Sjogren's Syndrome in Fibromyalgia & Chronic Fatigue Syndrome

A Common Overlapping Condition

Tennis star Venus Williams went public in 2014 about an illness that has given her trouble for years—Sjögren's syndrome. We have anecdotal evidence that this disease is common in those of us with fibromyalgia and chronic fatigue syndrome.

By itself, Sjögren's is enough to derail even an otherwise-healthy competitive athlete. Williams had to withdraw from a recent tournament because she was too fatigued to lift her arm. She told The New York Times, "The fatigue is hard to explain unless you have it...And the more I tried to push through it, the tougher it got." That's something I know most of us can relate to.

If you add Sjögren's to conditions like fibromyalgia and chronic fatigue syndrome, you've got a recipe for extreme debilitation. For us to feel better and gain back function, we need to make sure all of our illnesses are properly diagnosed and treated. This can be hard since we can have a host of similar illnesses that are all hard to diagnose. The key is to pay close attention to your symptoms and talk to your healthcare provider about anything new.

Tennis star Venus Williams

Zhong Zhi / Getty Images

What Is Sjögren's Syndrome?

Sjögren's, also called sicca syndrome, is an autoimmune disease. That means your immune system is incorrectly identifying your own tissues as dangerous and setting out to destroy them.

In the case of Sjögren's, the tissues under attack are glands that produce moisture. The primary symptoms are dry eyes and mouth. In addition, other areas, such as the vagina and the skin, can be abnormally dry. This dryness isn't just uncomfortable; it can be a real health hazard. A chronically dry mouth can lead to oral infections, tooth decay, mouth pain, and difficulty swallowing. Chronically dry eyes can develop ulcers. Sjögren's can also cause persistent fatigue and inflammation in your joints, muscles, nerves, organs or other parts of the body. The inflammation can be quite painful.

When Sjögren's overlaps with fibromyalgia or chronic fatigue syndrome, it can be hard to spot because some of the symptoms are similar. The important thing for you is to pay attention to any unusual or chronic dryness you may experience and ask your healthcare provider about it.

Sjögren's syndrome is a difficult thing to diagnose, so expect an array of diagnostic efforts including:

  • An examination of your mouth and eyes
  • Blood tests
  • A biopsy of your salivary gland (possible)

Treating Sjögren's Syndrome

Sjögren's is treated differently depending on the specific body parts that are affected and how severe it is.

Symptoms and treatments include:

Dry eyes: Treatments for dry eyes include over-the-counter liquid tears and prescription drops such as Restasis and Xiidra.

Dry mouth: Avoiding common toothpaste brands that have chemicals can be helpful. Tom's childrens toothpaste with flouride or Biotene brand products may be better. Chewing on gum or sucking on candy with xylitol as a sweetener can be helpful. Prescription medications that stimulate saliva production include Salagen or Evoxac.

Pain and inflammation: NSAIDS, low doses of steroids, and Plaquenil can be helpful for flu-ike symptoms that can affect people with Sjögren's. Recently, case reports in the medical literature have shown that off-label treatment with a low dose of naltrexone has been beneficial to some patients. Naltrexone is an FDA-approved drug to treat patients who take too much pain medication. (If patients are on narcotics, they need to be gradually tapered from these medications before starting low dose naltrexone (LDN). More severe inflammation may warrant treatment with corticosteroid medications.

Your healthcare provider may also prescribe drugs that suppress or alter the function of your immune system.

Sjögren's in Fibromyalgia & Chronic Fatigue Syndrome

So far, we don't have any research on why Sjögren's is common in these illnesses. It's possible that they have some of the same underlying mechanisms. Sjögren's is autoimmune, and some research suggests that chronic fatigue syndrome may be autoimmune as well.

The thing to remember is that Sjögren's must be treated differently than fibromyalgia and chronic fatigue syndrome, and if it's left untreated, it could exacerbate your other illness(es) as well as making your life more difficult. Talk to your healthcare provider if you have symptoms of Sjögren's and suspect you may have it.

12 Sources
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  1. Yan Gau S, Ying Leong P, Li Lin C, Kai Tsou H, Cheng-Chung Wei J. Higher risk for Sjögren's syndrome in patients with fibromyalgia: a nationwide population-based cohort study. Front Immunol. 2021 Apr;12(1):1-8. doi:10.3389/fimmu.2021.640618

  2. Nair JJ, Singh TP. Sjogren's syndrome: Review of the aetiology, pathophysiology & potential therapeutic interventionsJ Clin Exp Dent. 2017 Apr;9(4):584-589. doi:10.4317/jced.53605

  3. Both T, Dalm VA, van Hagen PM, van Daele PL. Reviewing primary Sjögren's syndrome: beyond the dryness - From pathophysiology to diagnosis and treatmentInt J Med Sci. 2017 Feb;14(3):191-200. doi:10.7150/ijms.17718

  4. Bucourt E, Martaillé V, Goupille P, et al. A comparative study of fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren's syndrome; impact of the disease on quality of life, psychological adjustment, and use of coping strategies. Pain Med. 2021 Feb;22(2):372-381. doi:10.1093/pm/pnz255

  5. Stefanski AL, Tomiak C, Pleyer U, Dietrich T, Burmester GR, Dörner T. The diagnosis and treatment of Sjögren's syndromeDtsch Arztebl Int. 2017 May;114(20):354-361. doi:10.3238/arztebl.2017.0354

  6. Holland E, Darvish M, Nichols K, Jones L, Karpecki P. Efficacy of topical opthalmic drugs in the treatment of dry eye disease: a systematic literature review. The Ocular Surface. 2019 Jul;17(3):412-423. doi:10.1016/j.jtos.2019.02.012

  7. Romão VC, Talarico R, Scirè CA, et al. Sjögren's syndrome: state of the art on clinical practice guidelinesRMD Open. 2018 Oct;4(1):1-8. doi:10.1136/rmdopen-2018-000789

  8. Zashin S. Sjogren's syndrome and clinical benefits of low-dose naltrexone therapy: additional case reportsCureus. 2020 Jul;12(7):1-4. doi:10.7759/cureus.8948

  9. Flament T, Bigot A, Chaigne B, Henique H, Diot E, Marchand-Adam S. Pulmonary manifestations of Sjögren's syndrome. Euro Resp Rev. 2016 May;25(1):110-123. doi:10.1183/16000617.0011-2016

  10. Leverenz DL, St. Clair EW. Recent advances in the search for a targeted immunomodulatory therapy for primary Sjögren's syndromeF1000Res. 2019 Aug;8(1):1-12. doi:10.12688/f1000research.19842.1

  11. Sotzny F, Blanco J, Capelli E, et al. Myalgic encephalomyelitis/chronic fatigue syndrome-evidence for autoimmune disease. Auto Rev. 2018 Jun;17(6):601-609. doi:10.1016/j.autrev.2018.01.009

  12. National Institute of Neurological Disorders and Stroke. Sjögren's syndrome information page.

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.