{"id":14923,"date":"2026-06-09T11:22:46","date_gmt":"2026-06-09T11:22:46","guid":{"rendered":"https:\/\/csiag.de\/?p=14923"},"modified":"2026-06-09T13:05:39","modified_gmt":"2026-06-09T13:05:39","slug":"fibromyalgie-small-fiber-neuropathie","status":"publish","type":"post","link":"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/","title":{"rendered":"Fibromyalgie &#8211; Small-Fiber-Neuropathie"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Tabla de contenido<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Unterschied\" >Diferencia<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Fibromyalgie\" >Fibromialgia<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Small-Fiber-Neuropathie\" >Small-Fiber-Neuropathie<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Differential-Diagnostik\" >Differential-Diagnostik<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_1_%E2%80%93_Haufige_und_behandelbare_Ursachen_ausschliesen\" >Stufe 1 &#8211; H\u00e4ufige und behandelbare Ursachen ausschlie\u00dfen<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Vitamin_B12-Mangel\" >Vitamin B12-Mangel<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Eisenmangel\" >deficiencia de hierro<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Vitamin_B6\" >Vitamina B6<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Diabetes_Pradiabetes\" >Diabetes \/ Pr\u00e4diabetes<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Schilddruse\" >Gl\u00e1ndula tiroides<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_2_%E2%80%93_Small-Fiber-Neuropathie\" >Stufe 2 &#8211; Small-Fiber-Neuropathie<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Hinweise\" >Notas<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Diagnostik\" >Diagn\u00f3stico<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Hautbiopsie\" >Hautbiopsie<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#QST\" >QST<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Autonome_Diagnostik\" >Autonome Diagnostik<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_3_%E2%80%93_Autoimmunitat\" >Stufe 3 &#8211; Autoimmunit\u00e4t<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Sjogren-Syndrom\" >S\u00edndrome de Sj\u00f6gren<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Weitere_Autoimmunitat\" >Weitere Autoimmunit\u00e4t<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_4_%E2%80%93_Dysautonomie\" >Stufe 4 &#8211; Dysautonomie<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#POTS\" >POTS<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Diagnostik-2\" >Diagn\u00f3stico<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_5_%E2%80%93_Mastzellaktivierung_MCAS\" >Stufe 5 &#8211; Mastzellaktivierung (MCAS)<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Diagnostik-3\" >Diagn\u00f3stico<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_6_%E2%80%93_Fibromyalgie_als_Primardiagnose\" >Stufe 6 &#8211; Fibromyalgie als Prim\u00e4rdiagnose<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Spricht_eher_fur_Fibromyalgie\" >Spricht eher f\u00fcr Fibromyalgie<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Spricht_eher_fur_SFN\" >Spricht eher f\u00fcr SFN<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Stufe_7_%E2%80%93_Seltenere_Ursachen\" >Stufe 7 &#8211; Seltenere Ursachen<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-29\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Zoliakie\" >Z\u00f6liakie<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-30\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Monoklonale_Gammopathien\" >Monoklonale Gammopathien<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-31\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Lyme-Borreliose\" >Borreliosis de Lyme<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-32\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Kupfermangel\" >Kupfermangel<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-33\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Therapieansatz_mit_Phyto-_und_Myko-Wirkstoffen\" >Therapieansatz mit Phyto- und Myko-Wirkstoffen<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-34\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Pregabalin\" >Pregabalin<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-35\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Duloxetin\" >Duloxetin<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-36\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Amitriptylin\" >Amitriptylin<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-37\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Gabapentin\" >Gabapentin<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-38\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Phyto-_Myco-Therapeutischer_Ansatz\" >Phyto- \/ Myco-Therapeutischer Ansatz<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-39\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Nervenregeneration_Neurotrophine_und_Regeneration\" >Nervenregeneration (Neurotrophine und Regeneration)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-40\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Senkung_der_Neuro-Inflammation_Entzundungs-_und_Stress-Achsen\" >Senkung der Neuro-Inflammation (Entz\u00fcndungs- und Stress-Achsen)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-41\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Senkung_des_Neuroimmun-Stressfaktors_Endocannabinoid-CB2-System\" >Senkung des Neuroimmun-Stressfaktors (Endocannabinoid-\/CB2-System)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-42\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Senkung_der_neuronalen_Ubererregung_Neurotransmission\" >Senkung der neuronalen \u00dcbererregung (Neurotransmission)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-43\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Zusammenfassung\" >Resumen<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-44\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Studienlage_%E2%80%93_wissenschaftliche_Sicht\" >Studienlage &#8211; wissenschaftliche Sicht<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-45\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Zentrale_Sensibilisierung_bei_Fibromyalgie\" >Zentrale Sensibilisierung bei Fibromyalgie<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-46\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Systematisches_Review_zu_MRT-_und_fMRT-Befunden\" >Systematisches Review zu MRT- und fMRT-Befunden<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-47\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Small-Fiber-Veranderungen_bei_Fibromyalgie\" >Small-Fiber-Ver\u00e4nderungen bei Fibromyalgie<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-48\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Dalakas-Gruppe_Athens\" >Dalakas-Gruppe (Athens)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-49\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Wurzburger_Arbeitsgruppe_um_Sommer_Doppler\" >W\u00fcrzburger Arbeitsgruppe um Sommer &amp; Doppler<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-50\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Autonome_Small-Fiber-Beteiligung_bei_Fibromyalgie\" >Autonome Small-Fiber-Beteiligung bei Fibromyalgie<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-51\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Small-Fiber-Neuropathie_%E2%80%93_Diagnostischer_Goldstandard\" >Small-Fiber-Neuropathie &#8211; Diagnostischer Goldstandard<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-52\" href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/#Das_aktuelle_wissenschaftliche_Gesamtbild\" >Das aktuelle wissenschaftliche Gesamtbild<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Tiempo de leer<\/span> <span class=\"rt-time\"> 4<\/span> <span class=\"rt-label rt-postfix\">minutos<\/span><\/span>\n<p class=\"wp-block-paragraph\">Fibromyalgie und Small-Fiber-Neuropathie (SFN) sind jeweils eigenst\u00e4ndige Diagnosen, die jedoch exklusiv, wie additiv auftreten und sich in \u00e4hnlichen Symptomen \u00e4u\u00dfern k\u00f6nnen. Deshalb ist die differntialdiagnostische Abkl\u00e4rung therapeutisch essenziell.<\/p>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Unterschied\"><\/span>Diferencia<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Fibromyalgie\"><\/span>Fibromialgia<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<pre class=\"wp-block-code\"><code>Nerv intakt\nVerarbeitung ver\u00e4ndert\nPrim\u00e4r eine St\u00f6rung der Schmerzverarbeitung<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">kann verursachen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Brennen<\/li>\n\n\n\n<li>Kribbeln<\/li>\n\n\n\n<li>Dys\u00e4sthesien<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">obwohl keine Nervensch\u00e4digung vorliegt.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Small-Fiber-Neuropathie\"><\/span>Small-Fiber-Neuropathie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<pre class=\"wp-block-code\"><code>Nerv ver\u00e4ndert\nVerarbeitung kann zus\u00e4tzlich ver\u00e4ndert sein\nPrim\u00e4r eine St\u00f6rung der kleinen Nervenfasern<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">kann verursachen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Schmerzen<\/li>\n\n\n\n<li>Fatiga<\/li>\n\n\n\n<li>Brain Fog<\/li>\n\n\n\n<li>Trastornos del sue\u00f1o<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">obwohl die Ursache prim\u00e4r peripher ist.<\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Differential-Diagnostik\"><\/span>Differential-Diagnostik<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_1_%E2%80%93_Haufige_und_behandelbare_Ursachen_ausschliesen\"><\/span>Stufe 1 &#8211; H\u00e4ufige und behandelbare Ursachen ausschlie\u00dfen<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Vitamin_B12-Mangel\"><\/span>Vitamin B12-Mangel<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Kann verursachen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Brennen der F\u00fc\u00dfe<\/li>\n\n\n\n<li>Ameisenlaufen<\/li>\n\n\n\n<li>Gangunsicherheit<\/li>\n\n\n\n<li>Fatiga<\/li>\n\n\n\n<li>Trastornos de concentraci\u00f3n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Nicht nur Serum-B12 bestimmen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sinnvoller:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Holo-Transcobalamin<\/li>\n\n\n\n<li>Methylmalons\u00e4ure<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Eisenmangel\"><\/span>deficiencia de hierro<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Auch ohne An\u00e4mie.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Insbesondere bei:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inquietud<\/li>\n\n\n\n<li>Trastornos del sue\u00f1o<\/li>\n\n\n\n<li>Missempfindungen<\/li>\n\n\n\n<li>Restless-Legs-\u00e4hnlichen Beschwerden<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Labor:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ferritina<\/li>\n\n\n\n<li>Saturaci\u00f3n de transferrina<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Vitamin_B6\"><\/span>Vitamina B6<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Wird oft vergessen. Sowohl Mangel als auch \u00dcberdosierung k\u00f6nnen Neuropathien verursachen, gerade bei Nahrungserg\u00e4nzungen wichtig.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Diabetes_Pradiabetes\"><\/span>Diabetes \/ Pr\u00e4diabetes<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Eine der h\u00e4ufigsten Ursachen f\u00fcr SFN.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nicht nur:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Glucosa en ayunas<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">sondern:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>HbA1c<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">ggf.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>oraler Glukosetoleranztest<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Schilddruse\"><\/span>Gl\u00e1ndula tiroides<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>TSH<\/li>\n\n\n\n<li>fT4<\/li>\n\n\n\n<li>ggf. fT3<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Hypothyreose kann viele Fibromyalgie-\u00e4hnliche Symptome machen.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_2_%E2%80%93_Small-Fiber-Neuropathie\"><\/span>Stufe 2 &#8211; Small-Fiber-Neuropathie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Wenn die Basisdiagnostik unauff\u00e4llig ist.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Hinweise\"><\/span>Notas<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Typisch w\u00e4ren:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Brennen in Ruhe<\/li>\n\n\n\n<li>Fu\u00dfsohlen\/Fersen betroffen<\/li>\n\n\n\n<li>Temperaturst\u00f6rungen<\/li>\n\n\n\n<li>Herzrasen<\/li>\n\n\n\n<li>Schwitzen\/Frieren<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Diagnostik\"><\/span>Diagn\u00f3stico<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Hautbiopsie\"><\/span>Hautbiopsie<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Goldstandard.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Messung:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>intraepidermale Nervenfaserdichte<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"QST\"><\/span>QST<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Pr\u00fcfung von:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>W\u00e4rme<\/li>\n\n\n\n<li>Fr\u00edo<\/li>\n\n\n\n<li>Schmerzschwellen<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Autonome_Diagnostik\"><\/span>Autonome Diagnostik<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>VFC<\/li>\n\n\n\n<li>QSART<\/li>\n\n\n\n<li>Tilt-Test<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_3_%E2%80%93_Autoimmunitat\"><\/span>Stufe 3 &#8211; Autoimmunit\u00e4t<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Diese Gruppe wird h\u00e4ufig \u00fcbersehen.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Sjogren-Syndrom\"><\/span>S\u00edndrome de Sj\u00f6gren<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Einer der wichtigsten SFN-Ausl\u00f6ser.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kann auftreten ohne:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>trockene Augen<\/li>\n\n\n\n<li>trockenen Mund<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Typische Beschwerden:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Neuropathie<\/li>\n\n\n\n<li>Fatiga<\/li>\n\n\n\n<li>autonome Symptome<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Labor:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ANA<\/li>\n\n\n\n<li>SSA\/Ro<\/li>\n\n\n\n<li>SSB\/La<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Weitere_Autoimmunitat\"><\/span>Weitere Autoimmunit\u00e4t<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Je nach Situation:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ANA<\/li>\n\n\n\n<li>ENA<\/li>\n\n\n\n<li>ANCA<\/li>\n\n\n\n<li>Komplement<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_4_%E2%80%93_Dysautonomie\"><\/span>Stufe 4 &#8211; Dysautonomie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Bei vegetativen Symptome genauer beachten.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"POTS\"><\/span>POTS<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">(orthostatisches Tachykardiesyndrom)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Typisch:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Herzrasen<\/li>\n\n\n\n<li>Brain Fog<\/li>\n\n\n\n<li>Fatiga<\/li>\n\n\n\n<li>mareo<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Diagnostik-2\"><\/span>Diagn\u00f3stico<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Kipptischtest<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_5_%E2%80%93_Mastzellaktivierung_MCAS\"><\/span>Stufe 5 &#8211; Mastzellaktivierung (MCAS)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Das ist wissenschaftlich deutlich kontroverser als SFN, aber die Symptom\u00fcberlappung ist auff\u00e4llig.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Typisch:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Herzrasen<\/li>\n\n\n\n<li>Schwitzen<\/li>\n\n\n\n<li>Temperaturwechsel<\/li>\n\n\n\n<li>Brain Fog<\/li>\n\n\n\n<li>Trastornos del sue\u00f1o<\/li>\n\n\n\n<li>diffuse Schmerzen<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Diagnostik-3\"><\/span>Diagn\u00f3stico<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Schwierig, aber m\u00f6glich:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tryptase<\/li>\n\n\n\n<li>N-Methylhistamin im Urin<\/li>\n\n\n\n<li>Prostaglandin-D2-Metaboliten<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Normale Werte schlie\u00dfen es nicht sicher aus.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_6_%E2%80%93_Fibromyalgie_als_Primardiagnose\"><\/span>Stufe 6 &#8211; Fibromyalgie als Prim\u00e4rdiagnose<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Die Frage ist:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sind die neuropathischen Symptome Ausdruck einer zentralen Sensibilisierung?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Oder liegt zus\u00e4tzlich eine SFN vor?<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Spricht_eher_fur_Fibromyalgie\"><\/span>Spricht eher f\u00fcr Fibromyalgie<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>generalisierte Druckschmerzhaftigkeit<\/li>\n\n\n\n<li>wechselnde Schmerzlokalisation<\/li>\n\n\n\n<li>starke Belastungsabh\u00e4ngigkeit<\/li>\n\n\n\n<li>unauff\u00e4llige Neuropathiediagnostik<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Spricht_eher_fur_SFN\"><\/span>Spricht eher f\u00fcr SFN<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Brennen der F\u00fc\u00dfe<\/li>\n\n\n\n<li>Beschwerden in Ruhe<\/li>\n\n\n\n<li>Temperaturdysregulation<\/li>\n\n\n\n<li>autonome Symptome<\/li>\n\n\n\n<li>objektivierbare Befunde in Hautbiopsie\/QST<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Stufe_7_%E2%80%93_Seltenere_Ursachen\"><\/span>Stufe 7 &#8211; Seltenere Ursachen<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Wenn die bisherigen Untersuchungen nichts zeigen.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Zoliakie\"><\/span>Z\u00f6liakie<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Kann SFN verursachen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Labor:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Transglutaminase-IgA<\/li>\n\n\n\n<li>Gesamt-IgA<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Monoklonale_Gammopathien\"><\/span>Monoklonale Gammopathien<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Labor:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Serum-Elektrophorese<\/li>\n\n\n\n<li>Inmunofijaci\u00f3n<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Lyme-Borreliose\"><\/span>Borreliosis de Lyme<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Nur bei passender Vorgeschichte.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nicht als unspezifisches Screening.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Kupfermangel\"><\/span>Kupfermangel<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Kann neuropathische Beschwerden machen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Labor:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>cobre<\/li>\n\n\n\n<li>Coeruloplasmin<\/li>\n<\/ul>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Therapieansatz_mit_Phyto-_und_Myko-Wirkstoffen\"><\/span>Therapieansatz mit Phyto- und Myko-Wirkstoffen<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<p class=\"wp-block-paragraph\">Neben S3-leitlinienbasierter Therapeutika, wie Amitriptylin, Duloxetin (SNRI), Milnacipran und Pregabalin gibt es nat\u00fcrliche Wirkstoffe, die \u00e4hnliche Effekte aufweisen, allerdings OHNE die typischen unerw\u00fcnschten Nebenwirkungen der Pharmatherapeutika).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pregabalin\"><\/span>Pregabalin<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 Calciumkan\u00e4le<br>\u2193 Glutamat<br>\u2193 neuronale Erregbarkeit<\/code><\/pre>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Duloxetin\"><\/span>Duloxetin<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2191 Serotonin<br>\u2191 Noradrenalin<br>        \u2193<br>st\u00e4rkere absteigende Schmerzhemmung<br>        \u2193<br>weniger Schmerzverst\u00e4rkung<\/code><\/pre>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Amitriptylin\"><\/span>Amitriptylin<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2191 Serotonin<br>\u2191 Noradrenalin<br>        \u2193<br>st\u00e4rkere absteigende Schmerzhemmung<br>        \u2193<br>weniger Schmerzverst\u00e4rkung<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">zus\u00e4tzlich:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 Histaminwirkung<br>        \u2193<br>Sedierung<br>Schl\u00e4frigkeit<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">Deshalb hilft es oft deutlich besser beim Einschlafen als Duloxetin.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">zus\u00e4tzlich &#8211; Muskarinische Acetylcholin-Rezeptoren:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 Acetylcholin<br>        \u2193<br>Mundtrockenheit<br>Estre\u00f1imiento<br>verschwommenes Sehen<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">zus\u00e4tzlich &#8211; Alpha-1-Rezeptoren:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 Sympathikusantwort<br>        \u2193<br>Descenso de la tensi\u00f3n arterial<br>mareo<\/code><\/pre>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Gabapentin\"><\/span>Gabapentin<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<p class=\"wp-block-paragraph\">Gabapentin bindet <strong>no<\/strong> an GABA-Rezeptoren, obwohl der Name das vermuten l\u00e4sst. Der Hauptangriffspunkt ist:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u03b12\u03b4-Untereinheit<br>spannungsabh\u00e4ngiger Calciumkan\u00e4le<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">Der Signalweg:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>Gabapentin<br>      \u2193<br>Bindung an \u03b12\u03b4<br>      \u2193<br>weniger Calcium-Einstrom<br>      \u2193<br>weniger Neurotransmitterfreisetzung<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">Haupts\u00e4chlich betroffene Neurotransmitter sind:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 Glutamat<br>\u2193 Substanz P<br>\u2193 CGRP<br>\u2193 Noradrenalinfreisetzung<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">Daraus ergibt sich die Konsequenz:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>\u2193 neuronale \u00dcbererregbarkeit<br>\u2193 zentrale Sensibilisierung<br>\u2193 neuropathische Schmerzsignale<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\">oder, vereinfacht dargestellt:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>Gabapentin<br>      \u2193<br>\u03b12\u03b4-Calciumkan\u00e4le<br>      \u2193<br>\u2193 Calcium<br>      \u2193<br>\u2193 Glutamat<br>\u2193 Substanz P<br>      \u2193<br>weniger Schmerzverst\u00e4rkung<\/code><\/pre>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Phyto-_Myco-Therapeutischer_Ansatz\"><\/span>Phyto- \/ Myco-Therapeutischer Ansatz<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Nervenregeneration_Neurotrophine_und_Regeneration\"><\/span>Nervenregeneration<br>(Neurotrophine und Regeneration)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>HERICIUM<\/strong> - <em>Hericium erinaceus<\/em> &#8211; Erinacin A, Hericenone<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2191 NGF (Nerve Growth Factor) \/ \u2191 BDNF (Brain-Derived Neurotrophic Factor)<br>F\u00f6rdert Axonwachstum, Synapsenbildung, Regeneration und Zell\u00fcberleben <strong>sensorischher<\/strong> als auch <strong>autonomer Nervenfasern<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Senkung_der_Neuro-Inflammation_Entzundungs-_und_Stress-Achsen\"><\/span>Senkung der Neuro-Inflammation<br>(Entz\u00fcndungs- und Stress-Achsen)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>REISHI<\/strong> - <em>Ganoderma lucidum<\/em> &#8211; Ganoders\u00e4uren (Triterpene), \u03b2-Glucane, Sterole (Ergosterol)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193 NF-\u03baB (Nuclear Factor kappa B ist ein\u00a0pleiotroper Transkriptionsfaktor, der Genexpression steuert)<br>\u2193 TNF-\u03b1 (Tumornekrosefaktor-alpha) ist ein zentrales, proinflammatorisches Zytokin)<br>\u2193 IL-6 (proinflammatorisches Zytokin, fr\u00fcher Entz\u00fcndungsmarker und Schl\u00fcsselfunktion im \u00dcbergang von angeborener zu erworbener Immunit\u00e4t, Mediator Mikrogliaaktivierung)<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Senkung_des_Neuroimmun-Stressfaktors_Endocannabinoid-CB2-System\"><\/span>Senkung des Neuroimmun-Stressfaktors<br>(Endocannabinoid-\/CB2-System)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Copaiba<\/strong> &#8211; \u03b2-CARYOPHYLLEN, \u03b1-Humulen, Germacren D, \u03b2-Bisabolen<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2191 CB2-Aktivierung (Hemmung der Aussch\u00fcttung entz\u00fcndungsf\u00f6rdernder Botenstoffe\u00a0(Zytokine); Reduktion von Neuroinflammation und kognitiven Dysfunktionen)<br>\u2193 Mastzellen (Ausl\u00f6ser von\u00a0allergischen Sofortreaktionen\u00a0(Typ-I-Allergie), Reizdarmsyndrom, Schmerzregulation)<br>\u2193 Mikroglia (residente Immunzellen &#8211; Aktoren)<br>\u2193 Neuroinflammation (Senkung induziert durch Mikroglia))<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Senkung_der_neuronalen_Ubererregung_Neurotransmission\"><\/span>Senkung der neuronalen \u00dcbererregung<br>(Neurotransmission)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>LAVENDEL<\/strong> &#8211; Linalool &#8211; Linalylacetat &#8211; Terpinen-4-ol<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2193 Glutamat (f\u00fcr synaptische Plastizit\u00e4t; Neurodegeneration, \u00dcbererregung der Neuronen -> Alzheimer, Morbus Parkinson oder Multipler Sklerose)<br>\u2193 Calcium-Einstrom (zentrale Sensibilisierung: kleiner Reiz wird auf dem Weg ins Gehirn verst\u00e4rkt, potenziert sich also)<br>\u2193 neuronale \u00dcbererregung (Senkung des Calcium-Einstroms wirkt dem entgegen und normalisiert den Reizpegel)<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Zusammenfassung\"><\/span>Resumen<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Glutamat\/NMDA\/Calcium<\/strong> \u2192 Hypervigilanz, Schlaf, zentrale Sensibilisierung.<\/li>\n\n\n\n<li><strong>NF-\u03baB\u2013IL-6\u2013TNF-\u03b1<\/strong> \u2192 Neuroinflammation und Fibromyalgie-Komponente.<\/li>\n\n\n\n<li><strong>CB2\u2013Mikroglia\u2013Mastzellen<\/strong> \u2192 Brennen, vegetative Dysregulation, neuroimmunologische Aktivierung.<\/li>\n\n\n\n<li><strong>NGF\/BDNF<\/strong> \u2192 m\u00f6gliche Regeneration kleiner sensorischer und autonomer Nervenfasern.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Die vier Supplements arbeiten weitgehend auf <strong>verschiedenen biologischen Ebenen desselben Netzwerks<\/strong> und haben damit <strong>efectos sin\u00e9rgicos<\/strong>.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Mecanismo<\/th><th>Lavanda<\/th><th>Reishi<\/th><th>Copaiba<\/th><th>Hericium<\/th><\/tr><\/thead><tbody><tr><td>Glutamat-Modulation<\/td><td>\u2605\u2605\u2605<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2013<\/td><\/tr><tr><td>Canales de calcio<\/td><td>\u2605\u2605\u2605<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2013<\/td><\/tr><tr><td>Sympathikusberuhigung<\/td><td>\u2605\u2605\u2605<\/td><td>\u2605\u2605<\/td><td>\u2605<\/td><td>\u2013<\/td><\/tr><tr><td>Inhibici\u00f3n de NF-\u03baB<\/td><td>\u2013<\/td><td>\u2605\u2605\u2605<\/td><td>\u2605\u2605<\/td><td>\u2013<\/td><\/tr><tr><td>Mikroglia-Regulation<\/td><td>\u2605<\/td><td>\u2605\u2605<\/td><td>\u2605\u2605\u2605<\/td><td>\u2013<\/td><\/tr><tr><td>Mastzellregulation<\/td><td>\u2013<\/td><td>\u2605<\/td><td>\u2605\u2605\u2605<\/td><td>\u2013<\/td><\/tr><tr><td>CB2-Aktivierung<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2605\u2605\u2605<\/td><td>\u2013<\/td><\/tr><tr><td>NGF-Steigerung<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2605\u2605\u2605<\/td><\/tr><tr><td>BDNF-Steigerung<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2605\u2605\u2605<\/td><\/tr><tr><td>Nervenregeneration<\/td><td>\u2013<\/td><td>\u2013<\/td><td>\u2605<\/td><td>\u2605\u2605\u2605<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h1 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Studienlage_%E2%80%93_wissenschaftliche_Sicht\"><\/span>Studienlage &#8211; wissenschaftliche Sicht<span class=\"ez-toc-section-end\"><\/span><\/h1>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Zentrale_Sensibilisierung_bei_Fibromyalgie\"><\/span>Zentrale Sensibilisierung bei Fibromyalgie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Systematisches_Review_zu_MRT-_und_fMRT-Befunden\"><\/span>Systematisches Review zu MRT- und fMRT-Befunden<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24508406\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Arbeit fasst MRT- und fMRT(<strong>F<\/strong>unktionelle <strong>METRO<\/strong>agnet<strong>r<\/strong>esonanz<strong>t<\/strong>omographie)-Studien zusammen und zeigt Ver\u00e4nderungen in Hirnregionen, die an Schmerzverarbeitung beteiligt sind:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>anteriorer cingul\u00e4rer Cortex<\/li>\n\n\n\n<li>pr\u00e4frontaler Cortex<\/li>\n\n\n\n<li>Insula<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Diese Befunde st\u00fctzen das Konzept der zentralen Sensibilisierung.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Small-Fiber-Veranderungen_bei_Fibromyalgie\"><\/span>Small-Fiber-Ver\u00e4nderungen bei Fibromyalgie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dies ist wahrscheinlich die spannendste Entwicklung der letzten Jahre.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Dalakas-Gruppe_Athens\"><\/span>Dalakas-Gruppe (Athens)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25304055\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Reduction of Intraepidermal Nerve Fiber Density in the Skin Biopsies of Patients with Fibromyalgia<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Eine kontrollierte Studie mit dem Ergebnis:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Etwa ein Drittel der Fibromyalgie-Patienten zeigte eine verminderte intraepidermale Nervenfaserdichte (IENFD), wie man sie auch bei Small-Fiber-Neuropathie sieht.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Wurzburger_Arbeitsgruppe_um_Sommer_Doppler\"><\/span>W\u00fcrzburger Arbeitsgruppe um Sommer &amp; Doppler<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26164586\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Reduced Dermal Nerve Fiber Diameter in Skin Biopsies of Patients with Fibromyalgia<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sehr wichtige Studie. Es wurden Hautbiopsien von:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fibromyalgie-Patienten<\/li>\n\n\n\n<li>Small-Fiber-Neuropathie-Patienten<\/li>\n\n\n\n<li>Gesunden Kontrollen<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">verglichen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Autoren fanden Hinweise auf Small-Fiber-Pathologie bei Fibromyalgie, allerdings mit Unterschieden zur klassischen SFN.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Schlussfolgerung lautet sinngem\u00e4\u00df:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Fibromyalgie und SFN k\u00f6nnen \u00e4hnliche Befunde zeigen, aber die zugrunde liegenden Mechanismen sind m\u00f6glicherweise nicht identisch.<\/p>\n<\/blockquote>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Autonome_Small-Fiber-Beteiligung_bei_Fibromyalgie\"><\/span>Autonome Small-Fiber-Beteiligung bei Fibromyalgie<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37524221\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Autonomic Small-Fiber Pathology in Patients With Fibromyalgia<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Neuere Studie (2023).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Untersucht wurden:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Schwei\u00dfdr\u00fcsenfasern<\/li>\n\n\n\n<li>autonome Hautnerven<\/li>\n\n\n\n<li>intraepidermale Nervenfasern<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Zus\u00e4tzlich wurden autonome Symptome erfasst.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Studie unterst\u00fctzt die Hypothese, dass bei einem Teil der Fibromyalgie-Patienten nicht nur sensorische, sondern auch autonome Small Fibers betroffen sein k\u00f6nnten.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Das ist besonders interessant bei:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Herzrasen<\/li>\n\n\n\n<li>Schwitzen<\/li>\n\n\n\n<li>Temperaturdysregulation<\/li>\n\n\n\n<li>Brain Fog<\/li>\n\n\n\n<li>orthostatischen Beschwerden<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Small-Fiber-Neuropathie_%E2%80%93_Diagnostischer_Goldstandard\"><\/span>Small-Fiber-Neuropathie &#8211; Diagnostischer Goldstandard<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22570215\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Small Fiber Neuropathy: Is Skin Biopsy the Holy Grail?<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u00dcbersichtsarbeit zur diagnostischen Bedeutung der Hautbiopsie.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Beschreibt:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>IENFD<\/li>\n\n\n\n<li>diagnostische St\u00e4rken<\/li>\n\n\n\n<li>Limitaciones<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">und warum klassische Nervenleitmessungen oft normal bleiben.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20065802\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Skin Biopsy for Diagnosis of Small Fiber Neuropathy<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kritische Bewertung der diagnostischen Genauigkeit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Autoren kommen zu dem Schluss, dass die Messung der intraepidermalen Nervenfaserdichte eine hohe diagnostische Aussagekraft besitzt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18769250\/?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noreferrer noopener\">Skin Biopsy as a Diagnostic Tool<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u00dcbersicht von Claudia Sommer, einer der international bekanntesten Forscherinnen auf dem Gebiet der SFN.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fokus:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>diagnostische Wertigkeit<\/li>\n\n\n\n<li>Sensibilidad<\/li>\n\n\n\n<li>Ursachenabkl\u00e4rung<\/li>\n\n\n\n<li>klinische Einordnung der Hautbiopsie.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Das_aktuelle_wissenschaftliche_Gesamtbild\"><\/span>Das aktuelle wissenschaftliche Gesamtbild<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Die Literatur der letzten Jahre zeichnet ungef\u00e4hr folgendes Modell:<\/p>\n\n\n\n<pre class=\"wp-block-code\"><code>Gruppe A<br><br>Fibromialgia<br>ohne nachweisbare SFN<br><br>\u2192 zentrale Sensibilisierung dominiert<\/code><\/pre>\n\n\n\n<pre class=\"wp-block-code\"><code>Gruppe B<br><br>Fibromialgia<br>+<br>nachweisbare Small-Fiber-Pathologie<br><br>\u2192 Mischbild<\/code><\/pre>\n\n\n\n<pre class=\"wp-block-code\"><code>Gruppe C<br><br>prim\u00e4re Small-Fiber-Neuropathie<br><br>\u2192 periphere Nervenpathologie dominiert<\/code><\/pre>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Tiempo de leer<\/span> <span class=\"rt-time\"> 4<\/span> <span class=\"rt-label rt-postfix\">minutos<\/span><\/span>Fibromyalgie und Small-Fiber-Neuropathie (SFN) sind jeweils eigenst\u00e4ndige Diagnosen, die jedoch exklusiv, wie additiv auftreten und sich in \u00e4hnlichen Symptomen \u00e4u\u00dfern k\u00f6nnen. Deshalb ist die differntialdiagnostische Abkl\u00e4rung therapeutisch essenziell. Unterschied Fibromyalgie kann verursachen: obwohl keine Nervensch\u00e4digung vorliegt. Small-Fiber-Neuropathie kann verursachen: obwohl die Ursache prim\u00e4r peripher ist. Differential-Diagnostik Stufe 1 &#8211; H\u00e4ufige und behandelbare Ursachen ausschlie\u00dfen Vitamin&hellip;&nbsp;<a href=\"https:\/\/csiag.de\/es\/blog\/2026\/06\/09\/fibromyalgie-small-fiber-neuropathie\/\" rel=\"bookmark\">Vaciar m\u00e1s \"<span class=\"screen-reader-text\">Fibromyalgie &#8211; Small-Fiber-Neuropathie<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_lmt_disableupdate":"","_lmt_disable":"","neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[5744,1078,354,5745],"tags":[],"class_list":["post-14923","post","type-post","status-publish","format-standard","hentry","category-fibromyalgie","category-medizin","category-medizin-gesundheit","category-small-fiber-neuropathie-sfn"],"acf":[],"modified_by":"Achim Goerner","_links":{"self":[{"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/posts\/14923","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/comments?post=14923"}],"version-history":[{"count":8,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/posts\/14923\/revisions"}],"predecessor-version":[{"id":14937,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/posts\/14923\/revisions\/14937"}],"wp:attachment":[{"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/media?parent=14923"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/categories?post=14923"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csiag.de\/es\/wp-json\/wp\/v2\/tags?post=14923"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}