
An equally interesting and earlier study by Kosek, K., Martinsen, S., Gerdle, B., et al (2016), also from the Karolinska Institute and on 126 real live people, found a link between some of the polymorphisms, of the gene that codes for TSPO, and the level of pain experienced by people with FMS. It found that people with FMS who had a genotype for high affinity binding TSPO reported greater severity of symptoms, including pain, than those with mixed and low affinity TSPO binding. They also looked at serotonin transporter 5-HTT polymorphisms and found that people who had high levels of TSPO expression AND had high levels of 5-HTT expression (leading to higher levels of serotonin) reported the highest levels of pain.
There was also a comment that TSPO upregulation has an association with higher levels of another inflammation indicator interleukin 8 (IL-8), which has also been recorded as elevated in cerebral spinal fluid in FMS people.
As usual, more research is required, but this is great to know and means that there is tangible evidence to start working with.
How can we make this knowledge work for us?
Reducing inflammation is likely to be a key to any wellness plan for someone with FMS.
But what are the triggers of inflammation?
Finding what works for you - taking ownership of fibromyalgia
Nutrition for reducing inflammation
Reducing stress to reduce inflammation
- Take the time to relax – mineral spas (balneotherapy) have been shown to be helpful for people with FMS. If you don’t have access to a spa then simple Epsom salts baths are a great and inexpensive alternative. Make use of a friend or family members bath if you don’t have one.
- Work on your internal dialogue. The way we talk to ourselves has a major impact on our stress response. When you catch yourself having negative thoughts, actively find something about the situation or just in general to be positive about and grateful for. This may feel difficult and awkward at first, but you will be surprised to find how quickly this becomes a habit.
- In your mind, talk directly to your cells at night as you fall asleep. Tell them that they are safe, they are not in danger, they are nourished, they are loved and that they can relax and heal. This is a great to do after a progressive relaxation exercise where you become aware of each part of your body and feel them relax.
For more ideas to help with coping with stress click here for one of my other blogs.
Ablin, J., Häuser, W., Buskila, D., (2013) Spa treatment (Balneotherapy) for fibromyalgia: A qualitative-narrative review and a historical perspective. Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 638050, 5 pages, 2013. Retrieved from: https://doi.org/10.1155/2013/638050
Albrecht, D., Forsberg, A., Sandstrom, A., et al (2018) Brain glial activation in fibromyalgia: A multi-site positron emission tomography investigation. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0889159118302423
Kosek, K., Martinsen, S., Gerdle, B., et al (2016) The translocator protein gene is associated with symptom severity and cerebral pain processing in fibromyalgia. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0889159116303440?via%3Dihub
Microglial cells. (n.d.) Farlex Partner Medical Dictionary. (2012). Retrieved February 28 2019 from https://medical-dictionary.thefreedictionary.com/Microglial+cells
Segerstrom, S., Miller, G., (2006) Psychological stress and the human immune system: A meta-analytic study of 30 years inquiry. Psychological Bulletin, 130(4), 601-630. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/