Is Fibromyalgia Hereditary?

Fibromyalgia is associated with a hereditary risk, but the exact percentage of a genetic contribution to fibromyalgia is not known.

Fibromyalgia is not hereditary in the classical sense, where a mutation of a single gene is responsible for a given trait. That's monogenic heredity, and it controls things like sickle cell disease; however, the evidence does suggest that your genes can predispose you to fibromyalgia, but in a complex way involving many genes, which is described as polygenic.

What's the Difference?

In a classical, monogenic, hereditary condition, a specific gene you inherit from your parents is the primary factor that determines whether you'll get a disease. For example, in cystic fibrosis, the child of parents who are both disease carriers has a 25 percent chance of developing cystic fibrosis. They either inherit the causative genetic mutation, or they don't. If they do inherit the mutation, they get the disease.

With polygenic predisposition, it's not as simple because your genes only mean that a particular illness is possible under the right conditions. You can have a higher or lower risk than other people, but developing the disease is not a certainty. Typically, other factors must come into play to actually trigger the illness.

In fibromyalgia, these other factors may include:

• Other sources of chronic pain
• Autoimmune disease
• Sleep disorders
• Chronic stress
• Infectious illness
• Abnormal brain chemistry

Some experts hypothesize that environmental factors such as food sensitivities or exposure to toxins could also play a role.

That means your child may have inherited a genetic predisposition for fibromyalgia, but that still doesn't mean he or she will end up with it. It would take an additional set of circumstances to take them down that path.

Genetic Links in Fibromyalgia

Researchers began looking into a possible genetic component of fibromyalgia long ago because it does tend to run in families, in what are called "clusters." Much of the work has involved identical twins. The body of research has been growing since the 1980s.

What we've learned is that there is a risk that's determined by genetics and that there is also a contribution from other factors.

Research also suggests that a low pain threshold (the point at which sensation becomes painful) is common in non-fibromyalgic relatives of people with fibromyalgia.

We're really just beginning to get a picture of the specific genetic factors associated with fibromyalgia. So far, we have multiple studies suggesting connections with numerous genes, but many of these studies have not been replicated.

Genetic abnormalities that have been suggested by preliminary studies include genes that code for the production of neurotransmitters (chemical messengers in the brain) that have been implicated in fibromyalgia—including serotonin, norepinephrine, dopamine, GABA, and glutamate. Other genes are involved in general brain function, fighting viral infection, and brain receptors that deal with opioids (narcotic pain killers) and cannabinoids (such as marijuana.)

As we learn more about these genetic associations, researchers may identify which of them contribute to the risk of developing fibromyalgia, as well as whether any can be used to diagnose or treat the condition.

What Does That Mean for Your Child?

It's scary to think that your child has a heightened risk of ending up with fibromyalgia. The key thing to remember is that nothing is guaranteed.

So far, we don't know what might help reduce the risk, but one study does suggest that the twin with the higher emotional intelligence was less likely to become sick.

Your emotional intelligence is your ability:

• To be aware of and in control of your emotions
• To express how you feel
• To deal with relationships fairly and empathically

Encouraging these skills in your child may help. Stress is also a cause for concern, so try to teach your child positive coping mechanisms. If your child seems to be struggling with any of these things, you may want to seek a professional counselor who can assist him or her.

Because pre-existing chronic pain is a risk factor for fibromyalgia, you may want to be especially aware of how injuries are healing and whether your child has migraines or "growing pains." Your pediatrician should be able to recommend treatments.

We don't have evidence that a healthy diet and general physical fitness specifically lower your child's risk of developing fibromyalgia, but they're always a good idea.

If you're concerned about anything having to do with your child's health, be sure to bring it up with your pediatrician.

And remember that you have not "doomed" your child to anything. In fact, your early awareness may well be what steers them in the healthier direction.