The Eight Stages of Fibromyalgia and Chronic Fatigue Syndrome

Did you know there are eight distinct stages of Fibromyalgia?

Here's how to untangle them so you can learn more about yourself.


I’m here today with dr. Andrew miles the
author of the fibro Bible and he’s going
to talk to us a little bit about the
eight stages of fibromyalgia there’s
different kinds of fibromyalgia and the
proper order and how to take care of it
so the pain doesn’t come back and you
don’t lose your progress hello thank you
hello thank you so much for having me on
though first of all what I would like to
tell everybody who’s listening is that
one yes
fibromyalgia pain is absolutely real now
we know the causative factors the
causative factors are many there are
eight main causative factors which are
physically causing your nerves to
disintegrate right now as we’re speaking
and it’s important to have the right
strategy in order to really nurture and
care for yourself so that step by step
we can systematically repair the body
and diminish the pain and the frequency
of flares so you can live your best
fullest life see dr. miles it gets
confusing because there are so many
causes and sometimes it’s hard because
we think we found the answer for one
patient you know treat the thyroid or
their gut health or something like that
and then they’ll do really well or maybe
they’ll do really well for a long time
or maybe they do really well on the
results of short-lived and then other
patients with a really similar
presentation we start with the same
strategy and it doesn’t even work at all
and sometimes even sets them off into a
flare absolutely absolutely and analogy
that I use with my patients is I tell
them to think about a house think about
the childhood house that you grew up
with and then just imagine this house
left in disrepair because the owners
have been out taking care of everybody
else and everything else and the house
has fallen into a state of decay now if
you leave a house in the woods for a
while after 20 years eventually the
windows break and then different types
of animals get into
the house they start tearing it up it
gets moldy it gets drafty the heaters
and the electrical have long since burnt
out and many people who come to see us
with fibromyalgia chronic fatigue they
feel like they don’t have a lot of
protection as though the windows in
their house have been blown out they
feel eaten by other people in terms of
their social interactions they get taken
advantage of a lot they get parasitic
infections quite a bit their immune
systems are under constant attack just
like a house which is fallen out of
repair and so when we look at a house in
the state and we think okay we’re going
to fix this house up so let’s get new
curtains and carpet in the house well if
it’s a nice sunny day out it looks like
you’ve repaired the house but really you
haven’t taken care of things in a
systematic order so the next time the
wind rip in the rain is in effect those
those drapes and the carpet are suddenly
wet and now they’re moldy again and
animals are coming in the house and
there are bugs so even with all of this
effort and expense to repair you know
this aspect of the house it quickly
falls into disrepair because there
wasn’t a correct order now if we were to
look at a house the first thing we would
do is we would seal up the windows so
that animals don’t get in and we could
really start to take care of the house
step by step and look at what’s most
essential for that exact condition and
that’s going to be different in a desert
climate than it is in a tropical climate
but we have to look at the whole house
and take care of it step by step so that
it’s completely it’s completely restored
not just to what it was but it can be
even better than it was before
so the first step is protecting the
house so that the other work can
actually be there without getting
further destroyed and you’re saying that
you’re saying the same thing happens in
our bodies so there are different
systems to go after first second third
absolutely what they’re finding
increasingly is that these different
systems in the body are all interrelated
the immune system has a direct effect on
your hormones your hormones have an
effect on the immune system so which one
do we work with first the answer is we
really need to be working with both but
in the right order
so if you are let’s just say you’re
trying to get ready for a marathon and
you’re getting stronger by the day but
your immune system is weak so that once
or twice a week you catch the flu your
progress as far as improving your
running time will be going backwards
instead of forwards and trying to push
through it and run through that flu
isn’t going to help your progress at
that point you have to directly look at
the fluid self and get the immune system
strong enough then you can make
incremental progress in the other areas
so the first stage that we look at is in
regulating the immune factors so many
people with fibromyalgia and chronic
fatigue have multiple chemical
sensitivities incredible allergies that
people without this state of
fibromyalgia just really have trouble
understanding but there’s such an
incapacity to respond and adapt to the
environment so that’s the very first
stages we must strengthen the immune
system before we go deeper and if you
think of a house this is just like
boarding up the windows and covering
vulnerable areas with maybe a tarp to
keep the rain and wind out so we really
have a protective cocoon to do the
deeper restoration that’s it yeah you
create that space that’s safe and then
the rest of the work can get done and so
this is tricky because sometimes we do
our research and we find out that you
know it’s all about gut health or it’s
all about cortisol or it’s
about adrenal fatigue or something like
that but you’re saying without
addressing immune factors first a lot of
that work can be easily undone yeah and
it’s not to say that that gut health and
adrenal fatigue these are all very very
crucial parts that we address one by one
it’s almost like for a two to three week
period you just take the vantage point
that we’re gonna look at this all from
the vantage point of the immune system
now distress affect the immune system
absolutely and when we get to the stress
part we look at the immune and endocrine
system through the vantage point of
those stress hormones
so we just have to look at it stage by
stage step by step so that we’re looking
at it not just from one angle we’re
looking at it completely holistically
taking care of it stage by stage so that
by the day people have less pain and
they’re feeling stronger and the immune
system is just so crucial because when
you’re allergic to everything when
you’re afraid of getting too cold when
you’re afraid of the way that the wind
is blowing it just it puts life and it
takes life from being something that can
be fun and enjoyable into something that
is just a living hell on earth where
people are afraid to be around their
friends they don’t want to be around
it looks like depression many times
there are types of depression where
people just don’t want to be around
anybody else but this is actually an
immune adaptation when your body’s
immune system is down nature wants you
to be away from other people because
other people may be carrying diseases
which will attack you and cause a
flare-up and cause your nerves to
disintegrate so it’s a protective
mechanism for many people with
fibromyalgia is it that it will avoid
people and maybe hang out more with
their pets this is because pets and
people they don’t always carry the same
types of diseases so they are able to
get the touch and feeling of love
without having that exposure so the
first thing we have to do is improve the
immune system which isn’t a magical pill
it’s a combination of exercises and buts
Nichole’s that chant they both raise and
regulate the immune system how many
people with fibromyalgia have the same
underlying symptoms or even have
rheumatoid arthritis itself so it’s not
a matter of boosting it’s a matter of
regulating and balancing those immune
factors so that you’re not afraid just
in terms of your emotional state you
feel like connecting with people
you can walk out to your car and if the
wind blows a little bit it’s not gonna
cause a tight stiff neck that’s the part
that’s the first key to freedom with
fibromyalgia and chronic fatigue
now you mentioned exercises and a lot of
times that can be kind of a daunting
word for people that have chronic pain
and especially limited mobility so
sometimes it may have done exercises
before it’s been too much and actually
hurt them or set them back so could you
elaborate more on what kind of exercises
you’re talking about
and is there awareness if they’re
appropriate so people don’t accidentally
hurt themselves absolutely so the rule
with fibromyalgia chronic fatigue is
that any any exercise or therapy that
you do on yourself needs to be unlocking
more energy then it costs you so that
you’re always getting a positive return
so what I suggested the very first stage
is actually for people to lie down and
simply to use a breathing and very light
breath holding and maybe some very
gentle lymphatic massage to use the
minimal action and get the maximum
result so it is not the case that we
need to be dunking ourselves in ice
water or running up mountains not yet
after we get to stage eight you’re free
to do that if you feel like it but in
the very beginning stage the most
important thing we need to do is the
minimal activity to get lymphatic flow
especially around the back of the neck
and to cause a deep relaxation response
lint flow is very very important
in the early stages so that the body can
actually heal and repair itself
yeah could you share a little bit I know
you’ve got some great cases and you were
just talking about one woman who had
really severe chronic fatigue and who
now does mountain biking in the desert I
mean that’s quite a transition and
you’re saying she mainly used these
strategies to get from basically what
bedridden to going around on the
mountain bike I mean that’s not kind of
unbelievable sometimes if you’re in that
situation absolutely and you know for
her in particular very bright woman um
really powerhouse at work and at the end
of the day she would come home and
couldn’t get out of bed she had been
giving and giving and giving and not
focusing a lot on self-care so the first
stage that we worked on was exactly this
getting the lymph to move and I can’t
say it was a complete upward trajectory
because the patterns of life that she
had been in were to use her brain
constantly and push through and work and
that was still a reality of her life so
her whole life was putting her into a
state of chronic fatigue and we were
just very gently working on the backend
to maximize her ability to cope with
life so we started with the lymphatic
massage and some of the very basic
geyser transmitter exercises and she
found that it over time was reducing her
recovery time instead of needing to lie
in bed until the next day maybe she
would be good after an hour so by giving
her something to do actively while she
was resting so while she was resting if
she could breathe a certain way and do a
certain type of massage that unlocked
the body’s ability to move the lymphatic
and cause the lymphatic system to drain
properly that really unlocked her energy
so as she got more energy like what do
all of us do when you’ve had a fever for
a few days and then suddenly your energy
comes back you know you run around and
do things and then it’s so easy to get
sick again isn’t it well that is just
especially with the go-getters who have
fibromyalgia and chronic
as soon as they get a little bit of
energy its spent so that was actually
the trick is okay now that you have all
this energy what you’re gonna do is
you’re gonna reinvest 20% of that back
into yourself so all the time you know
realistically okay my life just got
bigger because I have more energy
great reinvest 20% of that back into
self-care and by keeping that going by
keeping the well primed her energy
levels were able to increase and as well
as her life expanding so before she may
have to be inside and maybe the air
conditioner is on and then she goes out
into the heat and back and forth and
that caused its own tremendous fatigue
by working on the immune system first
she was able to get better temperature
regulation so that the temperature
changes no longer sapped her energy and
spiked her pain after that her energy
was able to sustainably grow and restore
itself we worked as we went through the
stages with repairing mitochondria and
she’s been getting stronger by the day
as a result of this and keep in mind
like all of us she’s not perfect there
are whole days that she forgets to do
her exercises that’s life but when we
have the right strategy we don’t need
perfection if we just get 80% it’s more
than good enough and we need to allow
space for ourselves to be human to make
mistakes and if we ha but truly have a
good system it won’t require perfection
and ours does not yeah I agree that
there’s a lot of resilience and you know
life happens I think the one of the
takeaways here is that it takes energy
to handle stress and there’s all kinds
of oh yes all kinds of different
stressors you know whether it’s
emotional stress or physical stress or
even though if it’s you know the stress
of handling the temperature changes like
that each one of those stressors is
taken a little bit out of your battery
and you’re right you know you have to
reinvest some of the energy that you
have into yourselves so that you can
have a bigger battery at the end of the
day because the stressors aren’t going
to change
absolutely and as we go through the
training people develop the ability to
have increased exposure to these
stressors like temperature changes like
exposure to viruses like even exposure
to toxic people maybe if they work with
people who are very mean before it would
just go right into their hearts and they
would be hurting physically for days and
as they go through the program as the
immune system boosts as their ability to
cycle stress hormones out of the body
increases it’s just like water off a
duck’s back and their whole life changes
you know one of the most common things I
see it especially around stage 5 is
people come in say I yelled at my
husband I told my boss to back off my
marriage is the best it’s been in 15
years and I got a raise and these are
you know just normal boundaries setting
that people you just don’t do when you
don’t have the energy for it it takes a
little bit of energy to set a boundary
and when you’re so beaten up by you know
the weather by lack of sleep you take
anybody anybody on earth I don’t care
what kind of a super awesome Navy SEAL
they may be you don’t let them sleep you
take away a lot of their diet and
digestive function and you do this for
months on end and then yeah I give ya
which is literal torture then they’ll
tell you the names of their family
members they’ll break and that they’re
broken they can’t set those boundaries
and when people come to us with
fibromyalgia they don’t look like
someone who is a soldier who’s been
tortured for months and months many
times especially if they’re good with
the makeup they look bright and cheery
like everybody else but what we have to
respect is that physiologically their
body is going through those exact same
challenges so when people are asking for
too much they just it’s hard for them to
have the inner resilience to say no so
in those beginning stages that’s so
important for people with fibromyalgia
to experience support particularly for
the immune system then they can get into
an upward cycle where
they’ll start to reprocess their
relationships with people their
relationships with life and set better
boundaries for themselves as they have
the energy to do so yeah that makes a
great deal of sense you know I always
understood the immune system is our way
of protecting ourselves from things that
aren’t us and are trying to hurt us in
the world and over time if that gets
and it’s not very effective then you
kind of lose your sense of what’s new
and what’s not you and then if that
boundary becomes such a blurry smear
instead of a kind of a firm line it’s
just this washy AIDS and so you know it
makes a lot of sense that as the immune
system gets stronger our sense of self
gets stronger too and even with you know
martial arts classes and things people
always talk about self-defense but
you’ve got to know who you are first and
I think that’s that’s really important
interestingly in the last few years
they’ve found that the immune system and
the lymphatic tissue itself goes up into
the brain so the immune system and our
brains have a very intimate relationship
and when we’re in a state of
inflammation as is everybody who has
fibromyalgia and chronic fatigue that
brain and blood barrier shuts down
because the body wants to protect itself
so as we do the lymphatic massage and
drop inflammation just a little bit it
allows the brain to flush particularly
at night and flush all of that toxic
material out of the brain and in that
sweet spot of inflammation where it’s
not too much and not too little the
nerves begin to repair and this is where
the fibro fog goes and people come back
to themselves so many times I see people
with fibromyalgia and the mental fog is
just so thick and then after a week or
two they come back and it’s as though
someone is just they’re completely home
again and then that’s what we can work
on the deeper strategy but in the
beginning is just so crucial to keep it
supportive to keep it simple and keep it
minimal in terms of effort the least
possible effort to get the maximum
returned systemically for the entire
body yeah that’s wonderful you know with
the brain trying to clean itself out
this is something I learned relatively
recently too is that we have metabolic
waste products in our brain which order
to make sense you know and the brain
trying to clean itself out is so
important so that the brain can continue
to function and we’ve talked before
about the dirty fishtank idea when the
filter on the fish tank goes and all the
sudden that clean water is now just a
murky haze and how difficult it is they
have normal function under those
conditions now a lot of this brain
cleaning tends to happen at night when
we sleep yeah mm-hmm and have you found
a lot of people that have these
conditions have trouble with regulating
their sleep cycle oh definitely I mean
some people with fibromyalgia in fact I
would say most and the the data supports
that is three-quarters of people with
fibromyalgia have severe insomnia so
what we look at is whether it’s trouble
getting to sleep or whether it starts
with waking up in the middle of the
night now when it’s getting to sleep
that’s the trouble that’s when we really
look at the immune function because
getting to sleep requires a little bit
of inflammation but if you have too much
inflammation you can’t get into that
sleep state and thinking happy thoughts
can relax you a little bit so when that
inflammation is caused by stress yes you
can listen to maybe peaceful music and
will calm you down
but when the immune system is at work
listening to that peaceful music does
nothing to allow you to enter into that
sleep state and in those cases you have
to address the immune system once you
address the immune function boom people
are out like a light they’ll just do the
immune exercises out like a light
they’ll still wake up in the middle of
the night because that’s a different
cause of insomnia that we get to in the
later stages but at least get into sleep
getting those three or four hours of
interrupted sleep which to an ordinary
person that sounds that sounds pathetic
as far as the nice nights
but for people with fibromyalgia who are
waking up every 45 minutes those four
hours of sleep consistently are heaven
on earth so they may get to sleep at
10:00 then you know are waking up Bob
between 1:00 to 3:00 o’clock
generally and that’s something that we
address in stages 3 and in stages 7 yeah
and that’s a good chance for the brain
to be cleaning itself out too so now you
can turn it yourself back that way
there’s just so much maintenance the
body needs that we have to give
ourselves time for these things and I
mean absolutely and understanding that
it’s not a perfectly upward trajectory
but it’s a spiral that is generally
going up but on the graph it goes up it
goes down it goes you know sometimes it
goes down lower than it was before but
it has an overall upward trend and
that’s something we have to respect is
that this is the human body if I was
going to just I used to be able to do
the splits if I just started working and
doing the splits today I would be making
incremental progress but maybe one day I
would overdo it and I would go back
maybe a week right but if I consistently
work at it and I’m making sure that my
body is well nourished and warm I can do
the splits maybe it’ll take three or
four months but I’ll get there and it’s
the same thing with fibromyalgia if
you’re trying to do the splits but
you’re icing your ligaments it’s not
going to work so well if you’re trying
to do the splits and you’re cold it’s
not gonna work very well and if you’re
trying to do the splits in the middle of
a fever you’re just not going to have
that that sweet spot of inflammation for
your body to repair and make progress so
just like you know doing the splits or
running a marathon or whatever it is
that we’re trying to achieve as human
beings we have to understand that
they’re gonna be good days and they’re
gonna be bad days and I’ll tell you if
you take an average person who is in
you know ordinary health in America and
train them to run 20 27 miles you can do
it and it takes about a year that’s the
equivalent to someone with severe
fibromyalgia and chronic fatigue going
from where there
in that horrid state of inflammation
lack of sleep to the point that most
normal people are at but what’s
beautiful is that once people with
fibromyalgia learn to get this far many
times they can keep going much further
than other people can because they’ve
just learned to take their body so far
they can actually take it further than
people who haven’t had these challenges
and won’t understand so well
how their body works so this is what I
call a hidden blessing with fibromyalgia
which I know it’s it’s like saying the
hidden blessing of torture and what that
can teach us but there is an upside to
all of this if we keep a positive
mindset yeah and there’s certain people
seem to have a mindset that’s easier for
them to hang on to about looking for the
good and and kind of always keep
fighting and some people you know kind
of give up and lose hope and there might
be something internal that happens you
know it’s just too much pain or just
kind of not not any options or whatever
that it makes people feel like they have
no outs but then there are many people
that have a spirit that you almost can’t
you can’t smother it I mean no matter
what you throw at them there they always
have that instinct to kind of fight and
keep moving and and all that mhm I think
for sure that the mindset is really
helpful do you have any advice for
anybody who feels like they’re hopeless
or like they don’t is you know not
working and they’re just gonna have this
absolutely the first thing that people
need to understand is that there is a
common underlying cause that involves
Gazza transmitters that is similar for
addictions major depression and
fibromyalgia and chronic fatigue so when
people have major depression they get
suicidal thoughts suicidal ideation if
you’re just listening to this and your
fibromyalgia and you’re thinking ah yeah
maybe those other go-getters or the type
of smiley people to go run marathons or
whatever That’s not me
that’s totally understandable because
when you’re in a state of inflammation
it’s normal to have negative thoughts
it’s normal to have suicidal thoughts
unfortunately this is this is where a
lot of people start and what I want you
to understand is that we’re not looking
for perfection and most people who start
this program are exactly where you’re at
now looking at things like very
negatively very pessimistically
this is just so normal and it’s
important not to judge yourself with
this there are physiological reasons why
you’re feeling this way and we’re not
asking you to take giant leaps all that
we are asking is that you do something
very very gentle to make yourself feel
just 5% better and what that will do is
unlock 15% more energy then just invest
a little bit of that back into yourself
within a month you’ll start feeling like
your brain is waking up you’ll start
feeling more positively about the world
and the kind of suicidal ideation which
it’s really common I mean and look any
of us in a state of torture in a state
of sleeplessness every person on earth
is going to have this cross their mind
nobody is going to go through that and
just constantly be smiling and chipper
if they are there in a state of denial
they’re lying to themselves and other
people so if you’re in a really dark
place yeah no kidding we understand we
get it the various stages in everyone’s
life we get these massive spikes and
inflammation and pain is something that
can kind of unite all of us in a way and
when you’re in this stage don’t worry
about it don’t worry about having the
perfect mind set because as the
inflammation clears from your brain as
you’re able to sleep better life is just
gonna start tasting better and it’s
gonna cause you to smile on your own so
there are people just like you who have
been in the exact same frame of mind who
right now you know I keep up with people
on Facebook they’re hanging out with
their family enjoying drinks on the
beach in Georgia they’re not worried
the wind not worried about the
depression or the perfect diet that was
a stage that we went through together
we’re yeah they weren’t drinking and
we’re on a reasonable diet and now it’s
a thing of the past because they’re
resilient and strong enough that they
can get there but in the early stages
we’re looking at dropping that
inflammation so that you can think so
that you can feel better so that your
body is no longer wired for these
negative thoughts but it’s wired for
success and happiness and that’s just
lowering inflammation really in the
early stages we look at the different
causes of inflammation we’re gonna lower
it for you we’re gonna do that together
so don’t worry you don’t have to be
perfect or chipper or even above-average
it’s okay we’ll work with you you’ll get
yeah that’s a great first step well do
you have any other final thoughts what I
would say is it should all come back to
simplicity although it’s complex the
road leads to simplicity and if you’re
looking at this fibromyalgia program or
anything else out there which you know
promises to have a success rate and it
looks like it gets more complex as it
goes it’s probably not a good fit
realistically for your lifestyle you’ve
got to look at what’s going to be simple
and fit within the framework of your
life there’s no way we’re gonna be
asking you stage one to be
bench-pressing realistically it’s
probably taken quite a bit of your
energy just to listen to this we get
that maybe you’re listening to this and
you need to do so with your eyes shut we
get that that’s why the videos we make
are short that’s why everything is
designed to give you just the right
amount of information without too much
explanation in the beginning so you can
start feeling better right away so you
can enjoy anything
it’s clarity of mind we get it we’ve
worked with thousands of patients with
fibromyalgia like yourself each person
is different but the progression that we
all need to go through
is the same in terms that we need to
work in the proper order and the path
we’re leading to is one of simplicity
and capacity capability and we know that
together we can get there because we’ve
done it thousands of times already
that’s wonderful
thank you so much thank you thanks for
all your work yeah you too