Functional Medicine and Nutrition Virtual Classroom 312 - Fibromyalgia Global Pain and Fatigue

Course overview

*Describe the historical evolution of fibromyalgia and explain why it is best understood as a centrally mediated allodynia disorder rather than a muscle or connective tissue disease. *Explain the ACR fibromyalgia criteria including the tender point examination methodology and its limitations for clinical diagnosis. *Differentiate fibromyalgia from inflammatory, autoimmune, muscle, and chronic fatigue disorders by identifying common misconceptions. *Evaluate diagnostic accuracy of fibromyalgia and recognize comorbid conditions commonly missed in patients labeled with the disorder. *Describe the ACR criteria including the widespread pain index and symptom severity scale used for fibromyalgia classification. *Identify FDA-approved pharmacologic agents for fibromyalgia and explain the proposed mechanism of low-dose naltrexone on microglial inflammation. *Describe the spinothalamic, spinoreticular, and spinomesencephalic pathways and explain how convergence projection produces referred pain. *Explain the role of the descending antinociceptive system and substance P in amplifying non-painful stimuli in fibromyalgia. *Analyze how limbic system dysfunction and early life adverse events contribute to central sensitivity disorders in a sex-dependent manner. *Describe alpha wave intrusion during delta wave sleep and explain its relationship to pain severity and fibrofog. *Apply sleep hygiene strategies and cognitive behavioral interventions to retrain hypervigilant nervous systems in fibromyalgia patients. *Explain serotonin biochemistry and justify the use of 5-HTP precursor therapy when SSRIs prove ineffective. *Describe how gut microbiota composition influences serotonin and tryptophan metabolism in the gut-brain axis. *Identify calming botanicals and cannabinoid therapies that support GABAergic tone and address endocannabinoid deficiency in central sensitivity disorders. *Differentiate fibromyalgia from suboptimal thyroid function, myofascial pain syndrome, and mitochondrial dysfunction as common diagnostic masqueraders. *Apply urinary organic acid testing to identify mitochondrial dysfunction and recommend targeted nutritional support including CoQ10, L-carnitine, and lipoic acid.