Fibromyalgia: The Invisible Disorder
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Understanding Fibromyalgia: The Invisible Disorder

Understanding Fibromyalgia: The Invisible Disorder

Patients with fibromyalgia experience chronic widespread pain that seems to begin in the muscles, and can be severe enough to disrupt daily activities. Muscles may twitch, burn, or have deep stabbing pain, and may feel like they’ve been overworked or pulled, even without exercise or other causes. Chronic fatigue syndrome often coexists with fibromyalgia, bringing ongoing, overwhelming fatigue that doesn’t improve with rest. Other symptoms include abnormal pain processing, sleep disturbances, difficulty concentrating, problems with memory and cognitive functioning, and sensitivity to light, noise and cold.

Originally Posted May 2013
Updated June 2019

For patients with severe symptoms, fibromyalgia and chronic fatigue syndrome can be extremely debilitating and can interfere with the basic activities of daily life, even bringing psychological distress and social isolation.

A Relatively New Diagnosis

Fibromyalgia is not a new syndrome, but it is surprisingly not well recognized in medical practice, even though it is the most common cause of chronic musculoskeletal pain. Fibromyalgia first began to be recognized in 1990, when the American College of Rheumatology (ACR) created a set of diagnostic criteria for the disorder. According to these criteria, patients just have (1) widespread pain for at least three months in three quadrants of the body, and (2) abnormal sensitivity to light pressure in at least 11 of 18 specific tender/trigger points. People affected by fibromyalgia may not even realize they have tender/trigger points until someone familiar with the condition applies pressure to these points.

Learn more about fibromyalgia tender/trigger points here.

Before the ACR diagnostic criteria were released, fibromyalgia was not considered to be a real disorder. Even today, many doctors deny that fibromyalgia is not a legitimate disease. On average, fibromyalgia patients spend three to five years and see an average of five physicians before receiving a diagnosis, and spend $4,800 to $9,300 annually on associated medical costs.

Learn even more about fibromyalgia here.

Causes of Fibromyalgia

It can be difficult for a patient to get a diagnosis of fibromyalgia, because many physicians believe there’s no clear cause or treatment. Many doctors treat the problem with NSAID pain relievers, antidepressants, and muscle relaxers. Unfortunately, none of these approaches address the underlying root of the problem.

Current research suggests that many triggers can initiate a cascade of events that cause the hypothalamic, pituitary, immune, and coagulation dysfunction common in fibromyalgia. The most common of these is a viral infection, mostly commonly Epstein-Barr, Cytomegalo or HHV6. These viruses are found in 80% of patients with fibromyalgia and chronic fatigue syndrome.

A large number of fibromyalgia patients also have low thyroid hormone levels and thyroid receptor resistance that don’t appear on standard blood tests due to pituitary dysfunction. Many have adrenal insufficiency and growth hormone deficiency, and others suffer from a coagulation defect set off by a chronic infection, effectively starving the cells from oxygen and nutrients. Stress also appears to be a contributing factor.  Unfortunately, these issues usually are not detected with standard blood tests and require more specific testing.

Multisystem Treatment for Fibromyalgia

Treatment of fibromyalgia requires a multisystem approach. If the patient is found to have one of the commonly found viruses, treatment with anti-viral medication can result in an improvement in symptoms. Thyroid, adrenal and other hormones deficiencies can be treated with medications. Patients may also have nutritional deficiencies, which can be treated with supplements or IV therapy.

Learn more about the multisystem treatment approach for fibromyalgia here.

Because fibromyalgia may impact multiple systems, the need for multiple interventions is important to restore a patient’s health. An integrated treatment approach is significantly beneficial if a patient is to get their life back. Once the underlying issues are addressed and treated, patients with fibromyalgia can see significant recovery or a complete resolution of their symptoms.

At Holtorf Medical Group, our physicians are trained to utilize cutting-edge testing and innovative treatments to uncover and address the underlying cause of fibromyalgia. If you are experiencing symptoms of fibromyalgia, but aren’t getting the treatment you need, call us at 877-508-1177 to see how we can help you!


1. Kent Holtorf, MD. “A Confounding Condition.”
2. Kent Holtorf, MD. “Chronic Fatigue Syndrome and Fibromyalgia; Now Treatable Diseases.”
3. Kent Holtorf, MD. “Cycle of Dysfunction in CFS/FM.”
4. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).” Journal of Chronic Fatigue Syndrome, Vol. 14:3 (pub) 2008.
5. Kent Holtorf, MD. “Are All Chronic Fatigue Syndrome and Fibromyalgia Patients Low Thyroid?”
6.Kent Holtorf, MD.“Growth Hormone Treatment of FM and CFS.”
7. Kent Holtorf, MD. “Hypercoagulable State and Chronic Fatigue Syndrome and Fibromyalgia.”
8. Kent Holtorf, MD. “Infectious Causes of Chronic Fatigue Syndrome.”
9. Kent Holtorf, MD. “Kent Holtorf, M.D. on Treating Chronic Fatigue Syndrome & Fibromyalgia.”
10. Kent Holtorf, MD. “New Standard for the Treatment of Chronic Fatigue Syndrome and Fibromyalgia.”

Understanding Fibromyalgia: The Invisible Disorder was last modified: June 4th, 2019 by Holtorf Medical Group

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