Fibromyalgia and Low Dopamine Levels

Dopamine is a neurotransmitter that is produced in several areas of the brain, including the substantia nigra and the ventral tegmental area. Dopamine is also a neurohormone released by the hypothalamus. Its main function as a hormone is to inhibit the release of prolactin from the anterior lobe of the pituitary.

Dopamine has many functions in the brain, including important roles in behavior and cognition, voluntary movement, motivation and reward, inhibition of prolactin production (involved in lactation), sleep, mood, attention, and learning.

Processing of pain
Dopamine has been demonstrated to play a role in pain processing in multiple levels of the central nervous system including the spinal cord, periaqueductal gray (PAG), thalamus, basal ganglia insular cortex and cingulate cortex. Accordingly, decreased levels of dopamine have been associated with painful symptoms that frequently occur in Parkinson's disease. Abnormalities in dopaminergic neurotransmission have also been demonstrated in painful clinical conditions, including burning mouth syndrome, fibromyalgia and restless legs syndrome.
People with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) generally have low dopamine levels as well. Symptoms of both conditions include both cognitive effects as well as movement and balance problems.

Low Dopamine
No neurotransmitter acts alone. They all work together in a complex web of activity that scientists are really just beginning to understand. Still, experts have been able to associate different neurotransmitter imbalances with certain conditions and symptoms and find some ways to help boost or decrease activity.
Low dopamine levels are associated with the following symptoms:

• Stiff, rigid, achy muscles
• Tremors
• Impaired fine motor skills
• Cognitive impairment
• Inability to focus attention
• Poor balance and coordination
• Strange walking pattern (gait), frequently with small steps
  

High levels of dopamine, on the other hand, are associated with addiction, euphoria, hyperstimulation, excessive focus, suspicion, and the inability to separate what is important from what isn't. If you're taking medication that increases your dopamine levels, you should let your doctor know if you have symptoms of high dopamine, which is associated with psychological side effects.
Neuroleptic (antipsychotic) drugs lower dopamine levels.

Increasing the Availability of Dopamine
Drug treatment of low dopamine levels may include stimulant therapy with Ritalin, Concerta and Methadate (all of which contain methylphenidate).
There are not a lot of research confirming that food can boost dopamine levels in your brain, and even if it can, it would take prohibitively huge amounts to have the desired effect. In spite of the lack of hard evidence, some practitioners recommend:

• Tea (black or green)
• Apples, bananas & watermelon
• Blueberry extract
• Red wine
• Beets, beans & legumes
• Chicken
• Cheese
• Eggs
• Fish
• Wheat germ

Supplements believed to help raise dopamine levels include:

• NADH
• L-Theanine (supplement form of amino acid unique to black and green tea)
• Omega-3 fatty acids, from fish oil or flax seed oil
• Rhodiola rosea

A note on tea & theanine: Studies show theanine increases both norepinephrine and dopamine while lowering glutamate levels, all of which can have a positive effect on those of us with FMS and ME/CFS. Research is mixed, however, on how theanine impacts serotonin levels. If you decide to try theanine, track your symptoms to see if serotonin-related symptoms get worse.
While it's generally safe to experiment with these kinds of foods, don't expect miracles and avoid extreme changes to your diet. Be sure to make changes slowly, and track your dietary changes and symptoms in a symptom journal to get an accurate gauge of what may be helping. You should always work with your doctor to decide what methods to try and how successful your treatments are.

Sources:

1. Amino Acids. 2008 Jan 15. [Epub ahead of print] All rights reserved. "Theanine, gamma-glutamylethylamide, a unique amino acid in tea leaves, modulates neurotransmitter concentrations in the brain striatum interstitium in conscious rats."
2. Goldstein, J. Alasbimn Journal2(7): April 2000. AJ07-5. "The Pathophysiology and Treatment of Chronic Fatigue Syndrome and Other Neurosomati Disorders: Cognitive Therapy in a Pill."
3. Nutritional neuroscience. 2006 Oct-Dec;9(5-6):251-8. "Dietary supplementation with blueberry extract improves survival of transplanted dopamine neurons."
4. Progress in neuro-psychopharmacology and biological psychiatry. 2008 Jul 1;32(5):1243-50. Epub 2008 Apr 7. "Resveratrol, a red wine polyphenol, protects dopaminergic neurons in MPTP-treated mice."
5. Psychoneuroendocrinology. 2008 Feb;33(2):188-97. All rights reserved. "Genetic evaluation of the serotonergic system in chronic fatigue syndrome."
6. wikipedia