L-Lysine for fibromyalgia?

Discussion in 'Fibromyalgia Main Forum' started by richvank, Jan 29, 2009.

  1. richvank

    richvank New Member

    Hi, all.

    I'd be interested to know if anyone here has tried L-lysine for fibromyalgia, and if so, what your experience has been. I've just heard of a case in which it was reportedly effective, and I don't know whether to believe it or not.


  2. Waynesrhythm

    Waynesrhythm Member

    Hi Rich,

    I experience what I refer to as periods of viral overload; most likely some kind of herpes virus in my system that occasionaly flares up (even though I've never done any specific testing for virus levels). These flareups can cause a number of symptoms, including an exacerbation of some of my pain syndromes, though I don't have the pain associated with full blown FM.

    I have supplemented with lysine for a number of years, feeling that it seems to keep these viral overload episodes down, with an associated reduction in overall pain. I can see how l-lysine could be effective for someone with FM and their much more serious pain levels. That is if some or all of their pain is in any way associated with a herpes virus.

    These viral overload episodes have decreased this past year for me. I believe the MMS I was taking for a while helped in this regard. More recently, I've been taking a supplement called Cell Food which supposedly increases oxygen in the body. This particular supplement seems to have helped even more with the viral overload symptoms than the l-lysine. At the present time, I suspect the Cell Food will end up being a key part of my protocol for addressing the Lyme bacteria I tested positive for this past fall.

    Regards, Wayne
  3. richvank

    richvank New Member

    Hi, Wayne.

    Thanks very much for the response. I'm glad to hear that you have been able to decrease the viral episodes. Thanks for the information on your MMS response and also the benefit you've gotten from Cell Food.

    I'm particularly interested in whether L-lysine is beneficial in fibromyalgia. I understand that you don't have full-blown fibromyalgia, but what sort of daily dosage of L-lysine have you used for the viral episodes?

    Thanks again.

  4. elliespad

    elliespad Member

    Hi Rich, I have both Fibro and CFIDS. I've used L-Lysine to treat Vertigo. I have also used Turmeric, the Herb, not the spice and find it to work better than the Lysine. It was recommended to me by Dr. Dennis Gersten, whom I was treating with at the time. He told me that Turmeric will put Epstein Barr Virus in remission. It got rid of my Vertigo but can't say it did much for my weakness or fatigue. The same goes for the L-Lysine. I have also gotten rid of Cold Sores using both. Has also worked for getting rid of what I have self-diagnosed as "nerve pain".

    Also, I had my girlfriends' son take Turmeric to get rid of warts on his feet that had been treated without success by his Pediatrician for 6 months. They were gone in a few days. Coincidence? Who knows. Would L-Lysine work? Who knows.
    [This Message was Edited on 06/09/2009]
  5. richvank

    richvank New Member

    Hi, elliespad.

    Thanks for the information. Turmeric is good stuff. One of the things it does is to stimulate the production of glutathione.

  6. heapsreal

    heapsreal New Member

    Are you looking into lysine to stop viral reactivation? Im interested to see what responses you get. I have been taking famvir for a couple of months for possible ebv reactivation, I have chronic elevated lymphocytes. Since I have been on the antivirals I have noticed I havent crashed like I use to do pre famvir, energy levels are slowly improving as well as aches and pains, sleep is still an issue.

    I have posted a similar request for peoples experience with lysine and if it works as well for ebv as it does for other herpees viruses I will start using it , not sure if in combination with antivirals or not, maybe once i have been on antivirals for 6 months may then turn to lysine to keep it dormant and have famvir on hand if required.

    Have you found whey protein good for increasing glutathione levels? Do you have any opinions on astragalus for immunity/ viral reactivation?

  7. richvank

    richvank New Member

    Hi, heapsreal.

    Thank you for your response.

    I think that there's no question that raising the lysine-to-arginine ratio will stop the propagation of at least some of the herpes family viruses that affect humans. It definitely works on herpes simplex I (the cold sore virus), and based on a small amount of experience that others have reported to me, including members of my family, I suspect that it also works on varicella zoster (herpes zoster), which is the chicken pox--shingles virus. It should be noted, though, that a shingles outbreak produces damage to nerves, and this takes time to mend, even though the virus has been stopped.

    I suspect that it also works on EBV, based on the experiences of a few people who had mononucleosis and were able to recover fairly quickly when they took a few grams per day of lysine, together with N-acetycysteine. The latter supports the synthesis of glutathione, and glutathione also stops herpes-family viruses, by a different mechanism than lysine. It involves blocking the synthesis of the glycoprotein B, which all herpes viruses that affect humans must make in order to propagate.

    The reason I'm asking about use of lysine for fibromyalgia is that I have heard of a case in which high-dose lysine (up to six grams per day) is reported to have cleared the symptoms. I don't know whether to believe this or not. If it does in fact work, it would imply that fibromyalgia is a herpes-family virus-based disease. As far as I know, this has never been discussed as a possible cause of fibromyalgia in the research literature, so it would be a major development if true. It is known that at least some of the herpes-family viruses infect nerves, so given the pain symptoms of fibromyalgia, this suggestion does not seem totally farfetched to me.

    The mechanism by which an elevated lysine-to-arginine ratio stops the propagation of at least some of the herpes-family viruses likely involves the histone molecules in the nucleus, which wind up the DNA on "spools." A high lysine-to-arginine ratio apparently keeps the herpes viral DNA from being expressed by this mechanism. I realize that various alternative explanations have been offered for the mechanism of the high lysine-to-arginine ratio in suppressing herpes-family viruses, but I think that this is most likely the correct one.

    I think there are some issues involved with taking a lot of lysine if it is done for a long time. The liver and kidneys would have to dispose of the extra, beyond what the body needs, so I think it would be important not to overdo this imbalance in amino acids, and I'm not sure where the limit lies. Lysine is an essential amino acid, though, and there is quite a bit of it in dietary proteins, especially in animal-based proteins, so the body is accustomed to dealing with it. There are a few people who have genetic issues that make it difficult for them to metabolize lysine, but this is fairly rare.

    I want to make it clear that I am not currently advocating this as a treatment. I am just collecting information about it at this point. If anyone with fibromyalgia has tried relatively high doses of lysine, while minimizing arginine intake (seeds, nuts, chocolate), I would be interested to know if it helped.

    With regard to whey protein and glutathione, my experience in people with CFS is that it can help to raise glutathione on a temporary basis for some, but it is not a permanent solution to the glutathione depletion. Lifting the methylation cycle block, on the other hand, brings glutathione up automatically, without special efforts to supply it or its amino acids. We have good measured data to support this now, which we are planning to present at the upcoming IACFS/ME conference in Reno in March.

    I don't have experience with astragalus, but I have read positive things about it.

    Best regards,


  8. hensue

    hensue New Member

    I am a little leary but i have heard both l-lysine and tumeric are good. So what do you think and if you say check with doc he will say I dont know?
  9. heapsreal

    heapsreal New Member

    Interesting that you mentioned chicken pox, its not mentioned very often but this is how my cfs start as well as ebv around or at the sametime. Chicken pox is pretty rough when your an adult. I would say I am more cfs but do get aches and pains, sometimes just an all over type of prickly type pain, sometimes intense muscle tightness and also get a strange nerve type pain that runs down the outside of my lower leg which likes to wake me up from sleep. I have always wondered if these pains especially the nerve type pain in lower leg was due to some type of nerve damage from chicken pox.

    Also would it be wise to get vaccinated for shingles when I have finished the famvir? or could it possibly aggravate my immune system.

    Also have looked into my diet as far as the food i eat and the lysine and arginine content go. I follow a low carb diet which appears to have a higher ratio of lysine to arginine, and my symptoms do worsen when not on this diet.

    You have convinced me to try lysine supps and see how my nerve pain reacts. I have been taking n-acetylcysteine and whey protein for awhile so hopefully this will complement the lysine treatment. Was there any suggestions on length of treatment before pain symptoms decreased??

  10. richvank

    richvank New Member

    Hi, hensue.

    Turmeric is the yellow spice used on Indian food, such as curry. It is available in supermarkets.

    The active ingredient in turmeric is curcumin. It is available from health food stores and on the internet.

    I think it's against the rules to talk about brands of supplements on this board, but if you go to www dot consumerlab dot com and pay a small fee, you can get their report on curcumin products. They measure impurities such as lead, and also how much of the active ingredient is present.

    Turmeric is approved by the German Komission E monographs (a respected source of information about herbal treatments) for use with dyspeptic complaints and loss of appetite, but it has also been used for many other conditions, and research is ongoing to make a modified form of curcumin that is more absorbable.

    I hope this helps.

  11. richvank

    richvank New Member

    Hi, heapsreal.

    Thanks for the information. I'll be interested to hear whether lysine helps you. You asked about length of treatment before symptoms decrease. The report I received about the single case was that it amounted to "a few days." Again, I don't know how reliable this report is.

    With regard to vaccination for shingles, my understanding from reading the medical books is that it is recommended for children and for adults who have not been exposed to the herpes zoster virus. There is also a study on people older than 60 years who had chicken pox as children. When they were given the shingles vaccination, it did decrease the number who got shingles later, compared to those who did not receive the vaccination. I can't advise you on whether you should get this vaccination. I recommend that you consult with a infectious disease physician.

    Best regards,

  12. richvank

    richvank New Member

    Hi, Elaine.

    Thank you for the information. I'm glad to hear that lysine has helped you. What daily dosage of lysine do you use?

    Best regards,

  13. richvank

    richvank New Member

    Hi, Elaine.

    Thanks for the information. Sounds like you are using a very careful and disciplined procedure, and I'm glad it's been helping.

    If your other approaches don't help with the fatigue, you and your doctor might want to consider testing to see if you have a methylation cycle block and glutathione depletion, and treating for it if you do. We're finding that most PWCs do have these issues, and the treatment is very effective, though it takes several months in many cases to get the methylation cycle and the glutathione level up to normal.

    Best regards,

  14. richvank

    richvank New Member

    Hi all.

    A very brief report on use of lysine in one case of fibromyalgia can be found in the discussion of Rheumatoid Arthritis on the web page www dot krysalis dot com. Dr. Gregg believes that fibromyalgia is actually an autoimmune disease, and that it and other autoimmune diseases are caused by herpes viral infections. This was the basis for his suggestion that elevating the lysine-to-arginine ratio would help in these disorders. This idea has not been tested on very many cases yet, but it appears to have helped in the few who have tried it.

    Also on his website is a table of the lysine-to-arginine ratios for a variety of foods, which can be helpful for people who are choosing foods to elevate their lysine-to-arginine ratio.

  15. outofstep

    outofstep Member

    Can you please tell me what test is used to determine methylation cycle blockage and glutathione depletion? Thanks!
  16. richvank

    richvank New Member

    Hi, outofstep.

    Here's the information on the test panel:

    Methylation Pathways Panel

    This panel will indicate whether a person has a partial methylation cycle block and/or glutathione depletion. I recommend that this panel be run before deciding whether to consider treatment for lifting the methylation cycle block. I am not associated with the lab that offers this panel.

    The panel costs $300 and requires an order from a physician or a chiropractor. The best way to order the panel is by fax, on your clinician’s letterhead.

    Available from:

    Vitamin Diagnostics, Inc.
    Rt. 35 & Industrial Drive
    Cliffwood Beach, NJ 07735
    Phone:+1 (732) 583-7773
    Fax: +1 (732) 583-7774)

    Lab Director: Tapan Audhya, Ph.D.
    (usually at the lab on Tues. and Wed. from 1 to 3 p.m., Eastern time)

    Dr. Audhya is willing to help clinicians with interpretation of the panel by phone.

  17. outofstep

    outofstep Member

    Thanks VERY very much for the info-I just have a few questions-these are blood tests right?, and if so, what in the blood indicates that there is a methylation block? And who usually gets these kinds of tests? Your theory is fascinating and will hopefully add another piece to the puzzle.
  18. richvank

    richvank New Member

    Hi, outofstep.

    Yes, these are blood tests. I'll post a discussion of the interpretation of the panel below. The panel was developed for use particularly for autism patients and for people with chronic fatigue syndrome. The basic biochemical abnormalities are very similar in these two disorders.

    Here's the interpretation information:

    Several people have asked for help in interpreting the results of
    their Vitamin Diagnostics, Inc., methylation pathway panels. Here are my
    suggestions for doing so. They are based on my study of the
    biochemistry involved, on my own experience with interpreting more
    than 120 of these panel results to date, and on discussion of some of
    the issues with Tapan Audhya, Ph.D., who is the director of the
    Vitamin Diagnostics lab.

    The panel consists of measurement of two forms of glutathione
    (reduced and oxidized), adenosine, S-adenosylmethionine (SAM) , S-
    adenosylhomocysteine (SAH), and seven folic acid derivatives or

    According to Dr. Audha, the reference ranges for each of these
    metabolites was derived from measurements on at least 120 healthy
    male and female volunteer medical students from ages 20 to 40, non-
    smoking, and with no known chronic diseases. The reference ranges
    extend to plus and minus two standard deviations from the mean of
    these measurements.

    Glutathione: This is a measurement of the concentration of the
    reduced (active) form of glutathione (abbreviated GSH) in the blood
    plasma. From what I've seen, most people with chronic fatigue
    syndrome (PWCs) have values below the reference range. This means
    that they are suffering from glutathione depletion. As they undergo
    the simplified treatment approach to lift the methylation cycle
    block, this value usually rises into the normal range over a period
    of months. I believe that this is very important, because if
    glutathione is low, vitamin B12 is unprotected and reacts with toxins
    that build up in the absence of sufficient glutathione to take them
    out. Vitamin B12 is thus hijacked, and not enough of it is able to
    convert to methylcobalamin, which is what the methylation cycle needs
    in order to function normally. Also, many of the abnormalities and
    symptoms in CFS can be traced directly to glutathione depletion.

    Glutathione (oxidized): This is a measurement of the concentration
    of the oxidized form of glutathione (abbreviated GSSG) in the blood
    plasma. In many (but not all) PWCs, it is elevated above the normal
    range, and this represents oxidative stress.

    Adenosine: This is a measure of the concentration of adenosine in the
    blood plasma. Adenosine is a product of the reaction that converts
    SAH to homocysteine. In some PWCs it is high, in some it is low, and
    in some it is in the reference range. I don't yet understand what
    controls the adenosine level, and I suspect there are more than one
    factor involved. In most PWCs who started with abnormal values, the
    adenosine level appears to be moving into the reference range with
    methylation cycle treatment, but more data are needed.

    S-adenosymethionine (RBC) (SAM): This is a measure of the
    concentration of SAM in the red blood cells. Most PWCs have values
    below the reference range, and treatment raises the value. S-
    adenosylmethionine is the main supplier of methyl groups in the body,
    and hundreds of biochemical reactions depend on it for their methyl
    groups. A low value for SAM represents low methylation capacity, and
    it usually results from a partial block at the enzyme methionine
    synthase. Many of the abnormalities in CFS result from lack of
    sufficient methyation capacity.

    S-adenosylhomocysteine (RBC) (SAH): This is a measure of the
    concentration of SAH in the red blood cells. In CFS, its value
    ranges from below the reference range, to within the reference range,
    to above the reference range. Values appear to be converging toward
    the reference range with treatment. SAH is the product of reactions
    in which SAM donates methyl groups to other molecules.

    Sum of SAM and SAH: When the sum of SAM and SAH is below 268
    micromoles per deciliter, it appears to suggest the presence of
    upregulating polymorphisms in the cystathione beta synthase (CBS)
    enzyme, though this may not be true in every case.

    Ratio of SAM to SAH: A ratio less than about 4.5 also represents low
    methylation capacity. Both the concentration of SAM and the ratio of
    concentrations of SAM to SAH are important in determining the
    methylation capacity.

    5-CH3-THF: This is a measure of the concentration of 5-methyl
    tetrahydrofolate in the blood plasma. It is normally the most
    abundant form of folate in the blood plasma. It is the form that
    serves as a reactant for the enzyme methionine synthase, and is thus
    the most important form for the methylation cycle. Most PWCs have a
    low value, consistent with a partial block in the methylation cycle.
    The simplified treatment approach includes FolaPro, which is
    commercially produced 5-CH3-THF, so that when this treatment is used,
    this value rises in nearly every PWC. If the concentration of 5-CH3-
    THF is within the reference range, but either SAM or the ratio of SAM
    to SAH is below the reference values, it suggests that there is a
    partial methylation cycle block and that it is caused by
    unavailability of sufficient bioactive B12, rather than
    unavailability of sufficient folate. I have seen this frequently,
    and I think it demonstrates that the hijacking of B12 is the root
    cause of most cases of partial methylation cycle block. Usually
    glutathione is low in these cases, which is consistent with lack of
    protection for B12, as well as toxin buildup.

    10-Formyl-THF: This is a measure of the concentration of 10-formyl
    tetrahydrofolate in the blood plasma. It is usually low in PWCs.
    This form of folate is involved in reactions to form purines, which
    form part of RNA and DNA as well as ATP.

    5-Formyl-THF: This is a measure of the concentration of 5-formyl
    tetrahydrofolate (also called folinic acid) in the blood plasma.
    Most but not all PWCs have a low value. This form is not used
    directly as a substrate in one-carbon transfer reactions, but it can
    be converted into other forms of folate. It is one of the
    supplements in the simplified treatment approach, which helps to
    build up various other forms of folate.

    THF: This is a measure of the concentration of tetrahydrofolate in
    the blood plasma. It is lower than the mean normal value of 3.7
    nanomoles per liter in most but not all PWCs. This is the
    fundamental chemically reduced form of folate from which several
    other reduced folate forms are made. The supplement folic acid is
    converted into THF by two sequential reactions catalyzed by
    dihydrofolate reductase (DHFR). THF is also a product of the
    reaction of the methionine synthase enzyme, and it is a reactant in
    the reaction that converts formiminoglutamate (figlu) into
    glutamate. If figlu is high in the Genova Diagnostics Metabolic
    Analysis Profile, it indicates that THF is low.

    Folic acid: This is a measure of the concentration of folic acid in
    the blood plasma. Low values suggest folic acid deficiency in the
    current diet. High values are sometimes associated with inability to
    convert folic acid into other forms of folate, such as because of
    polymorphisms in the DHFR enzyme. They may also be due to high
    supplementation of folic acid.

    Folinic acid (WB): This is a measure of the concentration of folinic
    acid in the whole blood. See comments on 5-formyl-THF above. It
    usually tracks with the plasma 5-formyl-THF concentration.

    Folic acid (RBC): This is a measure of the concentration of folic
    acid in the red blood cells. The red blood cells import folic acid
    when they are initially being formed, but during most of their
    approximately four-month life, they do not import, export, or use
    it. They simply serve as reservoirs for it, giving it up when they
    are broken down. Many PWCs have low values. This can normally be
    caused by a low folic acid status in the diet over the previous few
    months, since the population of RBCs at any time has ages ranging
    from zero to about four months. However, in CFS it can also be
    caused by damage to the cell membranes, which allows folic acid to
    leak out of the cells. Dr. Audhya reports that treatment with omega-
    3 fatty acids can raise this value over time.

  19. richvank

    richvank New Member

    Hi Elaine.

    You're welcome.

    If your doctor would like information on the glutathione depletion--methylation cycle block hypothesis and the treatment based on it, I would be happy to send it to him.

    I'm glad to hear that you are able to sleep better now. That certainly is an important aspect.

    Working on individual aspects one at a time can definitely improve one's quality of life over time. This approach has been used by many people with CFS over the past few years.

    What I am trying to do is to find and deal with the root issues in this disorder, which are leading to all these individual aspects. It's beginning to look as though the combination of glutathione depletion and the methylation cycle block is the key problem for many people with CFS, so that when they are corrected, there is improvement in quite a few downstream aspects. This treatment does appear to work for many cases of CFS, but recovery takes many months in most cases studied so far. I think the long times involved are largely due to the time it takes to actually excrete the backlog of toxins that has built up while the person has been ill, and their detox system has not been operating normally.

    However, for people who have "pure" fibromyalgia, I'm not convinced that the methylation block treatment will bring recovery, though I don't think there have been many with "pure" fibromyalgia who have tried it, since I haven't had a theoretical basis to encourage them to do it. So far, I think that "pure" fibromyalgia is caused by a different basic disease mechanism than CFS.

    Having received one report that lysine may be beneficial in fibromyalgia, and having been unable to shoot down the possibility that a herpes family virus is involved in fibromyalgia on a theoretical basis so far, I've been curious as to whether people have had experience with using lysine in fibromyalgia specifically, and what their experience has been. I appreciate the responses I've received here so far, which do indicate that some other people have received benefit from lysine. As I mentioned before, I'm not recommending this treatment for fibromyalgia at this point, because I don't feel that I have a firm enough basis to do so, but I am collecting information.

    Best regards,

  20. richvank

    richvank New Member

    Hi, all.

    As I’ve mentioned previously, Dr. David Gregg has proposed the hypothesis that a herpes family virus in the nervous system is the cause of fibromyalgia, and that lysine would be an effective treatment for it.

    I have been putting some thought into this, and have been digging in the literature, to see how well this hypothesis stands up to scrutiny on the basis of what is known about herpes viruses and about fibromyalgia. I would like to report on this effort here. I will present a series of questions, with the answers I have been able to come up with so far:

    1. Are herpes-family viruses known to reside in neurons?
    Yes, the alphaherpes viruses, which include Herpes simplex I and II and Varicella zoster (aka Herpes zoster) do occupy neurons. There are a total of 8 known herpes-family viruses that infect humans, but these are the only ones known to stay inside neurons. As you may know, Herpes simplex I is responsible for cold sores (fever blisters), Herpes simplex II is genital herpes, a sexually-transmitted disease, and Varicella zoster is responsible for chicken pox and shingles. Herpes simpex I has also been known to enter the brain, and can cause an encephalitis that can be fatal. Since current research in fibromyalgia points to a central sensitization problem (i.e. a problem in the brain itself), it would seem that if a herpes-family virus is involved in causing fibromyalgia, it would most likely be Herpes simplex I.

    2. If a herpes-family virus is actually the cause of fibromyalgia, why haven’t physicians or researchers detected it?
    The problem is that a large proportion of the population has been exposed to herpes-family viruses and has antibodies to them. It would be impossible using blood serum antibody tests to distinguish between a person who has latent Herpes simplex I viruses in their trigeminal nerve ganglion, and is thus subject to periodic flare-ups that cause cold sores, and a person who might have these viruses in neurons in the brain. The same would be true of PCR tests on the blood serum. Perhaps PCR tests on the cerebrospinal fluid would be discriminatory, but I doubt if this has been done. Biopsies of the brain are not normally done on living fibromyalgia patients!

    3. Have there been any histological studies that might point to herpes virus involvement in fibromyalgia?
    The only tissue study I have found is one performed on nerve axons in the skin of fibromyalgia patients. It showed ballooning of the Schwann cells in these patients. I think it’s conceivable that a virus could produce such an effect, but there is no direct evidence of that.

    4. If there is a viral infection that is producing damage that is causing fibromyalgia, one would expect that the immune system would be trying to respond to it. Is there any evidence of that?
    Yes, there have been some abnormal levels of certain cytokines observed in fibromyalgia. Cytokines are peptides secreted by cells of the immune system to signal each other during an immune response. This suggests that the immune system has detected something and is trying to counter it. In addition, there is a report of some autoimmune antibodies found in fibromyalgia. This would be consistent with Dr. Gregg’s hypothesis that fibromyalgia is an autoimmune disease, resulting from the immune system’s response to a herpes virus.

    5. Does treatment with antiviral drugs that are effective against herpes viruses help patients with fibromyalgia?
    As far as I know, antiviral drugs have not been tried against cases of “pure” fibromyalgia. They are, of course, used in treating some cases of chronic fatigue syndrome, notably by Drs. Lerner and Montoya, and there are many patients who satisfy the diagnostic criteria for both CFS and fibromyalgia, so in that sense, antivirals have been used in fibromyalgia with comorbid CFS. I don’t know to what degree this type of treatment has helped with the fibromyalgia-type pain in these comorbid patients. The Montoya study has not been published yet.

    6. Could this hypothesis explain why so many people have both CFS and fibromyalgia, and that CFS patients can later develop fibromyalgia?
    I think it could explain that. In CFS, in my hypothesis, because of glutathione depletion and a partial block in the methylation cycle and the folate metabolism, herpes viruses that have been in the latent state are allowed to reactivate, and the cell-mediated immune response, which is needed to put down viral infections, does not operate effectively. Thus, it seems conceivable that CFS could lead to fibromyalgia, if a herpes virus is the cause of fibromyalgia.

    7. Could this explain why many cases of fibromyalgia start with a physical trauma, such as an auto accident? Yes, I think it could. If the blood-brain barrier were damaged, as might occur from a blow to the head, it would likely be easier for a herpes virus to enter the brain.

    8. Are there ways for viruses to enter the brain other than via a damaged blood-brain barrier?
    Yes, viruses sometimes enter the brain via the olfactory neurons in the nasal cavity. These neurons are exposed directly to the outside environment in the nasal cavity, and the olfactory nerve represents a very short path to the brain.

    9. Could this hypothesis explain why people with fibromyalgia have different numbers of tender points?
    I think it could. Which tender points were present would likely depend on which neurons the virus is occupying. Herpes viruses tend to stay in certain neurons after the infection is established. For example, a person who gets cold sores always gets them in the same spot, because the herpes virus stays in the same neurons, and they serve that particular area of the skin. I suspect that once the herpes viral infection is established, the immune system raises antibodies to it, and that prevents the virus from propagating to new neurons. However, it can flare up and propagate new virions, and when these come out of the axon at the synapse, the immune system detects them and attacks them. This produces inflammation and damage to the axon, which is repaired after the flare-up ceases and the herpes virus goes back into latency inside the body of the neuron.

    10. Could this hypothesis explain why fibromyalgia is a chronic disease?
    Yes, it could. It is known that we can never get rid of herpes viral infections once they are established. The viruses go into latency until the next flare-up, but they are not eliminated.

    11. One question all of this raises in my mind is whether people with “pure” fibromyalgia had problems with periodic cold sores prior to the onset of their fibromyalgia. I’m not sure what answer would be predicted by this hypothesis. On the one hand, if they did have problems with cold sores, it would mean that they had a prior infection with Herpes simplex I (or possibly II), so the virus would have been available in their bodies. On the other hand, their immune systems would have raised antibodies to this virus, and that might have prevented it from getting established in the brain. Anyway, I think it’s an interesting question. If you’ve read this far, and you have “pure” fibromyalgia, I would be interested to know what your answer would be.