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Adrienne Dellwo

Smoking, Oxidative Stress, Fibromyalgia & Chronic Fatigue Syndrome

By February 7, 2012

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We all know smoking is bad for us. But did you know smoking may exacerbate symptoms of fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS)?

We have a handful of recent studies showing smoking makes FMS symptoms more severe:

  • One from the Mayo Clinic showed higher pain intensity, fewer good days, and more missed work;
  • A Turkish study linked cigarettes to more severe FMS symptoms as well as more anxiety and depression;
  • And Korean researchers found more tender points and depression.

An older Scandinavian study showed significantly more pain and numbness, more severe symptoms overall, and more functional problems in smokers with FMS. (However, this study did not show a difference in tender-point count.)

In ME/CFS, the effect of smoking hasn't been scientifically measured. In both conditions, though, the role of oxidative stress is getting more and more of researchers' attention and evidence is mounting that it plays a key role, and possibly a causative one. (For a look at the latest research and what oxidative stress is, see: Oxidative Stress in Chronic Fatigue Syndrome.)

In a nutshell, oxidative stress is caused by an excess of free radicals, which damage your health. Smoking is known to introduce a huge amount of free radicals to your system (as is second-hand smoke.) It also depletes antioxidants, which neutralize free radicals. That means cigarette smoke puts you at high risk for oxidative stress. If oxidative stress is a partial cause of FMS and ME/CFS, it's not a stretch to say that smoking could be a major contributor to the development and severity of them.

So the bottom line is that you have more reason to stop smoking - or avoid second-hand smoke - than you thought. Does that make it any easier to quit? Hopefully it'll up your motivation, but even then, it's still an incredibly difficult thing to break that addiction. Here are resources that can help, from About.com's Smoking Cessation Guide Terry Martin:

For information on fighting oxidative stress, see: Antioxidants for Fibromyalgia & Chronic Fatigue Syndrome.

Do you smoke? Have you quit smoking? What impact did it have on your symptoms? How did you do it? Leave your comments below!

Learn more or join the conversation!


Photo Brand X Pictures/Getty Images

February 7, 2012 at 3:46 am
(1) Ann Taplin says:

I have Fibromyalgia and actually found that giving up smoking made my symtoms WORSE. Yes it could have been withdrawal that did that but I spent 5 weeks in hell. Now I just smoke occasionally and I can manage the symtoms once more. Isn’t this justy another guilt trip to get people to stop smoking?

February 7, 2012 at 9:47 am
(2) lynn says:

I stared.smoking at 31 and having fibro since I was 19yrs. I would agree at the age of 38 symptoms were off the roof. I thought that smoking was calming but the truth is calmness is up to us in our mind. So I would agree. Its been 6mos. And I see more good days again. :-*

February 7, 2012 at 9:56 am
(3) Rachael says:

Any substance or activity that depletes dopamine/endorphins (including smoking) will make symptoms of CFS worse. The secretion of pituitary prolactin is under the inhibitory control of the hypothalamus and the most important inhibiting factor is dopamine. Prolactin is an immunostimulating peptide hormone. When prolactin levels are high so is your immune response.

Many people have described CFS like having a terrible hangover or flu. CFS sounds and feels a lot like, what people experience, who are going through opiate/drug/alcohol withdrawal, except it’s 24/7. The deficiency of dopamine/endorphins produces the syndrome of intense suffering known as withdrawal. Flu like symptoms; feelings of malaise; joint/muscle pain; problems regulating body temperature; anxiety; agitation; insomnia; nausea; irritable bowel are signs and symptoms of both conditions.

I believe that CFS is linked to dopamine/endorphin depletion (much like Parkinson’s Disease) and an inability to restore sufficient levels of these neurotranmitters in the brain, anything that causes a further depletion (exercise, stress, aspartame, alcohol, smoking cigarettes etc) will only make CFS symptoms worse (running on empty). You may feel good while engaging in these activities, but they will eventually lead to a crash and burn (high and then a low). Dopamine decreases and prolactin levels rise; the immune system becomes hyper-responsive.

February 7, 2012 at 10:32 am
(4) Rachael says:

The reason that cigarette smoking may seem calming to some people is that it does raise dopamine/endorphin levels in the brain, but eventually it also depletes these neurotransmitters. All those poisons your are inhaling gives your immune system something to do, and thus has a calming effect on the body (it’s too busy ridding your body of these substances to bother you). When you remove both of these side effects from smoking by quitting, 1) the cigarette no longer is raising dopamine/endorphins levels, which makes you feel good temporarily and 2) the immune system no longer working overtime to clear cigarette smoke/toxins from your body, which was actually suppressing (calming) your immune system.

February 7, 2012 at 3:36 pm
(5) Sandra says:

Has anyone tried marijuana for FMS/CFS?

February 10, 2012 at 4:04 pm
(6) K says:

I switched to e cigs (electronic cigarettes) and I think it really helps with the stress and pain of FMS to be able to smoke my e cig, without the harm of a ‘regular’ cigarette!

February 10, 2012 at 4:30 pm
(7) anonymous says:

I had been smoking for 4 years when I gt sick (years later diagnosed as CFS). It bothered my anxiety, weakness and other symptoms so much that I dropped to about one cigarette per day, down from a pack. Nine years later, after going on anxiety medication, I picked up the habit of a pack a day again and was able to handle it, though still felt a little anxious and weak with each cigarette. I finally was able to quit smoking completely in 1999. Four years later, after a two-year bout of complete loss of appetite, I had a flare-up of the CFS and have been going downhill ever since, until now I’m moslty housebound and bedbound.

I’ve always felt that smoking either caused or worsened the CFS but tried to quit too many times and never could. Now, I can’t even drink a glass of wine due to its causing exacerbation of my symptoms. One internist told me, when I first became ill in 1974, that he thought I was “allergic” to the cigarettes. Yeah, r-i-g-h-t!!

February 10, 2012 at 5:50 pm
(8) Lola says:

I live in a medical MJ state. I’ve been using marijuana capsules for about a year. The main benefit has been better sleep. When I don’t take them I get maybe 3 hours of fairly restful sleep, With them I get 5-7 hours of good sleep. It has made a big difference in my pain levels and I think it is the improved sleep rather than the MJ per se. I pretty much only take them at bedtime. They are pretty expensive, $25 for 10 capsules.

Despite all the hoopla, I think MJ is pretty benign. I never used it until recently. No withdrawal, I’ve had no side effects that I can attribute to it. It seems to me to be worth a try if you have access to it legally.

February 11, 2012 at 9:29 am
(9) John says:

Sorry Rachael but high prolactin levels supress the immune system as well as growth hormone. It can also have an inhibitory effect on sex steroid hormones.

February 12, 2012 at 9:23 am
(10) Rachael says:

Sorry John, but you’re wrong! Prolactin, an immunostimulating peptide hormone, is linked with a number of rheumatic diseases. Hyperprolactinemia stimulates autoimmune disease, and this stimulation is determined by genetics. Prolactin is a growth factor for lymphocytes with the potential to stimulate immune responses at many levels. Prolactin is a cytokine

Impaired Hypothalamic Function, Prolactinomas, and Autoimmune Diseases


February 12, 2012 at 8:52 pm
(11) wendy says:

i always said that if i got sick with an illness that was directly caused by smoking i would quit.
Almost five years ago i developed a polyp on my vocal cord that required surgery to remove. As smoking is the only cause of vocal cord polyps, i smoked my last cigarette on October 29, 2007, the night before the surgery. i quit cold turkey after smoking for forty years and had no cravings and no desire to sneak a smoke.
i feel i was lucky to have had the polyp caught and removed before it could become cancerous. And i never ever want to have to need surgery again for a smoke-related illness. i think the fear i had, from actually getting sick from smoking, helped me quit so easily.
Even when i visit my best friend, who still smokes, I am not tempted.

July 11, 2012 at 12:35 am
(12) Jacob says:

I am a 39 year old male with lifelong FMS. Trying to function with all of the chronic fatigue and other symptoms on a daily basis just adds stress to the body. I began smoking when I was 22 because I could no longer deal with the depressive elements of FMS. Smoking made life more tolerable and when brain fog or body pain flared up again, which is 95% of the time – I would just light a cigarette and deal with the helplessness I feel from FMS aka submit and just smoke. I just quit smoking (24 hours clean now), and I have constant and heavy brain fog, vertigo, and relative concentration issues. My next comment is HELP! I feel very strange, unproductive, not tired but not quite aware. I am on holiday in Malaysia at the moment and am not really sure what to do with my time. Thanks in advance for your responses

September 11, 2012 at 7:56 am
(13) Lena says:


i find your comments re dopamine and endorphins on CFS fascinating. I hate to sound like a pervert, but i am concerned: do you think orgasm also depletes the energy of CFS sufferers?

With Blessings,

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