Biomarkers have been identified that reliably test for the mysterious and frequently incapacitating disease fibromyalgia. The scientists who made the discovery expect the work will lead to a swift, robust diagnosis that is currently lacking. They also hope it will eventually point the way to better treatments. Meanwhile, sufferers feel vindicated in the face of longstanding claims the condition does not exist.
People with fibromyalgia – such as Lady Gaga and Lena Dunham – suffer chronic pain in many parts of the body, and are hurt by pressures others would be comfortable with, sometimes to the point where day-to-day living becomes a nightmare. A variety of accompanying symptoms are common. Diagnosis, however, has proven immensely difficult. After all, pain has many causes, and the differences between symptoms described by people with fibromyalgia and some other conditions can be subtle. Fibromyalgia is often a “diagnosis of exclusion”, where doctors reluctantly accept someone has it when they have ruled out everything else.
The uncertainty has impeded the search for treatments. It also has left room for discredited claims the condition is psychological, with no physical cause. Worse yet, sufferers may be treated by employers or family, and sometimes attacked publicly, as malingerers covering for laziness. As a condition more common in women, these lines are particularly appealing to sexist men.
A blood test will lay all that to rest, and Dr Kevin Hackshaw of Ohio State University claims to have one, although it is not yet ready for commercial application. Just a day after efforts to discredit sufferers of fibromyalgia returned to mainstream media, Hackshaw has published a paper in the Journal of Biological Chemistry describing a combination of blood molecules distinctive to people with the condition.
Hackshaw's testing was done on 50 people diagnosed with fibromyalgia, and 71 with a mix of three other chronic diseases. Without knowing which condition someone had, Hackshaw's team used vibrational spectroscopy on blood proteins and acids to distinguish the fibro-sufferers from the others.
The work needs to be replicated with larger samples. However, the absence of a single misdiagnosis in the sample is encouraging. The researchers also think the test has the potential to quantify the severity, which would help determine if trial treatments are working. Further streamlining for speed and cost will be necessary if the test is to be widely useful, something Hackshaw hopes to achieve within five years.
Estimates for the frequency of fibromyalgia are as high as 2 percent of the population, although the seriousness of the condition varies widely, and most have not been diagnosed. Failure to diagnose fibromyalgia may be a major contributor to America's opioid epidemic. “Fibromyalgia often gets worse, and certainly doesn't get better, with opioids," Hackshaw said in a statement. However, many people whose symptoms are consistent with fibromyalgia are prescribed opioids in the absence of a diagnosis.