Tracey Coleman

I’m A Rheumatologist. Then I Got Fibro.

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If you're living with fibromyalgia and your stomach knots up and swells every afternoon, I need to tell you something your doctor is missing. I've treated more than 3,400 fibromyalgia patients over 13 years as a rheumatologist focused on chronic pain. A lot of them women who look like me. And when someone sits down in my office with pain all over, fatigue that rest never fixes, and a gut that cramps and balloons by three in the afternoon, I already know what their intracellular magnesium test will reveal. Because no doctor has ever ordered one for them. Severe magnesium depletion inside the cells. The same depletion keeping their muscles locked is keeping their gut in spasm right now. My name is Dr. Angela Brooks. I'm a rheumatologist who specializes in fibromyalgia and chronic pain conditions. And when my own fibromyalgia began at 48, eight months after my Mama passed, I understood something most doctors never share with their patients. Your pain isn't really a pain problem. And your stomach isn't really a stomach problem. They're one warning, coming from one source. I've been reading patient labs for 13 years. I've seen thousands of fibromyalgia patients with that same gut. Thousands who heard "your bloodwork is normal" or walked out with an antidepressant and an IBS pamphlet before anybody ran one real test. And I've seen what happens two to four years down the road when nobody runs the test that truly matters. Because they see you one time. One doctor. One visit. He reads your chart, not your face. Calls it fibromyalgia with IBS overlap. Sends you home with a prescription and a low FODMAP sheet. He doesn't see you three years later, when you're taking three medications, living on twelve safe foods, and still can't make it through an afternoon without opening your jeans and lying down. But I do. Because I see what becomes of the women who quieted their symptoms with pills that soften the signal but never repair what's actually broken. The 58 year old who'd had one doctor across seven years. He started her on an antidepressant before he ran one test. Then Lyrica. Began at 75 milligrams. Then 150. Then 300. Put on 22 pounds. Still woke every night at 3am with her entire body aching and her stomach in knots. Her body spent six years warning her that it was running out of the one mineral it needed to let go. She numbed the pain with chemicals while the depletion kept getting deeper below the surface. The 63 year old. "It's only fibro and a touchy stomach, baby. Nothing major." Her doctor told her it was normal for her age. Never once lifted his eyes off her chart. Put her on an antidepressant and an antispasmodic. She followed the plan to the letter for four years. Kept working. Kept cooking Sunday dinner. Never said a word. Arrived in my office so drained she could hardly stay on her feet, cramping after every meal, getting four broken hours of sleep a night. Her pain and her gut were the early warning system shouting that her nervous system had lost the ability to turn off. The pills only lowered the volume on the alarm while the loop kept going. I see them in my office after years of struggling. They don't criticize the doctors who missed it. They're simply thankful someone finally looked at them and not their chart. But I know what it cost them. They had years to replace what was missing. Years to bring their body out of high alert. Years to spare themselves the medication stack, the weight, the canceled plans, the life that kept shrinking. Their body was shouting the warning. The prescriptions just muffled it while the real problem grew worse. My difficult year was my Mama. She had been sick for 22 years. No one ever figured out why. "Some bodies wear out faster, baby." She said it all the time. Twelve months of looking after her at the end. Hospital trips. Calls in the middle of the night. Seeing patients all day and then driving to her place to handle everything she no longer could. She passed in the recliner she had hardly gotten out of for years. Eight months after that, the pain began. Everywhere and nowhere. Shoulders. Hips. Hands. And my stomach. Cramping after I ate. Swelling by mid afternoon. Some weeks nothing moved at all, and then the cramping would fold me in half. And I kept moving. Because where I come from, you do not stop for pain. You show up. You smile for your patients. You cook Sunday dinner. You don't let anybody watch you struggle. My husband saw it regardless. I could read it in his face. The concern. The fear that I'd turn into one of those women who stops showing up for her own life. I went to a colleague. He read my chart. Not me. He didn't run one test. "Textbook fibromyalgia with IBS overlap. Grief set it off. Let's get you on an antidepressant. Add Lyrica for the pain, an antispasmodic for the gut. Try low FODMAP. Most people adjust within a year. You'll handle it fine." I'm a rheumatologist. And I still got treated like a chart. So I know exactly what happens to the woman behind the front desk, the woman working nights, the woman who gets one appointment a year. I knew Lyrica would take the edge off the pain. That isn't the point. It was my daughter who asked. Keisha is a nurse. She sees women who look like her grandmother every single shift. "Mama. Has anyone tested your magnesium? Not your blood. Inside your cells." I'm a rheumatologist. And it took my own child to ask me that. I ordered my own red blood cell magnesium test first thing the next morning. Because I know what a year of nonstop stress really does to the body. My intracellular magnesium was severely low. My serum magnesium, the number on the standard panel, looked completely normal. My cortisol was still high late at night, exactly when it should have been at its lowest. My pain wasn't a pain problem. My stomach wasn't a stomach problem. It was a full year of cortisol eating through the mineral my body relies on to calm everything down. And Lyrica would have silenced the one warning sign I had before the loop locked into place. Here's what doctors won't tell you, because they never order intracellular magnesium tests. Magnesium is the mineral your body relies on to let go. It's what lets a muscle relax after it tightens. Every muscle. The ones in your shoulders and hips. And the smooth muscle lining your entire gut. But when stress stays high for months, cortisol stays high. And cortisol eats through magnesium. Every single night. Faster than your meals can put it back. Once your cells are running low, three things happen. The muscles in your body can't fully relax. They stay tense. That's the deep, everywhere ache that shifts around and never completely leaves. Your gut wall can't fully relax either. It spasms instead of moving in smooth waves. Food and gas get trapped. That's why you wake up flat and look six months pregnant by three in the afternoon. That's the cramping. That's the days when nothing moves at all. And your nervous system loses its brakes. Every signal gets turned up. From your muscles. From your gut. That's why everything hurts more than it should, and why your stomach registers every meal like an injury. But here's what's going on that you CAN'T see: Your nervous system is trapped in high alert. Day and night. When your nervous system can't turn off, your body can't reach deep sleep. No deep sleep = no true recovery. The rest you tried to get? Your body never put it to use. The exhaustion sets in. The stretching, the walks, the diets? Your tense muscles and spasming gut push back against every one of them. The magnesium you may have picked up at the pharmacy? Most of it never made it inside a single cell. You're not "just dealing with fibromyalgia" or "eating the wrong things." Your cells are running dry. Your body can't let go. The pain and the bloating are the warnings you can FEEL. The depletion is the damage building quietly. Right now. Research has found that up to seventy percent of people with fibromyalgia also deal with IBS symptoms. Seven out of ten. And less than one percent of your body's magnesium sits in your blood. Which means the routine test your doctor orders can come back normal while your cells are running on fumes. And for women who look like us, that test reveals even less. So many of us begin with lower magnesium levels in the first place. The shortfall grows faster. And the blood work keeps saying fine. Your symptoms aren't shameful. They're life saving information. They're your early warning system telling you that your body has lost the ability to settle itself down. And the prescriptions mute that alarm while the depletion keeps spreading. But doctors don't order intracellular magnesium tests. They don't link chronic stress to fibromyalgia and a cramping gut together. They don't check for it. So they tell you "it's fibro, it's IBS, lower your stress" and send you home. My next move was obvious. Not more medication. Not more restriction. I tried what fibromyalgia patients try first. Low FODMAP. Stuck to it faithfully. Gave up garlic, onions, wheat, dairy, most fruits. Quit fixing a plate at Sunday dinner because I couldn't eat half of what was on the table. Eased the bloating slightly. The cramping and the pain didn't budge. Probiotics. Spent hundreds on brand after brand. Strain after strain. Count after count. Nothing changed. Because the problem was never the bacteria. It was a gut wall that couldn't let go. Magnesium from the pharmacy. The big bottle on the lowest shelf. Magnesium oxide. Within three days I was rushing to the bathroom all morning and cramping harder than before. So I quit. Like nearly every patient I've ever had who tried it. And standing in my bathroom with that bottle in my hand, I knew it. It was the same bottle I had picked up for Mama. Years before we lost her. I'm a doctor. And I gave my own Mama that bottle and told her it would help. Lyrica. Began at 75 milligrams. Then 150. Took the edge off the pain. Left me foggy. Did nothing for my gut. Tolerance creeping up every month. The depletion wasn't getting better. The pain was still everywhere. My list of safe foods kept shrinking. I quit going to Sunday service because I couldn't stand through the hymns anymore. Nothing was replacing the mineral a year of cortisol had burned away. But I kept coming back to something that didn't add up. Magnesium CAN be replaced. The loop CAN be broken. The research shows it. So why wasn't I getting better? Because everything I was taking was either quieting symptoms or couldn't get magnesium into my cells. November 3rd. 10:52 PM. I was going through research after a hard case. Couldn't fall asleep. The pain was worse in spite of the Lyrica, and my stomach had been in a knot since lunch. I was reading studies on magnesium absorption. Not searching for anything in particular. Just desperate. I came across the research on magnesium forms. Here's what made me freeze. Magnesium oxide, the form on every pharmacy shelf, the form most doctors suggest, absorbs at about four percent. Four. The other ninety six percent never leaves your gut. It stays there, draws water into your intestines, and sends you rushing to the bathroom. That isn't a side effect. That's what magnesium oxide is built to do. There's a reason it's sold as a laxative. That's why my pharmacy bottle made everything worse. That's why so many of my patients said "magnesium just doesn't work for me." That's why Mama's bottle never did anything for her. It never stood a chance. But one form works differently. Magnesium bisglycinate. Magnesium bonded to two molecules of glycine. Your body recognizes that bond and moves it across the gut wall the same way it absorbs protein. Roughly ninety percent absorbed. Into the bloodstream. Into the cells. Into the nervous system. It doesn't linger in your gut. It doesn't draw water. It doesn't send you rushing. It's gentle on the very stomach that couldn't handle the pharmacy version. I sat there at 10:52 PM going through the mechanism pathway. Lyrica calms nerve signaling by attaching to calcium channels. Then the dose stops working. Your depletion doesn't get better. It's chemically numbed. Magnesium bisglycinate replaces the mineral your cells have been going without. The muscles that have been tense for years can finally relax. The gut wall can move in smooth waves again instead of spasming. The nervous system gets its brakes back. Your body heals instead of being chemically sedated. But absorption was just the beginning. The glycine matters as well. It's a calming amino acid your nervous system uses to wind down at night. Bonded to the magnesium, it lands exactly where the loop needs to be broken. And timing matters. Cortisol was eating through my magnesium every night while I slept. So that's when it had to be replaced. In the evening. Before bed. Every night. I've been a rheumatologist for 13 years. I've studied chronic pain my whole career. And I had never linked the form of magnesium to fibromyalgia and a cramping gut on this level. Because most doctors simply prescribe an antidepressant, Lyrica, and an antispasmodic. They don't ask why magnesium "fails" for so many patients. They don't realize the bottle on the pharmacy shelf is absorbing at four percent and irritating the very gut they're trying to calm. At 11:18 PM, I ordered magnesium bisglycinate in gummy form. Full dose. Third party tested. Sugar free. Something I would actually take every night instead of forgetting. I wasn't expecting miracles. But the mechanism made sense. I started on November 4th. Two gummies every evening before bed. November 7th. 3 days in. I woke up at 6am and noticed I hadn't woken at 3am. First time in months. I lay there bracing for the ache to begin. Figuring it was just a lucky night. But it wasn't. The magnesium was reaching where it needed to go, doing what the pharmacy bottle never could because it had never reached a single cell. November 10th. 6 days in. Had lunch. Saw patients through the whole afternoon. At 4pm I noticed my stomach was still flat. No swelling. No cramping. No slacks unbuttoned under my white coat. My husband glanced at me over dinner. "Baby. You didn't lie down when you got home." I hadn't mentioned I was taking anything. I wanted to see whether the mechanism would show results before I said a word. "Trying something new," I said. "Whatever it is, don't stop." November 18th. 14 days in. The bloating was nearly gone. My gut was moving by itself again, regularly, with no cramping. No rushing to the bathroom. The ache in my shoulders and hips had dropped from a roar to a whisper. That Sunday I went back to service. I stood through every single hymn. I felt like my body before that year. But more importantly, I wanted proof this was happening throughout my whole system. February 2nd. 90 days in. Follow up red blood cell magnesium test and cortisol panel. I sat in the lab waiting for the results. When they came in, I looked at the numbers for a full minute. Intracellular magnesium back in a healthy range. Nighttime cortisol lower. My pain scores, which I'd logged every day the way I ask my patients to, cut by more than half. I opened the comparison. November panel against February panel. The depletion had turned around. The cortisol rhythm had normalized. And I had lowered my Lyrica under my doctor's supervision. My fibromyalgia and my gut were improving because the mineral had been replaced, the loop had been broken, and my nervous system finally had its brakes back. Not muted. Restored. Keisha saw them first. She went through both reports twice. Then she set the pages down. "Grandma would have loved this." I printed both reports. Walked down the hall to my colleague's office. Dr. Patel looked at the results. Looked at me. Looked back at the labs. "Angela, what did you do? Fibromyalgia patients don't turn around like this." I walked her through the form. The four percent. Why the pharmacy bottle had made my gut worse and why so many of our patients give up on magnesium after three days. The ninety percent absorption of bisglycinate. The glycine. The timing at night, when cortisol does its damage. She studied the results for another minute. "Your magnesium is back. Cortisol normalized. And... you're telling me your stomach is better too?" "Almost completely." She was silent for a moment. "I need to start ordering intracellular magnesium for my fibromyalgia patients instead of just adjusting their Lyrica and handing out FODMAP sheets." I canceled nothing. Because I wasn't hiding from life anymore. But I started telling fibromyalgia patients something doctors don't. I'm not saying this because I'm against Lyrica or low FODMAP. These tools help manage symptoms. They soften the pain. They cut down bloating triggers. They do exactly what they were designed to do. But they don't replace the mineral your cells are going without. They don't let your muscles relax. They don't let your gut wall move freely. They don't give your nervous system its brakes back. They don't break the loop. They manage the signal for a while as the real problem keeps advancing. And I see what happens two to four years later when those women are on three medications, twenty pounds heavier, living on twelve safe foods, and still waking at 3am. Your body isn't failing you. It's warning you. The same depletion behind the pain is behind the cramping, the bloating, and the exhaustion right now. And you have two choices. Muffle the warning with pills that soften the signal while the depletion gets deeper. Or replace what's missing, in a form your body can actually absorb, and give your body what it needs to finally let go. I think about what I nearly did. Not just resigning myself to fibromyalgia and a life of safe foods. That isn't the point. I nearly numbed a depleted nervous system with a climbing Lyrica dose. I nearly silenced my body's early warning system because where I come from, you don't stop for pain. You push through it until it takes you down. I nearly became Mama. Twenty two years in a recliner, believing some bodies just wear out faster. It was never a body that wears out faster. It was a body running low on something nobody ever bothered to measure. Because once the loop has been running for years, recovery takes longer. Once the medication stack piles up, getting off it is slow and hard. Once you've built your whole life around pain and your stomach, your life has fundamentally changed. You don't get a second warning. Your symptoms are your first warning. The only warning you can still act on. I'm telling you this because if you have fibromyalgia and a gut that won't calm down, you deserve to know what I know. Not from a textbook. From the labs I read every single day. And from my own. Your pain isn't the problem. It's the symptom. Your cells are running low because cortisol has been eating through your magnesium for years. Your muscles can't relax. Your gut wall can't relax. Your nervous system has lost its brakes. And every month you numb it with pills that only soften the signal is another month the depletion deepens and the loop tightens. The pain and the bloating show up first because they're the easiest to notice. The exhaustion and the broken sleep are the damage stacking up quietly underneath. By then, you're not looking at managing symptoms. You're looking at a life rebuilt around your illness. Or worse. Ninety days. That's how long it took for my magnesium to come back and my body to remember how to let go. Ninety days of replacing what was missing instead of numbing what was left. Heal. I'm not saying stop your medication. I'm saying understand what you're numbing. Your pain is your check engine light. The prescriptions are electrical tape over the warning light. The engine is still running low. You just can't see the light anymore. But I see it every day in the labs of fibromyalgia patients. Women who numbed their pain for years with climbing doses and shrinking food lists. Then showed up in my office depleted and worn down. Every single one tells me the same thing. "I wish someone had looked at me and not my chart. I wish someone had told me my pain and my stomach were connected, and that the magnesium I tried was never going to work in that form." I'm telling you now. Your fibromyalgia and your gut are connected. The same depletion is behind both. Replace the mineral, break the loop, and you may get back both your body and your life. Or numb the symptoms, and risk everything. I'm a rheumatologist. I understand chronic pain down to the cellular level. And I chose to replace what was missing before the loop locked in for good. That's all I'm asking you to think about. Give your body a chance to heal before you accept a lifelong medication stack. Because once the loop has run for years, once the medications pile up, once your safe foods list shrinks to twelve and your evenings end in a recliner at 7pm, recovery gets so much harder. Your symptoms are giving you months or years of advance notice. Use them. Ninety days. That's all it took to bring my magnesium back, quiet the pain, and get my gut moving the way it used to. Ninety days of addressing the source instead of numbing the symptoms. Dr. Angela Brooks Rheumatologist, 13 years Specializing in Fibromyalgia and Chronic Pain P.S. I wrote it all down. The exact form. The dose. Why the nighttime timing matters. What to expect at 14 days, 30 to 60 days, and 90 days. And why most of the magnesium on the shelf does the opposite of what you need. If you have fibromyalgia and your stomach won't calm down, read it before you pull another bottle off the pharmacy shelf. The same bottle I gave my Mama. I've read too many labs from women who look like us showing depletion that could have been prevented not to share this with you.