Fibromyalgia Diagnosis: Pitfalls and Highlights
You may find it difficult to get a health care professional to actually diagnose your condition. It is common for doctors and nurses to minimize your symptoms. It takes an especially experienced, compassionate, and insightful professional to come to a fibro diagnosis.
A trial and error approach can be costly and frustrating.
Getting a referral from someone you know with fibro is probably a better way. Don’t limit yourself to medical doctors, but explore other licensed health care providers (HCP). Chiropractors, physical therapists, massage therapists, and nutritional experts can be valuable resources. You probably need to find someone comfortable with thinking “outside the box”.
Choose a professional and prepare yourself for your initial appointment. It may help to write some things down first. Be sure and include information about how long you have had symptoms, what treatments you have undergone, what worked (and for how long) and what didn’t work, what other illnesses you have had, your family history, and any life stresses.
Past injuries are also important. List all your medications and supplements. Prepare, before your appointment, a list of questions you want to ask. Ask if there is any office paperwork that you can fill out beforehand to save time in the office.
The HCP will also ask you questions.
Listen carefully. Answer honestly. An important thing is to trust your gut feelings and get a sense for how you are being treated. If you feel intimidated or disrespected, or talked down to, it is a god idea to choose someone else.
Don’t get discouraged. It may take some effort to find a health care professional you can relate to. You need to find a reliable and comfortable partner in your fibromyalgia journey. Diagnosis and treatment is a teamwork effort.
What to expect for your initial work-up:
- Thorough health history
- Careful physical examination
- Review of past records
- Laboratory assessment including blood, urine, saliva, and possibly stool tests
Your past health history can reveal clues to why you are suffering. A vast majority of your diagnosis will come from your past health issues. Doctors are taught that health history is 80% of the information leading to a diagnosis. But that assumes that you provide an honest and accurate record. Don’t be embarrassed to give up the details of what has happened to you.
Physical exam is important.
Finding that state of your muscles, nerves, and joints offers more information to support an accurate diagnosis. The “18 points” come and go but are a significant factor, but not the only one.
Important lab tests to get are
- Comprehensive metabolic panel (checking for anemia and other underlying health issues)
- Homocysteine (checking for cell stress)
- Hemoglobin A1C (blood sugar stability)
- Thyroid panel, including antibodies (thyroid problems are common in fibromyalgia)
- Cytokine levels (inflammation markers).
- Celiac panel. Hidden celiac (or gluten sensitivity can cause fibro symptoms)
- Functional lab tests. These tests measure the actual metabolic processes that can cause fibro symptoms.
- Stool tests that use DNA markers to assess gut health.
- Saliva tests to measure stress hormones, insulin responses, and immune system status.
- Vitamin D.
These test are not widely used, but a health care profession familiar with these tests is more likely to provide you with not only the best diagnosis, but a better roadmap to recovery