Those of us with fibromyalgia do experience fatigue, but it is usually not as great as the fatigue of chronic fatigue syndrome. The fatigue of CFS can last for months, while many of us with fibromyalgia have only a few days at a time of overwhelming fatigue. This is not true for each one of us, as our symptoms are all different. Some people have both CFS and FMS, and their fatigue and pain levels can be so high that they sometimes wonder if they will ever feel like themselves again.
In the book,
Fibromyalgia & Chronic Myofascial Pain Syndrome, Devin Starlanyl, M.D., and Mary Ellen Copeland, M.S., M.A., describe extreme fatigue and lack of endurance as possibly being a part of the disrupted hypothalamic-pituitary-adrenal axis found in FMS. This means that the hypothalamus, pituitary, and adrenal glands are tied together with each affecting the other as well as many other regulatory systems in the body. If, for some reason, the hypothalamus stops functioning, then the ability to rapidly adjust to environmental changes is affected. The hypothalamus gland receives its control signals from neurotransmitters. A neurotransmitter is a chemical that is selectively released from a nerve terminal, and it interacts with a specific receptor on another structure of the body and produces a specific physiologic response. For example, the growth hormone is an important neurotransmitter which has a powerful effect on the myofascia, or connective tissue. It stimulates the production of fibroblasts, mast cells, ground substance, and collagen fibers. All of these affect the thickening and tightening of the myofascia in fibromyalgia.
One problem that those of us with fibromyalgia have is that this growth hormone is released only during delta-level sleep, and we never stay in the delta-level sleep. As the delta level is reached, alpha waves intrude and disrupt slumber. We also have very low levels of this growth hormone, so our body has problems with basic cellular repair. The myofascia plays a major part in providing information and is a repair mechanism of the body. Its chemistry also monitors inflammatory response, and its fluids deliver antibodies and white blood cells to fight infection. All of these functions of the myofascia are disrupted in those of us with FMS.
The constant attack of disrupted neurotransmitters causes an overabundance of mixed messages and sensory overload. This, plus sleep deprivation, exacerbates our fatigue. Also, the adrenals, which help to regulate energy, are often overworked because of the adrenaline surges that we may get, even when we are "bone weary" and longing to go to sleep. The toxic wastes resulting from the constriction of the myofascia also adds to our lack of energy and exhaustion.
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