Since I've had fibromyalgia, I've noticed that I'm staying sick a lot longer. I've read that the immune system is involved, but I've also read that this condition isn't autoimmune. If the immune system really is involved, why isn't fibromyalgia an autoimmune disease?
At this time, fibromyalgia is not believed to be an autoimmune condition. While it's possible that future evidence could change this view, it currently doesn't appear likely.
Some cases of fibromyalgia may involve dysregulation of the immune system that's different from autoimmune activity. However, the nature of this dysregulation is not yet well-understood.
What is Autoimmunity?
A lot of people seem to be confused about what "autoimmune" means and think it applies to anything with immune system involvement. In truth, immune system dysfunction can take many forms, and autoimmunity is just one of them.
In an autoimmune condition, the immune system mistakenly identifies a part of your body as a dangerous invader (such as a virus or bacterium). It then develops specialized antibodies against that type of tissue and actively tries to destroy it.
Autoimmune diseases are characterized by the presence of these autoantibodies and by abnormally self-reactive T lymphocytes, a type of immune cell that normally helps fight infection. Many autoimmune diseases also cause inflammation, which leads to markers in the blood that can be identified by tests.
Fibromyalgia & Autoimmunity
Thus far, fibromyalgia research has not uncovered evidence of autoimmunity. Inflammatory markers are not consistently elevated; no autoantibodies have been discovered; and the damage typical of autoimmune activity has not been observed.
However, a significant overlap between fibromyalgia and certain autoimmune conditions indicates that autoimmunity may be a risk factor for developing fibromyalgia. These frequently overlapping conditions include:
Why the Confusion?
Part of the confusion about fibromyalgia and autoimmunity comes from a misunderstanding of what "autoimmunity" means. However, it also could be due to several similarities between fibromyalgia and conditions such as those listed above.
- Similar Symptoms: These conditions all involve pain, fatigue and many other common symptoms.
- Difficult Diagnoses: Like fibromyalgia, autoimmune conditions can be tricky to diagnose and the process can take a long time.
- Poor Understanding: Because the public, and even many members of the medical community, don't understand fibromyalgia, it's often inaccurately lumped in with autoimmune diseases that, on the surface, appear to be similar.
It can be especially difficult to diagnose fibromyalgia when it occurs alongside an autoimmune disease with similar symptoms. However, it's important for each condition to be identified and treated separately, as they require different treatments.
American College of Rheumatology. Fibromyalgia. Accessed May 2012.
U.S. Department of Health and Human Services Office on Women's Health. Autoimmune diseases fact sheet. Accessed May 2012.