Fibromyalgia

fibromyalgia woman in pain all over

Fibromyalgia

Naturopathic Treatment for Fibromyalgia (FM)

What is Fibromyalgia?

Fibromyalgia is a chronic condition.  The symptoms of fibromyalgia include:

Certain inflammatory substances produced by your immune system, called cytokines, are increased in patients with this condition.

What Causes Fibromyalgia?

There are several theories as to what causes it:

Central Nervous System Hypersensitivity

Patients with FM are thought to have a sensitized or hyperactive central nervous system. This means that they have an increased volume control on pain and sensory processing.

Sleep

People with FM often also suffer from insomnia or lack of quality sleep.  Lack of sleep then contributes to the symptoms.

MTHFR mutation

MTHFR is an enzyme required to convert inactive folic acid to its active form, 5MTHF.  5MTHF is necessary to prevent DNA damage and also to perform a liver detoxification step known as methylation.  Poor methylators can experience symptoms such as those in this disease.

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, their function declines.  Many disorders including diabetes, FM, muscular and cardiovascular diseases have been associated with poor mitochondrial function.

Mineral deficiencies

Studies noted a correlation between low levels of zinc and the number of tender points in FM.  Low levels of magnesium correlate with greater fatigue in FM patients.

Tryptophan and niacinamide deficiencies

Deficiencies of tryptophan and niacinamide have also been suggested as a possible cause of fibromyalgia.  Tryptophan is an amino acid.  Niacinamide is a form of vitamin B3, or niacin.

Inflammation

Inflammation is what leads to pain.  There are multiple triggers for inflammation:  food sensitivities, latent infection, diet, unhealthy gut and even hormone imbalances.

What are the symptoms of Fibromyalgia?

An easy way to remember the symptoms of this disease is the word FIBRO which stands for:

F = Fatigue and Fog (foggy thinking)

I = Insomnia (difficulties with all aspects of sleep including getting to sleep, staying asleep, and quality of sleep)

B = Blues (depression and anxiety)

R = Rigidity (stiffness in muscles and joints)

O = Ouch! (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.  These other conditions include autoimmune diseases such as rheumatoid arthritis and lupus.

There are certain trigger points that will cause pain if they are pressed in someone with fibromyalgia.  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 natural treatment for Fibromyalgia?

Since this issue 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 and stiffness.

Vitamin B12

B12 is important for healthy nervous system function.  Studies have shown improvement in FM, from supplementing vitamin B12 along with folic acid.

Vitamin D

Low vitamin D levels correlate with chronic pain and heightened central nervous system sensitivity.

CoQ10

Coenzyme Q10 is important for the normal function of your mitochondria.  It’s a powerful antioxidant.

Aloe vera

Research shows 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 (B1) treatment in FM found a significant reduction in symptoms after treatment.

Address mineral deficiencies

Supplementing zinc and magnesium may help reduce the number of tender points and improve fatigue in FM.

Tryptophan and Niacinamide

Address potential tryptophan and/or niacinamide deficiencies.

Reduce inflammation

Identify food triggers and eliminate them either through testing or elimination diet.  Treat latent infections.  Ensure a healthy gut. Balance hormones.   Sure you can take anti-inflammatories.  They can help temporarily relieve the symptoms.  But, they are just suppressing the symptoms, not dealing with the underlying issue.

Other Approaches

A multidisciplinary approach is best for long-term pain relief in FM patients.  This approach reduces the abnormal cycle of heightened pain and the related consequences, like lack of sleep and mood disorders.

Beneficial non-drug therapies for fibromyalgia include aerobic and resistance exercise, stretching, and cognitive behavioural therapy (CBT).

For help with this or any other health problem, book an appointment here or call the clinic for more information at 416-481-0222.

by Dr Pamela Frank, BSc(Hons), ND

Fibromyalgia References

Clauw DJ. Fibromyalgia and Related Conditions. Mayo Clin Proc. 2015 May;90(5):680-692. doi: 10.1016/j.mayocp.2015.03.014.

Boomershine CS. Fibromyalgia: the Prototypical Central Sensitivity Syndrome. Curr Rheumatol Rev. 2015 Jun 18. [Epub ahead of print]

Sleep

Choy EH. The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol. 2015 Apr 28. doi: 10.1038/nrrheum.2015.56. [Epub ahead of print]

Vitamin B12

Regland B, et al. Response to vitamin B12 and folic acid in myalgic encephalomyelitis and fibromyalgia. PLoS One. 2015 Apr 22;10(4):e0124648. doi: 10.1371/journal.pone.0124648. eCollection 2015.

Vitamin B6

Nichols TW Jr, Gaiteri C. Morton’s foot and pyridoxal 5′-phosphate deficiency: genetically linked traits. Med Hypotheses. 2014 Dec;83(6):644-8. doi: 10.1016/j.mehy.2014.09.003. Epub 2014 Sep 16.

Vitamin D

von Känel R, et al. Vitamin D and central hypersensitivity in patients with chronic pain. Pain Med. 2014 Sep;15(9):1609-18. doi: 10.1111/pme.12454. Epub 2014 Apr 14.

Gheita TA, et al. Vitamin D status in rheumatoid arthritis patients: relation to clinical manifestations, disease activity, quality of life and fibromyalgia syndrome. Int J Rheum Dis. 2014 Oct 7. doi: 10.1111/1756-185X.12426. [Epub ahead of print]

CoQ10

Garrido-Maraver J, et al. Clinical applications of coenzyme Q10. Front Biosci (Landmark Ed). 2014 Jan 1;19:619-33.

Cordero MD, et al. NLRP3 inflammasome is activated in fibromyalgia: the effect of coenzyme Q10. Antioxid Redox Signal. 2014 Mar 10;20(8):1169-80. doi: 10.1089/ars.2013.5198. Epub 2013 Sep 19.

Zinc and Magnesium

Sendur OF, et al. The relationship between serum trace element levels and clinical parameters in patients with fibromyalgia. Rheumatol Int. 2008 Sep;28(11):1117-21. doi: 10.1007/s00296-008-0593-9. Epub 2008 May 22.

Aloe Vera

Budai MM, et al. Aloe vera downregulates LPS-induced inflammatory cytokine production and expression of NLRP3 inflammasome in human macrophages. Mol Immunol. 2013 Dec;56(4):471-9. doi: 10.1016/j.molimm.2013.05.005. Epub 2013 Aug 1.

Vitamin B1 (Thiamine)

Costantini A, et al. High-dose thiamine improves the symptoms of fibromyalgia. BMJ Case Rep. 2013 May 20;2013. pii: bcr2013009019. doi: 10.1136/bcr-2013-009019.

Niacinamide

Blankfield A. Kynurenine Pathway Pathologies: do Nicotinamide and Other Pathway Co-Factors have a Therapeutic Role in Reduction of Symptom Severity, Including Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM). Int J Tryptophan Res. 2013 Jul 21;6(Suppl 1):39-45. doi: 10.4137/IJTR.S11193. Print 2013.

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