Fibromyalgia: a condition that has confounded many doctors and is still known as a mysterious condition. This "mystery" may be getting a little clearer! New research is showing that fibromyaglia may be caused by another, underlying condition.
Originally Posted July 2016
Updated June 2019
Fibromyalgia is the name given to the mysterious illness typically characterized by widespread muscle and joint pain. The original diagnostic criteria from the early 90s revolved solely around the amount of tender points an individual had and their location on the body – learn about fibromyalgia trigger points here. In recent years, however, this criteria has expanded to include a wider range of symptoms including fatigue, cognitive issues, sleep problems, psychological disorders, and other symptoms that often do not appear to have a medical explanation.
Unfortunately, being given a fibromyalgia diagnosis does little to actually help the person, since recognizing and labeling a set of symptoms does not necessarily identify the cause of the condition. This is certainly the case for fibromyalgia as well as the closely related chronic fatigue syndrome – learn about the difference between fibromyalgia and CFS. With no clear-cut testing and no apparent cause, these patients have often been dismissed by physicians as being “hypochondriacs” and referred out for psychiatric care. Thankfully, this is beginning to change. Ongoing research and clinical experience have offered new insight into potential underlying causes and mechanisms involved in these illnesses.
Interestingly, some physicians have recognized overlap and similarities between fibromyalgia symptoms and those related to persistent Lyme disease and other tick-borne illnesses. Lyme disease expert Dr. Richard Horowitz explained in an article for Psychology Today that in the 12,000+ patients he has treated, chronic infection with Borrelia burgdorferi and other tick-borne pathogens was at the root of fibromyalgia symptoms in many of them. And in 2012, a study published in the Journal of Clinical and Experimental Rheumatology stated that patients with Lyme disease and other chronic infections (such as Human ImmunoDeficiency Virus (HIV), Hepatitis C Virus (HCV), and parvovirus) have a higher prevalence of fibromyalgia and chronic pain than the rest of the population.
These findings make sense when we consider that standard testing for Lyme disease misses up to 90% of cases and the Centers for Disease Control now recognizes that it may affect ten times the number of people originally thought to be infected. Many of these patients either test negative on the standard testing or are never tested in the first place and therefore may be given a fibromyalgia diagnosis when they actually have persistent tick-borne infections.
Another reason these patients have traditionally received inadequate treatment is the “one cause for one illness” mentality (known as Pasteur’s postulate) that is still prevalent among many in the medical community. As we learn more, it is becoming clear that conditions like fibromyalgia and chronic fatigue syndrome are complex, and thus exceptions to this theory. So while the discovery of chronic infections in these patients is a huge step in the right direction, it is only one piece of a much larger puzzle.
Dr. Horowitz coined the term “Multi-Systemic Infectious Disease Syndrome” to describe the sixteen known overlapping contributors, triggers, and disease processes – any combination of which could be keeping an individual sick with symptoms associated with fibromyalgia or chronic fatigue syndrome. Tick-borne infections are, in fact, number one on the list. A multi-factorial model for treating them is necessary and would include detecting underlying infections, hormone imbalances, exposure to toxins, alterations in the stress response, sleep disturbances, digestive issues, and dysfunction in energy production. Treatment is individualized and aimed at addressing these various malfunctions using a combination of antimicrobial medications, nutritional supplements, and other treatments that target both symptoms and root causes.
The results of the approach (which is used in our clinics) are so impressive that a study was published in the Journal of Chronic Fatigue Syndrome documenting the success of the treatment protocol with 500 consecutive patients. Their energy and sense of well-being had doubled on average by the fourth visit and 94% had improvement in their symptoms overall. Thousands of other patients have had success with this type of protocol as well, under the care of physicians trained in this model of treating these complex conditions.
If you have been diagnosed with fibromyalgia or chronic fatigue syndrome, you may be dealing with infection with Borrelia burgdorferi and other co-infections as a root cause of your symptoms.
1. Kent Holtorf, MD. “A Confounding Condition.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/A_Confounding_Condition.pdf
2. Kent Holtorf, MD. “Chronic Fatigue Syndrome and Fibromyalgia; Now Treatable Diseases.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Chronic_Fatigue_syndrome_and_Fibromyalgia_now_treatable_diseases.pdf
3. Cassisi, G et al. “Chronic widespread pain and fibromyalgia: could there be some relationship with infections and vaccinations?” Clin Exp Rheumatol. 2011 Nov-Dec; 29 (6 Suppl 69): 5118-26. Epub 2012 Jan 3.
4. Kent Holtorf, MD. “Lyme Disease Often Missed as a Cause of CFS.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Lyme_Disease_Often_Missed_as_Cause_of_Chronic_Fatigue_Syndrome.pdf .
5. Horowitz, R. “Are Your Fibromyalgia Symptoms Due to Lyme Disease?” Psychology Today.
6. Kent Holtorf, MD. “Infectious Causes of Chronic Fatigue Syndrome.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Infectious_Causes_of_Chronic_Fatigue_Syndrome_and_Fibromyalgia.pdf
9. Kent Holtorf, MD. “Kent Holtorf, M.D. on Treating Chronic Fatigue Syndrome & Fibromyalgia.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Kent_Holtorf_MD_on_Treating_Chronic_Fatigue_Syndrome_and_Fibromyalgia.pdf
10. Kent Holtorf, MD. “New Standard for the Treatment of Chronic Fatigue Syndrome and Fibromyalgia.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/New_Standard_for_the_Treatment_of_Chronic_Fatigue_Syndrome_and_Fibromyalgia.pdf