Dr. George B. Isaac MD - Fibromyalgia (FM) is a common, yet not well-understood a disorder that affects thousands of persons. The word fibromyalgia comes from
the Latin term for fibrous tissue (fibro) and the Greek term for muscle (myo)
and pain (algia). It is marked by widespread muscle pain, fatigue, and multiple
tender points on specific areas of the body. The challenges with FM are that
the symptoms are not clearly visible, and it cannot be diagnosed by a
particular blood test or marker. As such, FM is still associated with stigma
among both medical professionals and the public. For those with FM, not being
understood can be just as painful as the symptoms of the disease.
Defining Fibromyalgia
The American College of Rheumatology (ACR) has established
two criteria for the diagnosis of FM: a history of widespread pain lasting more
than 3 months and the presence of 11 or more tender points out of 18 standard
sites on the body (neck, shoulders, back, hips, and upper and lower
extremities).
Theories - Causes
While there are various theories and contributing factors,
the underlying cause(s) are not known. For many sufferers, there is an event or the experience that triggers the onset of the disease, such as an infection,
emotional stress, trauma, injury or exposure to certain drugs or chemicals.
According to a recent paper in the Annals of Internal Medicine, 33 percent of
FM patients also suffer from multiple chemical sensitivity.
Dr. George B. Isaac MD -
FM seems to run in families.
Researchers have identified one gene believed to be involved in the syndrome. A new 4-year study funded by the National Institutes of Health (NIH) will examine
this further.
Those with rheumatoid arthritis and other autoimmune
diseases, such as lupus, appear to be at greater risk for developing FM.
Individuals with FM have elevated levels of a chemical,
called substance P that is involved in our sensation of pain signals. They also
have lower levels of serotonin and norepinephrine - two very important chemical
messengers in the brain that modulate pain as well as mood.
A recent study has demonstrated that an imbalance of
oxidants and antioxidants may be at play in the development of FM. Researchers
from found significantly increased
levels of the oxidant malondialdehyde and decreased levels of the antioxidant
superoxide dismutase in patients with FM compared to controls.
Treatment for FM
A comprehensive program that includes counseling (emotional
support), proper nutrition, exercise, stress management and the use of various
supplements to reduce symptoms and improve well-being offers the greatest
benefit for FM sufferers. In some cases, medication may be required to control
pain, inflammation and insomnia, however, it is always best to try the non-drug
approaches first.
Dr. George B. Isaac MD - The following nutritional
supplements have been studied for their benefits in FM:
SAMe - short for S-adenosylmethionine, this nutrient is
involved in many biochemical reactions in the body, including the production of
neurotransmitters (serotonin), antioxidants, hormones, and the sulfur-containing
compounds of the joint. Levels are depleted with age and in those with
depression, liver disorders, and osteoarthritis. SAMe has been studied for FM
and found to alleviate pain, fatigue, and stiffness and improve mood. SAMe is
very safe and not associated with the unpleasant side effects seen with
prescription antidepressants. The recommended dose is 800 mg of natural
(Iso-Active) SAMe daily. It is best to choose a firm that is enteric-coated.
Take on an empty stomach.
5-HTP - short for 5-hydroxytryptophan, this supplement
helps to boost serotonin levels and alleviate depression symptoms. It may also
be helpful in reducing tender points, anxiety and improving sleep quality.
It is not good to combine this supplement with prescription antidepressants or
other drugs that modify serotonin levels. The recommended dose is 100 mg three
times daily.
Melatonin - this hormone is responsible for regulating
our sleep cycles. Supplementing with melatonin may help to shorten the time needed
to fall asleep, reduce night-time wakening and improve sleep quality. In one
study 3 mg of melatonin at bedtime was found to reduce tender points and to
improve sleep and other measures of disease severity.
Antioxidants - preliminary research has found that
vitamin E supplements could be helpful in improving the symptoms of FM.
Considering the new research on the oxidant-antioxidant imbalance seen in FM,
it makes sense to consider supplementing with a good antioxidant. Most
multivitamin formulas contain antioxidants like vitamins E and C. Some formulas
also contain hot new antioxidant ingredients like pomegranate, blueberry and
cranberry, which offers a range of health benefits.
Magnesium - one study found that a combination of
magnesium (300-600 mg) and malic acid (1200-2400 mg) helped to reduce muscle
pain in people with fibromyalgia.
Since stress is known to aggravate the symptoms of FM, it is
important to find ways to cope effectively. Here are some tips to consider:
· Relaxation techniques, such as breathing exercises,
meditation and yoga
· Regular exercise, such as walking, swimming, stretching
and Pilates
· Healthful diet - lots of fresh fruits, vegetables, whole
grains, lean protein, and essential fats
· Positive outlook - counseling and cognitive therapy can be
very helpful
· Sleep - important for overall well being
· Minimize alcohol, caffeine, and consumption of fast food
and processed food (which are full of dangerous chemicals and preservatives)
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