In fibromyalgia, at least six neurotransmitters can be out of balance. Neurotransmitters are the brain chemicals that carry signals (including pain signals) from one nerve cell to the next. Neurotransmitters literally control every system in the body either directly or indirectly. The main symptoms of fibromyalgia, heightened pain perception, fatigue, sleep disturbances, depression, and anxiety, are linked to these neurotransmitters.
The neurotransmitters involved in fibromyalgia come in pairs. They are:
- Serotonin and Melatonin
- Dopamine and Norepinephrine
- GABA and Glutamate
Their levels can be too high, too low or ineffectively manufactured and used by the body.
Serotonin and Melatonin
Serotonin is one the major neurotransmitters in the body. It is manufactured in the brain and the gastrointestinal tract. Serotonin plays an important role in many functions including sleep, appetite, learning and pain perception. It is closely involved in determining our mood. Serotonin levels are usually very low in people with depression.
Melatonin is made from serotonin. At night, when it gets dark a certain amount of serotonin is converted into melatonin, which helps us fall asleep. In the morning serotonin is released helping us wake up feeling refreshed.
Serotonin levels are usually low in people with fibromyalgia which also makes our levels of melatonin low. This is the main reason for the disturbed sleep patterns so characteristic of fibromyalgia.
Stress lowers our serotonin levels. When a person is under emotional stress, their serotonin levels automatically drop. Having fibromyalgia is stressful because we are in pain, feel unwell and life has become limited. Stress reduces serotonin levels which creates further stress.
Dopamine and Norepinephrine
Dopamine and norepinephrine are two critical neurotransmitters that regulate your mood and behavior. Norepinephrine (also called noradrenaline) is produced from dopamine.
Norepinephrine plays a central role in controlling alertness, rest cycles, attention, and memory. It also plays a key role in the “fight or flight” response.
Dopamine is a neurotransmitter that helps you focus your attention. Dopamine also has a role in modulating pain perception and helps regulate movement.
People with fibromyalgia are likely to have low levels of dopamine. It is thought to be the main reason for cognitive problems such as poor memory, difficulty concentrating and word mix-ups. Low dopamine could even be the cause of our coordination and balance problems.
GABA and Glutamate
GABA and glutamate are two neurotransmitters that are supposed to work in balance. One calms the brain while the other stimulates the brain. Your brain uses glutamate to produce GABA, which stands for gamma-aminobutyric acid. They are the brain’s most plentiful neurotransmitters.
GABA calms the brain and is involved in sleep, relaxation, anxiety regulation and muscle function. Glutamate stimulates the brain so you learn new things and form memories.
Research suggests that people with fibromyalgia have abnormally high levels of glutamate. Excessive glutamate is believed to cause anxiety, restlessness, the inability to focus and pain amplification. High glutamate levels are linked with depression and low cognitive function.
Because of GABA and glutamate’s close relationship, symptoms of GABA deficiency overlap with those of brain glutamate excess.
Treatment Of Neurotransmitter Imbalance
You may have seen neurotransmitter urine tests online but many experts believe these tests fall short. The actual levels of neurotransmitters found in the urine have nothing to do with the neurotransmitter levels in your brain.
Most often, your doctor will treat neurotransmitter imbalances based on your symptoms. The problem with this approach is that you may not be treating the right neurotransmitters.
Some possible ways to restore the balance of brain chemicals include:
- Prescription medications – Prescription drugs act by mimicking certain neurotransmitters. Antidepressants are often prescribed which work by increasing the available amount of serotonin and/or norepinephrine in the brain. Unfortunately, many antidepressant medications have unpleasant side effects. Another problem with medications is they can become less and less effective over time.
- Dietary supplements – A few supplements that have been shown to help balance your neurotransmitter are:
- L-Theanine – Studies show L-Theanine increases both norepinephrine and dopamine while lowering glutamate. It is said to improve mood, increase concentration, decrease stress and help with anxiety. Theanine seems to decrease blood pressure. Don’t take theanine with medications for high blood pressure. It might cause your blood pressure to go too low.
- Rhodiola rosea– Research shows rhodiola may stimulate activity of serotonin, norepinephrine and dopamine. Therefore it helps relieve stress, anxiety, fatigue and cognitive function. Rhodiola should not be taken with prescription antidepressants.
- 5-HTP – 5-HTP is converted by your body into serotonin. Studies have shown that 5-HTP can help alleviate many symptoms of fibromyalgia such as fatigue, disturbed sleep, headaches/migraines, mood disturbances, and depression. 5-HTP should not be taken with prescription antidepressants.
- Acetyl L-Carnitine – Acetyl L-Carnitine may help your brain utilize serotonin and glutamate. Studies show that carnitine supplementation can help lower pain levels and boost mental health in people with fibromyalgia. You should not take Acetyl L-Carnitine if your thyroid hormone levels are low.
- Diet – Neurotransmitter are primarily manufactured in the body from specific amino acids, as well as healthy fats. We get amino acids by eating protein-rich foods. One amino acid that helps your body produce serotonin is tryptophan. Here is a list of Foods-High-In-Tryptophan.
- Exercise – Exercise is one of the best things you can do for your brain. It can increase your levels of dopamine, serotonin and norepinephrine. You don’t even have to exercise strenuously. Taking walks or doing gentle exercises like yoga, tai chi, or qi gong all provide powerful benefits.
- Reduce stress – Chronic stress is the primary contributor to neurotransmitter imbalance. You can read my post on ways to relieve stress and anxiety here.
- Sunlight – Exposure to sunshine has been proven to affect brain chemistry. It helps increase levels of vitamin D. In turn, vitamin D naturally boosts serotonin levels.
Neurotransmitter imbalance is thought to be the main reason for many of the symptoms of fibromyalgia. Researchers have found several neurotransmitter dysfunctions in people with fibromyalgia. We are typically low in serotonin, melatonin, dopamine, and norepinephrine. We usually have excessive glutamate levels also, which results in a deficiency in GABA levels.
Unfortunately, there is still so much research that needs to be done to gain a better understanding of how neurotransmitter interactions and imbalances impact fibromyalgia. And why these neurotransmitters are out of balance in the first place. Hopefully, we are getting closer to the answers we need.