I think I speak for most fibromyalgia patients when I say we yearn for physicians and the general public to realize what we have known all along–that fibromyalgia is a real disease. We are not “just tired” or “just stressed out and just need to learn how to relax.” Our symptoms of pain, fatigue and non-restorative sleep (and many others) are not imagined. A definitive blood test would help silence the skeptics and legitimize our condition.
For fibromyalgia to be recognized as a disease (and not just a collection of symptoms) not only does there need to be an “identifiable group of signs and symptoms” attributable to fibromyalgia but “consistent anatomic alterations” must be found.*
Does the answer lie within our immune system? Years ago researchers began to hypothesize that certain immune system proteins (chemokines and cytokines) might be affected in people with fibromyalgia, so much so that the blood levels of these proteins might be different in their blood. If the pattern is unique in fibromyalgia patients could this be demonstrated in a blood test?
Dr. Paul St. Amand and the researchers at the City of Hope published a study in the Journal of Experimental Biology and Medicine (6/5/2008), entitled “High plasma levels of MCP-1 and eotaxin provide evidence for an immunological basis of fibromyalgia.” MCP-1 and eotaxin are types of cytokines and chemokines. This study found that these two proteins were elevated in the blood of people with fibromyalgia, and when 2 additional cytokines (tumor necrosis factor alpha and interferon gamma) were factored into the testing the diagnostic probability of a person with this blood protein pattern having fibromyalgia rose to somewhere between 70-80%. More information on this study can be found on Dr. St. Amand’s website at www.fibromyalgiatreatment.com. The researchers found that the people in the study who were treated with guaifenesin for at least 3 months (as part of Dr. St. Amand’s guaifenesin protocol) had higher levels of eotaxin than those not treated with guaifenesin. This indicates that guaifenesin has distinct effects on cytokines, an intriguing finding.
This week the March/April 2013 edition of “Fibromyalgia and Chronic Pain LIFE” reported that Dr. Bruce Gillis and the researchers at the University of Illinois at Chicago have developed a commercial blood test to diagnosis fibromyalgia, using differences in the chemokine and cytokine levels in the blood of over 200 people with fibromyalgia as compared to people without the syndrome. This test (called FM/a) is expensive ($774) but is reported to be more than 93% sensitive diagnostically and may actually save patients time and money if they are able to get a definitive diagnosis more quickly (Dr. Gillis notes that on average fibromyalgia patients spend 5 years and thousands of dollars before they receive a fibromyalgia diagnosis). For more information about the test, go to www.thefmtest.com.
So do we break out the champagne? Can we yell, “I told you so!” to all the naysayers? Could the FM/a test be the game changer we have been looking for–a reliable easy to obtain blood test that accurately diagnoses fibromyalgia? Maybe. Time will tell. I am cautiously optimistic. Even though Dr. St. Amand and practitioners trained by him (such as myself) can accurately make the diagnosis of fibromyalgia very quickly using a targeted muscular exam of the anterior thighs (for much less than $774!) we can’t possibly examine everyone in the world who wants to know if they have fibromyalgia. An accurate blood test would be helpful in some instances.
An accurate blood test may make the earlier diagnosis of fibromyalgia a reality. If we look back, most of us with fibromyalgia were having symptoms beginning in childhood or early
adulthood. Wouldn’t it be wonderful if we knew back then that we had fibromyalgia so we could begin treatment? Wouldn’t we love to have back all the days we were too fatigued or in too much pain to work, to attend school, to socialize with friends or to participate in family activities?
When fibromyalgia is recognized as a legitimate disease and diagnosis is made earlier perhaps a wider range of treatment options will then be discussed. Too often doctors hand patients Lyrica samples and do not have the time of the ability to discuss a wider range of treatment options–many of which can be more effective with fewer side effects than Lyrica type drugs (but that is the topic for my NEXT blog post!)
*”What’s the difference between a disease and a syndrome? And how it applies to Fibromyalgia and Chronic Fatigue Syndrome.” by Adrienne Dellwo in About.com Guide Updated March 29, 2012