CFS & Fibromyalgia Symptoms Physical and Emotional Symptoms of Low Serotonin By Adrienne Dellwo linkedin Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Adrienne Dellwo Medically reviewed by Medically reviewed by Grant Hughes, MD on May 11, 2020 linkedin Grant Hughes, MD, is board-certified in rheumatology and is the head of rheumatology at Seattle's Harborview Medical Center. Learn about our Medical Review Board Grant Hughes, MD on May 11, 2020 Print Many symptoms of fibromyalgia (FMS) and possibly chronic fatigue syndrome (CFS or ME/CFS) are believed to be tied to low levels of the neurotransmitter serotonin. These can include pain, fatigue, low energy, depression, negative thoughts, irritability, anxiety, abdominal problems, binge eating, and a reduced interest in sex. The assortment of symptoms can be confusing and bewildering, not to mention no fun to live with. But as varied as the problems are, they're not the only things related to serotonin, which is both a neurotransmitter (in your brain) and a hormone (in the rest of your body.) demaerre / Getty Images What Serotonin Does Serotonin is a regulator of all kinds of processes, so it's no wonder that when it's out of whack, nothing is regular. That's why you feel like your body is falling apart and your symptoms don't make any sense. Serotonin's dual nature, as a neurotransmitter and hormone, means it's found all over your body. In fact, there's more serotonin in your gut than in your brain. That may explain why illnesses such as irritable bowel syndrome (IBS) are extremely common in FMS and ME/CFS: IBS involves serotonin dysregulation as well. By recognizing symptoms of serotonin dysregulation, you may be able to not only understand your symptoms but actually improve your chances of proper diagnosis and treatment. Physical Serotonin-Related Symptoms Doctors don't test your neurotransmitter levels. Instead, they rely on symptoms for making diagnoses. For that reason, it's important for you to know what symptoms may be linked to serotonin. Otherwise, you may choose only one or two to focus on with your doctor, and that can get in the way of figuring out what's wrong. What we call "low" serotonin may come from a couple of different causes: either your body doesn't make enough, or it doesn't use it efficiently. Either way, the result is the same. Some of the major physical symptoms linked to low serotonin are: Chronic fatigue in spite of adequate restDisturbed sleepLoss of appetite or carb cravings, possibly due to the body's attempt to make more serotoninHot flashes and temperature changes that aren't linked to your environmentHeadachesStomach pains Certainly, some of these symptoms can crop up in anyone's life from time to time. The key here is to recognize whether you have clusters of symptoms that tend to occur together. Serotonin levels can fluctuate over time, leading to symptom flares and remissions (times when symptoms are gone or at low levels). Emotional Serotonin-Related Symptoms The presence of emotional symptoms in no way implies that FMS or ME/CFS are psychological illnesses. In fact, we know that they both include numerous physiological abnormalities. FMS is generally considered a neurological condition, and both of these illnesses are sometimes called neuroimmune diseases or neuroendocrine-immune diseases. It's true that serotonin (and many other neurotransmitters) are also involved in mental illness, such as major depressive disorder. Even in these cases, they represent a physiological problem. Neurotransmitters are also involved in numerous non-psychological conditions, including Parkinson's disease. Emotional symptoms include: Loss of interest in sexSocial withdrawalSadness and frequent crying spellsLow self-esteem and self-confidenceLoss of personalityFeeling emotionally sensitive and taking things personallyIrritability If your sadness and other emotional symptoms are especially pronounced, you should talk to your doctor about depression. It's common in FMS and ME/CFS, as it is in all chronic, debilitating illness. A Word From Verywell If you think your serotonin is low, talk to your doctor. You may need to consider treatments that raise your available amount of serotonin. Probably the most common treatment is medication: your doctor may prescribe antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclics. Some supplements and your diet can influence serotonin as well. Serotonin Dysregulation in FMS and ME/CFS Was this page helpful? Thanks for your feedback! Learn about treatment and lifestyle changes to cope with fibromyalgia and chronic fatigue syndrome. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Becker S, Schweinhardt P. Dysfunctional Neurotransmitter Systems in Fibromyalgia, Their Role in Central Stress Circuitry and Pharmacological Actions on These Systems. Pain Res Treat. 2012;2012:741746. doi:10.1155/2012/741746 Berger M, Gray JA, Roth BL. The Expanded Biology of Serotonin. Annu Rev Med. 2009;60:355-366. doi:10.1146/annurev.med.60.042307.110802 Padhy SK, Sahoo S, Mahajan S, Sinha SK. 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