Fibromyalgia, Chronic Fatigue … What Causes Them?
Research shows that exposure to environmental toxins is behind increasingly common diseases like fibromyalgia, especially in women
A challenge posed to medicine in the 21st century is to know if fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity have a common nexus, if they are related to exposures to products from the environment and what is the cause of the prevalence among women .
New diseases, what are the causes?
Recent research points to a dysfunction of the mitochondria of cells due to exposure to environmental toxins as a common origin of emerging diseases. The accumulation of estrogens would explain why it affects more women than men.
Fibromyalgia, chronic fatigue, and multiple chemical sensitivity are new diseases that occur together frequently. Their coincidence varies between 30% and 88% of the cases, depending on the study.
Some of the hypotheses point to the repeated aggression suffered by the hypothalamic-pituitary area due to physical or chemical microtrauma, or psychological and social (physical and mental stress), which produce alterations in endocrine function and immunity.
Recent research indicates as a possible common link the affectation of mitochondrial function (the mitochondria is the part of the cell where energy is produced). Its injury, especially by exposure to environmental toxins, ends up producing problems in the body, especially in the central nervous system and in the endocrine.
What is fibromyalgia?
It was defined by consensus by the American College of Rheumatology in 1990 as a generalized, non-articular muscular pain state, predominantly affecting the muscular areas and the spine and presenting exaggerated sensitivity at multiple predefined points.
It is considered generalized pain when:
- It occurs on the right and left side of the body and above and below the waist (that is, the four quadrants of the body).
- There must be pain in the axial skeleton: vertebral column, anterior thoracic wall, thoracic column and lumbar spine.
Up to a third of cases can lead to a poor quality of life for the patient and seriously compromise their personal, work and social life.
The diagnosis: there is currently no specific test, but it cannot be performed without ruling out all the diseases or deficiencies that can cause generalized muscle pain.
Exposure to toxins
Dr. Andrea t. Slotkoff already showed in 1997 the possibility that 70% of the cases were due to exposure to chemical substances at work. The work of Slotkoff and his collaborators was one of the first to establish this association and the one that indicated the female predominance of those affected.
- 60% of the cases could have been caused by exposure to tobacco, dust, fumes, cleaning products, perfumes, paint.
- Between 30% and 59%, from pesticides, food, hairspray, gasoline, carpets, soaps, newspaper ink, preservatives in food and air conditioning.
- Finally, 30% pointed to shampoos, plastics and polyester.
In the studies carried out by our team at the Barcelona Center for Health Analysis and Programs (CApS), it has been possible to demonstrate that the pain experienced by people exposed to pesticides in the workplace evolved by “imitating” the fibromyalgia clinic, and that a common factor with multiple chemical sensitivity was mitochondrial involvement.
The coenzyme q10 treatment trial – also tested in fibromyalgia by researcher Mario Cordero and collaborators from the University of Seville – is paving the way for hope, associated, among others, with the correction of metabolic, endocrine and vitamin deficiencies and minerals that can alter the function of mitochondria.
Chronic Fatigue Syndrome
Chronic fatigue syndrome has been defined as persistent and unexplained fatigue that is unrelated to physical exercise. It does not improve with rest and the affected person cannot carry out work, social, educational or personal activities.
The symptoms
You have four or more of the following symptoms in the past six months (or more):
- Loss of memory and ability to concentrate
- Throat pain
- Thickened lymphadenopathy in the cervical chain or axillary nodes
- Muscle pain
- Polyarticular pain without redness or swelling
- Headaches with new forms of manifestation or severity
- Non-restorative sleep
- Discomfort lasting more than 24 hours after exercise
The United States Center for Disease Control and Prevention revised the definition of this syndrome in 1994, together with an international study group, and established that patients must have persistent and unexplained asthenia (to rule out well-known diseases).
They also concluded that there are people who are tired for more than six months who do not meet the diagnostic criteria for chronic fatigue, cases that have been called idiopathic chronic fatigue.
The syndrome occurs in young and middle-aged people, and is twice as common in women as in men. It can occur in isolation, although sometimes it occurs in the form of outbreaks (neuromyasthenia or myalgic encephalomyelitis).
Professionals are advised to perform a thorough physical examination and advise patients to monitor their temperature and weight.
The diagnosis is complex because it is made by exclusion
The natural history of true chronic fatigue is:
- Sudden asthenia after a pharyngeal or respiratory tree infection, or mononucleosis.
- Later, the patient presents alterations in the capacity of concentration and memory and in the dream.
- Excessive physical activity makes symptoms worse.
- In general, there is no history of back pain or headache.
The causes
The origin of chronic fatigue syndrome remains unknown, but given the association with fibromyalgia and multiple chemical sensitivity, many authors believe that many cases share a common mechanism that would be located in mitochondrial involvement.
Multiple chemical sensitivity
In 1952, Dr. TG Randolp began to describe people who were highly sensitive to odors after exposure to various environmental compounds. This disorder was named multiple chemical sensitivity syndrome by Mark R. Cullen in 1987.
Since then it has been given many names: environmental disease, chemical response syndrome, total allergy syndrome, chemical-induced loss of tolerance, chemical hypersensitivity …
The symptoms
This is a disease with multiple symptoms, which occur when the person comes into contact with some environmental products. The most frequent are:
- Feeling of muscle weakness and fatigue
- Feeling of mental confusion and headache
- Dyspnea, cough and symptoms similar to bronchitis and asthma – even if there is no history.
- Intestinal disorders, with nausea, vomiting, spasms or diarrhea.
- It can be accompanied by sensitivity to the electromagnetic field.
The causes
The first hypotheses about the causes and the mechanisms that produce it were made by the psychiatrist Iris Bell. They are based on neurohormonal sensitization, especially of the mesolimbic areas of the brain that regulate affectivity and appetite.
The process could start with exposure to high doses of the product, but also with small and repeated doses. The autonomic nervous system, the immune system and the endocrine system, and, consequently, affectivity and memory are altered.
Hormonal imbalance: endocrine disruptors
Among the substances that can most affect the central nervous and energy systems of the mitochondria are formaldehyde, toluene, chlorinated insecticides, organophosphates and solvents.
These substances penetrate through hormones such as estrogens. Although these exist naturally in the woman’s body, today their levels have increased since most endocrine disruptors (external elements that alter the hormonal balance) mimic the role of estrogens in humans.
This may be one of the reasons why the incidence of multiple chemical sensitivity is increasing in today’s society.
If the exposed person is subjected to stressful situations, environmental toxins penetrate more
Thus, the profile of the person who can be more sensitized is:
- Woman of reproductive age
- With high levels of estrogens
- Subject to stressful situations (double or triple shift).
The group led by Dr. Chiara de Luca, from the Bilara Experimental Laboratory in Rome, has demonstrated the impairment of cellular oxidation / reduction metabolism in people with multiple chemical sensitivity.
Undoubtedly, the better knowledge of the causes of these pathologies opens a hopeful path to prevent them and improve the quality of life of the people who suffer from them.
