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Internal Tremors and Fibromyalgia: The Science Behind Invisible Vibrations

The script explains internal tremors (internal vibrations) as a subjective sensation of shaking or buzzing inside the body with little to no visible movement, often felt at rest and sometimes alongside fasciculations, myoclonic jerks, restless leg syndrome, or periodic limb movement disorder. It addresses fear of serious neurologic disease and emphasizes seeing a doctor to rule out causes like thyroid issues, Parkinson’s, multiple sclerosis, and ALS, while noting these often present differently with visible tremors. The video links internal tremors to central sensitization and altered interoception, describing fibromyalgia as a central sensitization syndrome where amplified nervous system signals are hard for the brain to categorize. Suggested strategies include medical evaluation, addressing co-occurring issues and possible medications, checking B12, tracking triggers like dehydration or blood sugar dips, nutrition emphasizing whole plant foods and less saturated fat, CBT, mindfulness and slow breathing, gentle movement, weighted blankets, pacing, and finding support communities, while noting ongoing research and emerging tools.

00:00 Invisible Internal Vibrations
01:09 What Internal Tremors Are
03:10 Why It Feels So Scary
03:44 Rule Out Serious Causes
04:59 Nervous System Explanation
05:18 Central Sensitization Basics
06:06 Interoception and Buzzing
07:29 Fibromyalgia Connection
08:19 Calming Tremors Toolkit
08:41 Doctor and Holistic Workup
09:42 Nutrition and Triggers
10:13 Stress Regulation Practices
10:54 Gentle Movement and Grounding
11:27 Pacing to Prevent Flares
11:57 Community Support and Hope
13:29 Wrap Up and Share Story

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

Gabapentin and Pregabalin Explained: Calming an Overactive Nervous System in Pain, RLS, Fibromyalgia, and Sleep

The script explains gabapentinoids (gabapentin and pregabalin) as neuromodulators that “turn down” an overexcited central nervous system seen in central sensitization/nociplastic pain syndromes, helping conditions such as neuropathic pain, restless leg syndrome (RLS), fibromyalgia, anxiety, and sleep disruption. It clarifies they don’t act on GABA receptors; instead they bind the alpha-2-delta-1 subunit on calcium channels, reducing calcium influx and release of excitatory neurotransmitters (glutamate, substance P, norepinephrine), lowering pain, restlessness, and anxiety. The script highlights guideline shifts making gabapentinoids first-line for chronic RLS due to minimal augmentation risk versus dopamine agonists, notes pregabalin’s FDA approval for fibromyalgia (gabapentin used off-label), and emphasizes improved slow-wave sleep and restorative recovery. Practical guidance includes nighttime dosing, “start low and go slow” titration, side effects, off-label use, and the need for doctor supervision.

00:00 Nervous System Overdrive
01:41 Central Sensitization Explained
03:52 What Are Gabapentinoids
05:45 How They Work in Brain
08:14 Restless Leg Syndrome Shift
10:14 Fibromyalgia and FDA Approval
12:05 Deep Sleep Healing Boost
14:55 Nighttime Dosing Strategy
17:04 Side Effects and Titration
20:59 Off Label Uses and Kids
22:49 Analogies and Key Takeaways
24:51 Final Summary and Disclaimer

Click here for the YouTube channel

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...

Text Dr. Lenz any feedback or questions

Adult Autism and Masking: Why Diagnosis Matters and How to Recognize What’s Beneath the Surface

Dr. Michael Lenz interviews clinical psychologist Donna Henderson, co-author with Sarah Wayland and Jamel White of “Is This Autism? A Guide for Clinicians and Everyone Else” and a companion diagnostic guide, about why autism in adults is often missed, especially in people who camouflage. Henderson describes realizing autism in a client with many prior diagnoses and how the field’s training focused on stereotyped, observable behaviors rather than internal experience. They discuss how diagnosis can support self-understanding, self-advocacy, and self-compassion; the difference between social motivation and social energy; why autism in girls often becomes evident around middle school; and how neurocrash, burnout, sensory overload, and misinterpretations of affect can lead to dismissal in healthcare. Henderson argues for clinician education, careful interviewing over test scores, broader access to diagnosis, and considering autism before personality disorder labels.

00:00 Late Autism Discovery
00:27 Meet The Expert
02:40 From Training To Insight
06:42 Why Diagnosis Matters
11:17 Beyond Observable Traits
16:07 Social Energy Vs Interest
20:11 Girls And Middle School Shift
24:43 State Of Autism Today
30:18 Clinicians Need Training
37:45 Misdiagnosed As Personality
39:37 Hoarding And Pink Flags
41:57 Strengths And Sensory Overload
44:39 Strengths Need Context
45:37 Medical Care and Misread Signals
47:35 Pain Expression and Masking
50:35 Social Mislabels and Directness
53:07 Neurocrash vs Burnout
57:42 Reframing Kids and Parenting
01:02:19 Cross Neurotype Communic

Click here for the YouTube channel

International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers.

Joy Lenz

Fibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start.

Support the show

When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...