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Walk and Talk in Austin: Activity, Weather, and Fibromyalgia Insights

Dr. Michael Lenz records a walk along the Lady Bird Lake trail in Austin, Texas, including views of downtown and the Congress Avenue “bat bridge,” explaining how bats congregate there in summer but are gone by mid-November. He reflects on staying active with chronic pain and fibromyalgia, noting many patients were previously very active and may grieve lost abilities, and recommends starting low and gradually increasing movement. He discusses how weather affects symptoms, with many doing better in warm summers and worse in dark winters, while others struggle more in heat due to dysautonomia, temperature regulation issues, POTS, or autism; he shares a patient who felt significantly better while hiking in Central America. He notes nature and activities like kayaking can reduce perceived pain and closes with channel and podcast information and his medical background.

00:00 Walk and Talk Intro
00:33 Austin Bat Bridge
01:55 Staying Active With Fibromyalgia
04:47 Weather and Symptom Flares
07:24 Music or Silence on Walks
10:09 Colorado River and Lady Bird Lake
11:59 Nature Therapy and Kayaking
12:48 Downtown Views and Trail Life
13:57 Wrap Up and About Dr Lenz

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

Cohort Study Links ADHD to Earlier and More Severe Perimenopausal Symptoms

The episode reviews a population-based cohort study using the Icelandic SAGA cohort (women aged 35–55; n=5,392) examining perimenopausal symptom severity in women with versus without self-reported ADHD (9.9%). Using the Menopause Rating Scale (MRS), Adult ADHD Self-Report Scale v1.1, and PHQ-15, researchers found higher overall perimenopausal symptom burden in women with ADHD (mean MRS 18 vs 13) across psychological, somatic, and urogenital domains, and higher prevalence of severe symptoms (overall PR 1.8; somatic PR 2.2; psychological PR 1.63; urogenital PR 1.57) plus severe general symptoms (PR 1.94). Symptoms peaked earlier in ADHD (ages 35–39 vs 45–49), suggesting onset up to 10 years earlier. Adjustments for sociodemographics, smoking, binge drinking, and PTSD (more common in ADHD) did not remove associations. Limitations include cross-sectional measures, self-reported ADHD, symptom overlap, and lack of treatment data; the script calls for tailored guidelines for perimenopausal women with ADHD.

00:00 ADHD Meets Perimenopause
00:23 Study Purpose And Rationale
01:16 Cohort And Measurement Tools
02:33 Menopause Rating Scale Breakdown
03:17 Overall Symptom Burden Results
04:11 Severe Symptoms And Ratios
05:26 Earlier Onset By Age
06:23 Confounders And PTSD Analysis
07:38 Clinical Takeaways And Guidance
08:39 Limitations And Future Research
10:00 Wrap Up And Call To Action

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

Trigeminal Neuralgia Beyond Nerve Pain: Marsha’s Racing, Menopause, and Advocacy Story

The episode explores trigeminal neuralgia as more complex than a simple nerve injury, often overlapping with nociplastic chronic pain features like widespread pain, fatigue, insomnia, and brain fog. Marsha, a longtime off-road racer, recounts an eight-year path to diagnosis after severe electric-shock facial and scalp pain, repeated ER visits, normal imaging, and feeling dismissed as drug-seeking. She describes TN as “torture,” worse than childbirth, and details treatments including carbamazepine, gabapentin, nerve blocks, and gamma knife, which provided about a year of relief but left facial numbness and corneal damage with vision loss. She also has Sjögren’s syndrome, concussion history, anxiety/depression, and discusses perimenopause/menopause timing, hormone therapy trials, and possible ADHD. Racing helps her cope mentally, though symptoms worsen after removing her helmet, and she emphasizes support groups, self-advocacy, and not giving up.

00:00 Trigeminal Neuralgia Beyond Nerves
05:05 Marsha’s First Symptoms
07:26 ER Visits and Misdiagnosis
08:35 Finally Getting a Diagnosis
09:38 Becoming an Advocate
13:49 What TN Feels Like
15:58 Neuropathic vs Nociplastic Pain
17:14 Treatments and Gamma Knife
23:13 Concussions and Early Clues
28:14 Hormones Menopause Connection
36:38 Racing as Therapy
39:23 Daily Management and Race Day Routine
41:42 Racing as Flow State
44:29 Adrenaline and Desert Races
46:46 TN Community and Daily Struggles
48:37 Fatigue Meds and Survival
52:13 Living Without a Cure
55:02 Faith and Being There
56:38 High School Trauma and Isolation

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...

Text Dr. Lenz any feedback or questions

Should You Accept a Fibromyalgia Diagnosis? Evidence-Based Response to “Don’t Accept Fibro” Claims

Dr. Michael Lenz reacts to a naturopath’s claim that fibromyalgia is “not an acceptable diagnosis,” acknowledging that patients often feel invisible and that fibromyalgia is diagnosed by symptoms after ruling out other conditions, but arguing this does not make it illegitimate. He explains fibromyalgia as a nociplastic/central sensitization pain syndrome supported by evidence such as amplified pain signaling on functional neuroimaging, disrupted deep sleep, neurotransmitter differences, and overlap with conditions like IBS, chronic fatigue, migraines, and TMJ. He critiques functional-medicine claims that fibro is primarily due to mold toxicity, food sensitivities, adrenal fatigue, leaky gut, or mitochondrial dysfunction, noting limited or debunked evidence and potential harm from chasing costly “root causes.” He outlines evidence-based, multimodal management: restorative sleep, gentle aerobic exercise and pacing, CBT/pain reprocessing and neuroscience education, addressing ADHD/autism/anxiety, and medications such as SNRIs and gabapentinoids.

00:00 Why This Reaction
01:04 Naturopath Claim Setup
02:07 Invisible Illness Explained
03:12 What She Gets Right
07:31 Why Rejecting Is Harmful
07:49 Real Science Of Fibro
08:39 Functional Triggers List
09:04 Gut Microbiome Claims
13:39 Debunking Pseudodiagnoses
15:05 Evidence Based Treatment Plan
17:46 Should You Accept Diagnosis
18:50 Closing Takeaways

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

Dr. Iris Manor on ADHD, Trauma, PTSD, and Resilience: Risks, Mechanisms, and Treatment

The host interviews Dr. Iris Manor, a child and adolescent psychiatrist and ADHD researcher, about links between ADHD and traumatic stress disorders, including a Denmark study finding children with ADHD are about 11 times more likely to develop PTSD. Manor distinguishes trauma exposure from traumatic stress disorders and describes behavioral risk (novelty-seeking, impulsivity) and shared neurobiology (hippocampus/ventromedial prefrontal networks, inflammatory cytokines), including possible transgenerational effects of maternal trauma. She argues ADHD and traumatic stress are usually separate but interacting diagnoses, and emphasizes resilience through structure, goals, and avoiding helplessness, noting ADHD makes these harder. She warns clinicians often stop stimulants after trauma despite potential benefit, recommends treating ADHD (and parents’ ADHD), and highlights emotional dysregulation requiring treatment (often guanfacine) to enable ADHD and trauma care. The discussion also covers overlap with chronic pain/fibromyalgia and long COVID, autism-related vulnerability, and disagreement with claims that ADHD is primarily caused by trauma.

00:00 Trauma and ADHD Link
03:11 Why Risk Is Higher
04:02 Biology and Inflammation
08:04 Which Comes First
09:49 Types of Trauma Examples
11:52 National Trauma Risk Groups
15:14 Covid and Chronic Pain
20:42 Resilience Rules and Structure
22:20 Treat ADHD During Trauma
26:39 Family Screening and Care
31:12 ADHD Impact on PTSD Treatment
33:33 Emotional Dysregulation Hierarchy
35:51 Guanfacine for Dysregulation
38:36 Autism Risk and Safety
40:13

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...

Text Dr. Lenz any feedback or questions

Abdominal Migraines, Weather, and Early Fibromyalgia Clues: Pediatric Case and Listener Feedback

The episode shares insights on fibromyalgia-related problems with a focus on the role of weather and activity in flareups and how symptoms can begin years before an adult fibromyalgia diagnosis. A pediatric case is presented of a 10-year-old boy with intermittent severe upper abdominal pain lasting hours to a day, nausea without vomiting, reduced appetite, and mild to moderate headaches, with no red-flag symptoms (no fever, diarrhea, bloody stools, weight loss, rash, bruising/petechiae, or joint swelling) and a normal physical exam. Family history includes migraines (maternal aunt), fibromyalgia (maternal grandmother), and restless leg/growing pains (father). The diagnosis is abdominal migraines, and the discussion emphasizes treatment approaches including restoring consistent exercise (noting a drop in activity during winter after basketball season), improving sleep regularity, considering coexisting restless leg syndrome and iron deficiency, maintaining a healthy diet, and screening for stressors and untreated ADHD. The episode also discusses how colder weather and shorter days can reduce activity and contribute to symptom worsening, and recommends tracking steps and adapting with indoor activity or appropriate clothing; it notes that extreme cold or heat can trigger fibromyalgia pain flares. Listener feedback includes praise for a five-part ADHD series with Dr. Dodson and a question about finding fibromyalgia care in Tampa, Florida, with guidance to start with primary care and noting rheumatologists often diagnose fibromyalgia after ruling out inflammatory disease.

00:00 Episode Overview
00:37 Pediatric Case Setup
01:54 Key History Questions
04:43 What Changed This Winter
06:42 Exam Findings
07:45 Diagnosis Abdominal Migraine
08:31 Treatment Basics
10:19 Weather Exercise Connection
14:56 Fibromyalgia Early Clues
15:49 Listener Feedback Q&A
16:42 Finding Fibro Care
17:53 Wrap Up and Goodbye

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

The Hidden Fibromyalgia Epidemic: How Bias Leaves Millions Undiagnosed—and How AI Can Help

The script explains fibromyalgia as a chronic, long-term condition marked by widespread pain, profound fatigue, cognitive difficulties (“fibro fog”), and related mood issues, affecting an estimated 2–4% of the U.S. population (7–14 million) but potentially far more due to underdiagnosis. It describes how the condition is often missed because it is “invisible,” lacks definitive objective tests, and commonly leaves patients in diagnostic limbo for about five years while being dismissed as stressed, depressed, or imagining symptoms. Although the 2016 American College of Rheumatology criteria rely on the Widespread Pain Index and Symptom Severity Score, the script argues diagnosis often fails at the moment clinicians don’t suspect fibromyalgia—driven by longstanding gender and age stereotypes that frame it as a middle-aged women’s disease. It highlights research showing that unbiased application of criteria yields a much closer gender split (about 59% female, 41% male), and that many more men report symptoms than receive diagnoses. The script centers on a study of over 21,000 pain-clinic patients who completed tablet questionnaires with a digital body map; an AI clustered pain patterns into nine groups and identified a “widespread heavy” cluster strongly associated with fibromyalgia, where patients were nearly 30 times more likely to have a fibromyalgia diagnosis than those with low back pain. Yet more than two thirds of patients flagged by the AI lacked a clinical fibromyalgia diagnosis; an objective “informatics proxy” applying the formal criteria found 66.3% of the widespread-heavy cluster met diagnostic criteria, while only 22.4% were diagnosed. The missed patients were more likely to be male and older, demonstrating diagnostic bias. Extrapolating from these findings, the script suggests the true U.S. population meeting criteria could be 21–42 million. It proposes integrating digital body maps and machine-learning alerts into clinic workflows to prompt unbiased evaluation, while emphasizing existing tools already work if applied. The script also frames fibromyalgia as nociplastic pain (central nervous system hypersensitivity), warning that proce

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

5 Lesser-Known Symptoms of Fibromyalgia: Understanding the Hidden Clues

This episode addresses the frustration of constantly feeling pain and fatigue despite normal medical tests and discusses fibromyalgia as a possible cause. It highlights five often-missed symptoms of fibromyalgia: extreme skin sensitivity (allodynia), non-cardiac chest pain (costochondritis), vision problems and sensory overload, pelvic and bladder issues (similar to interstitial cystitis), and widespread burning, tingling, or numbness (paresthesia). The goal is to provide viewers with information and validation to facilitate better conversations with their doctors, helping them feel more in control of their health. The episode emphasizes that fibromyalgia symptoms are real and offers hope for a path forward.

00:00 Introduction: The Frustration of Unexplained Pain
00:24 The Mystery of Fibromyalgia
01:11 Symptom 1: Extreme Skin Sensitivity (Allodynia)
02:49 Symptom 2: Non-Cardiac Chest Pain (Costochondritis)
05:17 Symptom 3: Vision Problems and Sensory Overload
07:11 Symptom 4: Pelvic and Bladder Issues
09:10 Symptom 5: Widespread Burning, Numbness, and Tingling
11:05 Conclusion: Empowering Your Health Journey

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...