Study opposes "Malingering" theory .....

Discussion in 'Fibromyalgia Main Forum' started by dojomo, Sep 4, 2003.

  1. dojomo

    dojomo New Member

    I love this study..... basically it says... If FM is used for secondary gains like collecting social security disability, then FM should be virtually non-existant in the Amish community.

    This completely self-sufficient community is not required by law to pay social security taxes.  Therefore, the Amish take the responsibility to care for their elderly and disabled

    If you find it hard to read studies..just scroll down to the conclusion.....

    Fibromyalgia syndrome in an Amish community: a controlled study to determine disease and symptom prevalence. White KP, Thompson J.
    Department of Medicine, University of Western Ontario, London, Ontario, Canada.
    OBJECTIVES: To estimate the point prevalence of fibromyalgia syndrome
    (FM) in Amish adults and to compare the prevalence of chronic pain, chronic widespread pain, FM, chronic fatigue, and debilitating fatigue in the Amish versus non-Amish rural and urban controls.

    The a priori assumption was that, if litigation and/or compensation availability have major effects on FM prevalence, then FM prevalence in the Amish should approach zero.

    METHODS: We surveyed 242 Amish adults in a small rural community southeast of London, Ontario, Canada. Individuals were screened using a validated screening instrument. Those reporting chronic, widespread pain were examined for FM using published classification criteria. Amish results were compared to results collected in a random telephone survey of 492 non-Amish adults living in rural Southwestern Ontario and 3395 non-Amish adults previously surveyed in London.

    RESULTS: Pain lasting at least one week in the preceding 3 months was reported by 34.3% of the Amish; pain in the upper extremities by 25.4%, in the lower extremities by 22.5%, and in the trunk by 28.1%. Twenty-six (15 women, 11 men) reported chronic, widespread pain.

    Eleven FM cases were confirmed among women (age adjusted point prevalence, p = 10.4%) and 2 among men (p = 3.7%) for an overall age and sex adjusted prevalence of 7.3% (95% CI 5.3, 9.7); this was both statistically greater than zero (p < 0.0001) and greater than in either control population (both p < 0.05).

    CONCLUSION: FM is relatively common among the Amish

  2. klutzo

    klutzo New Member

    Gosh durn, Dojomo! You just shot my favorite theory right out of the water with this study. I am a big fan of the adrenal fatigue due to crazy modern life theory, but these folk have always been withdrawn from the crazy life most of us live and they still get fibro. I'll bet they don't eat hardly any junk food either, so there goes nutritional theories too.
    This is VERY important stuff. Maybe this should be printed and taken to every appt. with a new doctor, in case they say, "I don't belive in fibro", you can whip this out and slap it down in front of them.
    As for me, I have to start all over from the beginning in how I think about fibro!
    Thanks for posting,
  3. klutzo

    klutzo New Member

    I can't belive nobody else realizes how important this is. If Fibro is common among the Amish ,there are many theories of it's cause that should be abandoned.
  4. tansy

    tansy New Member

    In the many years I worked in the voluntary sector and had contact with numerous (1,000s )patients with ME/CFS and FM all the theories about personality types, diet, lifestyle, stress, did not fit in with what I was observiung.

    Now they're going to have to do some serious research.


  5. dojomo

    dojomo New Member

    I was just looking at this from the malingering side of the argument. But your right ...this would eliminate a lot of theories.

    Hmmmmmmmm....I sit here and think...what do we have in common with the AMISH ???? .....dojomo
  6. kerrymygirl

    kerrymygirl New Member

    I find this very interesting. I researched Amish, lived not far from them and also took my kids to take a look at their lifesyles.BTW/used corn husks still then,not Toilet P.<even. If get my drift....little punn...

    I have always had a problem with the toxic environmental toxic theory, beacuse my grandmother who was ill all her life prob. fibro or maybe later polymyalsia rheumatica,whatever. Lived a very old fashioned,non outdoors person,not even in sun ever,died without a wrinkle. Ate all homecooked, rarely ate out, did not own anything with motor. Not car or lawn mower,etc.

    The amish I used to visit, found them always intreresting. Been to there homes, very clean, no use of toxic chemicals, for most part appeared non hyper and relaxed and very friendly. Food cooked from scracth, delicious I might add.

    Usually live away from toxic areas. Maybe alittle horse stuff, only real odors.

    Very little outside stumulii.,noises,etc. Not even radios for some.

    I also see people who live in horible conditions, in many other countries. Bodies have a way of adjusting to their environment.

    Look at Mexico we can not drink their water without it almost killing us. Yet, they live with it, their body adjusted.

    Plus coming from area where most men began their careers in steel mills, and very toxic jobs. I do not see the men with high incidence of fm/cfids.

    Still lots of questions, Good Info, Thanks......
  7. beckster

    beckster New Member

    pool as someone noted. It is not well known but there is a very high suicide rate. Also very high rate of bipolar disease ( which speaks of genetics.). They may not use chemicals on their farms but are surrounded by even bigger farms that heavily use chemicals. They drink well water which is heavily contaminated, and in no way treated (for bacteria or mercury, other metals, etc.) They are part of us (more than we are part of them). Even the most northern, isolated Eskimo tribes have high levels of the metabolite of DDT in their blood; far from farms/cities and the whole pollution of civilization, yet by merely eating their traditional foods from the sea (seals, etc which being at the top of the food chain in the sea are loaded with man's chemicals that are dumped into the oceans)they
    partake of our poisons. Gives new meaning the the phrase--
    "we are our brothers keepers."

    EZBRUZR New Member

    My brain not as big as previous Post Repliers,my words spelled incorrectly.
    Yet I still Think the Poor Quality Of Air And Tanted Water sources Alone qualify the Amish World Wide to enviormental toxin exposure.In Europe you cannot take out of the equation that many undergroud activities in History during Wars have basically Poisoned The Earth. in America we have all of the air and Water polution.As much as they try to live a life unaltered by progress,they encounter depleated resources and suffer all of the Ill effects of OUR progress.

    Only people in Bubbles are Immune to the silent killers of our poisons,and their "bubbles" probably caused polution while being made.

    Just a tad of food for thought.

  9. dojomo

    dojomo New Member

    For curiosity sake.. I'm not totally familar with all the Amish customs. But I did read that they do have a history of pesticide use and some have consented to vaccinations.

    We may be able to rule out pharmacueticals and anesthesia as a possible trigger...... But they are in as much contact with the polluted environment as we are....

    But everyone missed the GOOD news. People DON"T use FM for a reason to get money from the government....... have a good day
  10. IanH

    IanH Active Member

    What makes you think that FM is caused by psychosocial stress? Why is this idea still around. There is no evidence that FM is CAUSED by stress of this type. There is no doubt that it is aggravated by stresses and anxiety as are all neurologically involved illnesses.

    The evidence is very much weighted towards an immune system dysfunction causing neurological disturbance in pain pathways and in cognitive pathways and in digestive tract pathways. The originating cause is unknown but there is no reason (as yet) to suppose that FM or ME is caused by psychosocial stress. (Just as we do not know the originating cause of MS, even though MS was originally called "spastic hysteria").

    In many cases there is no difference between FM and ME. There are clearly many cases of FM that are associated with spinal trauma . The question for me is whether FM as it is being diagnosed is all the same pathology - I doubt it. I know many cases of diagnosed FM where the person clearly has previous regional pain but most cases show no physical pathology, in most of these cases they probably have ME.

    In nearly all cases of (Canadian criteria) diagnosed ME there is Natural killer cell dysfunction with raised IFN-gamma from NKC-dim cells. IFN-gamma damages mitochondrial membrane polarity resulting in impaired energy production and raised ROS. In the nervous system this causes channelopathy especially in the Na-K-ATPase pump. For some people this means lots of pain from both the periphery (neuropathy) and a central sensitization. The IFN-gamma directly affects hypothalamic function as does the lowered ATP and raised ROS. It only takes a 5% drop in ATP synthesis in the brain to cause many problems. This may also be the reason why adrenal output is altered with raised nocturnal glucocorticoid (ACTH and cortisol) output. Raised cortisol such as this "looks like stress" after all it is known as the stress hormone but the raised output is not due to stress.

    Chronic infections are known to raise both IFN-gamma and cortisol. When both of these are in high concentration they act synergistically and possibly interfere with CD4+ and CD8+ cells. In addition IFN-gamma is a powerful inhibitor of Treg development. When Tregs are not readily induced you have more general problems in immune regulation, which is typical of ME.

    In relation to muscle fatigue. We know that endotoxins plus IFN-gamma cause a prolonged expression of NOS2 and excessive production of Nitric Oxide in turn causing failure of myocytes. this leads to muscle pain and lots of fatigue. Add to this the poor function of partially depolarized mitochondria and some people have a complete failure of their energy systems and some have widespread pain. I addition some people have a failure of their xenotoxin detection system and suffer from MCS. It has been shown that people with ME, MCS and many with FM have raised intramuscular nitric oxide.

    I cannot see how any of this is caused by psychosocial stress BUT I can see clearly how psychosocial stress will aggravate the condition because if extra demands are placed upon the nervous system then it will not cope (in simple terms). The corollary is that if you manage your stresses well you suffer less, making ME and FM look like a stress related illness.

    Now, doctors, read the above carefully and then do more research and stop thinking of ME, FM and MCS as psychosocial disorders.

    What caused it all in the first place?
    Who knows?
    freida, TigerLilea and bct like this.
  11. TigerLilea

    TigerLilea Active Member

    Very well said, Ian. I saw the other message yesterday and didn't reply as I probably would have been banned from here.