Updated: June 2023
Fibromyalgia patients ALL complain of one common symptom: Chronic Fatigue. It makes sense when you really understand some of the most common underlying causes of fibromyalgia.
In this article, I will discuss fibromyalgia and the debilitating effects of lost quality of life due to the tremendous amounts of fatigue associated with “fibro”. Fatigue is so common with fibromyalgia that the way it makes people feel is often called “Fibro Fog”.
It is sad that a condition has become so pervasive in society that when the term “fibro fog” is mentioned, most people know what it is whether they have fibromyalgia or not.
What does that tell us? It tells us that poor health is pervasive and that our current healthcare system isn’t solving many of the chronic and persistent conditions that affect millions of people.
Additionally, I believe that fibro fog could be a possible precursor for dementia and other forms of decreased cognitive function. There haven’t been any studies that I’m aware of about long term fibro fog leading to dementia. But, it seems reasonable that fibro fog could lead to brain dysfunction and/or cognitive decline over time.
Can Fibro Fog be a Precursor or an Early Indicator of Dementia?
An inflamed brain is a suppressed and depressed brain. The pain associated with fibromyalgia is often described as random, achy, nerve impulses, and other symptoms. It’s safe to say that pain in general goes with fibromyalgia. Just ask someone who has fibromyalgia and the will tell you.
Physiologically and anatomically, the brain has its own immune system made up of white blood cells called “microglia”. Microglia clean up debris that make it into the brain. These white blood cells are the garbage collectors and help the brain be as healthy as possible.
It is also the microglia that can cause an upregulation of the immune system overall and possibly create detrimental effects on the brain and central nervous system, so I don’t think that it is a far reach. Do you?
Could an Infection cause Fibromyalgia?
Fatigue is what many people describe as tiredness. Fibromyalgia sufferers describe something totally different – extreme, unrelenting fatigue and a lack of energy to do almost anything.
A cause of possible fatigue associated with fibromyalgia is a chronic infection. A bacterial, fungal, parasitic, candida, or viral infection could all sap much needed energy from the body and cause chronic fatigue.
I’ve seen it many times where patients will have signs of an infection on their blood chemistry. I lay out strategies for them to become healthier and less inflamed and they feel better with much less fatigue. This happens over and over again.
I think that many people don’t realize how an infection can affect the nervous system and brain. Take a urinary tract infection for example. Most people are aware that a “UTI” can cause burning and discomfort while urinating, frequent urination, bloating, itching, etc…
But, a urinary tract infection is the number one cause of rapid onset dementia in a senior citizen. So, an infection down by the waist can cause the brain which is about 2 ½ to 3 feet away from the site of the infection to malfunction.
Using this example, it should be very easy to see how a chronic infection could pull down the entire nervous system and cause fatigue. Lyme’s disease would be another example. So is “mono” caused by the Epstein Barr virus. Chronic fatigue and tiredness are the main symptoms described by patients who suffer from mono.
What are Signs of an Infection on Lab Testing?
Some signs of possible chronic infections could be changes in white blood cell count. Neutrophils, lymphocytes, monocytes, eosinophils, and basophils are all types of white blood cells that have specific roles in the immune system.
Infections can cause fatigue by breaking down body systems, creating inflammation, and stimulating an immune response. All of which require energy. Energy the body may have used elsewhere if there wasn’t an infection.
Viruses are well known for their associated fatigue. In general, viruses have a tendency to elevate a type of white blood cell called lymphocytes. It is common for lymphocytes to elevate with an acute viral response. But, lymphocytes can sometimes go low when a chronic viral infection is present.
Probably the most common virus that is known for causing extreme fatigue is the Epstein Barr Virus (EBV). The EBV is also called “Mono” which is short for mononucleosis.
Remember how a couple of paragraphs ago I said that one of the possible signs of an infection (on blood work) is an elevated monocyte count? Epstein Barr Virus elevates monocytes throughout the body because monocytes are the type of white blood cells that are the most activated with “mono”.
This becomes important for fibromyalgia sufferers and other people who deal with unrelenting chronic fatigue because of the ability of an acute viral infection to become a chronic infection. An acute infection is the initial response and can be brutal for some. But, many people have a harder time dealing with the long term aspects of an infection that persists.
How could an Infection cause Fatigue?
Chronic infections are different than acute infections. Acute infections are when you first get sick. Chronic infections happen after the initial storm has passed. Sometimes the symptoms of the acute infection are extreme and sometimes they aren’t. The residual effects of chronicity can persist for weeks, months, years, decades, and for some – a lifetime.
Think of this: How do people feel when they get the flu? They feel miserable with no energy or desire to do anything. Kind of like fibromyalgia isn’t it? However, the flu is a perfect example of an acute viral infection.
Turn the flu down a notch or two and that is what fibromyalgia feels like. Instead of an acute viral infection, a low grade chronic viral infection can persist. The symptoms may not be as strong but they can still be there.
Fact: viruses can cross the blood brain barrier. The blood brain barrier is in the brain and protects the brain.
Why is a Strong Blood Brain Barrier Important?
The blood brain barrier is made up of cells called oligodendrocytes. Some people have a weak blood brain barrier and others have a strong blood brain barrier.
A large part of what determines if the blood brain barrier is strong or not is dependent on how tightly packed the oligodendrocytes are. If the oligodendrocytes are packed tightly, it’s a strong blood brain barrier and if they are loosely packed, it is considered weak.
An example would be someone who is especially sensitive to a drug such as caffeine. Caffeine is a central nervous system stimulant. However, it will affect some people more than others.
The same holds true for some medications and even chemotherapy. If the blood brain barrier is tightly packed in with oligodendrocytes, then certain drugs, medications, and other substances simply can’t make it through the tightly packed cells and get into the brain.
If the oligodendrocytes are loosely wrapping around the blood vessels of the blood brain barrier, substances can go through the gaps and make it into the brain. This is true of all substances, not just caffeine.
How can the Strength of the Blood Brain Barrier affect the Thyroid and cause Fatigue?
Viruses can make it across the blood brain barrier and affect part of the brain called the hypothalamus. Viruses can down regulate the paraventricular nuclei of the hypothalamus which can be the epicenter for fatigue.
The hypothalamus is the part of the brain that sends signals to the pituitary gland. The pituitary gland makes a hormone called Thyroid Stimulating Hormone (TSH). TSH signals the thyroid gland to make thyroid hormones.
When there is suppression of the hypothalamus, there is less stimulus to the pituitary gland and therefore, less signaling to the thyroid in general. Low thyroid hormones in the body is a sign of hypothyroidism.
The thyroid gland has major influence on metabolism and energy levels. Hypothyroidism has various signs and symptoms such as hard dry skin, fatigue, difficulty in losing weight, coarse hair, fungal toe nails, constipation, thinning hair, loss of the outer 3rd of the eyebrows, etc…
Hashimoto’s thyroiditis which is the autoimmune disease that creates a hypothyroid state has been widely linked to the Epstein Barr Virus. By now, it shouldn’t be stretch or seem too far fetched that a chronic viral infection could drive fatigue.
I believe that most cases of fatigue have a chronic infectious component. I’ve seen it too many times on lab testing. I’ve also worked with many fibromyalgia patients and helped them live much better lives.
I hope you enjoyed this article and that you check back often for more. There are a lot of people who need help and don’t know where to turn for answers. You are welcome to go to my “Become a Patient” page to fill out your application.
It’s never too late to begin the process of getting back to being the real you.
Health is Happiness,
Dr. Keith Currie