Norepinephrine in Fibromyalgia & Chronic Fatigue Syndrome

Norepinephrine (NE) is both a neurotransmitter and a hormone. Neurotransmitters send messages from one cell to another in your brain and spinal cord. Hormones help regulate things around your body.
Also called noradrenaline, NE plays a key role in the “fight or flight” response by spiking your heart rate and blood pressure when your body believes it’s in danger. NE is similar to adrenaline and many experts believe it helps determine your basic levels of stimulation and arousal. It’s is linked to anxiety and depression. High levels are associated with feelings of joy, and sometimes euphoria.

Since joy and euphoria aren’t exactly typical of fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS), it’s no surprise that research suggests most people with these conditions have either low NE levels or that our bodies don’t use NE efficiently.

The connection to low NE is more definite in FMS, but a growing body of research shows people with ME/CFS have an imbalance between NE and dopamine, and treatments that make more NE available to the brain are successful for some of us.

Norepinephrine Dysfunction
Neurotransmitter function is complicated and neurotransmitters work with each other in a complex way we’re just beginning to understand. Still, experts have been able to associate different neurotransmitter imbalances with certain conditions and symptoms and find some ways to change their activity.
NE activity takes place in several areas of your brain. Each brain region uses NE differently, and they each contain several different kinds of receptors that also influence how NE is used.
NE dysfunction is associated with these symptoms:

Loss of alertness
Memory problems (brain fog or fibro fog)
Lack of arousal and interest
We don’t yet know why NE is dysfunctional in people with FMS and ME/CFS. Constant fear and anxiety are known causes of impaired NE function, so people who live with a lot of those emotions may be especially at risk for developing these illnesses.
Making More NE Available
To make more NE available to your brain, you can take serotonin norepinephrine re-uptake inhibitors (SNRIs), such as Cymbalta (duloxetine) or Savella (milnacipran); or amphetamines, including Adderall (dextroamphetamine), which is often used to treat ADD/ADHD.
Several things that are part of life are generally believed to boost NE levels in your brain, including:

Quality sleep (which is difficult for us)
Exercise (which is difficult for us)
Meeting goals (even small ones!)
Aggression (This is NOT an excuse for bad behavior! Maybe try aggressive video games?)
We don’t have a lot of research confirming that food can boost NE levels in your brain, and it would likely take prohibitively huge amounts to have the desired effect. In spite of the lack of hard evidence, some practitioners say they’ve seen positive results from diets high in the following:

Theanine (a unique amino acid in black and green tea, also available as a supplement)
Apples, bananas & watermelon
Beets, beans & legumes
Wheat germ
While it’s generally safe to eat these foods, don’t expect miracles. It’s also best to avoid extreme dietary changes and to introduce changes slowly. Tracking your dietary changes and symptoms in a symptom journal can give you an accurate gauge of what may be helping. Be sure to involve your doctor in your decisions.

Symptoms of High NE Levels
When you take medications that raise your NE levels or activity, you might be told to notify your doctor if you become “too happy.” That’s because it’s a sign of potentially dangerous high NE levels, which can also cause symptoms such as:

Worry, anxiety, irritability and jumpiness
Fears of crowds and confined places
Impaired concentration
Restless sleep
Muscle tension or cramps
Many anxiety disorders are associated with too much NE. The effects of several street drugs, including cocaine and illegal amphetamines, stem from increased NE levels and the resulting physical arousal and feelings of elation, which is part of what makes these drugs addictive.

Be sure to include your doctor in any decisions about increasing your NE levels and notify him or her if you experience any symptoms of too much NE.

reference:Norepinephrine in Fibromyalgia & Chronic Fatigue Syndrome

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