Excerpts from “Fibromyalgia: A Nutritional Approach,” by William Hennen, PhD
Introduction
Fibromyalgia (FM) is a syndrome characterized by widespread musculoskeletal pain and tenderness at specific sites, fatigue, and unrefreshing sleep. Fibromyalgia (FM) afflicts predominantly middle aged women. Research investigations have shown a disturbed microcirculation in painful muscles, a decrease in adenosine triphosphate and phosphocreatine, and a reduced relaxation rate. Pain analyses indicate that the pain is nociceptive, meaning that there is an abnormally high pain sensitivity. A characteristic physiological sleep disturbance is also one of the main symptoms of FM. The cause(s) of FM is not known, though it may be different in different patients. FM is a clinical entity, but should be regarded as a syndrome rather than a disease.
The difference between a syndrome and a disease is that a disease is a condition with a clearly identifiable causative agent while a syndrome is a set of symptoms which define the condition without a single consistent causative agent upon which to place the blame. Thus a cold is a disease because a viral infection can be identified as the causative agent.
Fibromyalgia is a syndrome because the identifiable factors vary even though the symptoms are present. This can be likened to the operation of a car. A car will not run if its gas tank is empty. On the other hand, a car with a full gas tank still will not run if its battery is dead. Thus a whole list of functions must be present for a car to run properly while the absence of any one function is sufficient to prevent the car from running. The human body is infinitely more complex than a car and many more functions must be working properly for the body to operate efficiently. The body unlike the car has an interest in its own wellbeing. The body has many self-healing mechanisms and many self-compensating mechanisms. If given the right tools, sufficient time, and correct instructions the body can heal itself.
Comorbidities
Fibromyalgia has also been found to be related to a number of other conditions including chronic fatigue immune deficiency syndrome (CFIDS), major depressive disorder, myofascial pain syndrome, Sjogren’s syndrome, irritable bowel syndrome, temporomandibular joint (TMJ) syndrome, premenstrual syndrome (PMS), tension and migraine headaches, primary dysmenorrhea, mitralvalve prolapse, and sympathetic hypersensitivity, muscle deconditioning and microtrauma, muscle spasm and ischemia, and sexual abuse.
Need for a Holistic Approach
With so many correlations and contributing factors it is hard to determine which is the cause and which is the effect in analyzing fibromyalgia. It may also be the case that each of these factors may contribute slightly and in an additive manner resulting in overall poor performance and pain. Such an additive relationship may not be apparent especially when tests show that the individual parameters are all within the normal range albeit on the lower end of the range. This effect can be visually depicted as a spiral staircase with each step leading either up or down depending on whether the factor is improving or degrading thus leading to the proverbial “vicious cycle” or its opposite, the “precious cycle.”
Foods
Different people respond differently to the foods they eat. Some do better on a high carbohydrate diet some do better on a high protein diet. Because of the different response rates we have to the different carbohydrate-fat-protein ratios of our diet it is best to investigate what your best food ratios are rather than follow whatever trend is currently popular. A self-scored questionnaire format has been developed and is available to those who wish to get some guidance in determining the proper food ratios for themselves as and individual.
Supplements
Supplementation is important for all of us but it is especially critical for fibromyalgia sufferers. The section on Nutritional Supplementa- tion goes through a detailed discussion of the various supplements that have been beneficial in relieving fibromyalgia.
Exercise
Dr. Joe Elrod’s book Reversing Fibromyalgia details an exercise program specifically designed for improving both strength and flexibility. Readers are referred to this text for specific exercise guidelines.
Stress Management
A psychosomatic syndrome is defined as a syndrome in which psychological processes play a substantial role in the etiology of the illness in some of the patients. The extent of the biological and psychosocial contributions vary among these syndromes as well as among individuals with the same syndrome. The phenomena of the somatoform disorders are caused by clustering of psychosomatic syndromes or their incomplete or atypical manifestations and a low sensation threshold.
Psychiatric Diagnostic Interview data failed to discriminate in any major way between primary fibromyalgia syndrome and rheumatoid arthritis. These data do not support the psychopathology model as the primary explanation of the symptoms of primary fibromyalgia syndrome. Other clinicians similarly have observed that psychological factors are detectable in only a low percentage of their fibromyalgia patients. Nevertheless instruction in coping strategies in a structured pain school have been shown to be a useful addition to other treatments of fibromyalgia. Family support is also a great advantage to fibromyalgia sufferers in their day-to-day struggles with pain and depression. On the other hand emotionally traumatic events, such as sexual abuse, do not appear to be specific factors causing fibromyalgia, but they are correlated with the number and severity of associated symptoms.
Nutritional Support
Magnesium and Malic Acid: significant reductions in pain/tenderness severity could be achieved during extended treatment with high doses of magnesium and malic acid.
B-Vitamins: All fibromyalgia and chronic fatigue syndrome patients tested were found to have elevated homocysteine levels in their central nervous systems and B-Vitamins can lower homocysteine levels.
Glucosamine and Cartilage: Glucosamine accelerates the repair of tissue injuries and cartilage preparations exerted a protective effect on the heart. These soft tissue affects are in addition to the documented benefits of glucosamine and cartilage hydrolysates on joint function and pain reduction.
Methylsulfonylmethane (MSM): has demonstrated the remarkable ability to reduce muscle soreness, and cramps. MSM also helps alleviate the pain associated with systemic inflammatory disorders.
Boswellia Serrata: is a traditional Ayurvedic treatment for joint pain and inflammation. Boswellia serrata was found to have slow acting long term anti-inflammatory effects, which are beneficial to those suffering from adjuvant induced arthritis.
Cysteine and Derivatives: Cysteine plays a critical role in supporting the body when faced with skeletal muscle wasting and fatigue conditions.
Glutathione: The altered redox state in patients with RA indicate an important role for N-acetyl-L-cysteine (NAC) in the restoring of glutathione (GSH) levels in hyporesponsive joint T cells.
General Antioxidants: Cysteine and N-acetyl-L-cysteine (NAC) are good antioxidants in their own right separate from their role as glutathione precursors. Some of the conditions in which cysteine and NAC are important include ulcerative colitis, lens damage from low level radiation, and rheumatoid arthritis.
Creatine: A patent has been issued for the use of certain creatine preparations for treatment of fibromyalgia and other types of myopathy and cachectic states.
Hormonal Supplementation and Herbal Calmatives
Melatonin: regulates the sleep-wake cycle by inhibiting the mechanism used by the central nervous system to generate wakefulness.
Griffonia Simplicifolia: is a natural source of 5-Hydroxytryptophan(5-HTP). The high prevalence of migraines in the population of fibromyalgia sufferers suggests a common ground shared by fibromyalgia and migraine. Enhancing serotonergic analgesia while increasing adrenergically mediated analgesia seems to be an important tool in fibromyalgia.
Pregnenolone: receptor-active neurosteroids may represent an important class of neuromodulators that can rapidly alter central nervous system excitability via novel nongenomic mechanisms. Pregnenolone may significantly reduced exploratory anxiety.
St. John’s Wort: has consistently matched the antidepressant efficacy of synthetic antidepressants such as amitriptyline, imipramine, and maprotiline. St. John’s wort extracts, light therapy (LT), and specific antide- pressants have been shown to be beneficial.
Kava: is another herbal extract used for its calming effects on people with anxiety disorders which in some cases is recommended over synthetic psychopharmacological agents.
Summary
Chronic conditions like fibromyalgia are difficult to manage and frustrating for both the patient and the caregiver. But when patience can be applied and confidence achieved, a positive relationship can result and the patient can be helped.
Knowing exactly which of the multiple causative factors may be present in your fibromyalgia condition may be helpful and even comforting. Putting a face on our fears brings them to a manageable size. Identifying the source of our pain helps us focus our energies constructively. It is increasingly apparent, however, that there is not likely to be any one factor that is affecting us but rather a multitude of small contributions. None of these are necessarily significant by themselves, but taken together they can be a tremendous burden.
Through a comprehensive, holistic program of diet, exercise, stress management including adequate deep refreshing sleep, and supplementation, small additive changes can culminate in an optimal personal wellness.
We hope that those of you who suffer from fibromyalgia or know someone who suffers from fibromyalgia will be able to take courage and obtain hope from the information we have discussed above. Fibromyalgia is real and there are real solutions. Finding the approach that will most closely match your personality and individual metabolism are key to recovering from fibromyalgia and going on to leading a more rich and fulfilling life.
