Environmental Factors as Possible Fibromyalgia Triggers

With fibromyalgia syndrome (FMS) there is nothing certain at this point in terms of defining specific causes. It sometimes appears that the more you know the less you actually know. While research continues to study this disease, more questions than answers arise concerning possible causes. Consider one of the more recent research areas – the environment. Medical professionals are questioning whether environmental factors possibly trigger fibromyalgia.

Following are some of the questions being asked among medical researchers.

Are environmental factors possible triggers of fibromyalgia?

Are environmental factors really considered to be possible triggers of fibromyalgia? Based upon the complex nature of fibromyalgia, this is a question that results in a qualified “yes” as an answer. The environment may trigger FMS. Some researchers describe it as an environment-associated pathology, including it as part of a group collectively named idiopathic environmental intolerances (IEI). Other medical conditions included in IEI are chronic fatigue syndrome and multiple chemical sensitivity.[1] The conditions have in common the fact they are presented by a person having an over-reaction or unusual reaction to environmental factors and substances. These responses do not cause the same responses from person to person.

What are possible environmental triggers?

Research indicates that it is exposure of the individual to various metals and inorganic and organic chemicals at lower-than-toxic doses that may possibly trigger fibromyalgia. In many instances, the studies also indicate that patients have a genetic predisposition. In twin studies, if one twin has fibromyalgia, the other twin has a 20-30% chance of also having fibromyalgia. While there is clearly a gentic link, environmnental factors also play a role. Environmental triggers may also include diet, and other factors like pet dander.

Yet, environmental stressors need not always be physical. They can also be social. Your social environment is as important in helping you maintain your health as is your physical world. One of the most important factors in creating potential health problems is stress. Your working or home environments may be highly stressful situations, and stress can increase the risk of developing a number of diseases like cardiovascular disease and high blood pressure. It is quite possible that stress may also contribute to the development of FMS.

Is there a close relationship between FMS and environmental factors?

How close is the relationship of fibromyalgia and the environment? Indeed, research does indicate that the cause of fibromyalgia is based on the interaction that arises between two distinct factors: genetic susceptibility and the environment.[2] Further research is required to understand the exact link, but the evidence is becoming substantial in support of this theory.[3]

Studies on various IEI, including fibromyalgia, investigated the impaired biological mechanisms as well as the detoxification of both endogenous toxins and xenobiotics.[4] The role of enzymes in the process has been examined. The data indicates that the abnormal expression of the enzymes involved results in metabolic injury or defective action and, as a result, leads to the negative health outcome now commonly referred to as IEI. Such research aims to help scientists and medical professionals by providing them with more specific information on how to provide a treatment regime that will prove effective in the treatment of FMS and other types of IEI.

How is treatment approached?

The involvement of both an individual’s genetic make-up and diverse environmental factors indicates that treatment for fibromyalgia must be done on a case-by-case basis. If you have FMS, your physician must take into consideration your individual symptoms and address these in accordance with an evidence-based approach. This will result in a suitable treatment involving both pharmacological and non-pharmacological methods.

Simply put, it means your doctor will discuss with you your specific symptoms. Using a symptoms-based approach, he or she will then consider what factors are at work – including environmental aspects like stress, chemical exposure and many others. The result should be a combination of pharmacological treatments, drugs and other medications that will address the symptoms including pain, and non-pharmacological methods. The latter involves exercise and cognitive behavioral therapy.[5]

If the environment is a factor, how do you treat fibromyalgia?

Research into FMS has resulted in uncovering the multifaceted problems or elements that appear to act as causal factors – a combination of neurobiological, psychological and behavioral factors.[6] The information gleaned from studies also indicates that you cannot approach treatment in a linear fashion. A newly developed approach is actually a type of alternative or complementary medicine named environmental therapy.

Environmental therapy has also been referred to as environmental medicine and clinical ecology. It focuses only on the diagnosis and treatment of diseases and various other medical issues resulting from environmental factors such as FMS and other IEIs. Researchers and therapists who adopt this approach consider the major environmental factors that may cause a negative reaction. These include: various toxic chemicals, pharmaceuticals, pesticides, herbicides, food allergens, pollens, animal dander, mould, vehicle exhaust and the smoke from tobacco products. The practitioner will also look at your diet, specifically your intake of corn and dairy products, although meat, nuts and even fruit and vegetables will come under scrutiny, with the purpose of determining a dietary trigger for your physical reactions.

Once the factors are identified as being the possible sources or trigger of fibromyalgia, you will be asked to remove them as much as possible from your diet or your environment. You will stop eating a particular food or remove the chemicals from your home or avoid contact with particular substances at work. In addition, your practitioner and/or therapist may suggest other complementary therapies or medical practices. These may include Traditional Chinese Medicine (TCM), homeopathy, Reiki and related forms of alternative medical therapy and practice.

Will these methods work?

The complicated nature of FMS and the need to address each case with an individual approach means the ability of specific methods to reach optimal results is not uniform. The validity of applying environmental therapy remains questionable among most medical practitioners. There is also still some dispute concerning a single method for treating fibromyalgia. While some doctors are quick to adapt to newer and less conventional methods that may exclude the use of drugs, other doctors believe in following a more strict protocol. You need to talk to your doctor and learn which treatment regime is considered most effective for your situation.

References

[1] De Luca, C; Scordo, G; Cesareo, E; Raskovic, D; Genovesi, G; and Korkina, L (2010). “Idiopathic Environmental Intolerances (Iei): From Molecular Epidemiology to Molecular Medicine.” Indian J Exp Biology, 48(7):625-35.

[2] Becker, RM; da Silva, VK; Machado Fda, S; dos Santos, AF; Meireles, DC; Mergener, M; dos Santos, GA; and de Andrade, FM (2010). “Association between Environmental Quality, Stress and APOE Gene Variation in FMS Susceptibility Determination.” Rev Bras Reumatol, 50(6):617-24.

[3] Arnold, LM (2010). “The Pathophysiology, Diagnosis and Treatment of FMS.” Psychiatr Clin North America, 33(2):375-408.

[4] Korkina, L; Scordo, MG; Deeva, I; Cesareo, E; and De Luca, C (2009). “The Chemical Defensive System in the Pathobiology of Idiopathic Environment-Associated Diseases.” Curr Drug Metabolism, 10(8):914-31.

[5] Bradley, LA (2008). “Pathophysiologic Mechanisms of FMS and its Related Disorders.” J Clin Psychiatry, 69 (Suppl 2):6-13.

[6] Clauw, Dj; and Crofford, LJ (2003). “Chronic Widespread Pain and FMS: What We Know, and What We Need to Know.” Best Pract Res Clin Rheumatol, 17(4):685-701.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015