Fibromyalgia

Latest Edit: Iva Lloyd, ND 2016-05-01 (EDT)

Fibromyalgia is a rheumatic disorder characterized by generalized musculoskeletal pain and stiffness, chronic aching, fatigue and multiple areas of local tenderness. This syndrome, along with chronic fatigue are disabling conditions that are rapidly increasing in prevalence worldwide.

Fibromyalgia

Fibromyalgia
Causes	Stress, Environmental Toxins, Smoking, Injuries, Infections, Dietary Factors
See Also	Musculoskeletal Conditions, Chronic Fatigue Syndrome, Depression, Adrenal Fatigue, Hypothyroidism, Dysbiosis, Yeast Infection, Allergies, Osteoarthritis, Rheumatoid Arthritis
Books	Books on Muscle, Joint and Bone Conditions
Articles	Articles on Musculoskeletal Conditions

Naturopathic Assessment

Check out this book	Fibromyalgia and Muscle Pain, Your Self Treatment Guide

Article	D-ribose in Chronic Fatigue Syndrome, Fibromyalgia, and Cardiac Disease , Natural Medicine, 2010 February

Article	Novel Fibromyalgia Therapy, Open Pilot Study Using a Liquid Emulsion Form of Cetyl Myristoleate , 2012 July;Vol8(7) NDNR [1]

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With fibromyalgia (FMS) the causes are variable and include trauma, chronic stress and environmental factors. A detailed assessment is required to determine which factors are contributing to fibromyalgia.

During an polling of people with FMS, 59% could identify a single event after which their symptoms began. Out of this 59%, 39% said that this event was a physical injury, 27% said that it was a major emotional shock (such as a bereavement), 15% said that it was an infection, 9% said that it was surgery, and 5% said that it was exposure to a chemical agent or drug.

Lifestyle

• Sleep

• Sleep disorders are correlated with FMS.
• FMS patients often have impaired sleep, such that they do not spend sufficient time in stage four, delta stage, sleep. It is during this stage of sleep that 80% of growth hormone is released by the body. In adults, growth hormone causes tissue maintenance and repair. Thus, if a person is not spending adequate time in stage four sleep, then the ability of their body to heal damaged tissues such as muscles is hindered. This can contribute to muscle pain. Furthermore, disturbances in stage four sleep can cause difficulty concentrating and forgetfulness, as well as fatigue and lack of energy., ,

• Dietary Factors

• Foods that commonly aggravate FMS are: sugar, wheat, dairy products, caffeine, aspartame, alcohol, and chocolate. Sugar consumption worsens yeast overgrowth in the body, as yeast thrives on sugar. Yeast overgrowth and dysbyosis can contribute to FMS.
• Deficiency of B vitamins can exacerbate thyroid problems which are common in FMS patients

Social

• Stress

• Chronic stress is associated with increased occurrence of fibromyalgia and an increase in symptom flares. High stress leads to many of the symptoms due to increased cortisol levels, which in turn cause a decrease in triiodothironine (T3), and an increase in reverse triiodothironine (rT3), contributing to a 'sick euthyroid' state.
• It is common for those with FMS to have undergone a traumatic emotional experience preceding the onset of their illness, and this is typically a traumatic experience of long duration.

Environmental

• Environmental Toxins

• Toxic chemical exposure can cause FMS.,
• 75% of FMS patients report adverse reactions to various chemicals.
• Patients with FMS have been shown to have similar results on brain scans as patients with chemical sensitivities. That is, decreased blood flow to and through certain parts of the brain that deal with memory, concentration, and pain regulating functions (specifically, the caudate nucli). The disturbance of brain blood circulation may be one of the most significant contributing factors to the symptoms of FMS.
• Sources of chemicals include; medical treatments, illicit drug use, household cleaners, new carpets, perfumes, certain types of paint, and military ammunition made of depleted/reduced uranium. Exposure to the latter can cause disturbed thyroid function, and immune system dis-regulation. The following chemicals can also cause disturbed thyroid function, which is a typical component of FMS; poly-chlorinated biphenyls, dioxin, and DDT.

• Heavy Metals

• Excess aluminum, especially in the presence of magnesium deficiency has been associated with FM.,

• Infections

• It has been postulated that fibromyalgia is associated with viral infections, bacterial infections or with Lyme disease. The list of potential infections involved include: Epstein Barr Virus (EBV), Cytomegalovirus (CMV), Human Herpes Virus 6 (HHV 6), and the Coxsackie Virus (CSV)., ,

External

• Trauma

• A majority of those with FMS had been involved in a motor vehicle accident shortly before the onset of their symptoms.
• Traumas that resulted in whiplash were associated with chronic global pain and increased risk of fibromyalgia.,

• Smoking

• Smoking increases the risk of RA.,

Medical Interventions

• Prescription Medications

• Benzodiazepines, Valium, Halcion, and Restorol are sometimes prescribed to patients with FMS to help them sleep. These drugs can interfere with stage four sleep also known as deep sleep.
• Antibiotic and steroid medication use (including the birth control pill), can cause an overgrowth of yeast, especially candida albicans. When this occurs, candida can begin to develop rhizomes that grow in the the lining of the intestines leading to intestinal hyperpermiability and the resultant increase in permeation of toxins from the gut in to the blood stream. This can then increase the incidence of allergic reactions occurring in the body, and also the toxin load.

Physiology

• Breathing

• Breathing dysfunctions are common in FMS. One of the ways that people typically respond to a stressful situation is by using the upper chest instead of the diaphragm to breathe. When this shallow breathing persists it can lead to tension in the accessory muscles of respiration which connect the neck and head with the upper ribs. This leads to pain in these muscles, and to a modification in blood chemistry that in turn provokes feelings of greater anxiety.

Diagnostic Testing

Fibromyalgia is commonly diagnosed by assessing specific tender points on the body. Other testing can include:

• Blood tests such as CBC, serum titres of CMV specific IgA/IgM antibodies, serum titres of EBV IgM antibodies, serum titres of HHV 6 IgM antibodies, NK activity, Thyroid panel including T4, T3, TSH,thyroid hormone antibody test, and serum DHEA, serum cortisol. Thyroid hormone function can be impaired in FMS patients. Thus they may have normal levels of thyroid hormones, but still have hypothyroid symptoms because of the inadequate function of their thyroid hormone. Thyroid hormone in these patients can be inactivated by their immune system, and can be poorly absorbed into tissues.
• Urine tests including Koensiburg test, Oxidata test, Urine pH, heavy metal tests.
• Other diagnostic tests including Hair Mineral Analysis, Comprehensive Digestive Stool and Parasite Analysis, basal body temperature, deep tendon reflexes, iodine patch test and orthostatic blood pressure measurement.

Related Symptoms and Conditions

FMS and chronic fatigue are similar conditions. The main difference being that in FMS, muscle pain is a more prevalent feature than fatigue.

Conditions that are commonly associated with fibromyalgia include:

• Chronic Fatigue Syndrome
• Depression and Anxiety
• Adrenal Fatigue
• Hypothyroidism
• Dysbiosis
• Irritable Bowel Syndrome
• Yeast Infection
• Allergies
• Osteoarthritis
• Rheumatoid Arthritis
• Viral Infection
• Hypothalamus-pituitary-adrenal axis (HPA) dysfunction.
• Low serotonin levels
• Multiple chemical sensitivity
• Metabolic insufficiency
• Altered cellular acid base balance

Characteristics

• Fibromyalgia mainly affects women aged 25-50 years (female to male ratio is at least 5:1).
• An increased level of muscle tissue breakdown has been hypothesized as one of the main reasons for pain, aching and fatigue.
• Tension or laxity in neck muscles can lead to impairment in the circulation of cerebral spinal fluid and may account for the symptoms associated with FMS.

Common Symptoms

The primary symptoms of fibromyalgia include:

• FMS is typically characterized by widespread muscle pain (meaning pain on both right and left sides of the body, both above and below the waist, and both along the spine and in front of the chest). This pain or muscle tenderness can be measured by touching specific anatomical sites including low cervical, second rib, greater trochanter, knees, occiput, trapezius, suprasinatus, lateral epicondyle, and gluteal. The tender points are located over muscles and tendon insertions and the discomfort can range from mildly irritating to completely debilitating. FMS is typically diagnosed when at least 11 of 18 points are tender. A number of other symptoms commonly associated with FMS include:
• Chronic aching
• Stiffness
• Sleep disturbances
• Pain
• Fatigue
• Anxiety
• Depression
• Chronic fatigue
• Gastrointestinal disturbances
• Subjective soft tissue swelling
• Cardiovascular problems (dizziness, palpitations)
• memory and concentration difficulties
• feeling tired upon waking

Energetic Patterns

From a Traditional Chinese Medicine perspective fibromyalgia is associated with the following patterns:

• Wind Bi Syndrome
• Stagnation of Qi and Blood
• Dampness

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. The treatment of fibromyalgia include symptomatic relief in order to provide the energy and ability to address the underlying causes.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Lifestyle

• Positivity, laughter, confidence, and happiness strengthen the immune system.

Lifestyle recommendations include:

• Exercise

• Regular exercise decreases widespread pain and tenderness in women with fibromyalgia. The duration and intensity of the exercise should vary according to the abilities and tolerance of the individual. Exercise is an effective way of relieving tension and stress. It also increases blood flow to the body's tissues, increases flexibility, facilitates deep sleep, decreases pain, promotes relaxation, and stimulates the release of growth hormone.

• Dietary recommendations

• Choose an anti-inflammatory diet.
• Avoid food allergies and food intolerances.
• Eat every two to three hours so to help keep the body's metabolism high.,
• Decrease or eliminate sugar from the diet as its consumption contributes to yeast overgrowth.
• Avoid caffeine, alcohol, and nicotine, as they interfere with the body's ability to manufacture energy and proteins, and to carry out biochemical reactions.

• Water. Ensure you drink adequate water.

• Posture

• Weakness of posture and increased risks of falls in common in those with fibromyalgia. Addressing postural concerns may improve the symptoms associated with the disease.

• Sleep

• Sleep is facilitated by decreasing stress, especially before bed time. Practice proper sleep hygiene,and make the place that you are sleeping in as dark as possible

• Stress

• As stress is a major contributing factor to FMS, try to limit it decreasing daily tasks and responsibilities, and by planning ahead to facilitate difficult tasks

Naturopathic Therapies

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. The primary goal those with FMS is metabolic rehabilitation. The secondary goal is to minimize as many of the factors that contribute to the disease as possible.

Article	Novel Fibromyalgia Therapy, Open Pilot Study Using a Liquid Emulsion Form of Cetyl Myristoleate, NDNR; 2012 July

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

• Clinical Nutritional Supplementation

Metabolic rehabilitation can be achieved by the administration of specific nutritional supplements that function to improve the function of the biochemical processes of energy production that occur within the mitochondria, and to protect the mitochondrial membrane and mitochondrial DNA from oxidative damage.

• Identify any existing food allergens. Decrease the consumption of animal fats to help reduce inflammation. Consume fish oil and iodine rich foods such as salt water fish, and sea vegetables.
• Vitamins such as Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5, Vitamin B6, Vitamin C, Vitamin D, Vitamin E, and Vitamin K.
• Minerals such as , , magnesium, manganese, zinc, calcium, copper, phosphorus, iron, vanadium, iodine, and selenium.
• Amino Acids such as Cysteine, Tryptophan
• Other supplements such as: Plant enzymes, melatonin, S-adenosylmethionine (SAMe), malic acid, 5-hydroxy-1-tryptophan,, , reduced glutathione,, lipoic acid, carotenoids, flavenoids, Coenzyme Q10, acetyl-l-carnitine.

• Botanical remedies such as; Astragalus (Astragalus membranaceus), Burdock (Arctium lappa), Chaste Tree (Vitex agnus-castus), Devil's Claw (Harpagophytum procumbens), Echinacea (Echinacea angustifolia), Ginkgo (Ginkgo biloba), Hawthorn (Crataegus monogyna), Licorice (Glycyrrhiza glabra) St. John's Wort (Hypericum perforatum), Withania or Ashwaganda (Withania somnifera)., Other herbs include: Bladderwrack (Fucus vesiculosus), Rosemary (Rosmarinus officinalis leaf), Goldenseal (Hydrastis canadensis),, , Siberian ginseng (Eleutherococcus senticosus), Boneset (Eupatorium perfoliatum), Cayenne (Capsicum annuum), Jamaican dogwood (Piscidia piscipula), Hops (Humulus lupulus), Hyssop (Hyssopus officinalis), Purple loosestrife (Lythrum salicaria), Wild Lettuce (Lactuca virosa) and Chamomile (Matricaria recutita tea). Nettle (Urtica dioica)

• Gemmotherapies such as Acer campestre, Ampelopsis veitchii, Betula verrucosa, Fraxinus excelsior, Tilia tomentosa

• Homeopathic remedies such as; Arnica, Bryonia, Causticum, Cimicifuga, Gelsemium, Phytolacca, Rhus tox, Ruta.,

• Traditional Chinese Medicine & Acupuncture

• Acupuncture has been shown to decrease pain and improve the quality of life of those with fibromyalgia.
• Acupuncture is not only effective in pain relief but has been shown to decrease the fatigue and anxiety associated with fibromyalgia.

• Hydrotherapy

A body temperature bath helps to calm the nervous system. Essential oils of lavender or chamomile can be added to the bath water to increase the relaxing effect. Salt glows, or rubbing wet sea or Epsom salt over the body is an appropriate therapy for FMS patients.

• Physical Medicine

• Cranial electrotherapy stimulation was found to be as effective as drug therapies in reducing FMS symptoms.
• Relieving segmental facilitation via spinal manipulation, can "lower the threshold of activation for the preganglionic sympathetic neurons, and alpha motor neurons of the involved segment."
• Craniosacral therapy can be very helpful for people with FMS.

• Detoxification

• Support liver function by detoxification. Fasting is a particularly good way to help the liver recover from toxic stress. Short fasts stimulate the production of growth hormone, which helps with tissue repair and maintenance. While fasting, people with FMS should rest, keep warm, and do as little as possible so as to divert all available energy to the repair, cleansing, and healing process that occurs during fasting.
• Removing heavy metals from the body will improve thyroid hormone conversion.

References

Co-Authored by:

Dr. Iva Lloyd, BScH, RPE, ND[2]

Dr. Raymond Trott, ND