Neurotransmitters in Fibromyalgia & Chronic Fatigue Syndrome

What's Going On in Your Brain?

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Fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) long remained mysteries to medical science, and we're just now getting a picture of what's going on in the body, and especially the brains, of people with these conditions. One thing that research has shown, time and time again, is that when you have FMS or ME/CFS, several of your neurotransmitters are out of whack.

In fact, if you look at the various functions of these neurotransmitters, it quickly becomes clear why we have the symptoms we do.

These are complex illnesses that involve several systems, but the neurological component is an important one.

Neurotransmitters: What They Are & What They Do

Your brain is made up of billions of cells called neurons that communicate with each other to control everything that goes on in your body. Communication between neurons relies on brain chemicals called neurotransmitters, which create and control signals. Thanks to neurotransmitters, messages race through your brain at lightning speed.

Each bodily function, thought, and emotion is linked to the operations of specific neurotransmitters. When the activity of a particular one is too high or too low, things can start to malfunction. FMS and ME/CFS have been associated with irregular activity of these neurotransmitters:

Every time you feel an itch, hear a noise, move a muscle, learn something, or experience an emotion, these chemicals are, at least in part, responsible.

In addition, they tell your heart to beat, your lungs to breathe, and your stomach to produce digestive enzymes, all without your having to think about it.

You often hear about these conditions involving "low levels" of neurotransmitters, but we don't actually have proof that they're low. They could be low; they could be plentiful but used inefficiently; they could be plentiful, but have receptors (connecting points on neurons) that don't work properly.

Since we're not sure which it is, it's more accurate to say they're dysregulated or that the activity is low rather than the levels.

  • Serotonin: Low Activity
    Probably the best-known neurotransmitter, serotonin helps regulate the sleep cycle, pain processing, body temperature, appetite, sex drive, and mood. Serotonin function is altered by the most common drugs and supplements taken for FMS and ME/CFS, including antidepressants, anti-seizure drugs, SAM-e, 5-HTP, St. John's Wort, and Rhodiola Rosea. Your body uses serotonin to produce melatonin, which helps you fall asleep.
    Learn more: Serotonin
  • Norepinephrine (NE): Low Activity
    Also called noradrenaline, NE is involved in the "fight or flight" response (your body's natural response to threats), alertness, and memory. Your body uses NE to produce another neurotransmitter called dopamine. NE is boosted by a class of antidepressants called serotonin norepinephrine reuptake inhibitors and by the supplement l-theanine, which is derived from tea. When you get that feeling of accomplishment for getting something done? That's norepinephrine.
    Learn more: Norepinephrine
  • Dopamine: Low Activity
    Dopamine gets more attention in movement-based disorders such as Parkinson's disease, but along with movement, it's involved with mental focus and motivation. This is the chemical responsible for giving you a feeling of reward when you do something well, or even when you eat something that's decadently satisfying. Dopamine activity gets a boost from the drug levodopa and from l-theanine.
    Learn more: Dopamine
  • GABA: Low Activity
    Short for gamma-Aminobutyric acid, GABA is responsible for calming the mind, helping you relax and sleep, countering anxiety, and muscle function. If you have insufficient GABA activity, your brain cells may be unable to calm down. Serotonin can influence GABA creation, so GABA activity may be increased by treatments that regulate serotonin. You can buy GABA supplements, but they're not believed to get past the blood-brain barrier. GABA's counterpoint is glutamate.
  • Glutamate: Activity Sometimes Low, Sometimes High
    This one is responsible for stimulating your mind so you can learn, focus, and form memories. It can make your mind race, which is great when you're studying for a test but not so great when you're trying to sleep. In ME/CFS, it's hypothesized that glutamate function is low, but some evidence shows that it's excessive in FMS. Without sufficient GABA activity to counter it, glutamate keeps on stimulating and can become an excitotoxin, meaning it stimulates neurons to death.
    Learn more: GABA & Glutamate

Neurotransmitter function is hard to measure. Most labs don't perform such tests and most insurance companies don't cover them. Doctors typically diagnose neurotransmitter abnormalities based on symptoms, which is one of many reasons you may want to keep a symptom diary.

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