Description

Fibromyalgia is a chronic condition that causes widespread pain and tenderness in the body, along with other symptoms:

  • Fatigue
  • Trouble sleeping
  • Headaches
  • Lower abdominal pain or cramps
  • Depression
  • Insomnia
  • Hypersensitivity
  • Numbness or tingling in the arms and legs
  • Sensitivity to light, noise, odors, and temperature 

The pain can vary from mild to severe, and may be worse in the morning and evening. It can start in one part of the body, but any part of the body may be affected. It is important to rule out other causes of symptoms that are very similar.

This panel includes the following test:

Antinuclear Antibody (ANA)

C-Reactive Protein (CRP)

Creatine Kinase (CK)

Complete Blood Count (CBC)

Comprehensive Metabolic Panel (CMP)

Ferritin

Iron

Magnesium

Sedimentation Rate Test (ESR)

Thyroid-Stimulating Hormone (TSH)

Vitamin B12 and Folate Acid

Vitamin D 25 hydroxy

Fasting is not required.

Additional information about each test is listed below:

An Antinuclear Antibody (ANA) screen with reflex to titer and pattern test is sometimes ordered for individuals with fibromyalgia to rule out the presence of an underlying autoimmune disease, as a positive ANA can indicate an autoimmune condition, even though fibromyalgia itself is not considered an autoimmune disorder; however, a positive ANA in someone with fibromyalgia symptoms may require further investigation to determine the cause of their symptoms. 

C-reactive protein (CRP) is used in the context of fibromyalgia as a marker to indicate potential inflammation in the body, even at low levels, which may be associated with the severity of fibromyalgia symptoms, particularly in patients with elevated CRP levels; while fibromyalgia itself isn't considered an inflammatory disease, some research suggests a link between higher CRP and worse symptoms like pain and reduced physical functioning in fibromyalgia patients.

A Creatine Kinase (CK) test is used primarily to rule out other potential causes of muscle pain and fatigue by checking for significant muscle damage, as a normal CK level indicates that muscle breakdown is not likely the primary source of the patient's symptoms, which is important because fibromyalgia itself typically does not show abnormal CK levels; if elevated, further investigation into potential muscle disorders may be needed.

A complete blood count (CBC) is used in diagnosing fibromyalgia to rule out other potential medical conditions that could be causing similar symptoms, as there is no definitive blood test to diagnose fibromyalgia itself; a CBC can help identify issues like anemia, infection, or thyroid dysfunction which might be contributing to fatigue and pain experienced by the patient.

A comprehensive metabolic panel (CMP) is not used to directly diagnose fibromyalgia, but it can be used in conjunction with clinical evaluation to rule out other potential medical conditions that might be causing similar symptoms, as fibromyalgia is often a diagnosis of exclusion, meaning other possible causes of symptoms need to be eliminated first; a CMP can help identify underlying metabolic issues that could be contributing to a patient's symptoms, even if they have fibromyalgia.

Ferritin levels are measured in blood tests to assess iron stores and inflammation in patients with fibromyalgia (FMS). Low ferritin levels may be associated with FMS, and iron deficiency may contribute to the symptoms of FMS. 

Iron is a cofactor for enzymes that synthesize neurotransmitters, which may be linked to fibromyalgia (FM). Studies have shown that people with FM have lower levels of iron and other minerals in their hair and blood. 

Magnesium may help with fibromyalgia by reducing pain and inflammation, and improving sleep and stress relief. People with fibromyalgia often have low levels of magnesium, which may contribute to their symptoms.

A sedimentation rate test (ESR) is often used in conjunction with a fibromyalgia diagnosis to rule out other inflammatory conditions that might be causing similar symptoms, as a normal or slightly elevated ESR in a patient with fibromyalgia symptoms indicates that inflammation is likely not the primary cause of their pain, whereas a significantly elevated ESR could point towards a different disease like rheumatoid arthritis or polymyalgia rheumatica.

Thyroid-Stimulating Hormone (TSH) levels is important because there can be a significant overlap in symptoms between fibromyalgia and thyroid dysfunction, particularly hypothyroidism, where a high TSH level might indicate an underactive thyroid, leading to fatigue, muscle aches, and pain which are also common fibromyalgia symptoms; therefore, assessing TSH levels helps differentiate between the two conditions and guide appropriate treatment. 

Vitamin B12 and folate acid may be beneficial for people with fibromyalgia as research suggests they can help alleviate symptoms like pain and fatigue by potentially improving nerve function and reducing inflammation, with some studies showing that individuals with fibromyalgia may have deficiencies in these vitamins, particularly B12, which could contribute to their symptoms; however, further research is needed to fully understand their effectiveness in managing fibromyalgia.

Vitamin D 25 hydroxy (specifically measured as 25-hydroxyvitamin D) is important because research suggests a strong link between low levels of this vitamin and increased fibromyalgia symptoms, particularly chronic pain, indicating that supplementing with vitamin D could potentially help alleviate pain in individuals with fibromyalgia who are deficient in vitamin D.