Integrative GP Dr. Lily Tomas dives into the many complexities involved in fibromyalgia, a condition underpinned by chronic, systemic inflammation and neuroinflammation. Our Ambassador Dr. Michelle Woolhouse opens the conversation discussing the many aetiologies of fibromyalgia which include oxidative stress, mitochondrial dysfunction, mast cell activation, microglia activation, peripheral and central sensitisation. They discuss common risk factors such as Vitamin D deficiency, gut health, and abnormal peripheral and central pain pathways, as well as others that can play a part in the development of fibromyalgia - which mainly impacts women aged 20 to 60 years of age.

The gut is a major first focus for Dr. Tomas, who details connections between those with fibromyalgia and IBS, as well as how to investigate and treat through the gut. There’s also a deep discussion surrounding mitochondrial health and the development of fibromyalgia, due to the high concentration of mitochondria in skeletal muscle tissue as well as their impacts on damaging the nervous system and their ability to produce melatonin.

Further to this, there is a fascinating technical discussion around gendered mast cells and microglia, and how they are shown to act differently depending on their sex, exposure to environmental toxins, dietary triggers, and sex hormones, all of which may be impacting patients with fibromyalgia. The brain and nervous system aspect can’t be forgotten as various areas of the brain known as the pain matrix contribute to both peripheral and central sensitisation with the focus on trigger points on reducing peripheral sensitisation having an upstream effect.

This podcast is not to be missed for those who love technical details surrounding fibromyalgia and the multi-faceted aspects to treatment.

COVERED IN THIS EPISODE
[00:30] Welcoming Dr. Lily Tomas
[02:13] The multiple aetiologies of fibromyalgia
[03:49] Potential triggers of fibromyalgia
[07:19] Start with the gut
[08:41] Connections between IBS and fibromyalgia
[12:40] Microbiome testing
[14:10] The role of oxidative stress and mitochondrial function
[19:22] Treatment options: how CoQ10 can improve symptoms
[21:28] Treatment options: Melatonin is more than a sleep hormone
[24:17] How mast cells affect nerve and neuroinflammation
[30:25] Hormonal influences on mast cells
[34:37] The pain matrix
[39:57] The endocannabinoid system
[42:15] Topical preparations to reduce peripheral sensitisation
[45:53] Thanking Lily and final remarks

Find today's transcript and show notes here: https://www.fxmedicine.com.au/podcast...

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