"I believe there is significant overlap between FM and CFS"
future research and treatment
BAD NEWS: 25% improve over time, 39% get worse
GOOD NEWS: increased scientific interest -- there were 600 papers on fibro last year
Central nervous system? or muscles? brain? spinal cord?
Central Sensitivity Syndrome = brain and spinal cord
pain is our alarm system, and fibro is a broken alarm
the flu produces a sickness response -- your immune system does that to you on purpose
microglia protect us from everything -- they change shape, pro-inflammatory chemicals make neurons make you feel bad -- they function to make you rest so your body can divert all resources to fight infections
what if the microglia dysregulate? get stuck "on"
similarity between fibromyalgia and sickness response hints that they're related
primed, hair trigger, easy to activate, reaction to something that's not supposed to
we can't directly test this, can't get into the brain
CSS? undiagnosed other? SFPN? CSF leak? Vitamin D deficiency?
N.B. -- once you get a CFS/fibro diagnosis, all other testing stops
SFPN -- starts more distant from the heart, and treatment differs from fibro
pain worse, leptin rises -- chicken/egg
brain imaging -- some regions of brain are changing -- pain and emotion areas are shrinking -- this may be an adaptation rather than the cause
PET -- tracer is soaked up by activated microglia -- this has been tested in MS
brain temperature
TREATMENTS:
low dose naltrexone -- prevents microglia from reacting as strongly -- 50%+ improve
fluorocitrate
minocycline
ibudilast (AV 411)
dextromethorphan
3-hydroxymorphinan
some herbs suppress microglia, but this has not been tested in fibromyalgia
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