"...first question is do you ever see patients who experience inner Tremors can you address what this might be all about and I would say yes we can address what this is all about we see a lot of patients with a variety of some Tremors and inner tremors are something that have a specific medical understanding for us yeah and the internal Tremors can be a number of things you could be anxiety it could be an autoimmune response your thyroid it could be hyperthyroidism it could be something like a pheochromocytoma which is where your adrenal gland has a tumor on it and makes to me adrenal hormones so all of those are possibilities for the internal Tremors we frequently see it with autoimmune thyroid disease but we see a lot of so that so that's kind of our take on anxiety a lot of anxiety those are two things I would go to those two things first I don't know yeah okay but yes can you have fibromyalgia this is a great question because it's kind of fiber understanding of fibromyalgia can you have fibromyalgia not have irritable bowel syndrome and not hurt when someone hugs you or touches you great question the understanding of what it fibromyalgia is evolve and and we've stayed on top of that Gates has done continued to stay on top of the research so I think this is an interesting question to answer for people who are confused yeah like me right so if I were myalgia we had the 1990 criteria by the American College of Rheumatology and that criteria set forth that if you have tenderness at a certain number of the trigger points 11 out of the 18 I know they team basically then you had fibromyalgia to produce 11 out of 18 and then you had other Associated symptoms of brain fog and fatigue whereas the new criteria the 2010 American College of Rheumatology criteria that came out and it's predicated on not having the trigger points you don't have to be able to termed a low zdenek allodynia constitutes pain with a normally non painful stimulus so like somebody giving you a hug so you don't have to have that pain response when somebody gives you a hug and you don't necessarily have to have IBS either in order to be diagnosed with fibromyalgia now it can't be another condition that's causing the pain it can be associate with other pain but you have widespread pain so pain and many areas of your body there's a way to document that you have other disabling symptoms of fatigue and brain fog and the fatigue and brain fog half of these severe enough to be above a certain score level for you to be diagnosed with fibromyalgia so it's really more predicated on widespread pain fatigue and brain fog and then it also factors in other Associated symptoms like IBS but you don't have to have IBS you don't have to have trigger points to have fun that you can have other gut problems like I have Celiac can write or you could just have non-celiac gluten sensitivity.."
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