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Differences in Functional Medicine and Conventional Medicine for Fibromyalgia Treatment

Fibromyalgia Treatment: Conventional vs. Functional Medicine

Fibromyalgia is a complex and debilitating disease with unknown causes. While conventional medicine focuses on treating the symptoms separately, functional medicine tries to discover its roots to help patients with a more holistic approach.

In this article, we’ll cover the differences between these two approaches in diagnosing and treating the disease.

What is fibromyalgia?

Fibromyalgia is a common pain syndrome that physicians can't understand completely. The disorder affects 10 million people in the U.S. and an estimated 3-6% of the world population.

People with this condition present generalized aching (sometimes severe) and muscle tenderness and stiffness.

The disease affects any tissue, especially the neck, shoulders, thorax, low back, and thighs. In fibromyalgia, there is no specific tissue abnormality.

It affects seven times more women than men (75-90%), and it can occur at any age, although it is more common during middle age.

The following factors can contribute to the development of the disease:

· Viral infections (E.g., Lyme disease)

· Traumatic events

· Emotional stress

· Sleep disruption

What are the symptoms of fibromyalgia?

Patients with fibromyalgia have various symptoms, including(2):

· Widespread pain

· Fatigue

· Muscle stiffness

· Difficulty concentrating

· Mental cloudiness

· Headache

· Digestive problems

These symptoms may worsen with poor sleep, environmental and emotional stress, trauma, dampness, or cold exposure.

Fibromyalgia patients often suffer from anxiety and depression since the disease can significantly affect their quality of life.

Fibromyalgia is usually a chronic disease, but the symptoms can disappear spontaneously. A functional medicine approach can help patients treated with a comprehensive, supportive program, but some symptoms persist.

Diagnosis of fibromyalgia

The disease's diagnosis is difficult because there are no physical abnormalities except for discrete muscle tenderness areas without swelling, redness, or warmness; such findings suggest an alternative diagnosis.

Fibromyalgia's main characteristics:

· Generalized pain and tenderness, which is disproportional to physical findings that are present for at least 3 months

· Negative laboratory results despite widespread symptoms

· Fatigue

Genetic tests for fibromyalgia

Fibromyalgia is a complex disease, making it difficult to establish a link between genetic alterations and their pathophysiology.

Scientists are investigating potential genetic biomarkers for fibromyalgia. They believe genetic factors account for up to 50% of the disease susceptibility. Overall, first-degree relatives (siblings or children) have eight times more chances of developing the condition than the general population.

Potential candidate genes associated with fibromyalgia are SLC64A4, TRPV2, MYT1L, and NRXN3. Furthermore, an interaction between genes and the environment may trigger the disease's onset through epigenetic alterations.

Epigenetics comprises changes in gene function that are heritable and that don't alter the DNA sequence.

In fibromyalgia, genes implicated in stress response, DNA repair, and neuronal system functioning are hypomethylated (when a methyl group [-CH3] attaches to the DNA molecule). This mechanism can dysregulate gene expression and cause some of the symptoms of the disease.

Micro RNAs (miRNAs) are other molecules that participate in gene expression regulation. Studies show that some miRNAs express differently between fibromyalgia patients and healthy people. Therefore, they could be used as biomarkers to identify people at risk of developing the disease.

How is fibromyalgia treated?

Traditionally, the treatment of this condition aims to alleviate the symptoms. To achieve that, doctors recommend:

· Daily stretching

· Aerobic exercises (E.g., fast walking, swimming, exercise bicycling)

· Local heat

· Massages

· Stress management (E.g., deep breathing exercises, meditation, psychotherapy, counseling)

· Anti-depressive medication

· Sleeping pills

· Analgesics

The pharmacological treatment can cause undesired side effects such as drowsiness and dry mouth, which can be intolerable for older patients. These drugs can also interfere with sleep and affect the patient's mood, aggravating the disease.

Fibromyalgia and functional medicine

Unlike conventional medicine, functional medicine concerns finding the symptoms' roots to treat and prevent the disease(6).

According to Dr. Susan Blum, Board Certified in Preventive Medicine and Chronic Disease Specialist Founder and Director of Blum Center for Health, fibromyalgia is an inflammatory condition. She believes treating the person with painkillers is not enough – there is a need to understand what is causing the pain and fatigue(6).

In this approach, practitioners look at the three main areas involved in controlling the inflammatory response (6):

· The digestive system --- The surface lining of your digestive system contains immune cells that protect you from infections. Alterations in microbial composition or nutrient deficiencies can cause immune reactions that lead to chronic inflammation in distant sites (7). Therefore, functional medicine practitioners believe that fixing gut health can relieve the pain and inflammation in the muscle and joints. To do this, they encourage changes in food habits and supplements to restore the digestive tract's health (6).

· Food sensitivities --- This approach involves identifying foods that create inflammation resulting in painful muscles, joints, tendons, and fatigue in fibromyalgia. The most common are gluten, dairy, eggs, corn, and soy. Patients should do an elimination diet by “removing all five foods for three weeks, and then reintroducing them one at a time, every four days, and see if your symptoms get worse. If you have a reaction, this food is likely causing inflammation, and you should remove it from your diet for at least six months. If no reaction occurs, you can reintroduce it into your diet”.

· The liver detoxification system --- According to Dr. Blum, many people with fibromyalgia have accumulated toxins in their body that causes pain and inflammation. Detoxification would involve removing or limiting the exposure to these toxins like mercury in fish, lead in water from the pipes in your house and cosmetics, PCBs and dioxins from the pesticides in your foods, and chemicals in plastics. These toxins are a burden to your liver, which is responsible for clearing them out. A healthy diet with organic vegetables and fruits may help.


Fibromyalgia is a challenging condition because its causes are unknown. Because of that, conventional medicine can only manage the patient’s symptoms as they appear. This is done with stretching and physical exercise, as well as analgesics and anti-inflammatory drugs.

In turn, functional medicine uses dietary changes, gut health improvement, and liver detoxification to eliminate the causes of inflammation in the body and minimize the pain.

Amy Read, Sunshine Functional Healing, LLC


1. Association NF. Fibromyalgia Prevalence [Internet]. 2021. Available from:

2. MSD manuals. Fibromyalgia [Internet]. 2020. Available from:

3. D’Agnelli S, Arendt-Nielsen L, Gerra MC, Zatorri K, Boggiani L, Baciarello M, et al. Fibromyalgia: Genetics and epigenetics insights may provide the basis for the development of diagnostic biomarkers. Mol Pain [Internet]. 2018/11/29. 2019;15:1744806918819944–1744806918819944. Available from:

4. Medline Plus. Fibromyalgia [Internet]. 2020. Available from:

5. NIH. Epigenetics [Internet]. Available from:

6. Fibromyalgia: A Functional Medicine Approach [Internet]. Available from:

7. Agace WW, McCoy KD. Regionalized development and maintenance of the intestinal adaptive immune landscape. Immunity. 2017;46(4):532–48.

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