Fibromyalgia is a long-lasting or chronic disorder that causes muscle pain and an overall feeling of tiredness. People with this condition experience pain and tenderness throughout many parts of their body. It is often associated with other chronic conditions such as Chronic fatigue syndrome, endometriosis, irritable bowel syndrome (IBS), rheumatoid arthritis, lupus and more. Anyone can get this but it does occur more frequently in women and often starts in middle age.
Gut microbes, also commonly referred to as gut flora or gut microbiota, are any organisms too small to be viewed by the unaided eye, such as bacteria, protozoa, and some fungi and algae. Our gut microbiota is made up of tens of trillions of bacteria, that’s ten times more cells than are in our own body!
More and more evidence is showing that gut bacteria play a critical role in maintaining human health. When the bacteria in the gut get out of balance, something scientists refer to as gut dysbiosis, it has been associated with a wide variety of health issues including gut disorders, weight issues, cardiovascular diseases, allergies and more.
A Canadian study, published in June 2019, looked at how specific gut bacteria were found in lower levels in fibromyalgia patients. In the study, they looked at the gut microbiota of 77 women with fibromyalgia and 79 ‘control’ participants without the disorder. Participants gave stool, blood, saliva and urine samples which were analyzed and compared with those of the healthy control subjects. In some cases, control subjects lived in the same house as the fibromyalgia patients or were directly related parents, offspring or siblings.
The team identified 19 specific types of bacteria that showed up in either increased or decreased amounts in fibromyalgia patients. Some of the bacteria that were found in reduced levels in fibromyalgia patients include Faecalibacterium prausnitzii and Bacteroides uniformis, both of these bacteria are known for their involvement in the metabolism of butyrate. Butyrate is a short-chain fatty acid (SCFA) commonly produced by bacteria in our gut during the process of digestion, specifically when they assist our body in the break down of dietary fiber. Butyrate has received quite a bit of attention in scientific studies recently because it’s been shown to have positive effects such as anti-inflammatory properties, an ability to enhance the intestinal barrier and positively impact immunity. It seems, biologically, to make sense that reductions in this type of bacteria and therefore these metabolic pathways could be connected to fibromyalgia symptoms.
When the team applied their newly discovered data and worked backward, using computer-assisted models, to see if they could identify a fibromyalgia participant solely from the makeup of their gut microbes, the computer was able to correctly identify a fibromyalgia participant versus a control participant 87.8% of the time. The research team noted the potential for future diagnostic aids. It’s exciting to think that you could submit a fecal sample for analysis and be able to help confirm the presence or absence of fibromyalgia in future patients.
There are several older studies that connect fibromyalgia to gut issues. For example, a 1998 study found that “Up to 50% of patients with a diagnosis of Fibromyalgia syndrome complain of symptoms characteristic of functional dyspepsia (indigestion) and 70% have symptoms of IBS.” Probiotics have been well studied for aiding both digestion and bowel irritability and may offer some relief from these issues. In addition, for years now small intestinal bacterial overgrowth (SIBO) has been connected to fibromyalgia, with one research group finding 100% of patients with fibromyalgia having abnormal lactulose hydrogen breath tests, an indicator of SIBO. Probiotics may offer beneficial effects by balancing out “bad” or potentially pathogenic bacteria involved in bacterial overgrowth.
While at first, it may seem counter-intuitive to take probiotics (good bacteria) when dealing with an overgrowth of bacteria but, it can actually be really beneficial to try to offset the ‘bad’ bacteria by taking in more ‘good’ bacteria. In fact, one of the ways that probiotics work is through competitive exclusion. By competing for nutrients and attachment sites along the gut the good bacteria can help exclude pathogenic bacteria from internal surfaces of the body. We like to think of it as “parking spaces” -- if the good bacteria can fill up the available spaces it may help prevent bad bacteria from finding a place to “park” or attach to our body.
It is a fascinating time to be studying our gut microbes, every day more and more studies are being published linking our gut bugs to various health issues. There’s an obvious need for additional and larger studies to help confirm these findings, but even without that data ongoing research seems to make it very clear that the organisms living within us play a vast role in our personal health and well being and we already have tools, like probiotics, available to us to assist in changing our own internal ecosystems.