Bazzichi L, Rossi A, Zirafa C, Monzani F, Tognini S, Dardano A, Santini F, Tonacchera M, De Servi M, Giacomelli C, De Feo F, Doveri M, Massimetti G, Bombardieri S. “Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia?” Rheumatology International, Nov 18, 2010., by Division of Rheumatology, Department of Internal Medicine, University of Pisa, Pisa, Italy.
Laura Bazzichi, Alessandra Rossi, Tiziana Giuliano, Francesca De Feo, Camillo Giacomelli, Arianna Consensi, Antonio Ciapparelli, Giorgio Consoli, Liliana Dell’Osso and Stefano Bombardieri. “Association between thyroid autoimmunity and fibromyalgic disease severity .” Clinical Rheumatology Volume 26, Number 12, 2115-2120, DOI: 10.1007/s10067-007-0636-8
January 25, 2010
Dear Dr. Laura Bazzichi,
I want to thank you and your colleagues for studying the association of autoimmune problems in fibromyalgia.
Because of the life altering fatigue as a fibromyalgia patient, I was diagnosed with chronic fatigue syndrome. Several years later my TSH dropped for several months in a row. While that would normally indicate hyperthyroidism, it was no surprise to me the scan and uptake indicated a thyroid of severely low function. It is the thoughts of my mentor, Devin Starlanyl, and mine too, that in face of a dysfunctional HPA Axis, one may not see the usual abnormal values when assessing thyroid function. Eventually, I did get the proper test and I was positive for antibodies found in Hashimoto’s Thyroiditis. I feel certain there is a difference in Hashimoto's in fibromyalgia patients and may be under-diagnosed. Routine lab values we have come to rely upon may not reflect actual thyroid status in the fibromyalgia patient. It might explain the fatigue associated in some subgroups and lead to confusion of a dual fibromyalgia/chronic fatigue syndrome, now referred to as ME/CFS, diagnosis.
I am a registered nurse, author and have studied much literature for our book. I believe your research is of extreme value. Presently, I advocate for the assessment of myofascial trigger points in ALL fibromyalgia patients, and restless leg syndrome, since newer research suggests their presence. (A copy of my original correspondence, http://fmcfstriggerpoints.blogspot.com/2010_10_01_archive.html). The new proposed criteria, while addressing the centralization of fibromyalgia, exclude this assessment. Certainly, an underlying autoimmune disorder might explain why myofascial trigger points in fibromyalgia resist the usual treatments, and it might explain why trigger points are easily activated in the fibromyalgia patient.
Thank you again for all of your hard work, and please thank your associates for me.
Sincerely, Celeste Cooper, retired RN, author, past educator and author of CEUs for MO State Board of Nursing
American College of Rheumatology % Amy Miller
The American Nurses Association, Editor
Robert Bennett,MD, FRCP
Richard W. Clark, NIAMS Office of Communications and Public Liaison
Daniel J Clauw, MD
Shari Ferbert, Advocates for Fibromyalgia Funding, Treatment, Education, & Research
Fibromyalgia Coalition International,
Mary Ann Fitzcharles, MD (Canada)
Robert Gerwin, MD, FAAN
Donald L Goldenberg, MD
Alan Gurwitt, President Massachusetts CFMDS/ME & FM Ass.org
Cheryl Herrington, Fibro and Friends, Kansas City
Robert S Katz, MD
Phillip Mease, MD
National Fibromyalgia Association
National Fibromyalgia Research Association
National Fibromyalgia Partnership, Inc.
I Jon Russell,MD, PhD
Anthony S Russell, MD (Canada)
Marly Silverman, P.A.N.D.O.R.A (Patient Alliance for Neuroendocrineimmune Disorders Org for Researach and Advocacy)
Devin Starlanyl, Author, Researcher
Rocky Mountain CFS/ME & FM Association
Roland Staud, MD University of Florida, Gainsville,
Kristin Thorson, American Fibromyalgia Syndrome Assoc. Fibromyalgia Network
Muhammad B. Yunus, MD
John B Winfield, MD
Frederick Wolfe, MD