Q: I have been diagnosed with fibromyalgia. It has taken me 15 years to get the diagnosis. I am a 44-year-old male and think most doctors believe this is a female-only disease. It has totally disabled me to where I can no longer work my job as a mechanic. I have been keeping a diary and have noticed an interesting pattern.
I was first put on allergy medication 15 years ago. I also notice because I live in the north and quit taking my meds in the winter, the fibromyalgia is actually somewhat bearable. I was put on Cetirizine five years ago and have noticed the pain doubles while I am on it. I have talked to people who have experienced the same thing from allergy shots. Is it possible that allergy medication causes fibromyalgia?
A: No that I know of. Certirizine (Zyrtec) is an antihistamine used to treat sneezing, itchy/watery eyes, and allergy symptoms. While antihistamines may cause drowsiness and may impair thinking and other central nervous system effects may come into play, the product (as well as Clariten) were developed to have fewer side effects than others.
Fibromyalgia has been long-known, or used to be known, as a diagnosis of exclusion, meaning that when all other testing and beliefs are ruled out, health care specialists then classify the disorder as such. In defense of physicians, many of the symptoms can be attributed to other diseases or disorders which is why a primary care physician might refer a patient to a rheumatologist for clarification. And, while women are more likely to develop the condition than are men, it is not only diagnosed in females. It may present with widespread musculoskeletal pain, insomnia, fatigue, memory issues, tension headaches, irritable bowel, anxiety, a total inability to function, and more.
Symptoms may appear following physical trauma, infection, a surgical procedure, or without any preceding event at all. Widespread pain classified as a dull ache and fatigue head the list of complaints, followed by an inability to focus or pay appropriate attention, depression, and being out of sorts.
The cause for fibromyalgia to occur may be from an abnormal increase in specific chemicals in the brain known as neurotransmitters that signal pain to over-react. Risk factors including lupus, and rheumatoid arthritis, a person’s sex and genetics, implying that if a person has a relative with the condition, he or she may “inherit” a risk to develop it also.
Up until a short while ago the American College of Rheumatology (ACR) required point testing but this diagnostic criteria has been modified. The specific areas of the body, 18 to be precise, were tested for pain when palpated. Now, however, things have changed. The ACR recommends fibromyalgia uses a Widespread Pain Index and Symptom Severity Scale. There is no laboratory or imaging testing to help with the diagnosis, other than to rule out other disorders.
Treatment may initially consist of acetaminophen, ibuprofen, or naproxen sodium. When these OTCs fail to provide adequate relief, a physician may opt for a prescription pain reliever such as tramadol (Ultram or Conzip). Physicians commonly try to discourage the use of narcotics because of their addictive potential. As a point of information, Lyrica was the first drug approved by the FDA to treat fibromyalgia. A physician may also choose an antidepressant or anti-seizure drug to help with the overwhelming fatigue involved, as well as to diminish the pain. As I have addressed before, many medications on the market today are found to be extremely helpful in combating symptoms unrelated to those for which they were originally intended.
It’s unfortunate that at such a young age, you are so disabled but this crippling, exhausting and poorly-understood condition that knows no boundaries. The only recommendations I can make other than following your physician’s guidelines are to make an effort to reduce the stress in your life, be sure you get a sufficient amount of sleep every night, eat well-balanced meals, exercise slowly and gradually to the extent your physician allows, and don’t overdo. Consider acupuncture, massage therapy and perhaps even yoga. Pace yourself, do what you can, and live each day to the fullest. Good luck.
