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Fibromyalgia

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Painting by Euan Uglow

The term "fibromyalgia" derives from New Latin, fibro-, meaning "fibrous tissues", Greek myo-, "muscle", and Greek algos, "pain"; thus the term literally means "muscle and connective tissue pain".  The International Classification of Diseases (ICD-10) lists fibromyalgia as a diagnosable disease under "Diseases of the musculoskeletal system and connective tissue."

It has been estimated to affect roughly  2-4% of the general population in most countries studied, and it has been shown to be much more prevalent in women than in men.  The male:female ratio is 1:9.[ PMID: 19954696].

Symptoms

Fibromyalgia is characterized by pain – ‘chronic generalized pain’ in muscles and joints. 

Constant pain then leads to a host of other symptoms which include -  sleep disturbances, fatigue, stiffness, balance problems, hypersensitivity to physical and psychological environmental stimuli, depression and anxiety. It thus remains principally a disease of muscle fibres, which because of the terrible pain it causes can send the sufferers into a slough of despond.

Fibromyalgia also shares a high degree of co-morbidity with other conditions, including chronic headache, temporomandibular disorder, irritable bowel syndrome, and chronic fatigue syndrome.

euan uglow

Fibromyalgia has a cause and that cause is pathogens one or more pathogens.  Pathogens do not stay in one place, they travel around the body and each time our immune system is compromised, they travel a bit more and do more damage.  The problem with symptom based medicine, is that by naming symptoms and groups of symptoms, we may find a person with apparently numerous illnesses, which are actually caused by a single pathogen.  For example, here there is yet another symptom - an association with Vulvodynia:

Vulvodynia is a chronic pain syndrome of unknown origin with scant data on frequency. This study assessed the prevalence of vulvodynia symptoms in a sample of US women …..A phone survey contacted 2127 US households to identify 100 symptomatic women, …..Current vulvar pain of at least 6 months duration was reported by 3.8% of respondents, with a 9.9% lifetime prevalence. Forty-five percent of women with pain reported an adverse effect on their sexual life and 27% an adverse effect on their lifestyle. Cases more frequently reported repeated urinary tract infections and yeast infections. Associations existed with chronic fatigue syndrome, fibromyalgia, depression, and irritable bowel syndrome.  PMID: 17306651

Euan Uglow

In other words one possible cause in this study – of all the problems not just the vulvodynia – may be a fungal infection, slowly working its way round the body.  We will see shortly that there are multiple possible causes, but isolating Fibromyalgia in this way, may not be at all helpful when it comes to isolating the actual pathogen, as it diverts attention away from trying to find the cause or causes.

The question we need to ask is what is attacking the muscles?  And is it just the muscles it is attacking?

Some background to the functions controlling pain

The HPA axis

One finding from studies is that many patients with fibromyalgia are extremely sensitive to pain in general – hypersensitive.

In clinic studies, altered hypothalamic-pituitary-adrenal (HPA) axis function has been associated with fibromyalgia, a syndrome characterised by chronic widespread body pain. These results may be explained by the associated high rates of psychological distress and somatisation. We address the hypothesis that the latter, rather than the pain, might explain the HPA results. A population study ascertained pain and psychological status in subjects aged 25 to 65 years. ….. In all 131 persons with chronic widespread pain, 267 'at risk' (58%) and 56 controls (70%) were studied. Those in the chronic widespread pain and 'at risk' groups were, respectively, 3.1 and 1.8 times more likely to have a saliva cortisol score in the lowest third. …. Further, those in the chronic widespread pain and 'at risk'  groups were also more likely to have the highest serum cortisol scores. High post-stress serum cortisol was related to high levels of psychological distress …. This is the first population study to demonstrate that those with established, and those psychologically at risk of, chronic widespread pain demonstrate abnormalities of HPA axis function, which are more marked in the former group. Although some aspects of the altered function are related to the psychosocial factors measured, we conclude that the occurrence of HPA abnormality in persons with chronic widespread pain is not fully explained by the accompanying psychological stress. PMID:  16207340

 Euan Uglow
 

There is further evidence supporting this paper in studies of Growth hormone abnormalities, controlled by this same HPA system

Adult growth hormone (GH) deficiency is a well-described clinical syndrome with many features reminiscent of fibromyalgia. There is evidence that GH deficiency ….occurs in approximately 30% of patients with fibromyalgia and is probably the cause of some morbidity. It seems most likely that impaired GH secretion in fibromyalgia is related to a physiologic dysregulation of the hypothalamic-pituitary-adrenal axis (HPA) PMID:  12126582

And, of perhaps more importance, research has also shown an increase on nerve growth factor – meaning that sensitivity to pain is going to be far more than might otherwise be

To determine whether there is a difference in the concentration of nerve growth factor (NGF) in the cerebrospinal fluid (CSF) from patients diagnosed with primary fibromyalgia syndrome (FM), fibromyalgia associated with other secondary conditions (SFM), patients with other painful conditions but lacking fibromyalgia (OTHER), and healthy controls.  RESULTS:  The mean concentration of NGF measured in patients with FM was significantly increased .. compared to controls, but with large variability. Concentrations of NGF in SFM and OTHER were not elevated compared to controls.  PMID:  10405946

Thus the cause might be an attack to the endocrine glands, particularly the Pituitary gland which acts like a master controller in a number of key processes.  But not in all fibromyalgia sufferers.

Thus one of the key tests that ought to be made for anyone with Fibromyalgia should be the tests described in this sub-section.  If this is the problem, you need to now turn to the section on the Pituitary gland, where causes of attack are described there.

But if it is not damage to the HPA system, what is it?

The role of substance P

At one time research concentrated on some disruption of endorphins our natural pain relief neurotransmitter, but none was found

a lack of endorphin secretion does not seem to be the basis for the hyperalgesia observed in these patients. PMID: 1684241

Research has thus shown that it is the other way round, the endorphin levels are usually ‘normal’.  Fibromyalgia patients instead have high levels of Substance P - Substance P is released from the terminals of specific sensory nerves. It is found in the brain and spinal cord and is associated with inflammatory processes and pain.

To measure, and seek clinical correlates with, levels of substance P (SP) in the cerebrospinal fluid (CSF) of fibromyalgia syndrome (FMS) patients.  CONCLUSION:   SP is significantly elevated in FMS CSF  PMID:  7526868

Euan Uglow

Substance P is a key first responder to most noxious/extreme stimuli (stressors), i.e., those with a potential to compromise biological integrity. SP is thus regarded as an immediate defense, stress, repair, survival system. The molecule, which is rapidly inactivated (or at times further activated by peptidases) is rapidly released – repetitively and chronically, as warranted, in the presence of a stressor. Substance P is a potent vasodilator, meaning that it also helps the immune system troops get to the site of the cause of the pain.

Substance P is an important element in pain perception. Substance P and other sensory neuropeptides can be released from the peripheral terminals of sensory nerve fibres in the skin, muscle, and joints.  In other words, substance P goes FROM the source of pathogen or other attack  TO the brain telling it we are under attack. 

As such we might have two causes for the pain:

  • A disruption to the HPA axis which has resulted in an increase in the number of pain receptors releasing substance P [as described above]
  • A very aggressive pathogen [or one not being suppressed by the immune system]

In the latter case, the very fact that substance P is being released in these sorts of quantities, is a sure fire indicator – not that our regulatory system is messed up, but that we are under quite severe attack.  The pathogen is perceived as very dangerous. 

As long ago as 1988, researchers had found that one such pathogen was smoke – smoke particles from air pollution and chronic smoking.  But this is just one pathogen of many:

Anamnestic information from patients revealed that 53.3% had Raynaud/Raynaud-like phenomenon localized in the fingers, the toes or both. …. Substance P levels were significantly higher in patients who were smokers PMID: 2448729

Causes

Euan Uglow

One of the causes frequently cited in medical sites is ‘stress’, ‘the cause is stress’ they say.  As we have seen, Fibromyalgia often coexists and overlaps with other illnesses such as chronic fatigue, irritable bowel syndrome, and interstitial cystitis. And stress has been implicated in the pathogenesis of these illnesses too.  So let us tackle this first.

Stress

It is indeed true that female fibromyalgia patients (FMS) seem to have experienced more negative life events than healthy women.  For example:

During childhood or adolescence 51% of the patients had experienced very negative life events as compared to 28% of the controls. Conflict with parents was the most common life event. Before onset, 65% of the patients experienced some negative life event. Economic problems and conflicts with husband/partner were common. During the last year, 51% of the patients had life events which they experienced as very negative, compared to 24.5% of the controls. Stressful life events in childhood/adolescence and in adulthood seem to be very common in FMS. Furthermore, the life events were experienced as more negative than the life events experienced by healthy controls.  PMID:  10954873

Stress invokes the sympathetic nervous system – the fight and flight response – and chronic stress invokes it on a permanent basis, meaning the person never relaxes.  Stress suppresses the immune system, as such stress is not a cause per se – it is not a pathogen, but it means that by being stressed we have suppressed the one system we have for dealing with pathogens.  Whatever is causing the illness has no opposition.

The objective of this study was to carry out a review of all published comparative case-control studies investigating sympathetic nervous system performance in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis……A total of 196 articles are included in this review. … The majority of studies (65%) described sympathetic nervous system predominance in these overlapping syndromes. ….. The recognition of sympathetic predominance in these 4 syndromes may have potential clinical implications. It may be worth exploring the use of nonpharmacological measures … to regain autonomic balance. PMID:  24662556

There is a terrible and very vicious cycle being acted out here too.  Constant pain will cause stress, and stress will then suppress the immune system and the pathogen will spread and the pain will get worse.  Thus in any treatment, we have to find a way of breaking this cycle giving the person a way of relieving pain in order that their immune system can start working again to beat the pathogen or pathogens.  And a way of helping them deal with the events causing them stress – solutions to their problems, which means therapy, empathy and help NOT PHARMS.

Vaccines

Vaccines are heavily implicated in fibromyalgia and in a number of related conditions, and not just one vaccine, a number.  There are not enough studies yet to reach any final conclusions, however, one major cause appears to be the ADJUVANT in the vaccine, as opposed to the excipient or the virus itself: 

…..adverse reactions have been described after the injection of the newer vaccines viz. human papillomavirus (HPV). The symptoms more often reported are chronic pain with paresthesias, headaches, fatigue, and orthostatic intolerance. Adverse reactions appear to be more frequent after HPV vaccination when compared to other type of immunizations. Different isolated cases and small series have described the development of complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and fibromyalgia after HPV vaccination. These are illnesses often difficult to diagnose that have overlapping clinical features. Sympathetic nervous system dysfunction seems to play a major role in the pathogenesis of these syndromes. Also, small fiber neuropathy has been recently recognized in CRPS, POTS, and fibromyalgia.  PMID:  25990003

And

We used the …. validated questionnaires to appraise the chronic illness that might appear after HPV vaccination: …. Twenty-nine percent of the cases had immediate (within 24 h) post-vaccination illness onset. The most common presenting complaints were musculoskeletal pain (66 %), fatigue (57 %), headache (57 %), dizziness/vertigo (43 %), and paresthesias/allodynia (36 %). Fifty-three percent of affected individuals fulfill the fibromyalgia criteria. ….. After a mean period of 4.2 ± 2.5 years post-vaccination, 93 % of patients continue to have incapacitating symptoms and remain unable to attend school or work. In conclusion, a disabling syndrome of chronic neuropathic pain, fatigue, and autonomic dysfunction may appear after HPV vaccination.  PMID:  26354426

And

The objectives of this study were to gather information regarding demographic and clinical characteristics of patients diagnosed with either fibromyalgia (FM) or chronic fatigue (CFS) following hepatitis B vaccination (HBVv) and furthermore to apply the recently suggested criteria of autoimmune (auto-inflammatory) syndromes induced by adjuvants (ASIA).
Medical records of 19 patients with CFS and/or fibromyalgia following HBVv immunization were analyzed. All of which were immunized during 1990-2008 in different centers in the USA.
The mean age of patients was 28.6 ± 11 years, of which 68.4 % were females. … The mean latency period from the last dose of HBVv to onset of symptoms was 38.6 ± 79.4 days, ranging from days to a year. Eight (42.1 %) patients continued with the immunization program despite experiencing adverse events. Manifestations that were commonly reported included neurological manifestations (84.2 %), musculoskeletal (78.9 %), psychiatric (63.1 %), fatigue (63.1 %), gastrointestinal complains (58 %) and mucocutaneous manifestations (36.8 %). Autoantibodies were detected in 71 % of patients tested. All patients fulfilled the ASIA criteria. … ASIA criteria were fulfilled in all patients eluding the plausible link between ASIA and CFS/FM.  PMID:  25427994

Vaccine contents [according to Wikipedia]

Virus/vaccine

Culture medium

Adjuvant and excipient

Human papillomavirus (HPV) (Cervarix)

Trichoplusia ni cells

Aluminum hydroxide, amino acids, lipids, mineral salts, sodium dihydrogen phosphate dehydrate, type 16 viral protein L1, type 18 viral protein L1, vitamins

Human papillomavirus (HPV) (Gardasil)

Yeast or yeast extract

Amino acids, amorphous aluminum hydroxyphosphate sulfate, carbohydrates, L-histidine, mineral salts, polysorbate 80, sodium borate, vitamins, yeast protein

Hepatitis B vaccine (Engerix-B)

Yeast or yeast extract

Aluminum hydroxide, phosphate buffers, yeast protein

Hepatitis B vaccine (Recombivax)

Yeast or yeast extract

Amorphous aluminum hydroxyphosphate sulfate, amino acids, dextrose, formaldehyde, mineral salts, potassium aluminum sulfate, soy peptone, yeast protein

HepA/HepB vaccine (Twinrix)

Human diploid tissue culture (MRC-5), yeast or yeast extract

Aluminum hydroxide, aluminum phosphate, amino acids, formalin, MRC-5 cells, neomycin sulfate, phosphate buffers, polysorbate 20, yeast protein

 An alternative as a source is the mercury used in some vaccines

HgCl2 is a known environmental neurotoxin, but is also used as preservative in vaccines as thimerosal containing ethyl mercury covalently linked to thiosalicylate. We recently reported that mercury choloride (HgCl(2)) can stimulate human mast cells to release vascular endothelial growth factor (VEGF), which is also vasoactive and pro-inflammatory. PMID:  21244751

And in the following we have an example that the agent itself was the problem.  A recombinant vaccine against Lyme disease, based on the outer surface protein A (ospA) of B. burgdorferi, was developed, called LYMErix. LYMErix was approved by the Food and Drug Administration (FDA) on December 21, 1998.  Subsequently, hundreds of vaccine recipients reported they had developed side effects. LYMErix was withdrawn from the U.S. market in February 2002.  Here is a bit more detail:

  • About 3 months after a third dose of Lyme vaccine, a 16 year old boy developed arthritis of both knees.
  • 24 hours after a second dose of Lyme vaccine a 53 year old man developed flu-like symptoms and arthralgia; he later developed swelling of the finger joints and toe joints.
  • 24 hours after a second dose of Lyme vaccine a 43 year old man developed multiple synovitis.

….. the findings support post-infectious and mimicry models, .. showing that OspA, an outer surface protein of the causative organism of Lyme disease – B.burgdorferi, could cause acute arthritis…. From reports containing information on HLA types, clinical descriptions of adverse events in those given Lyme disease vaccine are similar in people with DR4 and non DR4 HLA haplotypes…. The characteristics of adverse events in people with a self reported history of Lyme disease, do not differ substantially from all adverse events after Lyme vaccine. [Ref ACIP –reports 1999-2006]

 

Viruses

Viruses can also cause fibromyalgia, as they are of course pathogens.  As such, one aspect which further confuses the picture is that viruses also appear to induce the same types of inflammation as vaccine contents, making it very difficult to know whether, in any one case it is the preservative in a vaccine, the adjuvant, the virus or the excipient.  Or all these things!

The purpose of our investigation was to evaluate the incidence of fibromyalgia syndrome (FMS) and identify FMS-related clinical symptoms in hepatitis B virus (HBV) patients…..The incidence of FMS, widespread body pain, fatigue, sleep disturbance, anxiety, morning stiffness, arthralgia was significantly greater among HBV patients relative to the control group. Additionally, the mean tender point counts and the visual analog scale values were significantly higher among the HBV patients PMID: 26133007

And

Clinical and serologic studies suggest an association of CFS (Chronic fatigue syndrome)  with all of the human herpesviruses, particularly Epstein-Barr virus (EBV) and the recently discovered human B lymphotropic virus (HBLV) or human herpesvirus 6; …… Preliminary evidence suggests that many of the features of CFS also are seen in patients with fibromyalgia.  PMID:  2691680

And

Inflammatory rheumatic conditions including rheumatoid arthritis and Sjögren's syndrome have been reported in individuals infected with human T cell lymphotropic virus type I (HTLV-I). Other chronic lymphotropic virus infections such as hepatitis C and human immunodeficiency virus are associated with fibromyalgia (FM). … We evaluated the association between FM and HTLV-I infection…. One hundred individuals with HTLV-I infection and 62 non-infected blood donors were studied. Thirty-eight (38%) HTLV-I infected individuals and 3 (4.8%) individuals from the control group presented the diagnosis of FM. Other rheumatic diseases were also more prevalent in the infected group … the association between HTLV-I and FM was statistically significant PMID: 17086610

The viruses that appear to be implicated the most often are those that exhibit latency and the retroviruses.

Retroviridae is a family of enveloped viruses that replicate in a host cell through the process of reverse transcription. A retrovirus is a single-stranded RNA virus that stores its nucleic acid in the form of an mRNA genome and targets a host cell as an obligate parasite. Once inside the host cell the virus uses its own reverse transcriptase enzyme to produce DNA from its RNA genome, the reverse of the usual pattern, thus retro (backwards). This new DNA is then incorporated into the host cell genome by an integrase enzyme, at which point the retroviral DNA is referred to as a provirus. The host cell then treats the viral DNA as part of its own genome, translating and transcribing the viral genes along with the cell's own genes, producing the proteins required to assemble new copies of the virus. It is difficult to detect the virus until it has infected the host. At that point, the infection will persist indefinitely

This family of viruses is also implicated in many so called ‘inherited or genetic’ diseases.  HIV is a retrovirus and it can cause fibromyalgia.

Food allergy

 

In many people with an intolerance to gluten and wheat, the gluten acts lie an abrasive poison causing damage to the intestines.  Thus this may account for the co-morbidity of IBS.  Once the gut is damaged, pathogens of all sorts can enter the blood stream, from parasites to bacteria, fungi to viruses, as such this may be the route by which the pathogens above have gained access to the muscles.

Non-coeliac gluten sensitivity is increasingly recognised as a frequent condition with similar manifestations which overlap with those of FM. The elimination of gluten from the diet of FM patients is recently becoming a potential dietary intervention for clinical improvement. In summary, this review reveals the potential benefit of specific dietary interventions as non-pharmacological tools as part of a multidisciplinary treatment for FM patients. PMID: 25786053

Pharmaceuticals

The eHealthme site collects the Adverse Drug reports submitted by doctors to the FDA and SEDA in the USA.  It then summarises them for ease of use.  We originally provided a direct link to Fibromyalgia listed on this site and the pharmaceuticals that can cause it, but the eHealthme website frequently reorganise the site and thus break the links.  Thus in order to find out which pharmaceuticals are implicated in XXXXX

  • Follow the LINK to the eHealthme website
  • Using the ‘All conditions’ index find the appropriate entry
  • Now scroll down until you get to the section marked ‘Drugs that could cause

The list shows you all the drugs implicated in CAUSING fibromyalgia as well as the number of people who have made a complaint to their doctor and had their case reported by him.  Note that it is up to the doctor whether he reports or not.

As of October 2016, about 1,350 pharmaceuticals were in this list.

All the pharmaceuticals that act in one way or another to suppress the immune system are implicated – anti-histamines and the nasal sprays and cough medicines containing them, PPIs, antacids, immunosuppressants and antibiotics.

Antibiotics appear to be particularly destructive in this respect.  The intestinal gut flora is a finely balanced garden of microbes that not only extracts nutrients but also acts as part of the immune system.  Antibiotics can destroy that garden, leading to what is called dysbiosis:

The human gut microbiome impacts human brain health in numerous ways: …. Excessive stimulation due to bacterial dysbiosis, small intestinal bacterial overgrowth, or increased intestinal permeability may produce systemic and/or central nervous system inflammation. PMID: 25402818

Equally interesting is that

Through these varied mechanisms, gut microbes shape the architecture of sleep and stress reactivity of the hypothalamic-pituitary-adrenal axis. They influence memory, mood, and cognition and are clinically and therapeutically relevant to a range of disorders, including alcoholism, chronic fatigue syndrome, fibromyalgia, and restless legs syndrome. Their role in multiple sclerosis and the neurologic manifestations of celiac disease is being studied. Nutritional tools for altering the gut microbiome therapeutically include changes in diet, probiotics, and prebiotics. PMID: 25402818

So the cause of the pain may be the antibiotics prescribed for you.

Nutritional deprivation

Generally speaking a deficiency of certain amino acids can exacerbate our ability to recover from pain and our body’s ability to modulate the pain response.  The cycle, which involves nitric oxide, is too complex to describe here, but the following paper provides an outline which can be followed up using the reference number. 

….measures of pain intensity, determined using an examination-based measure of pain intensity, the tender point index (TPI), covaried with their respective concentrations of glutamine and asparagine, metabolites of glutamate and aspartate, respectively. …. Individual concentrations of glycine and taurine also correlated with their respective TPI values in patients with primary fibromyalgia syndrome (PFMS). While taurine is affected by a variety of excitatory manipulations, glycine is an inhibitory transmitter as well as a positive modulator of the N-methyl-D-asparate (NMDA) receptor. In both PFMS and SFMS patients, TPI covaried with arginine, the precursor to nitric oxide (NO), whose concentrations, in turn, correlated with those of citrulline, a byproduct of NO synthesis. These events predict involvement of NO, a potent signaling molecule thought to be involved in pain processing. Together these metabolic changes that covary with the intensity of pain in patients with FMS may reflect increased excitatory amino acid (EAA) release and a positive modulation of NMDA receptors by glycine, perhaps resulting in enhanced synthesis of NO.  PMID:  10924813

Heavy metals

We have an observation for the link between fibromyalgia and heavy metals.

 Treatment

Cause based medicine

FIND THE CAUSE

According to Dr Duke’s Phytochemical database, food and plants [NOT SUPPLEMENTS] containing the following two chemicals help alleviate symptoms, for example apples contain malic acid.  Malic acid contributes to the sourness of green apples and rhubarb. It is present in grapes and in most wines with concentrations sometimes as high as 5 g/l.

Dr Duke’s list of Chemicals with Antifibromyalgic Activity

MAGNESIUM 200-300 mg 3x/day
MALIC-ACID 300 mg 3x/day


 

Malic acid is also a chelating agent, as such if the cause is heavy metals it may help here as well, alleviating the effects and removing the cause.

We have been able to include  a number of extremely helpful and hopeful observations from published research regarding the use of mindfulness and warmth to help - not cure - but greatly alleviate the suffering for people who have this disease.

Symptom based medicine

In a recommendation that is close to criminal the research community appear to be recommending that people with fibromyalgia are given anti-psychotics and TCAs [tricyclic antidepressants] and I quote:

the most widely used drugs that have the higher degree of evidence for efficacy include the .. the tricyclic antidepressants and serotonin noradrenaline (norepinephrine) reuptake inhibitors (SNRIs)…. …. First- and second-generation antipsychotics have shown analgesic properties both in an experimental setting and in humans, although most of the available evidence for the treatment of human pain concerns older antipsychotics and involves clinical trials performed several decades ago. PMID: 22296316

So the message doctors wish to send their patients is that they are psychotic.  I don’t think so, do you?  From what we have seen of the evidence, doctors are largely responsible for this illness, as such there is every reason for patients to be extremely ‘mad’, but certainly not insane.  And we have another useful statistic to add to this evidence, from the eHealthme site.  All the symptoms other than that of pain, were due to the drugs these poor people were given:

Most common Fibromyalgia symptoms

  • Pain - (4,855 reports)
  • Drug ineffective - (4,338 reports)
  • Nausea - (2,703 reports)
  • Dizziness - (2,670 reports)
  • Weight increased - (2,509 reports)
  • Headache - (2,390 reports)
  • Fatigue - (2,198 reports)
  • Feeling abnormal - (2,064 reports)
  • Insomnia - (2,009 reports)
  • Malaise - (1,864 reports)

References and further reading

The Painter

self portrait

Euan Ernest Richard Uglow (10 March 1932 – 31 August 2000) was a British painter, known for his nude and still life paintings and a shy artist who shunned publicity as well as honours, including an offer to become a member of the Royal Academy in 1961.  He was a conscientious objector in 1954, and spent two years undertaking community work instead.  After leaving art school, he taught at the Slade from 1961.  In 1962 he was at the centre of a storm at the municipal art gallery in Bradford, Yorkshire, when a local councillor, Horace Hird, had one of Uglow's paintings, removed from an Arts Council exhibition at the gallery. Hird claimed the painting 'offended decency'

Other help on the site

It may be helpful to have a brief glance at the entry for Chronic fatigue syndrome and  the more general section Nervous system diseases.  As it is also a muscle system problem it is also mentioned in the section Muscle system diseases.

PubMed papers

  • J Clin Rheumatol. 2014 Apr;20(3):146-50. doi: 10.1097/RHU.0000000000000089.  Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: a review of case-control studies. Martínez-Martínez LA1, Mora T, Vargas A, Fuentes-Iniestra M, Martínez-Lavín M.  1From the Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
  • Am J Obstet Gynecol. 2007 Feb;196(2):128.e1-6.  Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study.  Arnold LD1, Bachmann GA, Rosen R, Rhoads GG.
  • Autoimmun Rev. 2008 Oct;8(1):52-5. doi: 10.1016/j.autrev.2008.07.026. Epub 2008 Aug 24.  Chronic fatigue syndrome with autoantibodies--the result of an augmented adjuvant effect of hepatitis-B vaccine and silicone implant.  Nancy AL1, Shoenfeld Y.  1Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.
  • Clin Rheumatol. 2015 Jul;34(7):1165-9. doi: 10.1007/s10067-015-2969-z. Epub 2015 May 20.  Hypothesis: Human papillomavirus vaccination syndrome--small fiber neuropathy and dysautonomia could be its underlying pathogenesis.  Martínez-Lavín M1.  1Rheumatology Department, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, 14080, Mexico City, Mexico, drmartinezlavin@gmail.com.
  • Clin Rheumatol. 2015 Sep 10. [Epub ahead of print] HPV vaccination syndrome. A questionnaire-based study. Martínez-Lavín M1, Martínez-Martínez LA2, Reyes-Loyola P2.
  • Immunol Res. 2014 Dec;60(2-3):376-83. doi: 10.1007/s12026-014-8604-2. Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA). Agmon-Levin N1, Zafrir Y, Kivity S, Balofsky A, Amital H, Shoenfeld Y. 1The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel.
  • Int J Immunopathol Pharmacol. 2010 Oct-Dec;23(4):1015-20.  Luteolin and thiosalicylate inhibit HgCl(2) and thimerosal-induced VEGF release from human mast cells.  Asadi S1, Zhang B, Weng Z, Angelidou A, Kempuraj D, Alysandratos KD, Theoharides TC.
  • Int J Rheum Dis. 2015 Jul 1. doi: 10.1111/1756-185X.12593. [Epub ahead of print]  Fibromyalgia incidence among patients with hepatitis B infection.  Yazmalar L1, Deveci Ö2, Batmaz İ1, İpek D2, Çelepkolu T3, Alpaycı M4, Hattapoğlu E1, Akdeniz D1, Sarıyıldız MA1.
  • J Inorg Biochem. 2013 Nov;128:262-6. doi: 10.1016/j.jinorgbio.2013.07.020. Epub 2013 Jul 20.  Distinctive clinical features in arthro-myalgic patients with and without aluminum hydroxyde-induced macrophagic myofasciitis: an exploratory study.  Ragunathan-Thangarajah N1, Le Beller C, Boutouyrie P, Bassez G, Gherardi RK, Laurent S, Authier FJ.  1INSERM U955-Equipe 10, Université Paris Est-Créteil, Créteil, France.
  • J Med Food. 2014 Dec;17(12):1261-72. doi: 10.1089/jmf.2014.7000.  The gut microbiome and the brain.  Galland L1.  1Foundation for Integrated Medicine , New York, New York, USA .
  • J Rheumatol Suppl. 1989 Nov;19:23-7. The chronic fatigue syndrome: definition, current studies and lessons for fibromyalgia research.  Komaroff AL1, Goldenberg D.
  • Front Psychol. 2016 May 19;7:740. doi: 10.3389/fpsyg.2016.00740. eCollection 2016.  Commentary: Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients.  Castelli L1, Tesio V1.  1Department of Psychology, University of Turin Turin, Italy.  PMID:  27242640

Related observations