You may require extra supplementation People with FMS have unbalanced neuroendocrine systems. This can start a neurotransmitter cascade of imbalances. A thyroid antibody test may be needed in some cases. A 24 hour cortisol may not be relevant, since your cortisol may swing wildly through the night and day, but the median may be fine. You may need slightly more specific testing to get accurate results.
Paradoxical breathing is a major perpetuating factor, and it is often overlooked.
Your belly should expand when you inhale, and go in when you exhale. Paradoxical breathing is shallow breathing, and causes oxygen starvation. Focus on breathing correctly to flood your body with life-giving oxygen to help you heal. Air hunger can be compounded if the neurotransmitter histamine is in overabundance, and other neurotransmitters are creating extra mucus or constriction in the air passages. Anything which cuts down the available oxygen to the muscles can perpetuate TrPs.