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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 13 June 2021

Are You Sure It’s Really Fibromyalgia?

Are You Sure It’s Really Fibromyalgia?

16 Are You Sure It’s Really Fibromyalgia?
All About Fibromyalgia

Daniel J. Wallace

Janice Brock Wallace

Oxford University Press

A week doesn’t go by without a patient wanting my reassurance that he or she is not seriously ill or making it all up. “Are you just telling me it’s fibromyalgia because you don’t want me to be upset?” “A friend of mine told me that fibromyalgia is a ‘garbage can’ diagnosis that doctors give when they don’t know what you have.” These are frequent remarks or queries. How is your doctor really sure that something is not being missed? This chapter reviews some diseases with features that can overlap with or be mistaken for fibromyalgia. Fibromyalgia can seem to be working in concert with other diseases. For example, untreated inflammation associated with an autoimmune disease (such as rheumatoid arthritis or systemic lupus erythematosus), other forms of inflammatory arthritis (such as ankylosing spondylitis), or a chest disease known as sarcoidosis are associated with coexisting fibromyalgia. Withdrawal from or tapering of medications such as corticosteroids typically precipitates or aggravates fibromyalgia. Many disorders interact with or can be mistaken for fibromyalgia. They are reviewed here, as well as in other parts of this book, and listed in Table 11. Linda was not herself. Over a period of several months, she found it increasingly difficult to make it through the day. Her muscles started to ache, she gained 15 pounds while on the same diet, found it difficult to tolerate cold weather, and her voice became husky. Dr. Bridges did a complete blood count and a blood panel that was normal. He was impressed with her muscle aches and diagnosed her as having fibromyalgia. When Dr. White saw Linda in a rheumatology consultation, certain things did not fit. Weight gain, a hoarse voice, and cold intolerance of recent onset are not typical features of fibromyalgia, so she obtained additional tests that included a complete thyroid pel (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH]). Although the T3 and T4 levels were normal (as they had been with Dr. Bridges), the TSH (which was not part of Dr. Bridges’s panel) was quite high, indicating hypothyroidism. Linda was started on thyroid replacement therapy and was back to herself within a few weeks.

Keywords:   adrenal glands, back pain, caffeine, diabetes, heroin withdrawal, infections, low back pain, malignancy, neurologic disease, osteoarthritis

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