Genetic Predisposition in Fibromyalgia & CFS

Can They Run in Your Family?

Illustration shows a double helix strand of DNA/
Some people worry that their illness will be passed on through their DNA.. Science Photo Library - PASIEKA/Getty Images

It's common for multiple people in one family to have fibromyalgia (FMS) and/or chronic fatigue syndrome (CFS or ME/CFS). So does that mean it's genetic?

Not exactly. In a genetic disease, if you inherit the responsible gene(s) from your parent, you have (or later develop) the disease. It's just a matter of having that gene. That's not how it works with these conditions.

Most experts believe that FMS and ME/CFS are related to a genetic predisposition, which means that certain genes increase a person's risk of developing a given condition, but they don't make it a foregone conclusion.

Other factors would have to be involved in order to trigger the illness in you.

For example, multiple things in my life may have contributed to my developing fibromyalgia, including:

  • Chronic pain from age 10 due to myofascial pain syndrome and a significant back injury;
  • Life-long, treatment-resistant insomnia;
  • My seeking of high-stress situations (i.e., performing, working in TV news);
  • Hormonal changes from premature menopause.

Any or all of those things may have combined to cause fibromyalgia.

In someone else, genetic predisposition combined with a viral infection or environmental toxin may trigger ME/CFS.

We don't yet know exactly which genes are responsible for predisposing us to these conditions. However, researchers are learning more all the time.

Fibromyalgia & Genetic Research

In June 2015, a study was published (Inanir) that suggested a variant (called a polymorphism) of a particular gene may be related to the development of FMS.

It's called the ACE I/C polymorphism.

Multiple studies report that certain genetic abnormalities are linked with the condition. They'll often be linked to a symptom or cluster of symptoms, but we don't know whether the variants actually cause FMS.

Chronic Fatigue Syndrome & Genetic Research

Much the same is true of ME/CFS research -- genetic variants are found, often linked to certain symptoms.

Some of these changes may eventually help us identify different subtypes of the illness that need to be treated differently. However, in most cases researchers don't know how the variants might increase risk of developing the disease.

One study (Vangeel) sought to determine whether the stress of childhood trauma could lead to Modifications of the genes related to the body's stress-response system (the HPA axis) that were later tied to ME/CFS. (These modifications did not alter the genetic sequence, just the gene's activity.) They found one such modification in a gene called NR3C1, which could indicate that this gene is involved in triggering the condition.

Where That Leaves Us

For now, we're left looking at the tip of the iceberg and trying to glean what meaning we can from a small but growing body of information. Eventually, doctors may be able to perform genetic tests to reveal predispositions to these conditions.

Meanwhile, we do know that if you have close family members with one of these conditions, you have an elevated risk for developing it yourself.

We don't know how to prevent the development of FMS and ME/CFS, but it may help to identify your risk factors and do what you can to mitigate them. These articles can help:

Sources:

Inanir A, et al. Gene. 2015 Jun 15;564(2):188-92. Angiotensin converting enzyme and methylenetetrahydrofolate reductase gene variations in fibromyalgia syndrome.

Rajeevan MS, et al. Human immunolog. 2015 Jun 24. Pathway-focused genetic evaluation of immune and inflammation related genes with chronic fatigue syndrome.

Shimosako N, Kerr JR. Journal of clinical pathology. 2014 Dec;67(12):1078-83. Use of single-nucleotide polyorphisms (SNPs) to distinguish gene expression subtypes of chronic fatigue syndr/emyalgic encephalomyelitis (CFS/ME).

Solak O, et al. Rheumatology international. 2014 Sep;34(9):1257-61. Assessment of opioid receptor mu1 gene A118G polymorphism and its association with pain intensity in patients with fibromyalgia.

Vangeel E, et al. Psychosomatic medicine. 2015 Jul 30. [Epub ahead of print] Chronic fatigue syndrome and DNA hypomethylation of the glucocorticoid receptor gene promoter 1F region: associations with hypothalamic-pituitary-adrenal axis hypofunction and childhood trauma.

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