Is fibromyalgia an autoimmune disease?

What is fibromyalgia and what are its symptoms?

Fibromyalgia is a chronic, long-term illness characterized by widespread musculoskeletal pain and tenderness along with extreme fatigue, sleep problems, issues with memory, thinking and concentration, and depression or anxiety. 

It is unfortunately still poorly understood by the medical community and is thought to affect around 4 million US adults, or about 2% of the adult population.

What is an autoimmune disease?

Autoimmune diseases are disorders in which the body begins to attack itself due to the immune system’s misidentification of healthy cells as a harmful, invading element. In response, the body produces autoantibodies that target and destroy these healthy cells. This attack damages tissues and often causes inflammation in the targeted area.

Fibromyalgia can be difficult to diagnose because it shares many symptoms that are common in autoimmune diseases, and in some cases fibromyalgia can even co-occur with autoimmune disorders.

Conditions that are often associated with fibromyalgia pain include:

• Lupus
• Rheumatoid arthritis
• Restless leg syndrome
• Hypothyroidism
• Myofascial pain syndrome
• Temporomandibular joint (TMJ) disorders
• Lyme disease
• Depression

Is fibromyalgia an autoimmune disease?

Because fibromyalgia was formerly considered to be an arthritis-related condition and many types of arthritis, such as rheumatoid arthritis (RA), are autoimmune diseases, the medical community assumed that fibromyalgia could also be classified as such.

As of now, scientists have been unable to prove this claim, as there is no evidence that fibromyalgia produces autoantibodies or damages surrounding tissues, causing inflammation. The underlying cause of fibromyalgia has yet to be determined.

What does the latest research say?

Due to the fact that fibromyalgia often coincides with other autoimmune conditions, it is difficult for researchers to determine whether fibromyalgia is an autoimmune disease in its own right.

In 2007, a study found high levels of thyroid antibodies in fibromyalgia patients, leading them to question if this was a sign that fibromyalgia is an autoimmune disease. However, the presence of thyroid antibodies is not uncommon and often causes no symptoms in those affected, making it unclear.

A further study in 2013 connected the pain caused by fibromyalgia to small nerve fiber neuropathy, a type of peripheral neuropathy. However, this link between pain and neuropathy is not yet widely accepted across the medical community. Previously, strong data has indicated a link between small nerve fiber neuropathy and Sjogren syndrome (an autoimmune disease causing dry eyes and mouth), a condition that also causes painful nerve damage. But more research is necessary to establish the same conclusion between fibromyalgia and small nerve fiber neuropathy.

Additional research suggests that the immune system in fibromyalgia patients exhibits a number of irregularities, notably chronic overactivity. Some researchers believe that this serves as proof of its status as an autoimmune disease, but more research is needed to explore this aspect further.

Conclusion

For now, the jury is still out on fibromyalgia's position as an autoimmune disease. At the moment, it cannot be classified as an autoimmune disorder due to its lack of autoimmune antibodies or tissue damage, but with time and the advancement of research, hopefully we will have a better understanding in the coming years.

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