Often Overlooked: The Thyroid Gland and Fibromyalgia

If you suffer from Fibromyalgia and you have not had a proper Thyroid evaluation, then you are not being treated correctly for your Fibromyalgia. The reason; many, not all, but many Fibromyalgia sufferers are experiencing thyroid dysfunction and don’t even know about it.

They don’t know because the average medical doctor either doesn’t check, or does not know how to properly evaluate the thyroid gland. The overwhelming majority of medical doctors will only run a TSH test. Based upon the results of this one test, they will decide to prescribe thyroid hormone replacement drug therapy. This is entirely incorrect. Medical doctors know that by doing this your thyroid gland will eventually burn out, and you will require a lifetime of steadily increasing doses of thyroid replacement hormones. But this is what they are taught to do…often times by the very drug companies whose thyroid drugs the doctors prescribe.

The Fibromyalgia sufferer, as well as any other Thyroid patient, or anyone for that matter currently on thyroid replacement therapy needs to be aware that there are six (6) different patterns of thyroid dysfunction. The only way to find out exactly which pattern you might be experiencing, and how this might be a major contributing factor to your Fibromyalgia, is by running a complete thyroid panel.

Most patients wanting answers about their Fibromyalgia, and who come to my office bringing prior lab tests usually only have had their TSH levels checked. I find the same thing is true regarding thyroid patients who come to my office.
A complete Thyroid panel includes not only the TSH marker but also 7 other tests! By not having a complete thyroid panel performed you cannot gain perspective of the whole picture.

So what are the 6 patterns?
1. Primary Hypothyroidism
2. Hypothyroidism secondary to Pituitary Hypofunction
3. Thyroid under conversion
4. Thyroid over conversion and decreased TBG
5. Thyroid Binding Globulin elevation
6. Thyroid auto-immune dysfunctions.

To complicate matters even more, two or more patterns may exist at the same time! Therefore, thyroid problems can be extremely complex if you don’t have the right information, or if your doctor doesn’t know how to interpret this information. If you don’t test, you just don’t know. If a complete thyroid panel isn’t performed, and you have an underlying thyroid disorder, is it any wonder why the medical treatments that you have been receiving for your Fibromyalgia have not been helping!

One other very important item to mention is that of the 6 different patterns of thyroid dysfunction, there can be 30 different mechanisms that cause the thyroid gland to malfunction and only one of these patterns is helped by thyroid replacement therapy!

If you are tired of the mental fuzziness, tired of the pain, tired of the depression, tired of the inability to lose weight, tired of being told its in your head or tired of the chronic fatigue, and tired of living your life in isolation…….. Maybe it’s time to find out what really is going on.

Ask yourself the following questions:

– How has your chronic health condition affected your job, relationships, finances, family, or other activities?

– What has it cost you in time, money, happiness, sleep?

– Where do you picture yourself in the next one to three years if this problem is not taken care of soon?

– What is it worth to you if we could help improve your condition?

If you’re really serious about the possibility that there could be an effective Fibromyalgia treatment for you or your loved one, call our office at 561-627-2747 and tell us that you are interested in setting up a case review.
You will be glad you did.
Dr. Berl Michel, DC

If My Blood Tests Look Good, Why Do I Feel So Bad?

My doctor said my blood tests looked good, then why do I still feel so bad?

According to the American Association of Clinical Endocrinologists, many, not all, but many of the people who suffer from Fibromyalgia are also suffering from an auto-immune disorder. This is a condition where the immune system is attacking and destroying the nervous system as well as the thyroid gland. This may be the most overlooked disease process in the entire health care system.


Although auto-immune disorders may be the most common cause of fibromyalgia problems in this country, many medical doctors don’t test for them since it will not change their standard treatment plan, which is to prescribe thyroid hormone in the event that a thyroid problem is diagnosed. Thyroid stimulating hormone (TSH) is just monitored and medication is adjusted accordingly. As other symptoms pop up, they are prescribed more drugs. Prozac or another drug for depression, as well as anti-seazure drugs for other symptoms, pain medications, as well as additional drugs for continued thyroid malfunction. The person may feel better for a short period of time and then “crash” with their symptoms returning. Or they may or feel no change at all. The solution- more thyroid and other medications.

Conventional health care has no model to successfully manage an auto-immune related Fibromyalgia syndrome. The reason that this condition is so poorly managed and people seldom feel better is because most doctors are “barking up the wrong tree”. What do I mean? Well, if Fibromyalgia is a problem with the immune system….which it often can be…..shouldn’t the immune system be looked at?

I feel it should…. And that is one of the places where I look. By looking into the immune system, you can see what is not working correctly and why it is not working correctly. We do that-by testing. Doing the correct tests can give you the information needed to specifically see what is going on with the immune system.
Remember, if you don’t test, then you just don’t know. Once this is figured out, a specific protocol, unique to you can be set up in order for you to finally begin to feel better.

Ask yourself the following questions:
1. How has your chronic health condition affected your job, relationships, finances, family, or other activities?
2. What has it cost you in time, money, happiness, sleep?
3. Where do you picture yourself in the next one to three years if this problem is not taken care of soon?
4. What is it worth to you if we could help improve your condition?

If you’re really serious about the possibility that there could be an alternative treatment for you or your loved one, call our office at 561-627-2747 and tell us that you are interested in setting up a case review.

Dr. Berl Michel, DC

If you have Fibromyagia you not Crazy, You are ill!

If you have fibromyalgia, you are not Crazy, You are ill!

You may have been told that whatever you have is untreatable or that your symptoms are all in your head. People think you’re a hypochondriac and doctors may not want to handle your case. Or you may have been overmedicated by a prior health care provider who thought he/she could help you. You may be taking medications that make your life miserable. You may be in danger of losing your job and your relationships. You may have fallen victim to those who are making billions of dollars a year off those desperately searching for something, anything, that will help…

When I first started treating fibromyalgia patients many doctors didn’t believe in fibromyalgia. As a result, patients faced a daunting journey at odds with their physicians, and their families. But now that big pharmaceutical companies have discovered how lucrative chronic illnesses are, things have changed. Now everyone “knows” fibromyalgia is real because it’s advertised on television and in magazines. Lyrica, Cymbalta, and Savella sound great until you read the small print or try one and it doesn’t agree with you. Then you realize these “new” drugs don’t actually relieve your symptoms. But they do alter the chemistry of your brain. Not to mention side effects such as weight gain, fatigue, hair loss, headaches and thinning of your bones, as well as ulcers, sores and blisters which can form on your mouth, lips, tongue, hands and feet. If you live in Europe these drugs are not even available because their performance didn’t outweigh their risks in studies.

What’s lost in all this commotion is that none of these expensive drugs will actually treat fibromyalgia. They, and other medications like them, simply change the way your brain perceives your symptoms. Usually their side effects require other medications to counteract them. So here we are in the 21st century, and the average doctor now believes that the accepted regimen for fibromyalgia is actually a balancing act of polypharmacy (multiple drugs), because that’s what the drugs companies claim in their television ads. Meanwhile your illness continues to get worse and eventually require stronger medications as you develop a tolerance to the current medications. To make a bad situation more worse, many fibromyalgia patients are disabled and simply cannot afford expensive medications.

But the truth is that even in the best designed clinical trials the success rate of these drugs was no better, when compared,–not to other drugs–but to sugar pills. And this is why the standard medical treatments for Fibromyalgia don’t work. They are no better then sugar pills. However, they have the big money of the pharmaceutical industry pushing these drugs on television every evening. The pharaceutical companies have drug reps visiting medical doctors on a daily basis, buying them lunch, and pushing this “junk science” on them. So the average medical doctor thinks it must be true. And the poor fibromyalgia patient gets to suffer because they become a lab test subject for the lastest, greatest, miracle drug that the pharmaceutical companies are pushing.

Please don’t let this happen to you, or someone you love. You need to seek out a doctor who understands how to truely treat this condition. You need to seek out a doctor who understands that fibromyalgia has both a metabolic and neurological component, and who knows and understands that specific metabolic treatments must be paired with specific neurological treatments. Dr. Berl Michel, DC of Palm Beach Gardens practices with an emphasis on combining the metabolic treatments with the neurological treatments to help fibromyalgia patients recover.

The Importance of Oxygen in Treating Fibromyalgia

While the cause of fibromyalgia is not agreed upon in the medical community,a strong belief that it derives from an oxygen metabolism dysfunction is mounting. The various proposed hypotheses about fibromyalgia’s origin are varied, ranging from an infectious viral agent to an auto-immune disorder. From an atomic perspective, the smallest building blocks of life, all of the proposed theories behind fibromyalgia can be understood. A system that isn’t metabolizing oxygen (the basis of life) properly, can manifest as fibromyalgia through each of the proposed causes.

Humans metabolize oxygen from air to create energy and fuel all body processes. According to some experts, impaired oxygen metabolism may be the molecular basis of fibromyalgia’s primary symptoms (muscular pain, fatigue and concentration difficulties). Specifically, oxygen if poorly metabolized, causes fatigue and pain in muscles, memory disruption in the brain and impaired function of all of our body’s cells.

One aspect of this metabolic dysfunction occurs from oxidation’s creation of unstable molecules, also called free radicals. Oxidation is the loss of electrons occurring when oxygen breaks down a substance excessively. A natural process, oxidation is witnessed in our environment when iron rusts and fruit turns brown. In the human body, the damage incurred from free radicals contributes to aging and the development and perpetuation of chronic disease. Thus, preventing oxidative stress can significantly reduce fibromyalgia’s symptoms.

As published in Rheumatology International, researchers from Turkey studied 85 women with fibromyalgia and compared them to 80 healthy women, matched for age, weight and height. Each woman’s cellular damage by free radicals was evaluated. The results demonstrated that the women with fibromyalgia had significantly higher levels of cellular oxidation, compared to the controls.

Antioxidants may help prevent cellular oxidation by scavenging (destroying) the unstable molecules before they wreck havoc. Protecting the integrity of muscle and brain cells can end the fibromyalgia cycle of pain, fatigue and impaired concentration. Doctors who truely understand fibromyalgia are recognizing this connection.

Another aspect of oxygen metabolism dysfunction is a lack of available oxygen. Steps can be taken to increase oxygen’s availability for proper body functioning, although the reason behind its deficiency is not entirely understood. However, we do know that fibromyalgia patients can exhibit a spectrum of breathing difficulties. Whether insufficiently drawing in breath, experiencing “oxygen hunger,” or losing the ability to properly process oxygen, many individuals with fibromyalgia can’t seem to get enough oxygen. Often physicians will recommend avoidance of high-altitude locations to patients with fibromyalgia, due to the decreased availability of oxygen in these locations.

Decreased or inhibited ability to process oxygen means less oxygen can be delivered to the muscles, causing muscular fatigue and subsequent pain and stiffness. Occurring both in the skin above tender points and in the extremities, sensations of cold go hand-in-hand with a fibromyalgia diagnosis. It is no surprise that people with fibromyalgia typically have a general intolerance to cold temperatures. A decrease in local surface temperature can be the direct result of an absence of oxygen in the body’s blood supply.

Recent studies have confirmed that oxygen treatment might benefit individuals with fibromyalgia. The connection between oxygen metabolic dysfunction and fibromyalgia is the fact that as we age, our ability to process and utilize oxygen decreases 1% per year for every year that we are past the age of 25. The most successful treatment of fibromyalgia demands that the doctor ultilize appropriate oxygen therapy with his/her patients. This requires that the doctor have an excellent working knowledge of the metabolic side of treating this condition.

While fibromyalgia remains a complex condition, seeing the problem on the most essential of levels can shed light onto successful treatment. Most of us take for granted the way in which our body metabolizes oxygen. However, evidence and logic suggest this very process we take for granted may be at fault in fibromyalgia syndrome. The good news is that something can be done about it, without medications or surgery. Increasing the bodies ability to utilize oxygen to all parts of the body, especially the brain and spine, can prove extremely beneficial to the person suffering from fibromyalgia.

Fibromyalgia sufferers should make it a point to seek out a doctor who understands the role of utilizing oxygen in the treatment of their fibromyalgia.


Ali, M, Ali O., Fibromyalgia: An oxidative-dysoxygenative disorder (ODD), J Integrative Medicine, 1999; 3:17-37.

Bagis S, Tamer L, Sahin G, Bilgin R, Guler H, Ercan B, Erdogan C., Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?, Rheumatol Int, Dec 20, 2003.

Gusi N, Tomas-Carus P, Hakkinen A, Hakkinen K, Ortega-Alonso A., Warm Water Exercise Decreases Pain, Strengthens FM Patients in Study, Arthritis Rheum. 2006 Feb;55(1):66-73.

Lund, N., Bengtsson A, Thorborg P., Muscle tissue oxygen pressure in primary fibromyalgia, Scand J Rheumatol. 1986; 15(2): 165-73.

Fibromyalgia; New Findings and Brain Based Therapies

Fibromyalgia is a misunderstood condition that debilitates over 4 million people in North American alone. The average Fibromyalgia patient often finds themselves stuck on the medical- merry-go-round; being shuffled from one doctor to next, with no one being able to help. The standard medical treatment is focused on treating the symptoms and not the condition itself. When the standard protocol of pain medicines, muscle relaxers, anti-inflammatory medicines, sleeping pills, anti-anxiety medicines or anti-depressant drugs don’t work, the patient is told the condition is untreatable or that it’s “really all in their head”. There is nothing further from the truth.

The truth about Fibromyalgia is that it is not a muscle problem to be treated with pain drugs and anti-inflammatories. If that were the case, then fibromyalgia sufferers would respond to the standard medical treatments. Research is pointing out that Fibromyalgia must be addressed as a combination of both a metabolic condition and a neurological condition. Until Fibromyalgia patients are treated using a combination of metabolic and neurological approaches, they will never demonstrate improvement or begin to feel better.

The typical Fibromyalgia patient is being constantly bombarded with pain neurological stimuli. This can result in an over-firing or under-firing of the brain and nervous system. The effects: constant pain, chronic fatigue, gastrointestinal problems, indigestion, reflux, heartburn, insomnia, as well as bowel problems such as constipation and diarrhea.

These problems can be the result of a metabolic disorder; an unknown food allergy or sensitivity, a hidden thyroid or adrenal gland problem, an intestinal parasite, a bacteria, mold or yeast infection, as well high levels of specific markers in the blood which indicate high levels of internal inflammation. Unless all these are tested for, the fibromyalgia sufferer just doesn’t know. And neither does their medical doctor, because the average medical doctor has no interest in running these types of tests.

On the neurological side, a Fibromyalgia patient may be suffering from an oxygen deficit affecting the specific area of the brain which controls all the muscles of the spine. A few simple tests can be performed in the doctors office to determine if an oxygen deficit is a contributing cause of a patients fibromyalgia. If this proves to be the case, then a treatment protocol utilizing specific Brain Based Therapies (BBT) is in order.

However, if you don’t test then you just don’t know. And this is why the standard medical treatments for Fibromyalgia don’t work.

There is an answer to successfully treating Fibromyalgia and obtaining maximal relief. Specific metabolic treatments must be paired with neurological treatments. Dr. Berl Michel, DC of Palm Beach Gardens practices with an emphasis on combining the metabolic treatments with the neurological treatments to help fibromyalgia patients recover.

If you or a loved one is suffering from fibromyalgia, then you need to find a doctor who understands how to truely treat this condition.


The understanding of what fibromyalgia is has been more of an evolution than a cut-and-dried history.

Descriptions of the syndrome can be found in medical journals dating back to the 1800s. In 1824, a doctor named William Balfour briefly described “tender points” in his writing. The first person to write at length about tender points, however, was French physician François Valliex in “Traité de Neuralgies” (“Treatise on Neuralgia”), published in 1841. Other 19th-century doctors simply referred to the aches and pains of fibromyalgia as “muscular rheumatism” or “neurasthenia.”

Sir William Gowers, in his 1904 article, “Lumbago: It’s Lessons and Analogues” in the British Medical Journal (1:117-121), recommended that the pain of “muscular rheumatism” be called “fibrositis.” This stemmed from the erroneous belief that the pain and discomfort of the condition was the result of inflammation.

A contemporary of Gowers, a pathologist by the name of Ralph Stockman in Edinburgh, Scotland, reported seeing evidence in patient biopsies of inflammatory changes (swelling) in the fibrous, intra-muscular septa, the thin membrane that connects soft masses of tissue. This appeared to reinforce the inflammation theory, until it was found that future muscle biopsies did not produce the same results as Stockman’s. “Fibrositis” is now considered an incorrect term when used in reference to fibromyalgia.

In 1913, a Dr. Luff also wrote about “fibrositis”—before the term was discredited—in the British Medical Journal. He noted how a patient’s symptoms would tend to worsen when barometric pressure rose with an approaching storm. Dr. Luff also mentioned the relationship of infections, fevers, temperature variations, and automobile accidents to the pain and discomfort of fibrositis. Llewellyn and Jones, in a 1915 book plainly called “Fibrositis,” broadened the term to include other maladies, such as gout.

A rheumatologist named Smythe and a psychiatrist named Moldovsky found through electroencephalographic studies in 1965 that patients who had disturbed sleep accompanied by muscle pain were experiencing deep (non-REM) sleep interrupted by light (REM, or rapid eye movement) sleep. This resulted in symptoms such as morning stiffness, generalized muscle pain, fatigue, and cognitive impairment.

In reference to their findings, Smythe and Moldovsky resurrected the old term “fibrositis.” But the medical community’s reasons for dropping the term earlier in the century still applied: the patients were not experiencing inflammation. The term “fibrositis” was replaced by “fibromyalgia” in 1976 in order to correct the decades-old misnomer originally coined by Dr. Gowers.

Now that the syndrome had a more accurate name, the awareness of fibromyalgia began to speed along. In 1987, Dr. Don L. Goldenburg, in describing the symptoms and treatment of 118 of his patients, recorded their diagnoses as “fibromyalgia.” And in 1990, at long last, the American College of Rheumatology established the definitive criteria for diagnosing fibromyalgia.

The National Fibromyalgia Association (NFA) was formed in 1997. It was the first national organization dedicated to helping people with fibromyalgia better understand their condition. Almost 10 years later, on October 10, 2005, the American Pain Society published the first guidelines for treating fibromyalgia, stating that, “Fibromyalgia syndrome (FMS) has no cure, is difficult to diagnose, and effective pain management strategies are a must to help patients cope with the disease.” (http://www.ampainsoc.org/press/2005/101005.htm)