July 15, 2002
Question:
Is it possible that anemia is the cause of fibromyalgia?
Dr. Lowe:
Many people who are anemic have fatigue
and weakness, and some also have pain from trigger point in their muscles.
(The pain-mediating trigger points are caused by a muscle energy
deficiency resulting from an oxygen deficit in muscle due to the anemia.)
Like fibromyalgia patients, these particular anemic people have chronic
fatigue and pain. These symptoms alone, however, don’t constitute fibromyalgia, although some doctors might diagnose them as such.
Currently, the diagnosis of fibromyalgia requires that the patient have
tender points, and anemia itself doesn’t cause these. The anemic
person's pain and fatigue are usually relieved by effective treatment of
the anemia. Despite no longer being anemic, however, some patients
continue to suffer pain from trigger points until they get effective
muscle treatment for them.
The fibromyalgia patient, of course, may also be anemic. Correcting a
nutritional anemia, such as that caused by an iron deficiency, might improve
the patient’s pain and fatigue. But the nutritional treatment isn’t
likely to completely relieve these symptom. If the fibromyalgia patient’s
anemia is caused by hypothyroidism or thyroid hormone resistance (see
Q&A below), metabolic treatment including effective thyroid hormone
therapy may relieve the symptoms of both the anemia and fibromyalgia.
October 27, 1997
Question:
I am a 44-year old male and I have been diagnosed with
fibromyalgia. I also have anemia. My blood has been tested by a hematologist for all the
usual dysfunctions and no cause for my condition could be explained. I must be healthy
since anything of concern would have been discovered in the tests (or so they tell me). Is
there any relationship between hypothyroidism and anemia?
Dr. Lowe:
Anemia is reported to occur in
30%-to-40% of hypothyroid patients, but it is not a prominent feature of hypothyroidism.
The anemia appears to be a normal physiological response to the reduced tissue requirement
for oxygen in people with thyroid hormone deficiency. Decreased thyroid hormone levels
decrease tissue oxygen demand and consumption. This results in an increase of oxygen in
the blood. As the blood flows through the kidneys, the elevated level of oxygen suppresses
the kidney production of a chemical called erythropoietin (EPO), and less EPO is released
by the kidneys into the circulating blood. EPO is the major regulator of red cell
production. When the amount of EPO reaching tissues that synthesize red blood cells
decreases, red cell production also decreases. Essentially, because tissues require less
than normal amounts of oxygen, fewer red cells are needed to transport oxygen. When the
thyroid hormone deficiency is corrected, oxygen demand and consumption increase. The
kidneys produce more EPO, and the EPO increases production of red cells, correcting the
anemia.
