This blog
post, 5
Things You Should Know About Dysautonomia If You Have Fibromyalgia, originally appeared on ProHealth. Because the article continues to
garner attention, I am sharing it in its entirety here on The Pained
Ink Slayer.
______________________________________________
Published on ProHealth October 11, 2018
When I started looking at a way to raise
awareness for dysautonomia this month, I realized it was in 2015 that I wrote
about dysautonomia
and fibromyalgia. So, I thought it was time for an update.
What is dysautonomia?
Dysautonomia is a term used to
describe a disruption in the way our autonomic nervous system regulates,
communicates, and adjusts our body functions so we maintain balance.
As reported in the above-mentioned
article, the autonomic nervous system (ANS) consists of two branches: the sympathetic and the parasympathetic.
The sympathetic nervous system prepares
our body for fight or flight in stressful situations and sometimes seems to give
us superhuman powers in fearful or dangerous situations. Certain functions take
place, like the release of adrenaline, which cause other things such as an
increase in our heart rate so that more oxygen is delivered to our muscles when
it’s needed.
It is the parasympathetic arm of our ANS
that normalizes things after a threat is gone. Both branches of the autonomic
nervous system work “automatically” to provide the body balance and well-being,
referred to as homeostasis.
5 scientific advances in understanding
dysautonomia and fibromyalgia
1.
The
American College of Rheumatology posed at their annual meeting, Dysautonomia
may be the pathogenesis behind fibromyalgia (December 23, 2015). Two groups
of patients were part of a study: those
with fibromyalgia and those with rheumatoid arthritis. Martinez-Martinez LA, et
al., discovered a strong correlation between dysautonomia and the fibromyalgia
group. Shirley Pulawski had this to say about the paper.
“A consistent line of investigation
suggests that dysautonomia may explain the multisystem fibromyalgia features,
and that fibromyalgia is a sympathetically maintained neuropathic pain
syndrome,” the researchers wrote. “The sympathetic nervous network is the main
component of the stress response system.”
Her reference:
Martinez-Martinez LA, et al. Paper #71.
Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015;
San Francisco.
2.
Small
fiber neuropathy has been implicated in fibromyalgia dysautonomia once again.
In September 2018, Fibromyalgia and
small fiber neuropathy: the plot thickens, Martinez-Lavin suggests
"The recent recognition of small fiber neuropathy in a large subgroup of
fibromyalgia patients reinforces the dysautonomia-neuropathic hypothesis and
validates fibromyalgia pain... Skin biopsy and corneal confocal microscopy will
probably become useful fibromyalgia diagnostic tests. Dorsal root ganglia
sodium channel blockers are potential fibromyalgia analgesic medications.
Subgroups of young girls with ‘autoimmune neuropathic fibromyalgia’ may respond
to immunoglobulin therapy."
Side note: In light of the FDA approved
clinical trial on the BCG
vaccine for fibromyalgia, the plot does indeed thicken and the characters at
play are biological. The FM/a test is a multi-biomarker-based blood test that
looks specifically at immune system white blood chemokine and cytokine
patterns. The paper by Kenney, M.J. and Ganta, C.K., Autonomic Nervous
System and Immune System Interactions Autonomic Nervous System and Immune
System Interactions (2014, July), states that cytokines and other immune
factors affect the level of activity and responsivity of discharges in sympathetic
and parasympathetic nerves innervating diverse targets. I am in no way a
scientist, but I take this to mean immune influences such as those identified
in the FM/a test could be a player in our dysautonomia symptoms.
4.
Autonomic
nervous system dysfunction may contribute to poor sleep in fibromyalgia and
vice versa according to a
2017 study. The investigators describe it as a vicious circle.
5.
I
found the study, Dermatological
Manifestations of Postural Tachycardia Syndrome Are Common and Diverse
(2016, Jan.), particularly interesting since many of us experience POTS (a type
of dysautonomia called chronic orthostatic intolerance). I suspect I am not
alone in this one since so many of us also complain of unusual rashes, Raynaud’s,
and livedo reticularis. Note: Raynaud’s and livedo reticularis are thought to
be dysfunctions in the sympathetic arm of our autonomic nervous system.
Conclusion
There is sufficient evidence to
correlate dysautonomia and fibromyalgia. If you have symptoms of dysautonomia,
discuss it with your physician. Diagnosis needs to be made in order to explore
possible treatments that will ease your symptoms and improve your health.
Additional reading:
In healing,
Think adversity?-See opportunity!
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