González de Echávarri, neurologist: "Fibromyalgia is neither something that people invent nor psychological; there is an alteration"

On the occasion of World Fibromyalgia Day, celebrated on May 12, neurologist and science educator Chema González de Echávarri published a video on social media in which he debunks some of the stigmas that still surround this disease. Through a rigorous review, the specialist presents several types of alterations that science has identified in patients with this diagnosis. His objective is clear: to shed light on the biological dimension of a condition that is often minimized or even questioned due to its apparent invisibility.

One of the most notable aspects, as the neurologist himself explained, is the role of the central nervous system. According to González de Echávarri, people with fibromyalgia experience hyperexcitability in pain processing. This means that, even if the painful stimuli are mild, "the brain overreacts." He also adds that there is an alteration in the inhibitory mechanisms of pain, which prevents the body from properly regulating these harmful signals.

Another point addressed by the neurologist is the imbalance in brain chemistry. As he explains, "changes have been found in the secretion of glutamate, substance P, dopamine, serotonin, and norepinephrine," all of which are compounds directly involved in pain modulation. It is precisely these imbalances that help us understand why the discomfort experienced by patients is not subjective or imaginary, but rather has a measurable neurochemical reflection.

The expert also points out that research has detected genetic and epigenetic variations in people with fibromyalgia. These alterations affect genes related to the transport of neurotransmitters such as dopamine and serotonin, as well as others involved in the response to stress, inflammation, and pain. This reinforces the hypothesis that the disease does not respond to a single factor, but rather to a combination of genetic predisposition and external triggers.

One of these triggers could be related to the hypothalamic-pituitary-adrenal axis, one of the body's main hormonal regulation pathways. In patients with fibromyalgia, "there is an abnormal response in the secretion of cortisol," the stress hormone. This dysfunction can contribute to chronic pain and the appearance of other symptoms such as extreme fatigue or a constant feeling of alertness.

González de Echávarri also mentions the existence of signs of low-grade inflammation in patients' bodies. Some studies have detected elevated levels of proinflammatory cytokines in both plasma and cerebrospinal fluid, suggesting persistent immune activation. Furthermore, proteins associated with neuronal damage, such as neurofilaments, have been identified, further reinforcing the idea of ​​an organic basis for the disease.

The autonomic nervous system, responsible for involuntary functions such as heart rate and sleep, also appears to be altered in those with fibromyalgia. This could explain, according to the neurologist, the variety of symptoms patients experience. These include sleep problems, fatigue, and cognitive difficulties. In this last section, González de Echávarri mentions the well-known "brain fog," a feeling of confusion or mental slowness that affects memory, sustained attention, and the speed of information processing.

The communicator's final message is clear. "There is an alteration in the central processing of pain, and it's not just something purely psychological or something people make up." Fibromyalgia is, in his words, "a very complex neurobiological entity, about which I'm sure we don't even know half of what's going on."