An Exploratory Study On the Possible Relationship of Fibromyalgia and Candida Albicans

Introduction

Answers are always being sought to understand fully the different diseases and illnesses that plagued human life. Developments are continuous, seeking to fully grasp the meaning of each and how to properly diagnose and treat the medical problem. There are some illnesses in the past that were seen as just a simple case of pain or paranoia but are now given better perception because of the aid of technology.

Because of the developments and innovations brought about by technology, modern changes in various industries resulted in more busy lifestyles. Such changes often require more physical and mental work in order to cope up with the fast-paced scheme of activities during the day. Our body cannot at once adapt to such kind of lifestyle, and this results in fluctuations of some bodily conditions like body temperature, blood pressure and heart rate. This may also cause organ and tissue malfunction. Nowadays, most people who are having busy lifestyles complain about muscle pains and fatigue. These work-related ailments decrease one’s level of productivity and efficiency. This, with improper diet and lack of exercise, may lead to more serious problems that may cause permanent damage, or even death.

Most people nowadays experience muscle and joint pains, which are often referred to by physicians as musculoskeletal pain. The pain that each individual feels may vary across different conditions and may have different causes. Musculoskeletal pain is usually felt in the muscle, ligament and tendons. It is usually caused by wear and tear in some tissues, brought about by so much work o sometimes accidents that cause physical trauma. Exhaustive daily activities which usually result in postural strain, repetitive movement and muscle overuse may also cause musculoskeletal pain (Go, 2005).

There are various types of musculoskeletal pain that are usually caused by other diseases. However, there are other instances when the musculoskeletal pain becomes chronic, which becomes the main problem. Chronic musculoskeletal pain as an illness in itself is different in the sense that the pain involved in it represents not just a symptom of tissue damage, but also an essential feature of a disorder or malfunction of a specific system as a whole—including the brain and body. One of such chronic musculoskeletal illnesses is Fibromyalgia.

Fibromyalgia

Fibromyalgia has been a term used in the medical field for quite a long time now. It was in 1843 when it was first described as a type of rheumatism “with painful hard places.” Even if the symptoms of the disease had been studied since the 1800s, the term “Fibromyalgia” was formerly used in the medical world only during the ’70s. However, it was only during the last decade when it was accepted in the medical society as a disease though most of the way of diagnosis to check on Fibromyalgia is still almost the same as it was in the past century (Wallace and Wallace, 2002).

Those suffering from fibromyalgia complain of moderate to severe fatigue. They feel chronic, widespread pain and tenderness to light touch and have heightened sensitivity to the skin. “Tingling of the skin, achiness in the muscle tissues, prolonged muscle spasms, weakness in the limbs, and nerve pain are also defining symptoms of fibromyalgia” (Wallace and Wallace, 2002). Chronic sleep disorder is also one symptom. It is a condition that is brought upon by bursts of brain activity similar to wakefulness that interrupts deep sleep.

The term “brain fog” has also been associated with fibromyalgia. “Brain fog has been related to chronic sleep disorder and this is an impaired concentration and short-term memory consolidation, impaired speed of performance, inability to multi-task, and cognitive overload” (Wallace and Wallace, 2002).

The symptoms associated with fibromyalgia is a long list of symptoms that affects not only muscles but also the inner system of the body as well. Not everyone who has been diagnosed with fibromyalgia will manifest all the symptoms given but a collection of these symptoms is looked on to verify their sickness. “Those suffering from fibromyalgia might also complain of varying degrees of temporomandibular joint disorder, myofascial pain syndrome, chronic paresthesia, physical fatigue, irritable bowel syndrome, genitourinary symptoms, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia” (Wallace and Wallace, 2002).

The following is a more detailed description of the symptoms of fibromyalgia, taken from the List of Fibromyalgia Symptoms and Associated Syndromes in the Managing My Fibromyalgia Website (n.d.):

1. Stiffness. This usually occurs after prolonged periods of standing or sitting in one position. This may also often happen in sleeping positions. It may also coincide with sudden changes in humidity and temperature.
2. Increased Headaches or Facial Pain. Recurring migraine and vascular headaches may be experienced by patients diagnosed with fibromyalgia as well as tension in some parts of the head.. The pain felt may also be characterized by aching of the temporal area or the area behind the eyes. Consequently, this may impair the individual who engages in activities that need visual focus. Jaw and facial pain are also common to patients with fibromyalgia.
3. Sleep Disturbances. Even if the patients were not sleep-deprived, still they feel like they haven’t got enough rest. Patients may feel sleep-deprived even if they’re not. Some also experience sleep apnea, and may have difficulty sleeping or waking up. The reasons for this are still unknown.
4. Gastrointestinal Complaints. Some disturbances in the digestive system and pain in the abdominal areas are also common with individuals suffering from fibromyalgia. Diarrhea and constipation may also be experienced.
5. Genito-Urinary Problems. The frequency of urination may also increase, since the need to urinate is more frequently felt. However, this happens even without infection in the urinary tract. Women may also experience painful menstruation and pain during sexual intercourse. Conditions like vulvodynia and vulvar vestibulitis, which were characterized by pain in the vulvar area may also be experienced by women with fibromyalgia.
6. Paresthesia. Numbness of the hands and feet may also accompany fibromyalgia. Paresthesia may be characterized by a “burning” sensation. Patients may suddenly feel numbers in the fingers and toes without any reason at all.
7. Temperature Sensitivity. Those who suffer from fibromyalgia may tend to have increased sensitivity to temperature. Some usually feel cold compared to other people while others may feel warm, when it is not. This unusual sensitivity to cold is usually accompanied by changes in the color of skin. This is also known as “Raynaud’s Phenomenon”.
8. Skin Complaints. Itchiness and blotches may accompany fibromyalgia. Dryness of the eyes and mouth area may also be experienced as well as swelling sensations in fingers. Such swelling, however, is not because of arthritis; it is just an anomaly which is speculated and not yet thoroughly known.
9. Chest Symptoms. Those with the disease who engage in activities which involve excessive forward body posture (e.g. Typing) may often experience pain in the chest and upper body, which is also known as “thoracic pain and dysfunction”. The pain is usually accompanied by shallow breathing and other problems with posture. Individuals with fibromyalgia may also develop “costochondraglia”, which includes pain in the muscles in the chest.
10. Dysequilibrium. Patients may have difficulty in moving on the activities of the day because of the feeling of light-headedness, which may manifest in a number of ways, one of these can be seen in some problems with balance.
11. Cognitive Disorders. Persons with fibromyalgia usually report a number of cognitive problems which tend to be different each day. Difficulty in concentrating and memory lapses are two examples of these problems.
12. Leg Sensations. Some patients may develop “restlessness legs syndrome” or RLS, which is characterized by irresistible urge to execute leg movements, even when at rest. This syndrome may also include movements during sleep, which can be very disturbing.
13. Environmental Sensitivity. There may also be increased sensitivity to other stimuli other than temperature such as light, smell, and noise. This is usually because of the hyper-vigilance of some parts of the nervous system of the patients. Some reactions to chemicals, food additives, and pollutants may also be common. Patients may even develop nasal congestion and sinus pain.
14. Depression and Anxiety. Patients may feel depressed suddenly, which leads some to think that they may have hypochondriasis.

According to the Managing My Fibromyalgia Website (n. d.), “despite the fact that FM is a relatively common condition, and fibromyalgia symptoms affect millions, its diagnosis is often missed or misdiagnosed”. Fibromyalgia is often mistaken as some other disorder because its symptoms mimic other disorders involving soft tissues. Still according to the website, pain is the only factor that identifies fibromyalgia with other disorders. It does not produces traces that can be visible in X-rays, which makes it harder to identify.

There are still ongoing researches which seek to determine whether fibromyalgia is caused by some hyperactive body or even brain response to normal stimuli, or an exaggerated response to stimuli that actually illicit pain (Managing My Fibromyalgia Website, n. d.). the former is also known as allodynia and the latter is hyperalgesia. These may not directly cause fibromyalgia, but they may cause a heightened risk or higher rate of pre-disposition towards the disease (Managing My Fibromyalgia Website, n. d.).

There are some speculations that an “anomaly” in the way our brains manage the neurotransmitters maybe inherited. Some neurotransmitters that inform the brain of the pain felt are found in an unusually high levels in patients diagnosed with fibromyalgia (Managing My Fibromyalgia Website, n. d.).

Another inference is that fibromyalgia may be closely related to sleep disorders. Muscle pains are also symptoms of sleep-deprived individuals—especially those who were deprived of deep sleep for a few days (Managing My Fibromyalgia Website, n. d.).

Still another possible cause of fibromyalgia is “poor muscle oxygenation” (Managing My Fibromyalgia Website, n. d.). this assumption may explain the pain felt in the muscles.

The reason why fibromyalgia patients are vulnerable to muscle pain and tension is still not known, but the tension should be reduced whenever it is felt and particular treatment should be administered.

Western medicine has not been successful in devising a cure for Fibromyalgia and other chronic pain and fatigue syndromes. As a result of this, these had become a greater societal burden. Though it is not life threatening nor is it contagious, it has still been proven to cause disability to patients who suffer from it. Studies about Fibromyalgia are continuously being undertaken (Bradford, 2006).

Researches have been made to fully understand the nature of fibromyalgia. Some angles on its relationship to other diseases are also being studied to possibly pinpoint a common cause.

“In 1992, Hudson and his colleagues studied the comorbidity of fibromyalgia with other psychiatric and medical disorders. They studied 33 women who met the American College of Rheumatology criteria for fibromyalgia” (Bradford, 2006).

They have interviewed the subjects about their symptoms, as well as their family history of medical and psychiatric illness. The study found out that patients diagnosed with fibromyalgia displayed high rates of irritable bowel syndrome, migraine, major depression, panic disorder, and chronic fatigue syndrome. The study confirmed that fibromyalgia is indeed comorbid with other disorders.

Pillemer (1994) had compiled the exchange of information that took place in the first conference at the National Institutes of Arthritis and Musculoskeletal and Skin Disease center in Washington. They had discussed their assessment on the future direction of fibromyalgia as an illness. The 1993 conference focused on the experiments made by more or less six medical scientists on the underlying symptoms of fibromyalgia. Some of the results deemed important in the conference were the association of fibromyalgia and a spectrum of associated conditions termed as “dysfunctional spectrum syndrome”.

These illnesses associated with the syndrome were found to have an aberration of neurohormonal functions. In the 90’s the development in understanding fibromyalgia is still under a lot of investigation, the experiments of Wolfe presented in the conference tackled the validity of the clinical criteria used. His experiment showed that less restrictive criteria should be used when assessing fibromyalgia and that at that time, more clinical studies should be done to aid in properly diagnosing the illness.

“In 2001, Zerahn and his colleague determined hone mineral density of the calcaneus in pre-menopausal women with fibromyalgia as compared to age matched controls” (Bradford, 2006). A total of 116 pre-menopausal women diagnosed with fibromyalgia were put under scrutiny and the muscle strength of the thigh was also measured. The results showed that despite low level of physical activities for the women diagnosed with fibromyalgia, they had maintained normal levels of bone mass in the calcaneus. One notable difference between the controlled group and those with fibromyalgia, is that the latter’s group are obese and that this might have aided in increasing the load on the calcaneus and may have preserve bone mass.

Chronic fatigue syndrome and fibromyalgia has been the subject of a lot of experiments as to note of their differences and similarity. “In 2001, a comparative study of patients with Chronic fatigue syndrome, patients with fibromyalgia, and healthy subjects were done to check on the cardiovascular response during postural challenge. This was done by measuring the blood pressure and heart rate during a 10 min of recumbence and 30 min of head-up tilt”. The results showed distinct numerical values between patients with chronic fatigue syndrome and patients with fibromyalgia. This suggests a further investigation in the stress response system of the two diseases as it contradicts the known fact that it shares a common derangement (Naschitz et al., 2001).

One study tries to check on the relation of fibromyalgia with hepatitis C virus (HCV) infection. “The study aimed on evaluating the prevalence of rheumatological disease, fatigue and anxiety in different groups of patients with chronic HCV infection. Total of seventy-seven patients with HCV were considered. Assessment was performed by history, physical examination, the Fibromyalgia Impact Questionnaire (FIQ) and the Hospital Anxiety and Depression Score (HADS). And the conclusion drawn was that there was a moderate increase in prevalence of fibromyalgia in HCV patients” (Goulding and, Murray, 2001).

Fibromyalgia is not caused by a single problem. Pathogenesis of it is still being checked as medical scientists try to make a strong chain that would properly link the illness. Fibromyalgia does not only affect the outer components of the body but even the internal system as well. It is being related to other causes like viruses or chemical abnormalities and not just musculoskeletal pain. As research moves forward, better understanding of what truly causes Fibromyalgia are known (Gerwin, 2005).

Other types of illnesses brought about by the present lifestyle are those caused by fungal infections. According to Life Extension Website (2006), since people today are living longer, they are more prone to have inefficient immune systems—which play major roles in the propagation of fungi. The rampant use of antibiotics also contribute to the optimal growth f fungi, because antibiotics may kill even the “good bacteria” that prevent the spreading of fungi.

Developments in science may also cause new diseases. The following fungal infection is viewed in many angles, including its acquisition through the use of medical equipments. Some medical intervention we administer to treat a disease may actually cause other diseases to be easily acquired. This infection, which is caused by Candida—an organism found inside our body, may be closely related to fibromyalgia.

Candida infections

Candida is a good organism when it is in its yeast from. In this state it is non-invasive and a sugar-fermenting organism. However, when our bodies lose the proper immune protection due to prolonged antibiotic use, taking steroids or oral contraceptives on a regular basis, or a high sugar diet, Candida changed into its fungal form which is bad for the body. Candida becomes a dangerous organism in its fungal state. This normally lives in the mucus

membranes of the intestines/digestive tract and the vagina and thus when they became destructive fungus, there is also the first part of the body that is affected by it. Candida is a disease that manifests itself in many forms. Sometimes it is also undiagnosed when it affects parts of the body where it will be difficult to test it. Example of this would be the joints.

In 1982, immune response with Candida albicans was tested with six groups of mice with different genetic strains. The results of the test showed how candida Albicans affect the system and the factors that can be beneficial to restrain it from thriving. It was learned through the experiment that an intact complement system, an immune response and a cell that is mediated type are factors that can be considered for the system to be resistant to Candida infections (Hector, Domer, and Carrow, 1982).

“Candidiasis has more than 20 species and the most common of these is Candida albicans. They naturally live on all surfaces of our body but most of the infections happen in warm and moist areas. Examples of such infections are vaginal yeast infections, thrush, skin and diaper rash, and nailbed infections” (Hector, Domer, and Carrow, 1982). The skin effectively blocks the infection if it is in its healthy state but breakdown or cuts in the skin aid the penetration of the unwanted organism.

Babies and adults alike are affected by candida infections. “Babies are usually affected in the mouth and diaper areas while adults commonly have it around dentures, under the breast and lower abdomen, nailbeds, and beneath other skin folds” (Hector, Domer, and Carrow, 1982). If these infections are treated right away, it does not pose any harm to humans. What is harmful would be the infection spreading throughout the body because this might caused death. Candida infections that return may be a sign of more serious diseases such as diabetes, leukemia, or AIDS.

The following are some of the areas that may be affected by Candida infections Life Extension Website (2006):

1. Genitals. One of the most common areas that can be infected by Candida albicans is the genitalia. Candida infections are more prevalent in women. Most women complain about severe itching, burning, and soreness, irritation of the vagina and/or vulva, and a whitish or whitish-gray discharge when they suffer from the infection. Some women experience other symptoms like pain when having intercourse or when urinating. Candida albicans may also cause yeast infections, which usually occur when the genitals changes its pH (because of menstruation, menopause, and oral contraceptive intake) (Edwards, 2004). According to Edwards (2004), most women experience a vaginal Candida infection at least once in their life, and majority of those cases, according to Mitchell (2004) happen during the female reproductive stage. There are also some men who have been reported to suffer from Candida infections and some of the symptoms shown by these men are red patchy sores near the head of the penis or on the foreskin, severe itching and/or a burning sensation.
2. Skin. The areas commonly infected by candida albicans are those between the fingers and toes, around the anus, and on the male genitals. Infections usually occur in an area where the skin is always moist.
3. Mouth and Throat. Areas in the mouth can also be affected by Candida (oral Candidiasis). The usual symptoms were the appearances of white patches on the lips, inner cheeks, tongue, and the roof of the mouth—which is called Perleche. Perleche can be described as lesions or cracks at the corners of the mouth. This kind of infection usually occur in people infected with HIV ( Bennet, 2004).
4. Systemic Infection. People with weaker immune systems can have infections all over the body. Deep Candida infections are “serious medical conditions that require immediate medical treatment” (Life Extension Website, 2006). Candida albicans can be invasive and can cause fever, drop in blood pressure, elevated heart rate, respiratory malfunction and sometimes, peeling of the skin. This kind of Candida infection may occur in people who had administered corticosteroids for a long period of time, and who have weak immunity. Those who have undergone stem cell or organ transplant or who had critical illness may also be infected (CDC, 2003). Deep Candidiasis may damage major organs, thus, it needs to be treated effectively before it spreads through the body.

According to one study, done by Vincent and colleagues (1998), cases of systemic Candida infections have increased among those who are requiring intensive care. There are more patients who have other diseases which are underlying or “immunosuppression from anti-neoplastic or anti-rejection chemotherapy” (Vincent et al, 1998) who are being confined to the Intensive Care Unit. The developments in medicine resulted in more patients who survive because of intensive care.

However, some treatments and therapeutic interventions such as administration of broad-spectrum antibiotics and intravascular catheters are closely associated with candidiasis. Systemic Candida infections may be difficult to see or diagnose, thus, ICU staff need to be more knowledgeable of the fungi (Vincent et al, 1998). In one study made by Kojic and Darouiche (2004), Candida can reproduce through biofilms. Some of the devices used to cure patients may retain inside the body, and biofilm-associated infection may occur. According to Kojic and Darouiche (2004):

“ The formation of bacterial biofilms around devices has been comprehensively investigated, but until recently, less focus has been placed on the formation of fungal biofilms. Candida species are emerging as important nosocomial pathogens, and an implanted device with a detectable biofilm is frequently associated with these infections. The evidence linking Candida biofilms to device-related infections is growing as more standardized methods for evaluating Candida biofilms in vitro emerge.”

Candida infection can be diagnosed by the symptoms, and examination of the samples of the fungus. The samples may be taken from the skin, mouth, vagina, and nails. For deeper lesions, biopsy samples may also be taken (Edwards, 2004).

Fibromyalgia and Candida Infections

There were no literature found that would directly link Candida albicans to Fibromyalgia. Much of the researches about Fibromyalgia are centered on its relationship with physical pains. However, there are some that linked bacteria, viruses or infections as part of the whole picture. This study will check on the relationship of fibromyalgia with Candida infections. How one influences the other and how they aggravate the problem. Fibromyalgia has always attracted controversy and thus this study will try to give light on some of it in relation to Candida infections. This will also review the construct of fibromyalgia in light of current methods of diagnosis and classification. The clinical relevance of this would also be noted.

The present study aims to show a possible relationship between Candida infections and Fibromyalgia. Recent research has revealed a number of objective biochemical, hormonal and neurotransmitter abnormalities associated with fibromyalgia, making it a clearly identifiable condition. These abnormalities may clarify our understanding of the pathogenesis and treatment of fibromyalgia.

Given the objective, the study wants to prove the following hypotheses:

Since both diseases involve microorganisms, we may infer that they have the same origin or etiology. Thus the first hypothesis is:

H1: Candida infections and Fibromyalgia are inter-related sicknesses that are closely associated with each other Candida Albicans maybe present even in patients which are already diagnosed with fibromyalgia. We may infer that the two disorders are comorbid and that one of them aggravates the other. Thus, the second hypothesis is:

H2: Candida infections have an effect on the status of a patient diagnosed with Fibromyalgia

With the hypotheses presented above, the researcher wants to answer the following questions in the course of the study:

Central Question: Is there a significant relationship between Candida infections and Fibromyalgia?

Sub question 1: Does being diagnosed with candida infections be a sign of Fibromyalgia?

Sub question 2: How is candida infections correlated with Fibromyalgia?

Methodology

Research Design

A case study of 3 different types of research did in relation to Candida infections and Fibromyalgia was the subject for investigation. An exploratory document analysis was done to check on the correlation between Candida infections and Fibromyalgia. The retrospective study was opted out because it is quick and cheap to implement. However, the quality and completeness of data collection are completely dependent upon the quality and type of data recorded in the medical history or in the researches in focus.

To measure the degree of association between Candida infections and Fibromyalgia, Two continuous variables-Pearson Correlation Coefficient will be used to verify the findings.

Results

Correlation between Candida infections and Fibromyalgia

Candida and Fibromyalgia are conditions that affect the general public and are both without a particularly effective therapy. These syndromes affect women in the majority. The symptoms between these two also overlap.

Most women suffer from Fibromyalgia because of Candidiasis rather than men because:

1. Candida resides in our intestinal tract, on the skin and in the female vagina;
2. the antibiotics and hormonal birth control usage promotes the growth of Candida in women’s system;
3. and women experience more localized yeast infections.

Some fibromyalgia patients are prone to undiagnosed conditions with irregular bacteria and viruses, like vaginal yeast infections. Because fibromyalgia increases one’s sensitivity to pain and stress, yeast infection symptoms can often be more troublesome for fibromyalgia sufferers than for non- fibromyalgia sufferers.

There is an overlap of symptoms manifest by Candida infections and Fibromyalgia. In the experiment done by Eakman (2003), she was able to identify the interrelationship of diseases like Candida infections, Fibromyalgia and Chronic fatigue syndrome.

To verify if Fibromyalgia has underlying microbial causes, a broad spectrum of an antimicrobial agent against fungi and bacteria were administered to patients with the said disease. The level of pain that each patient felt during the process was identified to aid in better understanding of the disease. Results showed a great decrease in the pain and weakness felt by the patients after taking the broad spectrum of antimicrobial agent. This led to the conclusion that there are indeed microbial causes in Fibromyalgia. The greater percentage of fungal infections were noted of and treated in the process (Eakman, 2003).

In 2000, one patient that has been diagnosed with Fibromyalgia went to the clinic of Dr. Barrie (2007). Dr. Barrie had applied Bicom therapy for the said patient but it was only in 2006 when they had been successful in giving aid to the patient after doing a microorganism test to check on what might be blocking the therapy given. Candida Albicans and Candida Glabrata testing on the colon were done and it was identified to be positive. After which, a better therapy was given to the patient and thus better outcomes were seen (Barrie and Barrie, 2007).

Only last year, a clinical study was conducted to check on what are some of the underlying causes of fibromyalgia that have not been looked on. In this study conducted by Bradford (2006), he hypothesizes on the probability that fibromyalgia that infectious microorganisms had a big impact on the occurrence of the illness. He included Candida albicans as one of the infectious microorganisms that affects the disease.

Genetic defects have also been indicated, related to serotonin biochemical pathways. It was a prognosis in the research that the suppression of the immune system that is meant to destroy invading microorganisms and viruses in the body, in the process also allows survival of mutants of these organisms that are more infectious and virulent than those originally present. The association of fungemia with fibromyalgia was proven with the aid of a high-resolution microscopy (Bradford Variable Projection Microscope [BVPM]) used in the experiment. It has shown various fungemia including different species of Candida.

A variety of therapies and help was presented in association with the findings that were gathered. It includes live-cell injection (transplantation), antioxidants, probiotics, acupuncture, aerobics, amino acids, and other forms of dietary supplementation. A variety of conventional drugs have also been implemented as therapy.

People with chronic fatigue syndrome also suffer from candida infections. There is lot of instances when these two diseases’ symptoms have been correlated. In hospitals and clinics, when someone is being diagnosed with chronic fatigue syndrome, they also undergo tests to check if they are also infected with candida. If they are, this would mean that the infection needs to be treated first before curing the other symptoms that manifest. “Fibromyalgia is also associated in a patient with chronic fatigue syndrome” (Barrie and Barrie, 2007).

The symptoms of these three overlap as well as the diseases.

A link was established between fibromyalgia and bowel dysbiosis. Dysbiosis is a condition where harmful microbiological populations of bacteria or yeast living in the large intestine affect the condition of the patient. And thus this strengthens the notion that fibromyalgia and Candida overgrowth in the intestines are related.

Conclusion

There is still no exact cure for Candida infections and Fibromyalgia. Most therapeutic treatments are still clouded with some controversy. Medical understanding of Fibromyalgia has come along way since the first patient was diagnosed with it. However, fully understanding the disease is still a long way to go. Especially now that it may have high comorbity to other fungal infections.

Though hospitals and medicines goal is to make patients live longer, medical errors on the other hand causes harm, trauma and even worst fatality. There are many factors that contribute to medical errors; there is still a big room for improvement in dealing and practice of medical staff.

In life one could not avoid having bad experiences. However, if these bad experiences were brought on by a wrong judgment of doctor and medical staff, this kind of bad experience can be avoided. These can cause trauma to patients. Traumatic events will be defined as an experience that an individual had that causes him to feel emotional disturbances like horror, helplessness and a sense of disrupt equilibrium. Traumatic events could also be marked by an injury to the victim

The only certainty in fibromyalgia is that it is still being diagnosed. For prevention and treatment of fibromyalgia, doctors as well as politicians and media have to start by fundamentally changing the therapeutic domain. In such a renewed setting, fibromyalgia cannot become manifest in an individual and thus fibromyalgia syndrome can no longer exist. A firm public message that symptoms can be psychological in origin to prevent their spread, as Wessely recently stated in the comparable case of mass psychogenic illness, is only a part of the answer.

Recommendations

Since the study is limited to the exploration of the two diseases, further studies are recommended to be done to have deeper investigations of the matter. It is important that we find out if there is a direct pattern between the growth and propagation of the Candida albicans and the severity of fibromyalgia. Thus a study with the following characteristics are recommended to be done to fully understand the diseases involved:

1. The following investigations should be in-depth, not only relying on the related literature but may also involve discussion of the current news about both diseases, and even actual investigations via experiments.
2. The perception of the patients should also be looked at because this may help us understand why fibromyalgia is difficult o diagnose. An analysis of the descriptions of the symptoms by the patients should be also considered.
3. The current study is faced with time constraint, which may be the reason why it is literature-based. Follow-up studies should be more thorough, involving different methods for reliability.

It is important that we give attention to these kinds of diseases because it closely linked to our current lifestyle. We might as well try to find out the etiology of these illnesses in order to formulate specific treatment that will not cause another disease and will not aggravate another one. This field of study is significant in the sense that we may spare ourselves from the dangers of the medical innovations that we ourselves make.

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