Bottom Line/Health: Millions of women spend their days exhausted and in pain, and their pain and their exhaustion is very real. The problem is, not everybody thinks that it’s a real ailment. They call it fibromyalgia, and it’s been a source of great debate for years. So what’s the truth about fibromyalgia? Let’s get to the bottom line.

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m talking to Dr. Holly Lucille, a leading naturopathic physician and expert in integrative medicine. Dr. Lucille was listed in Time Magazine’s ALT list as one of the top 100 most influential people, and she’s the author of Creating and Maintaining Balance: A Woman’s Guide to Safe Natural Hormone Health. You can learn more about her at

Welcome, Dr. Holly.

Holly Lucille, ND, RN: Thanks, Sarah.

Bottom Line: In this country, we live in a world where if you can diagnose it, then you can name it, and you can treat it. Except for the fact that there’s no firm test for fibromyalgia. So is fibromyalgia real, or are these women running around with aches, pain and exhaustion that’s all in their head? What’s your opinion?

Dr. Lucille: All right, this is a really great conversation, and people need to I think tune in, because I’ve always said I don’t really care about diagnoses so much. Because sure, you can fill out and code an insurance form or what have you, and it gives us a language to talk about. But what does it get us?

I care about the mechanism behind the diagnosis. What’s been happening to the tissue? What are these symptoms? Tell me the story of the patient, of the tissue, of the pathology that’s going on. I think to your point, I have seen overdiagnosis of this syndrome. It’s a syndrome; I would say.

And sometimes, I have to tell you, I believe that doctors don’t really know what’s going on because they’re not asking critical enough questions, or because they’re in the scope of their practice, which is reductionistic. Allopathic medicine, conventional Western reductionistic medicine, truly is driven by a science called reductionism. You are reduced to a sign or a symptom, a lab test, a diagnosis, and a treatment protocol.

That’s fine, and there’s a place for it, absolutely. Very, very valuable. But there are other systems of medicine – like for mine, naturopathic medicine – really driven by a vitalistic perspective. The body has an innate ability to heal, so we just get to ask questions like if something’s going on, where are obstacles to that process?

The thing about fibromyalgia – here’s what I do think is going on. What happens is there’s almost a circuit breaker happening in the body. The place in your brain, the hypothalamus, actually shuts down, kind of in response to overwhelming chronic stress. And those stressors for folks can certainly be the ones that we’re all used to: financial stressors, relationship stressors, unresolved emotional issue stressors, or infection stressors, physical stressors as well.

The hypothalamus is responsible for sleep, temperature control, blood pressure. It’s almost like there’s an energy deprivation. When muscles are deprived of energy, guess what? They end up in shortened positions, and pain and aches can set in. Think about rigor mortis, almost.

So I want to get into that story and really understand, and I’ve actually treated many people that walk in the door with a diagnosis of fibromyalgia, but when we chunk it down, it’s easy to do things to get rebalance back in the system.

Bottom Line: Fibromyalgia exists, but it’s not a disease? There’s something that’s going on with these people, and they can call it fibromyalgia, they could call it banana, they could call it excessive stress, but those names are taken – but really under the root of it, it means that there’s these other stressors in the body that are causing the hypothalamus to do something and then impact it?

Dr. Lucille: Yeah, the brain is protecting the body from this overwhelm, meaning “Look, we’ve got to start shutting down because this is crazy town, and we’re headed for crash and burn.” Let me tell you, every single person that has come into my office with this diagnosis in hand, “I have fibromyalgia,” when I really start to poke around, think about their nutrition, talk about their chronic stressor, lack of sleep, lack of exercise – boy oh boy, my plate is full. I have so many places to start.

In fact, one of the best – and I’m not going to say protocols; I’m going to say wake-up calls – Dr. Jacob Teitelbaum has this acronym called S.H.I.N.E. when it comes to working with people with fibromyalgic-like presentations and/or chronic fatigue.

“S” stands for sleep. We’ve got to get people sleeping again. This is one of the best things that can be intervened on when people present with this type of pain exhaustion presentation.

“H,” hormonal balances. Certainly making sure big picture mentality when it comes to our endocrine system needs to be on board.

“I,” any infections. And mostly, Sarah, it’s one of the favorite things you and I love to talk about – in our gut. Any Candidal infections, other fungal infections, bacterial dysbiosis. That just means, hey, stuff growing there that shouldn’t be growing there at the amount that it is, and also good stuff that we need growing there that is under-growing. So infections.

“N” stands for nutrition. Do you need nutritional supplementation? Are there deficiencies that we need to – I think I made up this word, but if there’s a depletion, I like to say replete. Vitamin D is a big one. Magnesium levels, a big one as well.

And then “E” stands for exercise as tolerated. The best thing we can do to get circulation and nutrients back to these painful parts is start to move and unlock the tissue.

Bottom Line: The interesting thing about this – and people can bounce from doctor to doctor, they’ll have a little bit of fatigue or they’ll have pain – so how do they avoid getting each element treated? So going to a rheumatologist and having their pain treated, or going to the doctor and getting a sleep supplement or something? How many of the symptoms do they need to have in order to think about this fibromyalgia diagnosis, this fibromyalgia cascade of symptoms?

Dr. Lucille: I do actually want to say, and I know it’s important to you as well, this pain and exhaustion that people feel who have been diagnosed with fibromyalgia, it’s real. But still, as you said, if you’re not looking at it comprehensively, all of a sudden you’re got five different doctor’s appointments to deal with five different elements of what you’re going through, and nobody is unraveling the case so we can actually really support the systems that need support that have gotten out of balance in the first place.

There is a way with you touching, in a physical examination, different points – I think it’s five out of ten, but I’m not sure on that – that you can be categorized as fibromyalgic. Once again, who cares? What are we going to do with that information? Let’s see where the tissue has been, let’s see all of the contributing factors, and then really, really take the time and unravel that.

Bottom Line: That’s great. All right, thank you, Dr. Holly Lucille. The bottom line on fibromyalgia? It really is real. Call it what you want, you do have pain, you do have exhaustion, you do have sleep problems. But underneath it is actually what’s going on in your life, and when you can treat those root causes, the rest of these symptoms can ease. I’m Sarah Hiner with Bottom Line.