Current thoughts on fibromyalgia and the immune System
I have seen many research papers and articles claiming to have solved the puzzle as to what fibromyalgia actually is and what causes it. I have explored this myself from a social science perspective, from which the prevailing view is that fibromyalgia is triggered by trauma and may also be associated with a particular personality type. However, it seems obvious to me, that fibromyalgia is not a single condition with a single aetiology, but is probably many different conditions which present with similar symptoms. I also think that, when it cooccurs with ADHD and / or autism, in many cases it is actually a Hypermobility Spectrum Disorder (HSD), such as Ehlers-Danlos Syndrome (hEDS).
Anyway, as I was recently going through the rather large pile of research papers I have accummulated, I came across an article by Dr John Lowe, which concludes that, in many cases, fibromyalgia is actually a manifestation of hypothyroidism. He specifies that a large percentage of fibromyalgia sufferers have high levels of ‘anti-thyroid antibodies’, but because their thyroid stimulating hormone (TSH) is within the normal range, they are deemed not to require treatment. The presence of anti-thyroid antibodies means that a person has ‘Hashimoto’s’, which is an autoimmune disorder. Although I had not given it much thought, I realised that I fall into this category, as a private thyroid blood test I had done a couple of years ago showed that my thyroid peroxidase antibodies were 522 (‘normal’ is anything less than 34), whereas my TSH was within the normal range.
Furthermore, it is very interesting that thyroid issues are not only associated with fibromyalgia, but also with ADHD. At least one research paper suggests that children with ADHD are more likely to have ‘generalised resistance to thyroid hormone’ (5.4%) than those without ADHD (less than 1%). So, this leads me to question whether, at least in some cases, there is a genetic issue affecting the thyroid, which leads to the development of both ADHD and fibromyalgia symptoms? Of course, I could be jumping to the wrong conclusion here, because I don’t know how anti-thyroid antibodies and resistance to thyroid hormone actually relate, if at all.
Nevertheless, as I think the link between ADHD and fibromyalgia is likely to be multi-faceted, I have also started to question the role of the immune system as a whole, because as well as autoimmunity, immune deficiencies, in particular igG subclasses 1 and 3, are also linked to fibromyalgia. Symptoms of immunoglobulin G (igG) deficiencies include recurrent upper respiratory track infections, ear infections and gastrointestinal infections (Johns Hopkins Medicine, 2022). Although I have no proof of whether I am also affected by this issue, I did suffer from recurrent ear infections as a child, which left me with eustachian tube dysfunction, tinnitus and hearing loss. I was also a ‘difficult’ baby (pretty much as described in this article about signs of ADHD in babies), which was thought to be, in part, due to gastrointestinal issues. Interestingly, my youngest niece, who also has ADHD, was also a ‘difficult’ baby, who suffered from an immature digestive system.
So, how does all of this fit with other theories about fibromyalgia, especially how it is triggered by physical and emotional trauma? There is plenty of evidence of how stress, particularly chronic stress, can cause immune system dysregulation, and it makes sense, therefore, that fibromyalgia could also be triggered in people without previous immune issues. In other studies it is suggested that personality traits such as perfectionism and neuroticism may also lead to the development of fibromyalgia in women.
However, I would like to propose a different scenario. In some cases, could an immune system disorder lead to recurrent infections and metabolic issues (relating to the thyroid), presenting as ADHD-like behaviours? For example, ear infections can lead to auditory processing, social and academic difficulties. Is it any suprise, therefore, that a child with such difficulties would become neurotic and perfectionist in order to compensate?