Fibromyalgia Testing: Key Investigations to Consider After a Fibromyalgia Diagnosis
- Muriel
- 6 days ago
- 4 min read
Why fibromyalgia is better understood as a symptom rather than an actual diagnosis.
At The Autoimmune Clinic, our professional view is that fibromyalgia is not in itself a diagnosis, but rather a label applied to a pattern of symptoms, specifically referring to chronic widespread pain, fatigue, non-restorative sleep and cognitive symptoms..
The term fibromyalgia describes what someone is experiencing, but not why they are experiencing it, which is not really helpful.
This is why we do not ask, “Do you have fibromyalgia?”, but rather: What is driving this fibromyalgia symptom pattern in your body?
Testing for fibromyalgia is therefore not about finding a single confirming test, but about identifying the underlying causes contributing to this presentation.
Why There Is No Single Test for Fibromyalgia
There is currently no laboratory test that can confirm fibromyalgia in isolation.
This is because fibromyalgia is primarily a disorder of:
Pain processing
Nervous system sensitisation
Immune and inflammatory dysregulation
Stress and sleep disturbance
Standard scans and blood tests are often normal, which can be incredibly frustrating for individuals who are clearly unwell. However, this does not mean symptoms are psychological or “all in the head”, and we will always challenge a medical professinal who makes this assumption.
For this reason, fibromyalgia testing focuses on identifying diagnoses and contributing factors that cause those particularly symptoms.
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Fibromyalgia Testing Starts With Your Clinical Timeline
Before any laboratory testing, a detailed timeline is essential.
We carefully explore:
When your symptoms first began
What was happening in your life at that time
Whether there was an identifiable trigger
Whether symptoms appeared suddenly or gradually
Whether there were early warning signs
Your family history of similar diagnosis, autoimmune or inflammatory disease
Common triggers in fibromyalgia include:
Viral or bacterial infections
Psychological or physical trauma
Hormonal transitions
Environmental exposures
Prolonged stress or burnout
Fibromyalgia rarely develops in isolation. There is almost always a story behind it.
Core Blood Tests for Fibromyalgia
A comprehensive blood assessment is the starting point of fibromyalgia testing and should never be under estimated.
This can be arranged via your GP or through private laboratories such as Randox Health or Medichecks.
Inflammatory Markers
To assess whether systemic inflammation is present:
CRP
ESR
Nutrient Testing
Deficiencies frequently contribute to pain, fatigue and neurological symptoms:
Vitamin D
Ferritin and full iron studies
Vitamin B12
Folate
Correcting these alone can significantly reduce symptom burden in some individuals.
Thyroid Testing and Fibromyalgia
Thyroid dysfunction is commonly mistaken for fibromyalgia or coexists with it:
TSH
Free T4
Free T3
Thyroid antibodies (TPO and Tg)
Undiagnosed Hashimoto’s thyroiditis or hypothyroidism can closely mimic fibromyalgia.
Full Blood Count
This allows assessment of:
Anaemia
Immune function
Chronic infection patterns
Inflammatory or haematological abnormalities
Testing for Autoimmune Disease in Fibromyalgia
A fibromyalgia diagnosis should come with ruling out autoimmune disease.
Key autoimmune tests include:
Rheumatoid factor
Anti-CCP
ANA and ENA panels
Complement markers where relevant
This is essential to rule out:
Systemic lupus erythematosus
Other connective tissue and inflammatory autoimmune conditions
Missing these diagnoses delays appropriate care and treatment.
Environmental Testing in Fibromyalgia: Mould and Toxins
Environmental illness is an increasingly recognised contributor to fibromyalgia-type symptoms.
We carefully assess:
Past or current mould exposure
Water-damaged buildings
Symptom variation by environment
Chemical sensitivity
Testing may include:
Environmental mycotoxin testing
Environmental exposure screening
Visual Contrast Sensitivity (VCS) testing as a simple initial tool
Where mould is suspected, we also assess for CIRS (Chronic Inflammatory Response Syndrome), a biotoxin-related inflammatory illness that can present with fibromyalgia-like pain and fatigue.
Gut Testing in Fibromyalgia
Gut dysfunction is a major driver of immune activation and systemic inflammation.
We assess:
Digestive symptoms
Food-triggered symptom flares
Bloating, reflux, bowel changes
Food sensitivities
Testing may include:
SIBO breath testing
SIFO assessment
Comprehensive stool testing
Intestinal permeability markers
Gut-driven inflammation is a very common perpetuating factor in fibromyalgia.
Chronic Infection Testing in Fibromyalgia
A significant subset of individuals labelled with fibromyalgia have underlying infectious contributors.
These include:
Post-Viral Syndromes
Such as:
Epstein-Barr virus
Other viral reactivations
Tick-Borne Infections
Including:
Lyme disease and co-infections
Even when testing is not perfect, it is important to consider these infections.
Connective Tissue Conditions Linked to Fibromyalgia
We also consider:
Hypermobility spectrum disorders
These are associated with:
Chronic pain
Autonomic dysfunction
Immune dysregulation
MCAS
Increased autoimmune risk
In such cases, fibromyalgia represents a downstream expression rather than a primary diagnosis.
MCAS Testing in Fibromyalgia
When fibromyalgia occurs alongside:
Flushing
Hives
Food reactions
Chemical sensitivities
Histamine-type symptoms
We investigate Mast Cell Activation Syndrome (MCAS), which frequently overlaps with fibromyalgia and chronic fatigue presentations.
Why Fibromyalgia Testing Must Look Beyond Pain
Conventional care often becomes overly focused on pain and fatigue, without exploring the wider systems involved.
At The Autoimmune Clinic, fibromyalgia testing always considers:
Immune function
Inflammatory drivers
Hormonal balance
Nervous system regulation
Environmental and infectious burden
Only by addressing the full picture can sustainable improvements be achieved.
So remember, a fibromyalgia diagnosis should be regarded as a starting point, not a final diagnosis
Fibromyalgia should never be the end of the diagnostic journey.
If you have been diagnosed with fibromyalgia and feel that the underlying drivers have not been fully explored, a functional and integrative approach may offer the clarity and progress you have been seeking.
