Can You Have Fibromyalgia Without Fatigue?

Dr. Gates: So, today we have the question, “Can you have fibromyalgia without fatigue?” And the technical answer is, Yes, according to the classification system set forth by the American College of Rheumatology. One was established in 1990, another was established in 2010. There is actually now one in 2011.

In essence, for you to have fibromyalgia, you have to have widespread pain throughout your body. The old system involved you being tender to pressure. The new system does not involve that, but the new system does place great emphasis on associated symptoms of brain fog, headaches, fatigue, as well as Irritable Bowel syndrome.

So, in our experience, the answer is, not many fibromyalgia patients do not have fatigue. We were discussing before this, may be 2 to 3% of the fibromyalgia patients coming in here, and we’ve seen thousands of chronic pain patients, don’t have fatigue, but it is common. So, I’m going to kick it over to you, since you have fibromyalgia.

Dr. Rutherford: Well, you kind of stole my thunder there. But yeah, the reality is, in reality in clinical experiences, we’ve probably done a couple of thousand fibromyalgia patients. I have fibromyalgia. I am a fibromyalgia patient, and I certainly had massive chronic fatigue, and my energy levels are probably 95% good again. But the vast majority of people coming in here do have fatigue. And probably the number…did you say it’s 3%?

Yeah, probably the number of people that we’ve seen…Dr. Gates has been here about seven years now, six and a half, seven years. In that period of time, probably like 3% of the patients coming in. And I have noticed that, maybe a little more detailed than you are asking for looking up the subject, but one of the parts of the clinical entities that cause fibromyalgia is usually a thyroid problem. It’s usually Hashimoto’s. Hashimoto’s has two components to it. Most people present as overweight, hair falling out, putting on weight, can’t lose weight, ankle edema. They’re getting dryness on their tibia, on their shins, and so on and so forth. And then they get these hyper symptoms. Maybe they get heart palpitations occasionally for no reason at all.

Maybe they get anxiety now for no reason at all, or night sweats. So, the go to sleep and they can’t fall asleep. When they wake up they can’t go back to sleep. A lot of those are hyperthyroid symptoms. And as we just discussed before we went on here, we had a patient last week who is a fibro patient who does not have fatigue, but she is of that type of patient that has the more hyper symptoms of that aspect of that thyroid. So, it’s a small percentage, even [inaudible 00:02:45] piece who have Hashimoto’s. And that’s all another subject, but who have an immune attack on their thyroid. The vast majority of them experience hypo symptoms, but them we get that group that comes in here who is diagnosed with hypothyroid and actually don’t have hypothyroid, actually have Hashimoto’s — that group that does actually have Hashimoto’s.

Dr. Gates: Precisely.

Dr. Rutherford: And so those people, which is a small percentage…the point I want to make is, it’s a unique population. There’s a reason for it. You are going to probably have Hashimoto’s and you’re probably going to be in a hyper pattern. And then still, it’s probably…we agreed on probably 3% of people that came in here, actually have no fatigue. In fact, they might actually be hyperactive intermittently. So, that’s our observation.

Dr. Gates: Exactly. You said a lot of really great points there relative to Hashimoto’s being associated with fibromyalgia. Some of you may be aware of that, some of you may not be aware of that. So, we have several videos on fibromyalgia on our website. If you want more information, go to Search fibromyalgia, and then you can access those videos with a lot of references attached to each video at the bottom of the page.

So this is Dr. Martin Rutherford, certified functional medicine practitioner, also a chiropractor. I am Dr. Randall Gates, board certified chiropractic neurologist, also a chiropractor.

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