There has been considerable interest in the DNA results for CFS and fibromyalgia is typically co-morbid, so I thought a browse through the research, especially for items that can be checked on 23AndMe.
As before, log on to 23andMe and then click the links below
Low COMT Enzyme higher pain in FM
Specific reactions catalyzed by COMT include:
- Dopamine → 3-Methoxytyramine
- DOPAC → HVA (homovanillic acid)
- Norepinephrine → Normetanephrine
- Epinephrine → Metanephrine
- Dihydroxyphenylethylene glycol (DOPEG) → Methoxyhydroxyphenylglycol (MOPEG)
- 3,4-Dihydroxymandelic acid (DOMA) → Vanillylmandelic acid (VMA)
The key SNPs are
- rs6269, Mine is AG
- Type AA is associated with pain
- rs4633, Mine is CT
- Type CC is associated with pain
- rs4818 — Not Found
- Type CC is associated with pain
- rs4680 (Val158Met) — Mine is CT
- AA is associated with pain
- GG and AG are lower levels.
Severe Pain associated with the SCN9A Gene
“This association raises the possibility that some patients with severe FM may have a DRG sodium channelopathy.” found rs6754031 polymorphism to be most significant, unfortunately this is not included in the 23AndMe results for me.
Some SNP appear to be associated, but not at statistical significant levels (given the small sample) and less than half of the SNPs were listed in the 23andMe results.
I have no FM pain and have only one of the above SNPs – which is what would be expected by randomness.
There are a number of of studies associating the Gene with pain sensitivity. For example:
” there was a statistically significant correlation between SNP rs6746030 and higher maximum NRS scores during the postoperative follow-up of non-PCA patients (P < 0.05). Furthermore, there was a significant association between the tag SNP rs4286289 and both increased postoperative maximum NRS scores (P < 0.05) and higher incidences of severe postoperativepain (P < 0.05) in non-PCA patients. Meanwhile, in PCA patients, rs4286289 exhibited the strongest association (P = 0.001) with increased requirements for postoperative analgesics, which indirectly strengthened the significant association between this SNP and higher postoperative pain.” 
Predisposition to FM – T102C
I am reported as AG on 23andMe. The CC variation is the one of concern. SNPedia reports:
|(C;C)||higher risk for RA|
|(C;T)||higher risk for RA|
|(T;T)||2.1||depression, panic, stress response|
Having the SNPs does not mean that you will or will not get FM. If you go into a FM state, your symptoms may be worst (and your FM state may actually be the same as someone with a lot less pain lacking these SNPs).
This information can be helpful to explain to a MD that your need for pain relief is higher because of your DNA. It could provide justification to the MD to prescribe a higher dosage based on evidence instead of tears.
As a speculation: There seem to be some evidence that mild and worst cases of FM/CFS is not strongly related to disease state, rather to DNA that is responding to the disease state.
Radical suggestion for treating pain!
One of my readers report that many pains disappeared in less than a month after aggressively trying to correct their microbiome. My model is that the symptoms are the results of the shift of chemicals being produced/released by the microbiome. How the body responds to an increase or decrease of certain chemicals is influenced by the DNA. Symptoms like pain may be reduced or eliminated by shifting that chemical mixture — exactly how to shift it is beyond current research literature.