Hi: I am a 40 year old female, who was diagnosed 14 years ago with fibromyalgia . I have hypothyroid , am on 175 mg of thyroxine and was diagnosed also with sleep apnea (although I am not large). 5 ft 6 and 59 kilos. Despite sometimes dehabilitating pain, I lead an active life, swim 4-5 times a week (1-2k), do yoga 3 times a week and go to occasional gym, as well as keep a full time job. I need to see the chiropractor and massage regularly for pain. i take 10 mg of amytriptiline a night. I have been vegetarian since I was 8, and vegan this year. I drink a lot of water, don t drink alcohol much, don t smoke , and eat a lot of fruit, and vegetables. I have a healthy diet. I have (roughly) weekly B12 shots and take B12 and flaxseed oil. I had a blood smear done yesterday which showed rouleaux quite severe, with some sugar crystals. I note there is different views on the web as to whether this is normal or not. Dr suggested it wasn t, but most of their recommendations are things I am already doing. I am surprised that high rouleaux means high protein in the diet, because given my vege/vegan diet if a/thing I would have expected it to be low. Can you give me some general advice and information on whether rouleaux is abnormal, and what is the treatment. I think I can rule out any serious forms, ie. cancer, as other more standard recent blood work has come back okay.