Fibromyalgia is a complex disorder with many triggers and changes in physiology. Small fiber neuropathy, central sensitization, trauma, high stress, high levels of glutamate and histamine, genetics are some triggers and concerns related with fibromyalgia. There are other triggers for fibromyalgia including infection. A research study recently caught my eye on the topic of Epstein Barr Virus and Fibromyalgia and raises some interesting points. This study may help connect the dots on a few different levels with fibromyalgia sufferers.

The publication entitled Evaluation of Antiviral Antibodies Against Epstein-Barr Virus and Neurotransmitters in Patients with Fibromyalgia was published in the November 2015 Journal of Neurology and Neuroscience. Back in the 1980’s and 90’s, there was early research on fibromyalgia and Epstein Barr virus, but the focus fizzled out. Research on Epstein Barr virus and other illnesses like chronic fatigue syndrome, multiple sclerosis, and several cancers remains an active arena. Here are some of the findings.

Elevated IgG Epstein Barr Virus Antibodies Found In Fibromyalgia

Several infectious agents like Epstein Barr virus have been found with fibromyalgia and is thought to cause or contribute to its symptoms. In this study with 21 men and women with fibromyalgia, all participants were found to have elevated IgG antibodies to Epstein Barr virus. Blood tests showed an elevation of IgG antibodies to Epstein Barr virus. Elevated IgG antibodies reflect “an intracellular reactivation of an old infection.” Whereas, IgM antibodies reflect an acute active infection. Further information about Epstein Barr Virus and IgG may be found in the article New Findings with Epstein Barr Virus: The Sleeping Giant.

Results showed that antiviral IgG antibodies were present in all patients who participated in this study. Antibodies levels were as much as 5-10 times higher than normal range in 76 percent of the participants. Fourteen percent of participants had 2-4 times increase antibody levels. This hidden activity is thought to trigger immune system dysfunction and create some of the fatigue and pain seen with fibromyalgia.

Adrenaline, noradrenaline, and serotonin levels were also measured. In more than half of the patients, there were decreased blood levels of noradrenaline and adrenaline. Those individuals who had higher levels of IgG Epstein Barr virus titers correlated with lower concentrations of adrenaline. Other previous studies on these markers show mixed results so it is not a ubiquitous finding. Serotonin levels were found to be mixed. Many participants had decreased serotonin levels in the blood stream and cerebrospinal fluid, but it too was not applicable to all.

Catecholamines and Serotonin

This information on EBV patterns and altered levels of serotonin, adrenalin, and noradrenalin may help provide another dimension of focus and support. Indeed, when these neurochemicals are out of balance, pain, fatigue, and sleep problems occur. In addition, panic attacks, obesity, depression, anxiety, PMS, migraines, hypoglycemia, restless legs syndrome, and ADD/ADHD may occur.

Serotonin is highly involved with nervous system function and pain management, sleep, and mood. Ninety-five percent of serotonin is produced by gut flora. Serotonin is also essential for healthy thyroid function.

Adrenaline and noradrenaline also known as epinephrine and norepinephrine act as neurotransmitters and hormones and are part of a group of neurochemicals called catecholamines. Catecholeamines are produced by the adrenal medulla or the inner portion of the adrenal glands and by the central nervous system. These levels can be measured in blood tests.

Low adrenalin/epinephrine and noradrenalin/norepinephrine levels may leave other tell-tale signs – especially low blood pressure, orthostatic hypotension, and significant fatigue. Other symptoms may be related with depression, poor motivation, feeling cold, cognitive difficulty, movement/balance problems, and poor stress tolerance amongst pain and other difficulties of fibromyalgia.

It may be tempting to think that augmentation of cortisol is also appropriate with low catecholamine levels. In some circumstances that indeed may be necessary. However, cortisol or glucocorticoids intake can “awaken” EBV. Studies show that increased glucocorticoids can directly induce reactivation of the dormant or sleeping EBV by changing gene expression. High psychological stress levels and prescription drugs are sources of elevated cortisol. Work with your health professional for lab measurements of cortisol to see if this is a concern. The amount of cortisol is just as important as the natural diurnal rhythm of cortisol.

Mitochondria, Fibromyalgia, and the Immune System

Mitochondrial function is another factor in the layers of fibromyalgia and Epstein Barr virus. Numerous studies have implicated mitochondria dysfunction in fibromyalgia that contribute to the pain, fatigue and systemic dysfunction, but it is more than an mitochondrial energy production issue. Mitochondria are very active with the immune system and play a critical role in defense. They act as an immune signaling platform that orchestrates anti-viral activity inside cells. Mitochondria help modulate resistance to viral infections. Impairment within the mitochondria leads to fatigue, lactic acid accumulation, poor energy production, and compromised immunity. Mitochondrial dysfunction in immune cells has been noted to increase the susceptibility to infection and autoimmune disorders.

Fibromyalgia is a disorder of complexity and challenge. In the fast food world of medicine, the focus is often on pain management or psychotropic medications and being told to learn to live with the pain. Even though the EBV and fibromyalgia study was small and limited, it does unearth a mountain of potentially very valuable information in the quest of understanding and management of fibromyalgia. Use these nuggets of information to help your pathway to recovery.