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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 a

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

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...