What is Fibromyalgia?
Fibromyalgia is a chronic condition where there is muscle pain at specific points throughout the body, often accompanied by fatigue, sleep and mood disturbances. Certain inflammatory substances produced by the nervous system, called cytokines, are elevated in patients with fibromyalgia.
What causes Fibromyalgia?
There are several theories as to what causes fibromyalgia:
Central Nervous System Hypersensitivity – Patients with fibromyalgia are thought to have a sensitized or hyperactive central nervous system that leads to an increased volume control on pain and sensory processing.
Sleep – Sleep deprivation or lack of quality sleep may play a significant role in the development of fibromyalgia.
MTHFR mutation – MTHFR is an enzyme required to convert inactive folic acid to it’s active form, 5MTHF. 5MTHF is necessary to prevent DNA damage and also to perform a liver detoxification step known as methylation. Under methylators can experience symptoms such as those in fibromyalgia.
Mitochondrial dysfunction – every cell in your body contains a tiny organelle called the mitochondria, these are the energy generators for the cell. As we age, mitochondrial function declines. Many neurodegenerative disorders, diabetes, cancer, fibromyalgia, muscular and cardiovascular diseases have been associated with poor mitochondrial function.
Mineral deficiencies – Studies have noted a correlation between low levels of zinc and the number of tender points in FM and low levels of magnesium and greater fatigue in FM patients.
Tryptophan and nicotinamide deficiencies have also been suggested as a possible cause of fibromyalgia.
What are the symptoms of Fibromyalgia?
An easy memory device for the symptoms of fibromyalgia is the word FIBRO which stands for:
F = Fatigue and Fog (cognitive dysfunction)
I = Insomnia (difficulties with all aspects of sleep including initiation, maintenance and restorative)
B = Blues (depression and anxiety)
R = Rigidity (stiffness in muscles and joints)
O = Ow! (widespread pain and tenderness)
Is there a test for Fibromyalgia?
Fibromyalgia is mainly diagnosed by ruling out other conditions that might lead to widespread musculoskeletal pain, such as rheumatoid arthritis. There are certain points when if pressed in someone with fibromyalgia, will elicit pain. I would also recommend testing for MTHFR genetic mutation and/or homocysteine (an indicator of an MTHFR defect), vitamin B12, and vitamin D.
What is the naturopathic treatment for Fibromyalgia?
Since fibromyalgia is related to a hyperactive central nervous system (CNS) response, it makes sense to take measures to calm the CNS. Addressing and improving sleep issues is also important to break the vicious cycle of poor quality sleep and increased pain.
- Vitamin B12 is important for healthy nervous system function. Studies have shown improvement in fibromyalgia (FM), with vitamin B12 injections along with folic acid supplementation.
- Vitamin D – low vitamin D levels have been found in patients with chronic pain and heightened central sensitivity.
- CoQ10 – Coenzyme Q10 is important for normal function of mitochondria and it’s a powerful antioxidant.
- Aloe vera – Research has found that aloe vera significantly reduces the inflammatory cytokines IL-8, TNFα, IL-6 and IL-1β in a dose dependent manner.
- Vitamin B1 – Case reports using high dose thiamine treatment in FM found a significant reduction in symptoms after treatment with vitamin B1.
- Address mineral deficiencies – Supplementing zinc and magnesium may help reduce the number of tender points and improve fatigue in FM.
- Address potential tryptophan and/or nicotinamide deficiencies.
A multidisciplinary approach is best to reduce the abnormal cycle of pain amplification and the related potentially exacerbating behaviours. Beneficial non-drug therapies include aerobic and resistance exercise, stretching, and cognitive behavioral therapy (CBT).
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