It is believed as many as 25-40% of long-term Lyme patients develop fibromyalgia-like symptoms, particularly pain and fatigue; as many as 25% of HIV patients, 57% of RA patients and 24% of Psoriatic Arthritis patients also have FM symptoms. A 1993 Annals of Internal Medicine article (Lightfoot et al) found 10% of patients with Lyme Disease would have arthritis develop as a result of the spirochete infection. Because this organism (like mycoplasma) is difficult to culture, the diagnoses is based on the occurrence of (1) one or more of the classical features and (2) serum antibodies to the etiologic spirochete after the first 4 to 6 weeks of illness.

Some Lyme/FM patients do not respond to courses of antibiotics, causing researchers to dismiss the possibility of an organism as a trigger for the disease and antibiotics as a therapy. This might be a misleading assumption as explained by Garth Nicholson, PhD, as published in Environmental Phys, 1997. "Are chronic, systemic mycoplasmal infections the only answer to CFS, FMS, and other disorders? Of course not! This is likely to be an appropriate explanation for a rather large subset of people, but certainly not every patient will have chronic infection.

Some patients may have chemical exposures or other environmental problems as the underlying reason for their chronic signs and symptoms. In these patients, antibiotics should have no effect whatsoever." Nicholson has found mycoplasma infections in approximately one half of patients with FM as well as arthritis.

"The identification of mycoplasma infections in the leukocyte blood fractions of a rather large subset of CFS, FMS and arthritis patients suggests that mycoplasmas, and probably other chronic infections as well, may be an important source of morbidity in these patients. If such infections are important in these disorders, then appropriate treatment with antibiotics should result in improvement and even recovery. This is exactly what has been found." (Nicholson JAMA 1995).

"Only antibiotics that are effective against the pathogenic mycoplasmas result in recovery, and some antibiotics, such as penicillins, can worsen the condition." (Nicholson, 1996, & 1997.) Goldenberg suggests two possibilities for an infectious cause: 1) the infectious agent would either directly invade tissues such as the joints or central nervous system or 2) "trigger" factors that would cause the chronic myalgias, fatigue, headaches, sleep disturbances, and mood disturbances... Infectious agents are capable of activating cytokines, which may in turn cause severe myalgias, fatigue, and neurocognitive disturbances...

The potential role of a microbial agent as a trigger to fibromyalgia remains tenable.

Adapted from: The Roadback.org