Fibromyalgia – What Your Doctor Won’t Tell You

Fibromyalgia

Fibromyalgia is the name given to chronic, widespread muscular pain that has no obvious cause. The pain, usually described as aching, stiff, burning, or throbbing, may appear in any location of the body, but for a diagnosis of fibromyalgia to be made, you must have pain in at least eleven of eighteen specific “tender points.”

The tender points for fibromyalgia exist in pairs (one on the right side of your body and one on the left) at the following locations:
• Base of the skull
• Base of the neck
• Upper chest, a little more than an inch below the collarbone
• Along the top of the shoulder
• Upper back, close to the spine and about an inch below the preceding set of points
• Inside of the elbows
• Lower back, close to the dimples above the buttocks
• Upper outside edge of the thigh
• Inside of the knees If you are testing yourself for a reaction to these points, you must touch them with enough pressure to whiten your fingernail. A doctor who is knowledgeable in the diagnosis of this condition can test these points for you.

The pain from tender points and elsewhere in the body usually feels most severe upon waking and gradually lessens as the day goes on.

Although the pain of fibromyalgia alone can be so severe as to render its victims disabled, the disease can be complicated by any of several other problems. Fibromyalgia is closely linked to chronic fatigue syndrome, and many of its sufferers experience symptoms similar to those of chronic fatigue syndrome (see the symptom Iist further on). Irritable bowel syndrome, premenstrual syndrome, palpitations, and temporomandibular joint syndrome (TMJ) may also be present.


FibromyalgiaAs with chronic fatigue syndrome, there is currently no one agreed-upon cause for this disease. In most cases, many factors combine to produce the varied components of fibromyalgia. Disordered sleep is a very common problem with this condition. The length and the quality of sleep must be improved for long-term success in most cases of fibromyalgia. Also, hormone imbalance is quite common. Particularly, low thyroid function and imbalances in estrogen/progesterone, as well as in the stress hormones DHEA and cortisol. Digestive function and detoxification usually need improvement to help people with fibromyalgia. Along with this digestive weakness come leaky gut syndrome and candida overgrowth, as well as general dysbiosis. Chronic infections that include viruses can be a factor. Food allergies are a significant contributor for some people, especially allergies to wheat, sugar, and cow’s milk. As well, nutritional deficiencies, of magnesium, B vitamins, coenzyme Q1O, L-carnitine, and several others, are very common. We have also found that many people with fibromyalgia have a brain chemistry imbalance. Using natural therapies to balance serotonin and other neurotransmitters results not only in a better mood but in less muscular pain. Toxic elements, such as lead, mercury, arsenic, and others, can also be one of the root contributors to fibromyalgia. These toxic elements interfere with the normal enzyme and cell function in the body. In addition, blood-sugar imbalances worsen pain and inflammation. Many people develop symptoms of fibromyalgia after a car accident, and thus structural abnormalities must be addressed through physical therapies. Chiropractic, osteopathic, and craniosacral therapy; physiotherapy; and sometimes massage are very helpful in reducing pain.

In essence, all of these potential imbalances lead to a defect in how the cells produce energy. Normally, the “energy-producing plant” of the cells, known as the mitochondria, produces efficient energy for the cells of the body. When a defect occurs in mitochondrial metabolism, it can lead to a shortage of energy for the muscle cells and other tissues of the body, resulting in fatigue and pain. Mitochondria require organic acids that are intermediaries in metabolic pathways in the body that create energy. Researchers have found that people with fibromyalgia often have imbalances in these organic acids. To correct this problem, one must address the root causes, as have been described. Fortunately, a comprehensive natural approach to fibromyalgia is very effective in eliminating the pain or greatly improving it.

SYMPTOMS

For a diagnosis of fibromyalgia to be made, two factors must be present:
• Unexplained, widespread pain that lasts at least three months
• Pain in at least eleven of the eighteen tender points when gentle pressure is applied

Many other symptoms may exist alongside the pain, including the following:
• Fatigue fibromyalgia
• Premenstrual syndrome (PMS)
• Sleep disturbances
• Temporomandibular joint syndrome (TMJ)
• Irritable bowel syndrome
• Anxiety
• Heart palpitations
• Depression
• Heightened sensitivity to loud noises, bright lights, and changes in the weather
• Difficulty concentrating
• Memory problems
• Dizziness
• Headaches
• Tingling of the skin or other odd sensations

ROOT CAUSES

• Sleep disorder (fibromyalgiaincluding apnea)
• Allergies or sensitivities to certain chemicals, food, or the environment
• Chemical imbalance in the brain, especially of serotonin
• Virus (especially Epstein-Barr, HHV-6, cytomegalovirus)
• Hormone imbalance
• Damage to cells by free radicals (oxidative stress)
• Poor digestion and detoxification
• Toxic metals
• Blood-sugar imbalance
• Candidiasis and parasites
• Nutritional deficiencies, especially of minerals
• A build-up of phosphate or uric acid
• Structural abnormalities (spine and soft tissues)
• Emotional stress
• Overexertion

Testing Techniques

The following tests help assess possible reasons for fibromyalgia:
• Chronic infection (human herpes virus type 6 [HHV-6], cytomegalovirus [CMV), Epstein-Barr virus [EBV] ➜ blood
• Blood pressure ➜ blood pressure cuff
• Hormone testing (thyroid, DHEA, cortisol, testosterone, IGF-1, estrogen, progesterone) ➜ saliva, blood, or urine
• Intestinal permeability ➜ urine
• Vitamin and mineral analysis (especially for magnesium, B1, B12, iron, and CoQ10) ➜ blood
• Digestive function and microbe/parasite/candida testing ➜ stool analysis
• Food and environmental allergies/sensitivities ➜ blood, electrodermal
• Blood-sugar balance ➜ blood
• Toxic elements (such as mercury, arsenic, etc.) ➜ urine, hair
• Cellular energy (organic acids) ➜ blood or urine
• Amino acids ➜ blood or urine
• Detoxification profile ➜ blood or urine

TREATMENT

Diet

Recommended Foods

Follow a sound diet that is based on whole, unprocessed foods. Emphasize raw or lightly cooked vegetables, especially greens, and other foods that are high in nutrients and fiber.

To keep up a steady supply of energy to your muscles, eat lots of lean protein: beans, raw nuts, soy products (fermented only), fish, chicken, and turkey are all good sources and plan on several meals throughout the day, instead of three large ones.

Eat some live unsweetened yogurt or other cultured food daily to combat candidiasis.

Omega-3 fatty acids help the body create prostaglandin, a hormone that reduces inflammation. Flaxseeds and flaxseed oil, as well as fatty fish, are excellent sources of omega-3 fatty acids.

Fibromyalgia has been linked to a magnesium deficiency, so make sure to consume foods that are high in this mineral, including green leafy vegetables, kelp, soybeans, cashews, and almonds.

Vitamins A, C, and E together help fight free radicals, whose presence may inhibit cells’ ability to produce energy. For vitamin A, eat plenty of colored vegetables (especially the green, leafy ones) and milk. Good sources of vitamin E are soybeans, broccoli, brussels sprouts, whole grains, and, again, green leafy vegetables.

Drink a glass of clean water every two waking hours. You’ll flush out toxins and reduce pain.

Foods to Avoid

Determine whether a food allergy is causing or contributing to your pain. Read about Food Allergies and follow the elimination diet there or have a nutrition oriented doctor test your food sensitivities or allergies.

Mineral deficiencies have been linked to fibromyalgia, so avoid caffeine, which interferes with their proper absorption. Caffeine also contributes to sleep disturbances.

Reduce or cut out fried and junk foods. They contribute to inflammation and pain, as well as to insomnia; in addition, they slow your circulation and deplete your stores of energy.

AVOID SUGAR. It increases pain, weakens the immune system, disturbs sleep, saps your energy, and encourages the growth of Candida albicans, a fungus that some believe is a cause of fibromyalgia. The most common sources of sugar are sodas and processed food, but you also need to severely restrict your intake of natural sugars, like honey and even fruits.

Dramatically reduce your intake of processed food and carbonated drinks. These items are full of food additives that will only aggravate your condition.

Detoxification

A detoxification program can help improve cellular energy production. Follow the previous dietary suggestions, especially regarding fiber and water intake, and try these additional recommendations:

Follow a juice fast for three days for an initial cleanse, but limit your intake of sweet fruit juices. Instead, use vegetable and green drinks, along with unsweetened lemon or cranberry juice.

Seven Super Prescriptions for Fibromyalgia

Super Prescription #1 Magnesium Take 250 mg two to three times daily. Magnesium glycinate and magnesium aspartate are the preferred forms. Magnesium is important for cellular energy production and relaxes the nerves and the muscles.

Super Prescription #2 Malic acid Take 1,000 to 1,200 mg twice daily. Malic acid is important for cellular energy production.

Super Prescription #3 5-Hydroxytryptophan (5-HTP) Take 50 to 100 mg three times daily. This amino acid is a precursor used by the brain to manufacture the neurotransmitter serotonin, which reduces pain, improves sleep, and improves mood.

Super Prescription #4 Methylsulfonylmethane (MSM) Take up to 10,000 mg daily in divided doses. Start with 1,000 mg three times daily, and increase the dosage until pain relief is evident. Reduce the dosage if diarrhea occurs.

Super Prescription #5 S-Adenosylmethionine (SAMe) Take 400 mg twice daily. SAMe is a naturally occurring nutrient that improves the balance of neurotransmitters such as serotonin; improves detoxification; and helps with cartilage formation.

Super Prescription #6 Vitamin B12 Have your doctor inject you with 1 cc twice weekly for four weeks and then once weekly or as needed. It can also be taken in the sublingual form, up to 1,000 mcg daily of the methylcobalamin form.

Super Prescription #7 Enzymes Protease enzymes taken on an empty stomach have an anti-inflammatory and pain relieving effect. Take as directed on the container.

A double-blind, placebo-controlled study of fifty people with fibromyalgia looked at the effect of 100 mg of 5-HTP, taken three times daily for thirty days. In people supplementing with 5-HTP, significant improvement was found in their pain severity, morning stiffness, sleep patterns, anxiety, and fatigue.

A double-blind trial involving 800 mg of SAMe (S-adenosylmethionine) per day for six weeks found significant benefit for people with fibromyalgia in regard to pain, fatigue, stiffness, and mood. SAMe has been shown in numerous studies to also be effective for depression and osteoarthritis.

General Recommendations

• A high-potency multivitamin provides a base of nutrients required for cellular energy production. Take as directed on the container.
• Coenzyme Q10 supports cellular energy production. Take 200 to 300 mg daily.
• Acetyl-L-carnitine supports cellular energy production. Take 500 to 1,000 mg daily.
• Calcium relaxes the nerves and the muscles. Take 500 mg Calcium citrate twice daily, along with 5,000 IU of vitamin D3.
• Milk thistle (Silybum marianum) supports liver detoxification. Take 250 mg of a 80 to 85 percent silymarin extract three times daily.
• Vitamin E has anti-inflammatory benefits. Take 800 IU daily.
• Vitamin C has anti-inflammatory and immune-enhancing benefits. Take 2,000 mg two to three times daily to bowel tolerance.
• Grape seed extract or maritime pine bark improves circulation and has anti-inflammatory effects.
• Take 100 mg two to three times daily.
• Alpha lipoic acid is an antioxidant that supports detoxification. Take 100 to 200 mg daily.
• N-acetylcysteine supports detoxification and helps produce glutathione. Take 500 mg daily.
• NADH supports cellular energy production. Take 10 to 20 mg on an empty stomach.
• Passionflower (Passiflora incarnata) relaxes the nerves. Take 300 to 500 mg in capsule form or 1 ml of tincture three times daily. It can also be taken before bedtime to help with sleep.
• Valerian (Valeriano officinalis) relaxes the nerves. Take 300 to 500 mg in capsule form or 1 ml of tincture three times daily. It can also be taken before bedtime to help with sleep.
• Olive leaf extract (Olea europa) is good if you have a chronic viral infection. Take 500 mg three times daily.
• A probiotic is important for digestive function and immunity. Take a product containing at least 4 billion active organisms daily.
• Thyroid controls cellular energy and mood. If your levels are low, work with a knowledgeable doctor to use natural thyroid hormone (such as Armour or compounded T4/T3 or T3).
• DHEA reduces stress and inflammation. If your levels are low, work with a doctor to normalize your levels. The normal starting dosage is 5 to 15 mg daily.
• Natural progesterone can be helpful for women with fibromyalgia. Premenopausal women should apply 1/4 teaspoon (20 mg equivalent) to the inside of their forearms one to two times daily on days 14 to 28 of their cycle. Menopausal women should apply 1/4 teaspoon (20 mg equivalent) to the inside of their forearms twice daily for three to four weeks of the month. Postmenopausal women should apply 1/8 teaspoon (10 mg equivalent) to the inside of their forearms once daily for 3 weeks of the month.
• Estrogen, cortisol, and testosterone need to be prescribed, based on your levels, by a doctor who is knowledgeable in natural hormone replacement.
• Ginkgo biloba improves circulation and memory. Take 60 to 120 mg of a 24 percent flavone glycoside extract three times daily.
• Fish oil supplies pain-relieving omega-3 fatty acids. Take a fish oil product containing at least 480 mg of EPA and 360 mg of DHA twice daily.
• Flaxseed oil supplies pain-relieving omega-3 fatty acids. Take 1 to 2 tablespoons daily.
• Evening primrose (Oenothera biennis) oil contains gamma linoleic acid (GLA), which decreases inflammation and pain. Take 2,000 mg daily.
• A greens drink containing super green foods, such as Chlorella, spirulina, barley grass, and others, supports detoxification and energy production. Take as directed on the container.
• Melatonin promotes sleep. Take 0.3 to 0.5 mg a half hour before bedtime.
• Black cohosh (Cimicifuga racemosa) is a good hormone balancer and relaxes spasms of the muscles. Take 40 mg of a 2.5 percent triterpene glycoside extract twice daily.
• Cordyceps sinensis supports adrenal gland function. Take 800 mg twice daily of a standardized product.
• Arnica (Arnica montana) oil relieves muscle pain and tenderness. Apply the oil to painful areas twice daily.

Homeopathy

Pick the remedy that best matches your symptoms in this section. Take a 6x, 12x, 6C or 30C potency twice daily for two weeks to see if there are any positive results. After you notice improvement, stop taking the remedy, unless symptoms return. Consultation with a homeopathic practitioner is advised.

• Arnica (Arnica montana) is the top choice for pain that feels deep and bruised and for all-over tenderness. Symptoms are worse after exertion.
• Bryonia (Bryonia alba) is for pain that is aggravated by the slightest movement. Muscles feel better with cool applications and pressure and feel worse with warmth. The person is irritable and does not want to be touched.
• Calcarea Carbonica is for people who get muscle soreness from exertion and cold, damp climates. They are usually chilly, with clammy hands and feet. There is a craving for sweets and eggs. There are often symptoms of anxiety and a feeling of being overwhelmed and easily fatigued.
• Causticum is helpful when the muscles and the joints become stiff and sore from overuse and from the cold or dry weather. Symptoms are improved with warm applications. The muscles and the joints feel contracted.
• Cimicifuga is for muscles that feel sore and bruised and worse in the cold. The back of the neck is sore and stiff. The person is prone to depression and hormone imbalance.
• Ignatia (Ignatia amara) is for tight, spasmodic, or cramping muscles and fibromyalgia that comes on from stress or emotional upset.
• Magnesia Phosphorica is for cramping or spasming muscles that feel better with warm applications.
• Nux Vomica (Strychnos nux vomica) is for tight muscles that spasm. The person is chilly, and the symptoms are worse in cold weather and better with warm applications. Digestive problems, such as stomach ache or heartburn, are often present. The person is irritable and fatigued.
• Pulsatilla (Pulsatilla pratensis) is helpful if your pain moves from joint to joint, and if you feel tearful and depressed. Fibromyalgia is often connected to the menstrual cycle or hormone imbalance.
• Rhus Toxicodendron is for pain and stiffness that’s worse in the early morning or after resting and during cold, rainy weather. Symptoms ease with continued movement and warm applications. The person feels restless.

Accupressure

• Conception Vessel 17 supports the immune system and also eases depression and anxiety.
• Stomach 36 improves the body’s ability to absorb nutrients. It will also lend general support to the digestive system, a helpful quality if you have irritable bowel syndrome.
• To relax cramped muscles and soothe your nerves, use Liver 3.
• Pericardium 6 relieves anxiety, indigestion, and heart palpitations.
• Bladder 38 quiets tension and promotes sleep.

Other Recommendations

Accupuncture has a good track record of relieving fibromyalgia pain. Search for agencies that can provide you with lists of qualified acupuncturists in your area.

Bodywork

Many fibromyalgia sufferers have found that bodywork is quite helpful for easing pain and stress. Try several of the following techniques, as everyone responds differently…

Chiropractic or Osteopathic Manipulation: This improves structural alignment and nerve flow.

Massage: A gentle all-over massage eases pain and brings down stress levels. Lymphatic drainage massage supports the immune system by detoxifying the tissues. This kind of massage is especially supportive during a fast.

Reflexology: Because fibromyalgia is a systemic, whole-body disease, it is best to work the entire foot, with special attention to the parts corresponding to the areas of your body that hurt.

Hydrotherapy: Hot or warm water can feel wonderful to fibromyalgia sufferers. Try taking a hot shower in the morning, when the pain is likely to be at its worst; at night, when you might have trouble sleeping, try a warm bath. Saunas and heated compresses are other pleasant ways to relax your muscles. Constitutional hydrotherapy is a good long-term treatment.

Other Bodywork Recommendations

Postural therapies, such as the Feldenkrais method and the Alexander technique, help you move with greater ease and less strain. They are a good option for sufferers who can tolerate only the gentlest treatments. Contact a local specialist to learn more.

Aromatherapy

Add oils to a bath for additional pain-relieving qualities. Chamomile, lavender, and rosemary will reduce inflammation, and black pepper, ginger, and eucalyptus stimulate circulation and blood flow to the muscles.

If you don’t have access to a bathtub, here’s another way to use any of the previous oils: Add 25 drops of the oil to 2 quarts of boiling water. Soak several strips of cloth in the mixture, and let them cool to a comfortably warm temperature. Wrap the cloths around the painful area.

Juniper and melissa oils help break down toxins. Add them to a base oil, and use it as a detoxifying supplement to a lymphatic massage.

To reduce stress, experiment with a number of oils until you find the ones you like best, then alternate them so that you don’t become inured to their effects. Some good choices to begin with are chamomile, jasmine, lavender, and rose. Almost any preparation method will work (except a straight application to the skin), but for all-day stress relief, you might like to diffuse the oil into the air of your office or room.

Stress Reduction

General Stress-Reduction Therapies

Consider positive mental imagery, meditation, and prayer a first line of defense against the symptoms of fibromyalgia. Regular meditation is both refreshing and calming. It improves your concentration and memory and, when used just before bedtime, can help you sleep. Biofeedback helps you learn to improve the way your body responds to stress.

It’s not a bad idea to supplement your daily meditation with a yoga class once or twice a week. Yoga relaxes your body and mind, improves digestion, and can ease both joint and muscle pain.

Bach Flower Remedies

• Consult Bach Flower Remedy charts to find the best remedy for your personal situation. Once you’ve chosen a remedy, place 10 drops of the liquid under your tongue. Hold the drops in place for thirty seconds and swallow. Use as often as needed.
• Rescue Remedy is available in cream form. When your pain is particularly acute, rub a little of the cream onto the affected area.
• If you are overexerted and burned out, take Hornbeam.
• Aspen is for people with vague, un-namable fears that result in insomnia or nightmares.
• Olive is the remedy for people who are so exhausted that daily life is robbed of all pleasure.
• lf you have given up the belief that you’ll ever feel better again, try Gorse.

Other Recommendations

• Magnet therapy can be helpful to reduce pain. Work with a practitioner who is knowledgeable in this area.
• Moderate, nonjarring exercise is one of the best treatments for fibromyalgia.
• Daily exercise for half an hour (a brisk walk or a swim are excellent choices) is far preferable to less frequent but more vigorous workouts. Studies show that people with fibromyalgia who exercise regularly have less symptoms than those who are inactive. Get adequate rest. Most of us need at least eight hours a day; if you need more, however, by all means take it. Overexertion will only aggravate your symptoms.

REFERENCES

Caruso, I., P. Sarzi Puttini, M. Cazzola, and V. Azzolini. 1990. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. Journal of Internal Medicine Research 18(3):20 1- 9.

Jacobsen S., B. Danneskiold-Samsoe, and R. B. Andersen. 1991. Oral S-adenosylmethionine in primary fibromyalgia: Double-blind clinical evaluation. Scandinavian journal of Rheumatology 20:294-302.

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