By: Adrienne Dellwo | Reviewed by Grant Hughes, MD
Is Fibromyalgia Hereditary?
“Several people in my family have had fibromyalgia and now I’m showing a lot of the symptoms. That makes me really worried about my kids—have I doomed them to this? Is fibromyalgia hereditary?”
This is a common concern. It’s scary to think that we may have, unwittingly, passed a chronic, debilitating illness along to our children. The good news is that while they may have an elevated risk, they are absolutely not guaranteed to develop fibromyalgia.
Based on research, the current belief is that fibromyalgia is not hereditary in the classical sense, where a mutation of a single gene is responsible for a given trait. That’s called monogenic, and it controls things like blue eye color; however, evidence does suggest that your genes can predispose you to fibromyalgia, but in a complex way involving many genes, which is called polygenic.
What’s the Difference?
In a classical, monogenic, hereditary condition, the specific genes you get from your parents are the primary determining factor in whether you’ll get a disease. For example, in cystic fibrosis, the child of parents who are both disease carriers has a 25 percent chance of developing cystic fibrosis. They either get the right genetic mutation or they don’t. If they do get the mutation, they get the disease.
With polygenic predisposition, it’s not as simple because your genes only mean that a particular illness is possible under the right conditions.
That means there’s a higher risk than in other people, but not a certainty. Typically, other factors must come into play to actually trigger the illness.
In fibromyalgia, these other factors may include:
other sources of chronic pain
abnormal brain chemistry
Some experts hypothesize that environmental things such as food sensitivities or exposure to toxins could also play a role.
That means your child may have inherited a genetic predisposition for fibromyalgia, but that still doesn’t mean he or she will end up with it. It would take an additional set of circumstances to take them down that path.
Genetic Links in Fibromyalgia
Researchers began looking into a possible genetic component of fibromyalgia long ago because it does tend to run in families, in what are called “clusters.” Much of the work has involved identical twins. The body of research has been growing since the 1980s.
What we’ve learned is that about half of the risk is determined by genetics and half is determined by other factors like those listed above.
Research confirms the high rate of occurrence in families and suggests that low pain threshold (the point at which sensation becomes painful) is common in non-fibromyalgic relatives of people with fibromyalgia.
We’re really just beginning to get a picture of the specific genetic factors associated with fibromyalgia. So far, we have multiple studies suggesting connections with numerous genes, but many of these studies have not been replicated.
Genetic abnormalities that have been suggested by preliminary studies include genes that deal with neurotransmitters (chemical messengers in the brain) that have been implicated in fibromyalgia, including serotonin, norepinephrine, dopamine, GABA and glutamate. Others are involved in general brain function, fighting viral infection, and brain receptors that deal with opioids (narcotic pain killers) and cannabinoids (such as marijuana.)
As we learn more about these genetic associations, researchers may identify which of them contributes to the risk of developing fibromyalgia as well as whether any can be used to diagnose or treat the condition.
What Does That Mean for Your Child?
It’s scary to think that your child has a heightened risk of ending up with fibromyalgia. The key thing to remember is that nothing is guaranteed.
So far, we don’t know what might help reduce the risk, but one study does suggest that the twin with the higher emotional intelligence was less likely to become sick. Your emotional intelligence is your ability:
to be aware of and in control of your emotions
to express how you feel
to deal with relationships fairly and empathically
Encouraging these skills in your child may help. Stress is also a cause for concern, so try to teach your child positive coping mechanisms. If your child seems to be struggling with any of these things, you may want to seek a professional counselor who can assist him or her.
Because pre-existing chronic pain is a risk factor for fibromyalgia, you may want to be especially aware of how injuries are healing and whether your child has migraines or “growing pains.” Your pediatrician should be able to recommend treatments.
We don’t have evidence that a healthy diet and general physical fitness specifically lower your child’s risk of developing fibromyalgia, but they’re always a good idea.
If you’re concerned about anything having to do with your child’s health, be sure to bring it up with your pediatrician.
And remember that you have not “doomed” your child to anything. In fact, your early awareness may well be what steers them in the other direction.
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Burri A, Lachance G, Williams F. Twin research and human genetics. 2015 Apr;18(2):188-97. A discordant monozygotic-wtin approach to potential risk factors for chronic widespread pain in females.
Matsuda JB, et. al. Revista brasileira de reumatologia. 2010 Apr;50(2):141-9. Serotonin receptor (5-HT 2A) and catechol-O-methyltransferase (COMT) gene polymorphisms: triggers of fibromyalgia?
Reeser JC, et. al. PM & R: the journal of injury, function, and rehabilitation. 2011 Mar;3(3):193-7. Apolipoprotein e4 genotype incrases the risk of being diabnosed with posttraumatic fibromyalgia.
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