The Fatigue Factor

A relatively new muscle malady, fibromyalgia is no figment of the imagination

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Illustration by Gary Eldridge

Perhaps Leona Ellis enjoyed too much good fortune. A salon owner who worked four days a week, Ellis spent her free time in northern Michigan kayaking, bicycling, rollerblading, cross-country skiing, and snowshoeing. But two years ago, seemingly out of the blue, Ellis began suffering from overwhelming fatigue, even following nights when she slept well.

As time passed, her problems multiplied. Her body began to ache; first in her knees, then traveling to her hips, her quadriceps, and buttocks. The pain was compounded by severe muscle spasms in her legs. “By August and September of 2007,” she recalls, “it was almost impossible to bend over and pick something up. [My] muscles didn’t feel like they would stretch that far. I was in constant pain.” Visits to her regular internist were met with quizzical looks and assurances that her blood levels were normal. She was told to take ibuprofen and an antidepressant. “I lived out of that ibuprofen bottle to keep going,” she says.

By November, the muscle spasms and aches had progressed to Ellis’ shoulders, and she was bedridden. A visit to an urgent-care clinic suggested a virus. Following Christmas — some 18 months after the first symptoms appeared — her internist suggested she might be suffering from fibromyalgia.

First diagnosed in 1990 by the American College of Rheumatology, fibromyalgia is recognized by most doctors as a disabling illness, although some still see it as a more psychological malady. Because fibromyalgia is a relatively new disease, proper diagnosis and successful treatment can take months, or even years, with patients running the gamut of medical specialists.

Lisa Meloche, a 36-year-old therapist from Sterling Heights, believes she may have been suffering from some form of fibromyalgia most of her life. “I was tested for mono many times, my legs ached, and I couldn’t get answers why,” she says. Meloche was finally diagnosed in 1999, after having physical therapy for sciatica. There were also terrible headaches, thyroid problems, severe menstrual cycles, carpal tunnel syndrome, irritable-bowel syndrome, insomnia, and aches and pains all throughout her body. She was extremely sensitive to varying temperatures, as well.

Yet she was reluctant when she heard the diagnosis, concerned that it wasn’t a “real” disease.

But new research has helped people recognize fibromyalgia as a disease. “The development of two new drugs, Cymbalta and Lyrica, has validated [for] many doctors that it is a real disorder, not just a trashcan disorder,” says Dr. Gamal Wazni, principal of Fibromyalgia & Fatigue Centers Inc. in Troy. According to the National Institutes of Health, however, Lyrica (Pfizer’s trade name for pregabalin) has caused decreased fertility in male animals, as well as birth defects in the offspring of male and female animals who were treated with the medication.

Some researchers believe that a central-nervous-system malfunction is what causes fibromyalgia. Others believe that fibromyalgia is caused by a lack of deep REM (stage 4) sleep, when the muscles recover from the previous day’s activities. Other researchers feel that it’s triggered by a virus, which causes the body’s nerves to misfire. Symptoms can vary from person to person, but there are several that are commonly shared by most sufferers — 90 percent of whom are women.

Approximately 6 million people, or 2 percent of the population, have fibromyalgia. Typically, fibromyalgia patients experience severe aches and pain in the muscles, tendons, and joints, especially along the spine. In turn, specific areas of the body — often called trigger points — can be extremely tender to the touch.

Additionally, sleep disturbances, notably insomnia, are often associated with the pain, as well as headaches, fatigue, chest pain, morning stiffness, anxiety, depression, irritable-bowel syndrome, and cognitive memory impairment known as a “fibro fog.” Hormonal imbalances, which cause women to experience painful menstrual cramps, skin problems, and infertility, are also common. Patients can also suffer from other overlapping health conditions, such as chronic-fatigue syndrome, temporomandibular joint syndrome, restless-leg syndrome, myofascial pain syndrome, and multiple-chemical sensitivity. In other words, they’re a mess.

Ellis’ doctor discovered she had a virus called Epstein-Barr, which causes mononucleosis and chronic-fatigue syndrome, in addition to fibromyalgia. After some diligent research, she came across Dr. Wazni. “What we know about fibromyalgia is that you will live, but you will [have] a poor quality [of] life,” Wazni says. “We can now improve that quality of life. We have learned that the basis of fibromyalgia and chronic fatigue has a lot to do with one’s hormonal and nutritional status, in addition to the underlying infection and [a] weak immune system.” Wazni adds that whether from illness or aging, there is a breakdown on the cellular level whereby cells do not receive the proper nutrition.

Dr. Edward Lichten, a Birmingham obstetrician/gynecologist, has spent years studying patterns in medicine, which he writes about in his book Textbook of Bio-Identical Hormones. He and Wazni see eye to eye. “Because all of their energy systems are off,” Lichten says, “these patients do not absorb the minerals, proteins, and fats you need to repair, restore, and have an active life. There’s a cycle causing more inflammation and more cellular degeneration.”

Lichten has found that six glands in the body — pineal, pituitary, thyroid, adrenal, pancreas, and gonads — regulate most bodily functions. “To treat disease,” he says, “you have to treat all six.”

Lichten has determined that fibromyalgia is caused by biological sleep disturbances due to low levels of vitamin D (which can cause insomnia), as well as by low levels of growth hormones in the pituitary gland. To treat fibromyalgia, patients are often given a concentrated form of vitamin D.

“We can prove it raises their blood levels,” Lichten says. “If you don’t sleep for a night, you wake up feeling stiff. If you don’t sleep well for a month, you feel like you ran a marathon all night.”

In addition, Lichten has found that most fibromyalgia patients have low thyroid levels, even after being put on thyroid medication. The result is that patients have little or no metabolism, making it difficult to heal bruised or overworked muscles. Often, the adrenal glands are overly taxed, which leaves patients feeling wired, as if they were perpetually over-caffeinated.

This article appears in the November 2008 of DBusiness.
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