Once one tests positive for Epstein-Barr virus (EBV), he/she will always test positive which means the immune system has reacted to the virus and formed antibodies which are measured during EBV testing. The immune system always remembers the virus via these specifc antibodies circulating in the bloodstream.
Some people will have a chronic active form of EBV and get recurrent infections, but most people will have a dormant form. They may have initially had acute mono symptoms, but often there were no obvious symptoms. In most, the virus is vigorously defended against by our healthy immune responses and rendered harmless and dormant, even if we still test positive for EBV.
But in some, the EBV can trigger FM to develop, presumably in one who is genetically susceptible. The EBV infection goes away, but the fibro cascade gets triggered, and once fibro develops, it is a lifelong problem indeed. Fibro patients often report their symptoms began after a mono infection that was like "hitting a brick wall." Fatigue often dominates first, then the pain evolves over time, usually within a few months.
If a person with fibro tests positive for EBV but did not have any history of acute mono, I am less likely to attribute the fibro "cause" to the EBV. As you've indicated, a large number test positive for the virus so just testing positive does not seem to trigger the fibro; I think acute mono can trigger it, though.
Very interesting questions! Research has shown that our brains change in fibro, It appears that other chronic pain conditions including migraines can cause similar brain changes like fibro.
The brain is quite dynamic and always changes in response to chronic illnesses, stress, and pain. I like to say that the brain rewires itself in response to fibro's chronic neural bombardment with pain signals, dysfunctional autonomics, and hormone changes. The brain rewiring, in the case of fibro, is creating a "better" way for the brain to accomodate and signal all the extra amplified pain signals it receives from the spinal cord and peripheral nerves. In other words, fibro turns our brains into "lean, mean pain-signalling machines!"
Once our brains become rewired in fibro, the typical central pain we experience becomes the new norm. Theoretically, our brains could be rewired back to the previous "normal." The problem with fibro, or any chronically painful condition, is that we haven't figured out how to change it back to normal....yet.
More women than men have these chronically painful condition such as fibro and migraines. A lot has to do with how women's nervous systems have slight differences compared to men's. Women tend to experience pain more globally with the entire brain compared to more focal or one-sided brain pain experiences in men. (Yes, men are more half-brained!) Some of the reasons likely include: larger corpus callosum in women which connects the 2 brain halves, higher estrogen & lower testosterone in women, and genetic differences in pain processing.
One genetic difference studied has to do with how we normally block chronic pain signals with a specialized nerve pathway in our spinal cord. People (with and without fibro) are continuously being bombarded with potentially chronically painful signals, but these specialized nerve pathways function as a wall to block any chronic pain condition from breaching it. As normal aging occurs, this wall develops some cracks and starts allowing more pain signals through. The deterioration is faster in women than men, so this may be another reason why woman get more chronic pain conditions over time compared to men.
This difference may also explain how it may take years for fibro pain to develop, even though we may have inherited the fibro susceptibility. It takes time for the "wall" to deteriorate to the point where fibro signals are finally able to "break through" and establish a "foothold." Once that happens, the rest of the nervous system changes occur leading to full blown fibro. And this occurs more readily in women due to the aging differences in the specialized blocking nerves as mentioned.
Hope this info helps answer your questions. I reread my answer and I half confused myself...perhaps only half my brain is working right this morning! Let me know if you'd like any additional clarification, Susan.
Thank you for you very well written, interesting, and timely posts! You definitely have reasearch and writing skills. I learned a lot from reading your info and following up with additional research of your links. You are certainly correct in the lack of awareness, or need for it, regarding this topic.
Fibro is certainly complex, and the hormone dysfunctions can be mind boggling to try to understand and treat. This can be intimidating and confusing even to supposed experts like me.
As you know, everything is interconnected: the central nervous system, autonomic nerves, neuroendocrine and immune systems are all intricately weaved together and modulated by endless feedback loops. If you disrupt one piece of this puzzle, everything can seem to unravel. Fibro is the equivalent of reaching in and scooping out a handful of pieces!
We know the importance of the thyroid in our fibro symptoms, and are only recently beginning to better understand the role of reverse T3 in some patients' fibro symptoms. Measuring reverse T3 is not presently a part of the "normal" thyroid lab screening. Maybe it should be.
Medicine has always evolved as research and education lead the way. Doctors' behaviors, on how they diagnosis and treat specific conditions, for example, change over time once the compelling evidence mounts. We are still in the evolving stage with understanding and treating fibro, including the thyroid connection.
I would like to see more emphasis on checking the reverse T3 as part of the specific thyroid/fibro work-up, and looking more closely at the connections to other glands ie adrenals, pituitary. I would like to see "low normals" treated more aggressively in those with fibro. I would like to see more use of Cytomel (liothyronine, T3) and compounded long acting T3 and less use of thyroxine or Armour thyroid. I would like more "comprehensive" hormonal treatment strategies that focus on multiple puzzle pieces.
I'm confident we will soon get to wherever the fibro research/education inevitably takes us....but sometimes it seems to move so slooooow! In the meantime, I'm going to be a little more vigilant about checking the hormone dysfunctions, and will educate my colleagues a little more. (I think I just heard them sigh!)
It's never fun being flared-up. It's never fun having fibro in the first place! Fun and fibro do not mix.
Any new symptom that develops during a flare, or anytime, should be investigated. If dizziness is occuring and interfering with balance, walking, driving, then it should be reviewed to determine possible causes and what testing and treatment options may be available.
Dizziness causes include a number of things: fibro flare-up affecting the autonomic nerves including vestibular ones, viral syndrome, medicine reaction, underlying nervous system disorder, etc
Sometimes dizziness and lightheadedness are reported together so other conditions to consider could include metabolism or electrolyte problems, dehydration, heart rhythm changes, low blood pressure issues, etc. A lot of things can be considered, and a lot of treatments are possible depending on the specific cause(s).
If your dizziness has been off and on for the past year, and recently worsened during a fibro flare, you could very well have dizziness as part of your fibro, and managing the fibro may help control the dizziness. I hope you get your function back soon.
I hope you're feeling better already on your Cymbalta trial. I use Cymbalta often as a prescribed treatment for fibro pain. Most of my patients report improvement in their pain, ranging from some improvement to much improvement.
The medicine is usually well tolerated; I review possible side effects such as nausea, constipation, dry mouth, and sometimes, sleepiness. Most of the time, side effects are mild and limited to the first few days of treatment.
Some of the things I like about Cymbalta for my fibro patients include: - only once a day dosing; I recommend taking it in the morning. -fast acting; usu know within 2 weeks if it will help -well tolerated -can help mood, anxiety, energy, cognition, in addition to pain
Sorry you have polymyalgia rheumatica (PMR). In this Fibromyalgia Community, some of the members have the misfortune of having both fibromyalgia and PMR. From time to time, there are discussions here involving PMR. You may wish to try the "Search This Community" in the upper right above my name to see if you can find any past discussions.
There's no controversy about PMR like there is with fibro. If a person (usu age 60 or older) with widespread pain and weakness has a high sed rate lab, the doctor may consider a diagnosis of PMR and try prednisone. The doctor will watch for a complication of PMR called temporal arteritis which can cause severe headaches and loss of vision.
I'm not sure if you were trying to set up the poll to ask if people here have PMR. Put the question, ie Do you have PMR? in the heading box and then put the answers, ie Yes, No, Not sure in separate answer boxes so the members can respond by checking one box. We can't elaborate on anything when taking a poll; we can only check off one box.
Welcome to this community: it's a great place to learn more about your fibro and meet people who know exactly how you feel and what you're going through!
You've gotten great responses already. I'll help clarify your question about prednisone and rheumatoid arthritis (RA).
The diagnosis of RA does not involve whether or not one responds to prednisone. In fact, as Nancy B said, most people who take prednisone will report feeling better, regardless of what condition(s) they have (or don't have!)
RA is diagnosed based on a typical clinical presentation, ie multiple painful swollen inflamed joints, and usual lab abnormalities, ie elevated sed rate, C-reactive protein, rheumatoid factor. Prednisone may be used to treat RA, but prednisone is used to treat a number of inflammatory conditions. Also, steroids can be used in certain situations involving fibro.
Your treating doctor could determine if you are a candidate for prednisone or specific meds based on your specific situation.
You should be very hopeful, true hope, that you will absolutely do better with your fibro. You can learn to successfully manage this condition, and the wonderful FMily here can help you accomplish this goal!