An increased prevalence of fibromyalgia in iron deficiency anemia and thalassemia minor and associated factors

Abstract

In this study, we evaluated the prevalence of fibromyalgia (FM) in iron deficiency anemia (IDA) and thalassemia minor (TM) patients and associated factors. In addition, we investigated the prevalence of IDA in outpatients with fibromyalgia, and its effect on clinical findings. The study included 205 IDA, 40 TM patients and 100 healthy controls. FM was diagnosed according to 1990 ACR criteria. Whole blood count, biochemical tests, and serum iron parameters were determined. Pain, fatigue, and FM Impact Questionnaire (FIQ) functional item scores were assessed in FM subjects. In addition, the prevalence of IDA in FM patients diagnosed at the Rheumatology Outpatient Clinic was determined. The prevalences of FM in IDA (17.6%) and TM (20%) groups were higher than in controls (6%; p values 0.006 and 0.025, respectively). When IDA patients with FM were compared to those without FM, it was seen that a higher percentage were females, married, and a higher percentage had history of pica (all p values < 0.05). Serum hemoglobin and iron parameters did not differ between IDA patients with and without FM. IDA was detected in 48 (24.5%) of 196 FM patients. FM patients without IDA had higher sleep disturbance scores (p = 0.012) and longer duration of FM (p = 0.045). FM was a common finding in patients with IDA and TM. FM was associated with female sex and history of pica in IDA patients, and not associated with serum hemoglobin and selected iron parameters. The presence of FM in TM had no association with any of the above-mentioned parameters.

A Blinded, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Ferric Carboxymaltose in Iron-Deficient Patients with Fibromyalgia

“…In an analysis of hair minerals, Kim and colleagues [9] reported significantly lower levels of iron in patients with fibromyalgia compared with healthy age-and BMI-matched controls (P = 0.007). Pamuk and colleagues [10] found an increased prevalence of fibromyalgia in patients with iron-deficiency anemia (P = 0.006) and thalassemia minor (P = 0.025) compared with healthy controls. These studies suggest that iron therapy may have a role in the management of fibromyalgia.…”

“…Kim and colleagues [9] noted that the concentrations of calcium, magnesium, and iron in the hair of women with fibromyalgia were lower than in the hair of control patients, even after adjusting for potential confounders. Pamuk and colleagues [10] demonstrated that the prevalence of fibromyalgia among patients with iron-deficiency anemia and thalassemia minor was higher than among control patients. Finally, Ortancil and colleagues [8] reported that mean serum ferritin levels were lower in patients with fibromyalgia than in control patients.…”

Association between serum ferritin level and fibromyalgia syndrome

“…Ferritin levels decrease in the initial stage of iron deficiency, and anemia develops subsequently. In a recent study, the prevalence of FMS was found to be significantly higher in patients with iron deficiency anemia than in healthy controls (Pamuk et al, 2008). They reported that ferritin levels of iron deficiency anemia patients with or without FMS (4.5 ± 2.9 and 3.7 ± 2.2, respectively) did not differ.…”

Fibromyalgia and nutrition, what do we know?

“…Some nonspecific symptoms of IDA and TM, like impaired cognitive function, fatigue or inability to concentrate, may not be explained by only anaemia, and consequently may not respond to therapy. In these cases considering the possibility of a FM diagnosis is recommended, since in this study the results show higher prevalence of FM in IDA and TM patients [59]. A second step will be to understand the role that iron replacement therapy could play in some cases suffering from FM and IDA or TM at the same time.…”