Is Fibromyalgia an Autoimmune Disease?

Fibromyalgia Is (Probably) Not Autoimmune

Discussing symptoms with a doctor.
JLPH/Getty Images

Fibromyalgia is not currently classified as an autoimmune disease. However, we can't definitively say it's not one since we still don't know the underlying cause(s) of the condition. It's possible that future studies may discover that autoimmunity plays a part in some or all cases.

Fibromyalgia affects an estimated five-million adults in the United States. Autoimmune diseases can, and frequently do, occur alongside it.

Additionally, some autoimmune diseases, such as lupus, have symptoms that are strikingly similar to fibromyalgia.

Because fibromyalgia was once believed to be an arthritis-related condition, and many types of arthritis, such as rheumatoid arthritis (RA), are autoimmune diseases, the assumption used to be that fibromyalgia fit into this category. Research, though, has pointed in different directions.

Why Isn't Fibromyalgia an Autoimmune Disease?

Some research suggests that the immune system in fibromyalgia may tend to have some irregularities, such as being chronically overactive. Some people believe that means it's autoimmune, but in fact, these are two different types of immune dysfunction.

First, it's important to understand what autoimmunity is.

In autoimmune disorders, the immune system mistakes a particular tissue or structure in the body for a dangerous invader, such as a virus or bacteria.

It then attacks that tissue or structure in an attempt to destroy it. That process typically causes damage and inflammation at the site.

In laboratory tests, people with fibromyalgia typically have low inflammatory markers, while autoimmune diseases are associated with high inflammatory markers. So far, researchers haven't found much evidence of damage, either.

So that turns the tide of thought away from autoimmunity.

However, emerging research may have the attention back in that direction. It shows that certain nerve structures, including the optic nerve, are sometimes damaged in fibromyalgia. So far, we don't know why or how prevalent this damage is. That means whether this is evidence of autoimmunity remains to be seen. It's certain to be looked at as one possible cause, though.

Causes of Fibromyalgia

No particular trigger has been shown to spur the onset of fibromyalgia. Clinicians believe there are a variety of causes, including:

  • emotional trauma
  • viral infections
  • physical injuries

More and more, fibromyalgia is being called a neuroimmune disorder or a central sensitivity syndrome.

Brain Chemicals & Hormones

Fibromyalgia patients typically exhibit abnormalities in brain chemicals as well as hormonal abnormalities. At this point, though, no singular pattern has emerged among patients. Although these imbalances are associated with fibromyalgia, there is no clinically conclusive evidence they cause this disorder.

Brain chemical and hormonal imbalances common in fibromyalgia include: 

  • reduced opioid receptor activity in the parts of your brain that regulate mood and the emotional aspects of pain

Other Common Symptoms of Fibromyalgia

As you now know, there is no singular pattern of symptoms for fibromyalgia. However, a group of symptoms is common in many patients and include:

Similar Diseases

RA and lupus are two autoimmune diseases that may present symptoms similar to fibromyalgia. Others may be similar as well, depending on the particular fibromyalgia symptoms that are present.

Additionally, fibromyalgia may also co-occur with both of these diseases, meaning you can have both at the same time. A correct diagnosis is important to an effective treatment plan.

RA and lupus, however, do have diagnostic markers that doctors can look for when making a diagnosis. They're both associated with inflammation and damage.

A Word from Verywell

We'll need a lot more research to determine whether fibromyalgia belongs in the autoimmune category. Until we know for sure, doctors are unlikely to prescribe common autoimmune treatments, such as drugs that suppress the immune system, for this condition.

As more research comes it, we'll gain a clearer picture either way.

Sources:

Garcia-Martine E, Garcia-Campayo J, Puebla-Guedea M, et al. Fibromyalgia is correlated with retinal nerve fiber layer thinning. PLoS One. 2016 Sep 1;11(9):e0161574.

Pilar Bambo M, Garcia-Martin E, Gutierrez-Ruiz F, et al. Study of perfusion changes in the optic disc of patients with fibromyalgia syndrome using new colorimetric analysis software. Journal francais d'opthalmologie. 2015 Sep;38(7):580-7.

Uceyler N, Zeller D, Kahn AK, et al. Small fibre pathology in patients with fibromyalgia syndrome. Brain: a journal of neurology. 2013 Jun;136(Pt 6):1857-67.

Continue Reading