Test for FMS?

>Does this mean that FMS can be diagnosed from a blood test now?

Hi Jesse, 
You asked if the data published by John Russell, M.D. in "Biochemical
Abnormalties in Fibromyalgia Syndrome" in the _Journal of Musculoskeletal
Pain_ could provide the basis of a blood test for CFS. In a word, the
answer is no. These findings are quite non-specific, and would not provide
for a definitive test for CFS. 

My area of expertise is celiac disease, and all of these findings could
also be found in someone with untreated celiac disease. Of course, the
serum and CSF features are also not the defining characteristics of celiac
disease. I have, however, previously suggested a relationship between
celiac disease and FMS. It is my opinion that FMS is often undiagnosed
celiac disease or gluten sensitivity.  If we take each of the findings
reported by Dr. Russell, I think you will see some of the reasons for my

1.  Kynuernine is a metabolite of tryptophan, a metabolite of tryptophan.
CSF kynuernine levels were elevated in FS patients. Such findings have also
been reported in some forms of epilepsy(1,2). Abnormal levels of CSF
kynuernine have also been reported during severe phase anorexia (3). This
finding is non-specific, and may, according to Russell's report, be the
indirect result of the NADP abnormalities he also reported in CFS. Since
anorexia and epilepsy are overrepresented among celiac patients, there may
also be a connection with celiac suggested by these data.

2. Low serum serotonin is reported in CFS by Dr. Russell. Celiac disease
has long been associated with abnormalities in serum serotoinin, and recent
research suggests this is due to a reduction in platelet receptors for
serotonin (4). Impaired availability of serum tryptophan, the precursor of
serotonin, has also been reported in celiac disease (5), which would
further support the possibility of a connection. Relatedly, depression has
been asserted to be the most common symptom of celiac disease (6).

3. Dr. Russell also reported deficienciencies in ATP, a finding which is
paralleled in celiac disease (7). 

4. I could find no direct parallel in the celiac literature for Dr.
Russell's report of elevated CSF substance P in CFS. I did, however find a
report of elevated substance P in the duodenal mucosa of untreated celiacs

Taken together, these data support my suspicion that CFS may sometimes
represent undiagnosed celiac disease, but Dr. Russell's data would not be
diagnostic for either celiac disease, or CFS. Still, it is an exceedingly
interesting report, and I am grateful that you posted it. 

1. Yamamoto H, et al.   Studies on cerebrospinal fluid kynurenic acid
concentrations in epileptic children. 
Brain Dev. 1995 Sep-Oct;17(5):327-9. 

2. Heyes MP, et al.   Kynurenine pathway metabolites in cerebrospinal fluid
and serum in complex partial seizures. Epilepsia. 1994 Mar-Apr;35(2):251-7.

3. Demitrack MA, et al.  Cerebrospinal fluid levels of kynurenine pathway
metabolites in patients with eating disorders: relation to clinical and
biochemical variable. Biol Psychiatry. 1995 Apr 15;37(8):512-20. 

4. Chiaravalloti G, et al.   Platelet serotonin transporter in coeliac
disease. Acta Paediatr. 1997 Jul;86(7):696-9. 

5. Hernanz A, et al.    Plasma precursor amino acids of central nervous
system monoamines in children with coeliac disease. Gut. 1991

6.  Cooke & Holmes Coeliac Disease. Churchill Livingstone, N.Y., 1984

7. Lundberg A, et al.  Muscle abnormalities in coeliac disease: studies on
gross motor development and muscle fibre composition, size and metabolic
substrates. Eur J Pediatr. 1979 Feb 8;130(2):93-103. 

8. Domschke S, et al.  Coeliac sprue: abnormalities of the hormone profile
of gastroduodenal mucosa. 
Scand J Gastroenterol Suppl. 1989;167:86-9.