Nora Apothecary Nora Apothecary

Fibromyalgia

Sandra Justice, P.D., FACA

Between three and six million Americans, 70-88% of which are women, suffer from fibromyalgia syndrome (FMS). FMS is characterized by pain in the muscles and bones, trouble sleeping (or waking up feeling tired), and multiple tender points to the body. FMS, while different for everyone who has it, tends to come and go throughout life. It is not deforming, degenerative, life-threatening, or imaginary.

SIGNS AND SYMPTOMS
  • Dizziness
  • Fatigue
  • Headaches
  • Irritable bowel syndrome
  • Joint pain and swelling
  • Memory lapses
  • Morning stiffness
  • Pain after exertion
  • Paresthesia (tingling)
  • Psychological disturbances
  • Skin sensitivity
  • Sleep disorders
  • Raynau’s phenomenon
  • Restless leg syndrome
WHAT CAUSES IT?

The tendency to get FMS may be inherited. Illness, autoimmune dysfunction, sleep disturbances, or physical trauma such as an accident often precedes FMS symptoms. Many patients report a history of psychological problems, such as depression or anxiety.

TREATMENT OPTIONS
Drug Therapies

The most widespread treatment approach to fibromyalgia involves the use of various pharmacological agents. Tricyclic antidepressant medications increase the amount of serotonin in the central nervous system and increase the delta-wave sleep stage and are found to improve the symptoms of FMS, though not by acting as an anti-depressant and not in all patients. Combinations of various antidepressant and sedative medications have been tried as well. Side effects from antidepressants include drowsiness, confusion, seizure, agitation, nightmares, blurred vision, gastrointestional disturbances, constipation, urinary retention, impotence and mouth dryness.

Pain in bones and muscles can be treated with lidocaine, procaine, and cortisone (injected into trigger points) or with capsaicin (used topically).

Alternative Therapies

1. Nutrition Individuals suffering from FMS benefit from a basic hypoallergenic diet, plus detection and elimination of food and chemical allergies. Common allergenic foods are dairy, soy, citrus, peanuts, grains except rice, corn, all refined carbohydrates, red meats, tomatoes, and processed foods. Remove suspected allergens from the diet for two weeks. Reintroduce one food every three days. Watch for reactions such as gastrointestinal upset, mood changes, flushing, fatigue, and worsening symptoms. A rotation diet, in which the same food is not eaten more than once every four days, may reduce sensitivities.

Beverages such as alcohol, caffeine, and artificial sweeteners may worsen sleep disturbances. Carbonated beverages high in phosphates should be eliminated since they deplete calcium and magnesium from the body. These two minerals are usually already deficient in FMS sufferers.

Vegetarian diets that exclude dairy and eggs and use flaxseed oil, evening primrose oil, borage oil, and canola oil provide more linoleic and linolenic essential fatty acids. These stimulate the production of anti-inflammatory components that block pain and inflammatory effects. An alternative way to get more of these anti-inflammatory essential fatty acids from the diet is to consume more cold-water fish such as salmon, trout, mackerel, swordfish, shark, cod, and halibut. These fish contain high concentrations of omega-3 fatty acids, which blunt the inflammatory or allergic response. Whole foods such as vegetables, fruits, and protein are a good addition to this alternative diet.

The following nutritional supplementation may help reduce FMS symptoms:

Vitamin C (1,000mg three to four times per day) reduces swelling and helps your immune system function better.

Coenzyme Q10 (50 to 100mg one to two times per day) improves oxygen delivery to tissue and has antioxidant activity.

Chromium picolinate (200 mcg with meals) may reduce reactive low blood sugar which may make your symptoms worse.

Magnesium (200mg two to three times per day) with malic acid (1,200 mg one to two times per day) relieves pain and fatigue.

5-Hydroxytrytophan (100mg three times per day) may help with depression and insomnia.

B vitamins help reduce the effects of stress:

B-complex (50mg to 100mg per day), niacinamide (100mg per day), and B6 (100mg per day). Melatonin (0.5 to 3mg one time before bed) may help sleep. Zinc (30mg per day) is essential for proper immune function.

Phosphatidyl choline and phosphatidyl serine (300mg per day) may help depression and improve memory. Consider hydrochloric acid supplementation as deficiency is associated with most autoimmune diseases.

2. Herbs Herbs are generally a safe way to strengthen and tone the body’s systems. The following herbs may help increase resistance to stress and strengthen the immune system. Siberian ginseng, Echinacea, gotu kola, and astragalus root. These may need to be taken for four to six months for maximum benefit.

Herbs that alleviate pain and nervous tension include the following: black cohosh, kava kava, and valerian. Essential oils of jasmine, lemon balm, rosemary, and clary sage relieve nervous exhaustion and may be used in aromatherapy.

3. Exercise Daily, gentle, low-impact aerobic exercise has been stated to be helpful in rehabilitation from FMS. One reason may be that exercise increases the time spent in deep sleep. Sedentary patients should start out with three to five minutes of exercise every day and increase, as tolerated, up to 20 to 30 minutes a day. The methods of exercise best suited to FMS patients are cycling (static cycle), walking, or swimming. Exercise works best if the patient avoids exercising the most painful muscles. Patients must be careful not to overdo physical activity because this may trigger a relapse.

4. Acupuncture Acupuncture treatment may be helpful in stimulating circulation and promoting a sense of well-being. Electroacupuncture in particular has an excellent track record in treatment of pain. Acupucture is used to suppress neural hyperactivity for short periods which can lead to decreased use of pain killing medications and significant increase in quality of sleep. The fact that there are virtually no side effects from electroacupuncture make it attractive when compared with pain killing and /or antidepressant medication.

5. Other treatments Other treatment protocols advocated for FMS patients include massage to reduce stress and improve circulation, warm Epsom salt baths to soothe aching muscles, supportive homeopathy therapy, antifungal regimes and probiotics to improve nutrient absorption in the intestinal tract, hormonal therapies to boost the immune system, and participation in support groups to help you manage your condition.

PREGNANCY

Fibromyalgia may be exacerbated in pregnancy. Dietary changes may be safely followed, however, nutritional supplements and herbs should be used only with caution.

PATIENT MONITORING

As with any therapy, it is important to ascertain a diagnosis before pursuing treatment. Even natural protocols should only be initiated under the guidance of a health professional trained in alternative medicine.

HEALTHY ROUTE TO PAIN RELIEF?

Fibromyalgia is still poorly understood. Since traditional treatments to date have met with little to no, brief success, perhaps the focus should be on improving the overall health status of FMS patients. Nutritional support and exercise play an important role in improving cellular communication, enhancing the immune system, and supporting the endocrine functions of the human body and show promise in benefiting fibromyalgia patients.