Low Dopamine in Fibromyalgia and ME/CFS

Why should you know about low dopamine symptoms -- that is, the effects of low dopamine -- in fibromyalgia and chronic fatigue syndrome?

First, because dopamine is a neurotransmitter, a chemical released by nerve cells (neurons), that has a number of important functions in your brain. 

Second, because people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) generally have low dopamine levels, which makes them prone to a variety of symptoms and conditions.

The different functions of dopamine in your brain include helping you:

• Focus your attention and concentrate on tasks -- low levels of dopamine are linked with development of ADD/ADHD
• Control how your body moves -- extremely low levels of dopamine can lead to Parkinson's disease, characterized by tremors (shaking) and problems with balance and coordination

No neurotransmitter acts alone. They all work together in your brain and body, forming a complex web of activity that scientists are only just beginning to understand. There has been progress, however: Experts have been able to 1) link different neurotransmitter imbalances with certain symptoms and disorders and 2) find ways to help boost or decrease neurotransmitter activity.

Low dopamine levels are associated with the following symptoms:

• Stiff, rigid, achy muscles
• Tremors
• Impaired fine motor skills -- problems making small movements, such as picking up small things or holding a fork
• Cognitive (thinking) impairment (often called brain fog or fibro fog)
• Inability to focus attention
• Poor balance and coordination
• A noticeably odd, small-step walking pattern (gait)

High levels of dopamine are associated with addiction, euphoria (intense excitement or joy), overexcitement, excessive concentration or focus, suspicion, and the inability to separate what's important from what isn't. If you're taking medication that increases your dopamine levels, let your doctor know if you have symptoms of high dopamine.

Neuroleptic (antipsychotic) medications typically lower dopamine levels. If you're taking any of them, check with your doctor about symptoms that could be due to your having low dopamine levels. Common medications in this class include:

• Clozaril (clozapine)
• Haldol (haloperidol)
• Risperdal (risperidone)
• Seroquel (quetiapine)
• Zyprexa (olanzapine)

Treatment of low dopamine levels may include therapy with a central nervous system (CNS) stimulant medication containing methylphenidate, such as Ritalin, Concerta, or Methadate.

There isn't a lot of research confirming that food can boost dopamine levels in your brain. What's more, even if it does, it's believed you'd need to consume huge amounts to get the desired effect. Nevertheless, despite the lack of hard evidence, some experts believe that the following foods may help:

• Tea, black or green 
• Apples, bananas, and watermelon
• Blueberry extract
• Red wine
• Beets
• Beans and other legumes
• Chicken
• Cheese
• Eggs
• Fish
• Wheat germ

Supplements believed to help raise dopamine levels include:

• NADH, the supplement form of amino acid unique to black and green tea
• Omega-3 fatty acids, from fish oil or flax seed oil
• Rhodiola rosea, an herb sometimes called golden root or Arctic root
• L-theanine, also known as suntheanine, an amino acid derived from tea leaves

A Note on L-Theanine. Studies show that L-theanine, available as a supplement, increases both of the neurotransmitters norepinephrine and dopamine while lowering glutamate levels, which can have positive effects on people with fibromyalgia and chronic fatigue syndrome. However, researchers aren't sure how L-theanine impacts levels of serotonin, an important neurotransmitter found mainly in your brain, bowels, and blood platelets. If you think you may want to try L-theanine, get your doctor's okay first. You can also learn about serotonin-related symptoms; if you notice any, tell your doctor.

While it's generally safe to experiment with these kinds of foods and supplements, don't expect miracles or make extreme or sudden changes to your diet. Instead, make changes slowly, and track your dietary changes and symptoms in a symptom journal, which will give you an accurate sense of what's helping and what isn't. And remember, always work with your doctor about managing your diet and taking medications and supplements.