Fibromyalgia and Nutritional Support
Renata Trister DO
Fibromyalgia is one of a group of chronic pain disorders that affect connective tissues, including the muscles, ligaments (the bands of tissue that bind together the ends of bones), and tendons (which attach muscles to bones). It is a chronic condition that causes widespread muscle pain, “myalgia,” and excessive tenderness in many areas of the body. Many patients also experience fatigue, sleep disturbances, headaches, and mood disturbances such as depression and anxiety. Despite ongoing research, the cause, diagnosis, and optimal treatment of fibromyalgia are not clear.
In the United States, fibromyalgia affects about 2 percent of people by age 20, which increases to approximately 8 percent of people by age 70; it is the most common cause of generalized musculoskeletal pain in women between 20 and 55 years. It is more common in women than men. Most people initially develop symptoms between the ages of 30 and 55.
The cause of fibromyalgia is unknown. Various physical or emotional factors may play a role in triggering symptoms. Although the pain is felt in muscles and soft tissues, there are no visible abnormalities at these sites. The muscles and tendons are excessively irritated by various painful stimuli. This is thought to be the result of a change in pain perception, a phenomenon termed “central sensitization.” Other conditions may also develop as a result of central sensitization, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), chronic headaches, and chronic jaw and facial pain.
As research studies continue, the factors that lead to chronic pain in fibromyalgia will be better understood, hopefully allowing for the development of better treatments.
Despite the large number of symptoms, there is no generally agreed-upon explanation for how or why central sensitization develops. The most plausible theory suggests that some people have a genetic predisposition to fibromyalgia because of a heightened sense of pain. In other people, various stressors, including infection, physical or emotional trauma, sleep disturbances, or other medical conditions allow for the development of fibromyalgia.
The chance of developing fibromyalgia is increased eightfold in family members of a person with fibromyalgia compared with people in the general population. Similar genetic factors are noted in people with irritable bowel syndrome, depression, and migraines. Various conventional treatment modalities have been tested in fibromyalgia patients; unfortunately, these are often ineffective and may result in adverse side effects. A natural approach that incorporates nutritional support for the body processes implicated in the pathogenesis of fibromyalgia holds great promise for the millions suffering from this chronic syndrome.
There are no specific laboratory or imaging tests used to diagnose fibromyalgia. Thus, the diagnosis is typically based upon a thorough patient history, a complete physical examination, and blood tests, which are used to exclude conditions with similar symptoms.
The American College of Rheumatology (ACR) developed classification criteria for fibromyalgia in 1990 that have often been used to help make the diagnosis. According to the ACR, people can be classified as having fibromyalgia if they have the following symptoms and findings:
●Widespread musculoskeletal pain
●Excess tenderness in at least 11 of 18 specific sites known as “tender points”
Fibromyalgia can be diagnosed by a tender point examination. Mildly irritating to completely debilitating tenderness in at least 11 of 18 defined points, such as in the neck, spine, shoulders, and hips, signifies FM.
Nervous System: Toxin Exposure
Every day we are exposed to numerous toxins such as pesticides, food additives (e.g., MSG, aspartame), and chemicals that can adversely affect various bodily functions, including nervous system function. Excessive toxin exposure can result in increased and prolonged pain sensation by the nervous system, contributing to the chronic pain associated with FM.
Digestive System: Intestinal Tract Abnormalities
Data suggest that up to 70% of patients with FM complain of symptoms associated with irritable bowel syndrome (IBS), such as chronic abdominal pain, alternating diarrhea and constipation, morning stiffness, and fatigue. Since IBS and FM have overlapping symptoms, it has been suggested they may have a common cause.
It is further theorized that dysfunction in nerve pathways between the intestinal tract and the brain help to explain the increased pain sensitivity and fatigue in FM.
Muscular System: Mitochondrial Dysfunction
Mitochondrial dysfunction is thought to be a possible cause of FM. Mitochondria are found in all cells of the body, but a re highly concentrated in muscle cells. They are responsible for cellular energy production. Decreased cellular energy production in muscle cells can result in increased muscle stiffness, pain, and fatigue in FM patients.
Endocrine System: Hormone Imbalance
Many patients with FM have experienced significant amounts of stress, which can contribute to abnormalities in the endocrine system. The endocrine system regulates hormone (e.g., serotonin, cortisol, thyroxine) production by portions of the brain, as well as by the adrenal and thyroid glands. Imbalanced hormone production caused by stress can contribute to the increased fatigue, sleep disturbances, and psychological distress experienced by FM patients.
Conventional Medical Approaches
Doctors may prescribe antidepressants, sleeping pills, muscle relaxants, and/or pain-relief medications. Unfortunately, none of these medications have been shown to be of significant benefit and they can cause adverse side effects (e.g., headache, nausea, stomach bleeding).
A Natural Treatment Approach
In addition to a healthy diet and regular exercise program as prescribed by your healthcare provider, incorporating a basic nutritional regimen that addresses the abnormalities previously discussed may be of benefit.
What a Basic Nutritional Supplement Program for FM Patients May Include.
Nutritional Supplement / Area of Support
Multivitamin/Mineral Formula / Overall health and energy levels
Mitochondrial Antioxidant Formula / Muscular system: comprehensive mitochondrial support
Malic Acid/Magnesium Complex OR Magnesium/Potassium Aspartate Complex / Muscular System: mitochondrial energy production
Bifunctional Detoxification Support Formula / Nervous system: elimination of toxins
L. Acidophilus NCFM and Bifidobacteria / Digestive system: intestinal health and function
LIFE WITH FIBROMYALGIA
Most people with fibromyalgia continue to have chronic pain and fatigue. After an average follow-up of 14 years, one study found that there is usually little change in the patient’s symptoms. However, two-thirds of patients reported that they were working full-time and that fibromyalgia interfered only modestly with their lives. These studies are from specialists; there is evidence that people with fibromyalgia in the general population often get better with little or no treatment.
Many people with fibromyalgia worry that their symptoms represent the “early stages” of a more serious condition, such as lupus. Long-term studies of people with fibromyalgia do not indicate that there is an increased risk of other rheumatic diseases or neurologic conditions. Fibromyalgia is not life-threatening, although it can affect the quality of day-to-day life. The severity of this impact depends upon a number of factors, including the patients’ medical, family, and social supports; their financial status; and their past experiences.
One of the most important factors in a person’s long-term prognosis is the person’s ability to take charge, to avoid “catastrophizing,” and to learn to cope well with symptoms while remaining as active as possible.
Staying active, avoiding toxins and nutritional support can improve and help manage the symptoms.