Findings Link Gut Bacteria and Fibromyalgia

(Credit: Vladislav Muslakov/Unsplash)

POSTED BY JULIE ROBERT-MCGILL

There are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia, report researchers.

Fibromyalgia affects 2-4 percent of the population and has no known cure. Symptoms include fatigue, impaired sleep, and cognitive difficulties, but the disease is most clearly characterized by widespread chronic pain.

“AS PAIN PHYSICIANS, WE ARE FRUSTRATED BY OUR INABILITY TO HELP…”

 As reported in the journal Pain, approximately 20 different species of bacteria were found in either greater or lesser quantities in the microbiomes of participants suffering from the disease than in the healthy control group.

“We used a range of techniques, including artificial intelligence, to confirm that the changes we saw in the microbiomes of fibromyalgia patients were not caused by factors such as diet, medication, physical activity, age, and so on, which are known to affect the microbiome,” says Amir Minerbi of the Alan Edwards Pain Management Unit at the McGill University Health Centre (MUHC), and first author of the paper.

“We found that fibromyalgia and the symptoms of fibromyalgia—pain, fatigue, and cognitive difficulties—contribute more than any of the other factors to the variations we see in the microbiomes of those with the disease,” Minerbi adds.

“We also saw that the severity of a patient’s symptoms was directly correlated with an increased presence or a more pronounced absence of certain bacteria—something which has never been reported before.”

At this point, it’s not clear whether the changes in gut bacteria seen in patients with fibromyalgia are simply markers of the disease or whether they play a role in causing it. Because the disease involves a cluster of symptoms, and not simply pain, the next step in the research will be to investigate whether there are similar changes in the gut microbiome in other conditions involving chronic pain, such as lower back pain, headaches, and neuropathic pain.

The researchers are also interested in exploring whether bacteria play a causal role in the development of pain and fibromyalgia. And whether their presence could, eventually, help in finding a cure, as well as speed up the process of diagnosis.

DIAGNOSIS SOONER?

Fibromyalgia has proved difficult to diagnose. Patients can wait as long as 4 to 5 years to get a final diagnosis. But this may be about to change.

“We sorted through large amounts of data, identifying 19 species that were either increased or decreased in individuals with fibromyalgia,” says Emmanuel Gonzalez, from the Canadian Center for Computational Genomics and the department of human genetics at McGill University.

“By using machine learning, our computer was able to make a diagnosis of fibromyalgia, based only on the composition of the microbiome, with an accuracy of 87 percent. As we build on this first discovery with more research, we hope to improve upon this accuracy, potentially creating a step-change in diagnosis.”

A FRUSTRATING DISEASE

“People with fibromyalgia suffer not only from the symptoms of their disease but also from the difficulty of family, friends, and medical teams to comprehend their symptoms,” says Yoram Shir, the senior author of the paper and the director of the Alan Edwards Pain Management Unit at the MUHC and an associate investigator from the BRaiN Program of the RI-MUHC.

“As pain physicians, we are frustrated by our inability to help, and this frustration is a good fuel for research. This is the first evidence, at least in humans, that the microbiome could have an effect on diffuse pain, and we really need new ways to look at chronic pain.”

The research was based on a cohort of 156 individuals in the Montreal area, 77 of whom suffer from fibromyalgia. Participants in the study participated in interviews and gave stool, blood, saliva, and urine samples, which researchers then compared with those of healthy control subjects, some of whom lived in the same house as the fibromyalgia patients or were their parents, offspring, or siblings.

The researchers’ next steps will be to see whether they get similar results in another cohort, perhaps in a different part of the world, and to do studies in animals to discover whether changes in bacteria play a role in the development of the disease.

Funding for the work came from the Louise and Alan Edwards Foundation and the Israeli Society for Musculoskeletal Medicine. The team also included researchers from McGill University and Université de Montréal, as well as others from the Research Institute of the MUHC.

Source: McGill University

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Vitamin D and serotonin among Fibromyalgia patients.

Clinical association of vitamin D and serotonin levels among patients with fibromyalgia syndrome, was published in the journal Neuropsychiatric Disease and Treatment at the end of May 2019.

Serotonin is a neurotransmitter - one of the most important neurotransmitters in humans.  It is synthesized from the amino acid tryptophan. It has an important role in the brain in physiological responses, such as circadian rhythm, mental processes, mood and cognition.

A decrease in serotonin levels is often found in mood swings, major depression, aggressive behavior, and bipolar disorder.  Many researchers have indicated that FMS is also associated with low serotonin levels.

Vitamin D is an essential vitamin and a deficiency can lead to many musculoskeletal diseases such as osteomalacia, rickets, and osteoporosis. Several studies have linked vitamin D deficiency to FMS. However, studies examining the relationship of vitamin D and serotonin levels in fibromyalgia patients are lacking.

The main goal of this study was to assess the presence of vitamin D deficiency and low serotonin levels among randomly selected FMS patients. They also examined the relationship between vitamin D and serotonin levels and the severity of FMS.

This study investigated the relationship between vitamin D and serotonin levels among people with Fibromyalgia (FMS). There were many conclusions made from the research including:

• indication of an association between FMS and hypertension, with 22.5% of the FMS patients having high blood pressure
• a clear association between obesity and FMS among the patients.
• a negative relationship between the serotonin levels and FIQR scores.
•  improved health of FMS patients is associated with normal serotonin levels.

The primary goal of this study was to evaluate the relationship between vitamin D and serotonin levels and FMS severity.

Methods: Forty participants with fibromyalgia were included in the study.  They were aged 20–60 years and diagnosed with FMS, and selected from a hospital rheumatology clinic.

They had their medical history taken, a physical examination, and laboratory testing in the Rheumatology Department at Al-Ameen Hospital in Taif, Saudi Arabia. 

The revised Fibromyalgia Impact Questionnaire (FIQR) was used to determine the severity of their FMS symptoms.

Results: The results showed that 42.5% of the patients were considered to have mild to moderate fibromyalgia. 

The rest had severe/extreme fibromyalgia. This group was more likely to have lower serotonin levels. The results showed a significant negative relationship between the serotonin levels and FIQR scores (P=0.002). However, no significant correlations were found between the vitamin D levels and FIQR scores (P=0.112).

 Serotonin level according to the FIQR categories,
it shows a significant negative correlation
between serotonin level and FIQR scores.

Conclusion: The findings of this study show that the improved health of FMS patients is associated with normal serotonin levels.

These results support the importance of serotonin medication to improve the symptoms of FMS patients. Given that serotonin levels play a significant role in the FMS diagnosis, doctors should request testing for the serum serotonin level in any patient suspected of having FMS. Finally, increasing the sample size and conducting this study in different regions of Saudi Arabia would be recommended for future studies to enhance our understanding of how serotonin and vitamin D levels influence FMS. Authors of study:  Amin OA, Abouzeid SM, Ali SA, Amin BA, Alswat KA

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Treatment for fibromyalgia?

Fibromyalgia sufferers given fresh hope as common drug ‘eradicates pain’ 

Fibromyalgia – an agonising condition that causes pain all over the body – may be caused by insulin resistance, scientists say.

Sufferers of fibromyalgia and other forms of chronic pain have been given fresh hope following a groundbreaking new health study into how their symptoms could be treated successfully.

Researchers have found that the agonising condition may be caused by insulin resistance, and it could be treated using a common drug taken by diabetics.

Scientists hope their findings could lead to a major change in how chronic pain is treated and potentially save billions in painkillers

Fibromyalgia is a long-term condition that causes pain all over the body and other symptoms such as extreme tiredness, headaches , muscle stiffness and difficulty sleeping.

It can affect even the healthiest and fittest of people, and it has been included in an NHS list of 20 painful illness that can prevent someone from performing daily tasks.

The exact cause is unknown, there is no cure and it is thought to affect about seven times as many women as men.

Celebrities who suffer from the condition include pop star Lady Gaga, actor Morgan Freeman and singer Sinead O’Connor.

Revealing their findings, scientists from the University of Texas said they identified people with fibromyalgia using a common blood test, A1c, for insulin resistance, or pre-diabetes.

During their study they treated fibromyalgia patients with metformin, a drug used to combat insulin resistance in diabetics.

model of the metformin molecule, C₄H₁₁N₅.

All the patients experienced reduced pain, the scientists said.

They also found that the blood glucose levels of all the patients were much higher than the levels in normal people.

Neurology professor Dr Miguel Pappolla said previous studies had overlooked the connection between fibromyalgia and A1c levels.

He added: “The main reason for this oversight is that about half of fibromyalgia patients have A1c (blood glucose) values currently considered within the normal range.

“However, this is the first study to analyse these levels normalised for the person’s age, as optimal A1c levels do vary throughout life.

HbA1c in patients with fibromyalgia versus controls.

“Adjustment for the patients’ age was critical in highlighting the differences between patients and control subjects.”

Pre-diabetes sufferers who had slightly higher A1c values had a higher risk of developing headaches, a symptom of fibromyalgia and other chronic pain disorders, he said.

SOURCE: HEALTH IS FITNESS

READ ORIGINAL REVIEW ARTICLE: Is insulin resistance the cause of fibromyalgia? A preliminary report