Fibromyalgia Blood Test Gets Insurance Coverage

The founder of a bioresearch company that offers a controversial blood test for fibromyalgia says the test is now covered by Medicare and some private insurers. But questions remain about the viability of the test.

“We are a Medicare approved laboratory. It covers 100% of the test. We are getting private insurance companies that are reimbursing for the test. And we have gotten most Blue Cross Blue Shield agencies to pay for the test.”

EpicGenetics introduced the FM/a test in 2013, calling it the first definitive blood test for fibromyalgia, a poorly understood disorder that is characterized by deep tissue pain, fatigue, depression and insomnia. The test costs $775 and results are usually available in about a week…

The test looks for protein molecules in the blood called chemokines and cytokines, which are produced by white blood cells. Fibromyalgia patients have fewer chemokines and cytokines in their blood than healthy people, according to Gillis, and have weaker immune systems as a result. But critics have contended that the same immune system biomarkers can be found in people with other illnesses, such as rheumatoid arthritis, making the FM/a test meaningless…

Quintner calls fibromyalgia a “symptom cluster” and says lower levels of chemokines and cytokines could be caused by a number of different disorders that trigger an immune system response.  “Such conditions might also include major depressive disorder and post-traumatic stress disorder,” Quintner wrote in an email to Pain News Network…

Gillis says Wolfe’s views about fibromyalgia may have been influenced by funding he received from Pfizer, a pharmaceutical company that makes Lyrica – an anti-seizure drug that was re-purposed by Pfizer to treat fibromyalgia. Lyrica is Pfizer’s top selling drug with annual worldwide sales of over $5 billion.

According to ProPublica, Wolfe received $200,000 in funding from Pfizer from 2010 to 2013 for research and consulting.

“Our test says that fibromyalgia is an immunologic disorder,” said Gillis. “Why would you take an anti-seizure medicine for an immunologic disorder? Lyrica’s primary indication is for anti-seizure therapy.” …

17 thoughts on “Fibromyalgia Blood Test Gets Insurance Coverage

  1. well maybe it can still be helpful, like if you have already used the normal tests to rule out rheumatoid arthritis, depression, ptsd, etc. besides, each disorder has its own set of symptoms, and they have been accurately diagnosing these other disorders for a long while now.

    i am interested (so far) in asking for the Fibro test, as I have been told I have it, and while I feel it is on the mild extreme, I do have several of the symptoms. and i have already been diagnosed with ptsd, arthritis, and depression….that should make it simpler when using this test. am glad to see it is covered by Medicare as well.

    Liked by 1 person

      • ok, maybe i used ‘tests’ a bit liberally. there are certain things docs (pcp’s and pdoc’s) listen for when people describe ‘invisible’ illness. generally speaking, they can identify a Mood Disorder (even PCP’s) from and Anxiety Disorder. If a pcp suspects one or both, off to a pdoc who will ask specific questions (in a flow-chart-y kind of way) to determine the kind and intensity of the Mood Disorder as well as the kind and nature/identity of an Anxiety Disorder. Other information provided will help to narrow down the possibilities, allowing pdocs to make a specific dx (which may change as he/she gets to know you better and see you more often. Often Depression is first dx’d, but later on MAY change to bipolar or even to PTSD. But that all depends on an ongoing relationship with your pdoc so he learns more about you and your affect and behaviours, and about more symptoms you may (unknowingly) provide over time.

        also, PTSD has a specific constellation of symptoms, that is very unique and taken as a whole will not fit any other diagnosis.

        also, they are in the process of developing a test specific for bipolar as well. this is an old link, but still works

        Liked by 1 person

  2. First, this is a meaningless test if it crosses over to other conditions, because fibro-resistant doctors will be still be able to dismiss the result.
    Second, whilst there seem to be many cases of fibro that involve autoimmune diseases, there is no evidence to confirm that an autoimmune disorder is what triggers fibro initially. There is far more evidence of it being a neurological disorder, triggered by a trauma such as childhood or adult sexual abuse, car accident or other seriously traumatic event. But that doesn’t convince me to take Lyrica (I think it’s either gabapentin or pregabalin over in the UK, but it’s the same drug) because the side-effects are identical to the illness, and I’m highly chemically sensitive.
    Third, there is already a test to check for substance P levels, which are higher in…….hold on, fibro fog has landed……nope, no good, brain not playing fair, is hiding in corner and laughing inanely….well anyway, substance P is higher in either fibro or CFS or ME, one of them. and can therefore be used as a potential diagnostic tool, even if only to rule out the other two conditions that don’t produce raised substance P.
    Fourth, what the hell is wrong with the current fool proof method of diagnosis, which is the patient response to pushing on the 18 pairs of tender points which are VERY particular to fibro. No other condition produces that level of tenderness at those points.

    So, fifth, it’s just another way of extracting money from the patient, and still leaving them no closer to acceptance of their chronic condition. Typical.

    Effing fibro!

    L. X

    Liked by 1 person

    • The thing about the tender points is that they can also be misleading. I had a rheumatologist diagnose me with fibro just by pressing on the tender points, even though I didn’t have them all. My chronic pain has some of the same symptoms, but I don’t have fibro. Maybe the blood test can help rule out other causes, and along with a list of symptoms, diagnose fibro. I know it’s important to get a diagnosis for the cause of a patient’s chronic pain, but since the treatments for pain are the same, I’m just not sure patients should spend so much money obtaining the diagnosis.

      Liked by 1 person

      • You don’t have to have them all, I think the minimum to allow a dx of fibro is 11 out of the 18. Why do you think you don’t also have fibro? You have the insomnia, the pain – do you have the wading through wet concrete uphill in a headwind lack of energy and strength, too? Do you get refreshed by sleep, even if you’ve managed more than your usual couple of hours because of the pain? Does it hurt if you push into your muscles? Can you lean on a counter, for example, without it hurting your forearms? Can you lean your hands on a trolley without them hurting? Does it hurt if someone claps you on the back or shakes your hand firmly? Can you stand hot water?

        I don’t think I’ve ever asked you what led to your pain, or asked you to describe it, and if you’d rather not, I’ll understand, but I’d like to understand what you’re having to deal with 🙂

        L. X

        Liked by 1 person

        • My head pain became constant in my early 20s from TMJ. The pain didn’t start to travel for many years after that, caused by degenerative disc disease in my neck. Basically, all my pain can be traced back to the abuse and injuries I suffered during gymnastics, a sport that is very hard and destructive on the body.

          Liked by 1 person

        • I had an idea it was from gymnastics injuries, but wasn’t sure.

          TMJ also recognised fibro symptom, though I don’t get that, fortunately. Wondering if the trauma of all that training and those injuries could have been a trigger for fibro? You know my theory about a trigger trauma instigating fibro by the brain gettinig stuck in Red Alert mode, hence the inability to relax, enter Deep Sleep, etc.

          Was it this comment where I asked about other symptoms? I’ve lost the thread of where I was, and guess what, even though I’m using the laptop today, it’s suffering from kangaroo cursor and random select and delete, too……So, how many tender points, why don’t you agree with that rheumy’s fibro dx, and what other symptoms? X

          Liked by 1 person

        • I’ve read a lot about fibro, but particularly the descriptions of patients who suffer from it. While there are some common aspects, fibro just doesn’t really fit for me. And the medications that help other fibro sufferers (not you, as your chemical sensitivities are rather extreme), didn’t help me at all. The majority of my pain is in my head (and upper body), and not as diffuse as in fibro.

          I’m sure it’s possible that suffering from chronic pain for such a long time could also trigger fibro, but at this point, it doesn’t really matter to me if I have it or not. It’s my head and facial pain that are debilitating and disabling (and mostly responsible for my insomnia), not any of my other symptoms.

          Liked by 1 person

        • You know how it feels when you have a bad tooth? Multiply that feeling for every tooth in your mouth — that’s part of my jaw pain. Then there’s the pain in my facial muscles, which travels to my temples, the sides of my head, and my ears (in which the ringing is constant). Allergies exacerbate the facial and head pain. My teeth, face, ears, and head never stop throbbing. It’s painful to smile or move any of the muscles in my face.

          The pain also travels to the back of my head, which is so sensitive, it’s uncomfortable to lay my head on a pillow. My head feels like it weighs five times the average of 10 pounds — like I’ve got a bowling ball attached to my neck. My hair hurts.

          All the head pain travels into my neck, shoulders and upper body, which often stoop with the weight of my head, unable to carry such a heavy bowling ball.

          And I’m describing an average day, not what it feels like during a pain storm.

          Liked by 1 person

        • That’s horrendous. You poor thing. I wish I had a magic wand and could make it all stop for you. Does anything like hot or cold packs give any relief at all? I know how crap my head feels when my sinus cavities, usually air-filled, get full of gunk. My head is literally to heavy for my neck to support – nowhere near as severe as yours is, but I get the bowling ball analogy. Jeez, Jo. How the fuck do you cope,day in day out? X

          Liked by 1 person

        • Cold therapy helps sometimes, but heat can cause inflammation in my face. How do I cope? I keep breathing. (And keep wishing I had some bud.)

          Have I finally convinced you that I’m not suffering from fibro? 🙂

          Liked by 1 person

        • I wasn’t convinced you were, just curious as to why that rheumy dx’d you and you disagreed 🙂 I can’t offer much help even for fibro, despite a fair amount of research, experiment and study. I think I already talked to you about DLPA, didn’t I? Binds to same receptors as morphine.

          Soz, tired, and eyes dry, so typing has to stop now because it’s blurry and hurting. X

          Liked by 1 person

  3. PS I always thought that once I had a dx, 1) I could be fixed, 2) the medical profession would take it more seriously and stop writing me off as a hypochondriac, a neurotic, a depressive, an attention-seeker…… did none of those things. It’s useful in as much as it validates us feeling so ill, and takes away some of the responsibility that we feel when doctors tell us it’s our own fault we’re ill because we’ve magically talked ourselves into it or aren’t cheerful enough, or aren’t trying hard enough, but really, over and above that, a dx of fbro isn’t that helpful. I can’t take any of the Lyrica type drugs, or any anti depressants, and am limited to opiate based painkillers because I’m allergic to all the rest, the NSAIDs, paracetamol, aspirin, the fake opiods like Tramadol (turns me into competition for Linda Blair’s role in The Exorcist), so it’s morphine and codeine only for me. And branded sumatriptan for the migraines, the generics don’t touch them. At. All. And make me sick.

    So, you’re right. There seems little point in chasing a dx unless it’s going to get you better medical care or a cure or at least more effective management.

    Liked by 1 person

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