Fibromyalgia Treatment

Meeting a new doctor

2019-10-15T00:03:00.002-07:00

I sympathise with you if you’re dissatisfied with your doctor but afraid to find a new one. Some positive self-talk can help in such a situation. You don’t have to leave the doctor you have until you’ve found one more suitable, so seeing a new doctor won’t leave you without medical care if the visit doesn’t yield positive results. Seeking a doctor better able to help you is not an act of disloyalty to your current doctor. Moreover, it is an important step on the way to improving the quality of your own life, which should be your most important consideration. There is a saying among people who earn their living in sales: each ‘no’ brings you one step closer to your next ‘yes’. I suggest that each non productive meeting with a new doctor brings you that much closer to the right doctor for you. What’s really at risk in meeting a new doctor is the price of the office visit. While that’s not trivial, it fades in importance compared to your need and desire to be as healthy as you can be.

Take the time required to prepare for your meeting with a doctor you hope to hire for your medical care committee. Write a brief medical history listing in separate sections child- hood illnesses and immunisations, major illnesses, surgeries, injuries,

and allergies. Add a section for fibromyalgia symptoms, including date of onset of each, what you tried and with what results. You probably have a great deal to say about each of these categories. Write it all out, but then edit carefully, omitting as many extraneous details as you can and leaving out descriptive words such as severe, terrible, and so forth. Be as factual and unemotional as you can. Although you’re talking about yourself, your written information will make the best impression if you can present it in a detached manner, somewhat the way a doctor would write to another one about a patient, except that you’ll use your own words, not medical jargon.

Then write a covering letter in which you introduce yourself as a human being, not a medical case. Again, be as concise as you can be, but let the doctor know of your distress at the situation in which you find yourself. Stress your desire to feel well and be able to function fully. Say that you have done what you could do to educate yourself about fibromyalgia, and that you are looking for someone who will help you learn more about self-management of the condition. Mention the actions you are taking to improve your well-being, and add that you are open to suggestions of more and better things to try. In doing this, you will make it clear that you are trying hard to take a positive approach and are not expecting a miracle on the first visit. If that doesn’t show the doctor that you are a person worthy of help and capable of being helped, nothing will and you may as well stay with the doctor you are currently seeing.

If there’s time, mail your letter and history to the doctor in advance of your appointment. Go to the appointment with a written list of two or three of your most pressing questions or problems. Be sure that the material you prepared is given to the doctor.

Try to meet the doctor while you are still fully clothed so that the first impression you create is of an adult in control of herself and trying to be well, not a sick, submissive person. If you must disrobe first, at least be seated in a chair and not upon the examining table when the doctor walks in, stand up if you can and offer to shake hands. This is the way you establish the relationship as one of adult to adult, rather than child to parent or, perish the thought, worshipper to a god.

Over several decades and more disappointments than I can count, I have learned to view my relationship with my doctor as a business relationship in which I am buying the doctor’s time and advice based on her training and knowledge. I once asked my doctor–before I signed on to her service–if she would have a problem knowing that I intended to use her as my consultant and make my own decisions. She beamed. ‘That’s exactly what I want, too,’ she said. When we meet to solve a health problem of mine, we know that we are bringing different perspectives and collections of knowledge to bear, and we work as a team,

respectful of each other.

Your advocate

The third member of your basic medical team is your advocate. This should be someone you trust: your spouse, life partner, a family member, or a good friend. Most often your advocate will be an almost-silent partner, available if you need help and someone with whom to explore ideas and strategies. When you are in crisis, however, you may want your advocate to speak for you and will surely want her or him to accompany you on your visit to the doctor. My husband drove me to the visit during which I got my FM diagnosis because I was too sick to drive myself. I wanted him in the examining room with me because I was in such bad shape cognitively that I didn’t trust myself to remember what the doctor said. Since then there have been times when I needed his company, but I make sure that he knows the results anytime I see or speak with my doctor. He has my medical power-of-attorney, a legal form on file in my medical records with a copy at home where he can find it. He has the authority to make decisions on my behalf if ever I am unable to speak for myself. I find it very reassuring to have this arrangement and recommend it to you.

Think of this triad–your doctor, your advocate and you–as the steering committee that oversees your health care. If you think you need a referral to a specialist, that might well be a decision for the steering committee. The right doctor for you is one willing to recognise when he or she lacks the specific knowledge you need and to refer you to a specialist for a consultation. In the best of circumstances, though, the specialist will suggest a course of treatment or action to you and your doctor but will not continue to treat you unless the situation demands it. It is of utmost importance that your GP know the details of your treatment.

Otherwise, you risk having prescriptions that conflict with each other, possibly causing adverse interactions. There are exceptions to this requirement of extensive communication between GP and specialist, however, in the case of a referral for emotional counseling–often a very good idea if you are new to this diagnosis and need some time to express anger and grief.

Also, auxiliary medical professionals such as physios and occupational therapists don’t need to report in detail, but your GP should know if you are seeing them.

Standing up for yourself

You need to stand up for yourself in all matters pertaining to your medical care. You have the right to receive respectful, considerate, nondiscriminatory treatment at all times, to take part in all decisions pertaining to your medical treatment and to get a full explanation, in terms you can understand, of the pros and cons of any course of action.

Publication details

The Fibromyalgia Relief Book: 213 Ideas for Improving Your Quality of Life

by Miryam Ehrlich Williamson

ISBN 1-86508-265-1 (paperback)

Living with Chronic Pain

2019-10-14T23:59:00.001-07:00

This article first appeared in the Fibromyalgia Magazine. Why not subscribe and receive the latest Fibromyalgia News every month?

It may not be easy, but you can find ways to live with your chronic pain. Some key ways to succeed at this are to regularly evaluate your pain and pain-fighting strategies, identify and stick with treatments that work, seek out social and psychological support and involve your health-care provider as a trusted collaborator. The specific approach will vary from person to person, but anyone with chronic pain can make the following changes to better manage his or her condition.

Learn about your condition.
Have regular medical checkups.
Take your pain medications.
Keep an open mind.
Make adjustments.
Try not to let pain define you.
Get busy. Learn about your condition. Although sometimes there’s no explanation for chronic pain, it is often associated with a well-known, even common condition, such as arthritis, fibromyalgia or migraine. Look on the Web or at your local library for organizations devoted to helping people with these problems.
Have regular medical checkups. The cause of chronic pain may be difficult to identify initially, but it may become clear over time. Seeing your health-care provider regularly will reduce the chance that something is missed. In addition, your health-care provider can tell you about any new therapies that may have become available.

Regular medical care may also prevent the source of your pain from getting worse or my head of new problems...

Take your pain medications. Medications are a central part of most pain-management programs. It’s often important to stay a step ahead of your pain, taking pain drugs on a routine schedule. Unfortunately, however, pain medications may be associated with side effects. These side effects can make sticking with a medication program hard. Some patients may give up, opting to endure their pain instead.

However, some of the side effects associated with pain medications diminish over time. For example, antidepressants may initially cause mouth dryness, which will improve by itself over a few weeks. And problems such as constipation, nausea, and anxiety that may accompany chronic pain or its treatment can be effectively treated. If the medications your health-care provider has prescribed are making things worse rather than better, don’t give up. Talk with your health-care provider about your alternatives.

Keep an open mind. There may be a complementary or alternative treatment that makes little sense to you (or to your health-care provider), but if it is safe, you will know if it works for you only if you try it. Some conventional treatments were once considered alternative until clinical trials proved that they worked. In the case of today’s complementary of alternative treatments, you should not deny yourself the chance to reap their possible benefits, especially if conventional therapies have failed.

Make adjustments. Recognizing pain, rather than denying it, does not mean you are giving in to it. Making changes in your life to reduce pain is not an admission that you are not trying to get better, nor does it mean you never will. For example, you may need to change your preferred exercise, from jogging to swimming or reduce the intensity of your exercise regimen. You may need to use devices that will reduce pain, such as wrist supports or special ergonomic chairs. Such changes may be needed only temporarily. Bear in mind that “playing through pain,” rather than making accommodations, can make things worse when you have chronic pain.

Try not to let pain define you. For some people, efforts to eliminate chronic pain dominate their life. Their pain controls them. Unfortunately, this single-minded focus can be counterproductive, as it can push away your family, friends and even health-care providers who seek to help. It can prevent you from participating in activities that can make chronic pain endurable. And it can fuel anger, depression, and isolation — a vicious cycle that can make the pain worse.

Collaboration with a health-care provider is essential to ensure you are following the most current, aggressive pain treatment program. And support groups or individual counseling for people with chronic pain can provide the perspective and coping strategies needed to put chronic pain in its place.

Get busy. You must learn to strike a balance between managing your pain and living as full and outwardly focused life as possible. Focusing on aspects of your life other than pain can be liberating, as it can actually reduce the pain you feel. When the brain has something else to do, it can modify pain signals, suppressing them (for example, an athlete distracted by the game may not feel an injury until after the game is over). Many people with chronic pain find that a hobby, career interest or family or other social activities can reduce the effect of pain on their lives by shifting their focus away from the pain.

The Art of Drawing a Blank Fibromyalgia and Memory

2019-10-14T23:42:00.001-07:00

Okay, so you’re still looking for that slip of paper with your doctor’s new phone number on it. And you have yet to recover from the embarrassment of driving around town with the grocery bag perched on top of your car. And you still worry that your new boss will never forgive you for “blanking” on his name when you tried to introduce him to an important client. In short, it’s hard to deny that your memory just isn’t what it used to be. Does that mean you have a problem? If so, is fibromyalgia (FM) the cause? Or is there some other culprit? Or both? The answers to these questions may surprise you.

This article first appeared in the Fibromyalgia Magazine. Why not subscribe and receive the latest Fibromyalgia News every month?

What probably won’t surprise you is that to date very little research has been done on the subject of memory and FM. This article will explore available findings and offer insights which will at the very least help you make peace with yourself. First, a few basics on how memory works (and when it doesn’t). As is widely known, there are two types of memory: short-term and long-term. Short-term memory, also known as active or working memory, consists of the day-to-day details that people consciously pay attention to at any one time: the physical objects that surround them, the conversations or sensory information they are taking in, and the activities or projects in which they are engaged. In contrast, long-term memory is a permanent storage area where factual information, recollections of personal experiences, and knowledge of particular skills (i.e., riding a bike or driving a car) are retained.

Psychologist Kenneth Higbee, Ph.D., compares short-term memory to the in-basket on an office desk which has a limited capacity to hold information and must, therefore, be “emptied” regularly before new material can be placed there. [1] Information which is emptied is either discarded permanently (i.e., the phone number of a local carryout restaurant that you look up but don’t need to remember) or is sent on to long-term memory, a series of filing cabinets used for permanent storage. Unlike short-term memory, long-term memory has virtually unlimited capacity and is not easily disrupted by environmental “noise”. It also changes very little with age. It is helpful to think about memory as consisting of three stages: (1) the acquisition of information, (2) the storage of information, and (3) the retrieval of information when it is needed. When we forget things, we tend to blame our retrieval powers.

However, according to Cynthia Green, Ph.D., of the Memory Enhancement Program at Mt. Sinai (NY) School of Medicine, the most common reason that healthy adults have problems with memory is because of their failure to focus on new information. [2 ] In other words, they aren’t paying very good attention in the first place so they never actually learn the new material they will later try to remember. Of course, people often fail to pay proper attention to things that aren’t particularly interesting to them or have a little emotional impact. However, there are also a number of factors that simply get in the way of memory and can cause even “healthy” people significant problems. Many of these factors are also relevant to people with FM.

Factors Which Interfere With Memory
Multiple Tasks: Many people suffer from information overload. They may have many competing tasks to perform during a given period of time or have pressing demands from a wide variety of sources (work, family, friends, etc.). As a result, they must process an amazing amount of information, some of which come at them with a speed or complexity which makes remembering difficult. Ironically, simple things that should be easily recalled (like the location of car keys or even the car itself) are frequently forgotten because they involve routine activities (i.e., parking the car) which are done quickly and often unconsciously amidst a maze of other involvements.

Emotional State: Depression and anxiety are two variables which have been a central focus in the study of memory. Depression is of interest because it can cause problems with attention, perception, speed of cognitive response, problem-solving, and memory and learning. [3] People who are depressed tend to be preoccupied with other concerns and find it difficult to concentrate on new tasks, particularly those requiring prolonged attention or the complex processing of information. The good news is that when depression gets better, either with time or with medical treatment, memory usually improves as well. [4]

The term “stage fright” is already familiar to most people. Many comic sketches have portrayed actors or comedians fumbling desperately for lines they have spent hundreds of hours memorizing. Thus, it is no surprise to learn that anxiety can be a formidable foe to the acquisition, storage, and retrieval of information, though it can be beneficial in boosting performance in small doses. [5]
Fatigue: Whether from lack of restful sleep, overdoing it, or conditions like sleep apnea, fatigue can have significant effects on memory because it often impedes attention and concentration. Some researchers also believe that it makes retrieving information from long-term memory difficult, even familiar or easy-to-remember items. [6] Likewise, stress in general (particularly chronic stress) can have a negative effect on memory because it is a powerful distraction and contributes to fatigue.

Medications: If you take medications regularly for fibromyalgia, you already know that they can cause grogginess or other side effects which make concentration and recall difficult. Antihistamines, anti-anxiety drugs, painkillers, beta-blockers, and some anti-depressants are particular culprits in this regard. Drug interactions can be problematic as well. While it may be imprudent for FM patients to discontinue medications which happen to impair memory, knowing that such side effects exist can also provide peace of mind. Maybe your memory isn’t so faulty after all!

Illness: There is no question that illness or disease can interfere with memory. Not only can a cold or the flu impair one’s ability to retain or recall information, but many chronic conditions like diabetes, hypertension, endocrine imbalance, and multiple sclerosis can also worsen memory. [7] There is also mounting evidence that chronic fatigue syndrome, a medical condition which overlaps with fibromyalgia, can cause difficulties with recall. In many chronic health conditions, impairment often improves as the underlying illness is treated.

This article first appeared in the Fibromyalgia Magazine. Why not subscribe and receive the latest Fibromyalgia News every month?

What is fibromyalgia?

2019-10-08T05:19:00.001-07:00

Fibromyalgia

What is fibromyalgia?
Fibromyalgia, or fibromyalgia syndrome (FMS), is a condition
where the whole body is affected by pain and tenderness for
more than three months. People with fibromyalgia often have
other symptoms, including poor sleep, difficulty concentrating,
and problems with their bladder and bowels.
Fibromyalgia is thought to be a disorder of how pain signals are processed in the spine and brain. People with fibromyalgia feel constant pain, but this is not due to problems in the joints,
bones or muscles. Some features are similar to chronic fatigue
syndrome (known as CFS, or ME). Fibromyalgia cannot be
diagnosed with blood tests, X-rays or scans. Doctors should
make a diagnosis through listening to people’s descriptions of
their symptoms, performing a physical examination (which may
include checking for tender points) and other tests to exclude
other causes of constant pain and fatigue.
Fibromyalgia is a group of symptoms, which is why it is classed
as a syndrome. It is not classed as a form of arthritis, because
the pain is not caused by swelling or damage to the joints.
However, like arthritis, it causes pain and fatigue or severe
tiredness.
It is not known what causes fibromyalgia. However, research
suggests there may be specific problems with the way people’s
bodies work. Studies of brainwaves show that people with
fibromyalgia do not get enough deep sleep. Research has also
uncovered problems with the central nervous system (the
spine and brain) in people with fibromyalgia. The parts of their
brain that register pain react differently, so they feel pain when others would just feel uncomfortable or stiff.

Morgan Freeman Speaks About His Fibromyalgia

2019-10-04T23:22:00.001-07:00

Morgan Freeman Speaks About His Fibromyalgia

A little over a year ago, Esquire magazine published an insightful article about Morgan Freeman. During a day spent with Freeman at his home in Mississippi, the author of the article Tom Chiarella recalls noticing Freeman was in pain, as they walked around his property Freeman revealed to him that he was a long-time sufferer of fibromyalgia. Below is an excerpt from the original article.

Every so often he grabs his left shoulder and winces. It hurts when he walks when he sits still when he rises from his couch, and when he missteps in a damp meadow. More than hurts. It seems a kind of agony, though he never mentions it. There are times when he cannot help but show this, the fallout from a car accident four years ago, in which the car he was driving flipped and rolled, leaving Freeman and a friend to be pulled from the car using the Jaws of Life. Despite surgery to repair nerve damage, he was stuck with a useless left hand. It is stiffly gripped by a compression glove most of the time to ensure that blood doesn't pool there. It is a clamp, his pain, an icy shot up a relatively useless limb. He doesn't like to show it, but there are times when he cannot help but lose himself to a world-ending grimace. It's such a large gesture, so outside the general demeanor of the man, that it feels as if he's acting.

“It's the fibromyalgia,” he says when asked. “Up and down the arm. That's where it gets so bad. Excruciating.” source.

How I Found Relief From My Fibromyalgia Pain

By Elaine Riley

I was diagnosed with Fibromyalgia 7 years ago. I had severe pain in my shoulders every day since I was 16. Later it made its way into my lower rib areas as well. When I was 16 I fell off a swing and landed straight on my back. Nothing broke, nothing cracked. But I remember lying on my back that day, with the wind completely taken out of me, in excruciating pain and thinking….am I dying? I couldn't move that day. I laid on the ground paralyzed with pain until an ambulance came. After the MRI's and X rays, the doctors told me I luckily didn't break anything, but I had several severely bruised vertebra.

That was the day my life changed.

Months after the accident I could not kick the pain. Sleeping became a problem and life started getting frustrating and painful. Every move I made I felt my fibro pain, although at that time my doctors told me it was all in my head and I didn't know it was indeed my “fibro” pain, not yet.

7 years. It took me 7 years. Why did I waste so much time?

After a couple years of being told I'm crazy, I was finally diagnosed with fibromyalgia. It was a huge sense of relief followed by a huge feeling of overwhelming disappointment. On one hand, I was relieved to hear someone tell me the things I have been experiencing were real, and other people out there were going through the same thing. Being able to finally put a name to what I was suffering from gave me a great sense of relief as well. Finally, we knew what was wrong and now we can fix it. Right? ………………Wrong.

In the same conversation with my Doctor, I was informed of the available treatments. To my shock, he told me that research on treating fibromyalgia was in it's “infancy” and currently there was only 1 recommended treatment…Lyrica. A pain medication. I was blown away.

Not only was I not interested in taking a prescription for the rest of my life, but Lyrica didn't help me much and also made my groggy. After a month of Lyrica, I knew this wasn't for me. I stopped taking my prescription and thought I was destined to live with this pain forever.

7 years later

Fast forward 7 years. One April morning I decided that enough was enough. I knew that if something didn't change I would continue down this downward spiral for the rest of my life. I couldn't take it anymore. I knew I needed a change.

I started reading everything I could find on fibromyalgia. Unfortunately, there wasn't much out there. I turned to the internet and started posting on all the help boards I could find. Looking for someone, anyone who had success treating their fibromyalgia.

Eventually, I found Cindy Sparling and the Fibromyalgia Treatment Group. I was lucky enough to be able to speak with Cindy on the phone. To my amazement, her story was so similar to mine.

“It all started five years ago when I was involved in a serious rear-end car accident. I was hospitalized, and my recovery took much longer than was expected. I started experiencing serious pain and inflammation which seemed to move throughout my body. I had been experiencing tender spots all over my body, especially my back. I had trouble sleeping.

Cindy went on to create the Fibrolief Support Formula and offered it to me for free if I recorded my experience in a journal. I gratefully agreed and ordered my Free Trial immediately. What happened in the 4 weeks following, was one of the most incredible transformations I have ever experienced.

On their website, the Fibrolief Support Formula claimed to do the following:

Reduction of lower back pain, headaches, joint, and muscle pain
Reduced inflammation
Improved energy levels
Increased mental clarity diminishing the effects of fibro fog
A full nights sleep without waking up groggy
And it's backed by a 1-year money-back guarantee

My Results

Week One

After one week of using Fibrolief Support Formula I was surprised at the dramatic results. My energy level was up, and I found myself having less and less trigger point flare ups throughout the day.

I honestly felt fantastic.

I didn't even change anything about my daily routine. On day 7 I woke up in the feeling better than I had in years. I was excited about the possibilities the future held and looking forward to what the next 7 days would bring.

Week Two

After two weeks of using Fibrolief Support Formula, I started the week off with even more energy and was actually sleeping more soundly than before. I was no longer waking up during the night and tossing and turning because my body was actually able to relax (this is a result of getting rid of the toxins I think). At the end of week two, I started to think that this might be a real, long term solution.

Week Three

After 3 weeks all my doubts and skepticism had absolutely vanished! I had a ton of energy. My flare ups were reduced to a point where I didn't even think about them anymore. I was ecstatic. Quite often, around the third week of a new routine you tend to run out of steam. The initial effects get milder and you begin to plateau. But with the Fibrolief Support Formula, my energy levels didn’t dip, they continued to remain steady throughout the day. I no longer wanted that cat nap around 3pm in the afternoon! I even noticed that my stomach was digesting food much better. No bloating or embarrassing gas after I ate!

Week Four

I couldn’t be any happier with the results. I finally felt like there was light at the end of the tunnel. My symptoms were reduced so much that I started to ride horses again. I started jogging again. I began to LIVE again!

Since my test with Fibrolief Support Formula I have not looked back. I often wonder what my days would be like without it, what my life would be like without it. When I first met Cindy I was introduced to Fibromyalgia Support Formula I was at my breaking point. I had reached a placed in my life where depression took over, hope was lost, and I honestly wished I was dead. It has been 8 months since I ran that trial. In those 8 months I have come very close to COMPLETELY eliminating my fibro pain and I lost a couple pounds in my mid section ( a side effect of the Fibromyalgia Support Formula + proper dieting). Without it, I think I would still be lying in bed, wondering why this is happening to me.

How Malic Acid (Malate) Helps Fibromyalgia Pain

2019-10-04T23:13:00.001-07:00

How Malic Acid (Malate) Helps Fibromyalgia Pain

Fibromyalgia is a crippling chronic condition estimated to affect around ten million Americans. Despite increasing acknowledgment of fibromyalgia as a serious illness, and despite multiple attempts to treat its symptoms (generally widespread muscle and joint pain, chronic fatigue, fibro “brain fog,” and more, depending on the individual), we still don’t have a clear biochemical or neurological account of what fibromyalgia really is, why it causes the symptoms it does, and, perhaps most importantly, how to effectively treat the condition itself rather than just its symptoms.

There is room for hope, however. Growing research shows a strong correlation between fibromyalgia symptoms and multiple severe vitamin deficiencies. Though this correlation alone isn’t enough on its own to understand fibromyalgia’s mechanism of action, researchers are hopeful that vitamin deficiencies and their causes might be a better starting point from which to work toward discovering the underlying processes of fibromyalgia than a cluster of symptoms alone.

In the meantime, though, there is also increasing evidence that correcting for these vitamin deficiencies can significantly improve fibromyalgia pain and other symptoms. While there are multiple supplements increasingly used to regulate fibro patients’ vitamin levels, I’ll discuss only one of them in this article: the supplement malic acid (or malate).

1. What is malic acid?

Malic acid is an organic substance typically found in fruits, responsible for their sweet-tart taste (in fact, it’s often used as an additive in sour candies). It’s also synthesized by your body in a series of chemical reactions known as the Krebs cycle (or citric acid cycle).

#1 Rated Supplement For Malic Acid-Fibrolief

What is the Krebs cycle?

Well, it’s quite complicated biochemically, so the clearest way to understand it is through metaphor: to start, imagine that your body is run by an engine. In order for your body to run properly (or at all!) you must put coal (that is, food) into the engine (or, your cells’ mitochondria), where the raw coal is synthesized into fuel that makes the engine run (in your body, that final fuel substance is called ATP). There isn’t just a single reaction transforming raw coal (or food) into fuel (or ATP), however. Instead, there are multiple steps, where each step takes the substance produced by the previous step and uses it in another reaction to create a new substance. To add another metaphor into the mix, you can also think of the Krebs cycle as a sort of cyclical assembly line, where, at each stop, the product being put together is turned into something new.

Why am I talking about this, again? Well, malic acid is one of the last byproducts of the Krebs cycle—its production is one of the last stops on the assembly line—on the way to synthesizing ATP. And ATP is extremely important for fibromyalgia patients, as I’ll discuss next.

2. Why and how does malic acid help reduce fibro pain?

Remember how fibromyalgia symptoms are linked to multiple vitamin deficiencies? Well, one of those deficiencies (though not a vitamin exactly) is ATP. In fact, upon taking biopsies and studying the muscle tissue of fibro patients, researchers consistently find muscle tissue breakdown, decreased levels of oxygen in the muscles (called muscle hypoxia), mitochondrial damage, and very low levels of ATP.

Depending on the extent to which the mitochondria are damaged, Krebs cycles in fibro patients’ muscles function very poorly if at all. If the Krebs cycle isn’t working, then little (if any) ATP can be produced; if the muscle doesn’t have enough ATP—if it doesn’t have enough fuel—it can’t function properly and begins to break down. And if your muscle tissue is significantly broken down, this can go a long way toward explaining the widespread muscle pain experienced by fibro patients. A lack of fuel throughout your body can also cause chronic fatigue—another symptom common to fibromyalgia.

By taking malic acid, though, you can help your damaged mitochondria produce more ATP. Again, since malic acid is one of the last byproducts produced by the Krebs cycle and is necessary for ATP production, taking the supplement can jumpstart the production of ATP, helping to fuel and repair the damage to your muscles (and causing a significant decrease in pain).

3. How should I take malic acid?

As mentioned previously, malic acid does occur naturally in fruits, especially tart fruits such as apples (and you can find smaller amounts in some vegetables as well). In non-fibro patients, the body synthesizes enough malic acid on its own—however, that isn’t very helpful information for treating fibromyalgia! In addition, there isn’t enough naturally occurring malic acid in foods for you to ingest a therapeutic dose, even if you eat multiple apples every day! For this reason (and because it’s easier to regulate doses), doctors prescribing malic acid usually prescribe it in pill form.

The Fibromyalgia Treatment Group and their supplement product Fibromyalgia Support Formula is the market's leading supplement for fibro pain and contains one of the most concentrated doses of malic acid as well as alpha lipoic acid. You can read more about it here.

Unlike many supplements, there aren’t many known interactions with other drugs or serious side effects at therapeutic doses of malic acid (some patients taking the highest doses mentioned reported loose stools). Still, as with any new medication, whether it’s prescription, an OTC drug, or a supplement, it’s always best to talk to your doctor before beginning a new regimen.
Finally, please note: while malic acid can help restore your body’s levels of ATP, it can’t reverse mitochondrial damage, which is usually caused by free radicals. Taking additional antioxidants—especially alpha lipoic acid—can help to reverse this free radical damage and heal your mitochondria so that they are better able to produce essential fuel for your body themselves.

1. It’s usually recommended to take malic acid and magnesium together. Magnesium is also severely deficient in fibro patients: its deficiency is associated with decreased serotonin and increased levels of a neurotransmitter called “substance P” which can cause hypersensitivity to pain. However, there’s evidence that taking magnesium in combination with malic acid improves the function of the malic acid and production of ATP—though the reason for that isn’t exactly clear.

Understanding Fibromyalgia Trigger Points and Tender Points

2019-10-04T23:08:00.001-07:00

Understanding Fibromyalgia Trigger Points and Tender Points

Fibromyalgia Trigger Points

Fibromyalgia is a massively misunderstood disorder characterized by a range of symptoms but most commonly associated with widespread musculoskeletal pain throughout the body. Other common effects of fibromyalgia include chronic fatigue and/or insomnia; mild to moderate loss of cognitive function; memory and mood disorders; major depressive disorder; and more.[1]
In this article, I will focus on one particular symptom that is specific to fibromyalgia. Unlike many other symptoms, it is not associated with the myriad additional disorders that are often confused with, misdiagnosed as, or presenting in addition to fibromyalgia. This symptom is a series of “trigger points” or “tender points” located in multiple specific areas across a fibromyalgia patient’s body.

1. What is a trigger point/tender point?

Trigger points associated with fibromyalgia—also called “tender points” so as not to be confused with the trigger points that characterize myofascial pain syndrome —are regularly presenting local pain points. (Due to the aforementioned confusion about/conflation of symptoms,[2] I will refer to fibromyalgia-symptomatic pain points strictly as “tender points” for the entirety of this article. When discussed, “trigger points” refer to those pain points associated with myofascial pain syndrome.) Tender points are quite small and often occur in superficial areas, seemingly just under the surface of the skin: though a fibromyalgia patient might feel severe soreness and pain around and associated with a specific joint, for example, tender points do not occur within the joints themselves.[1]
Though fibromyalgia patients experience widespread pain throughout the body, tender points are notably different from other fibro-related pain: they are significantly more sensitive and painful when touched than other nearby areas. A doctor’s application of firm but not ordinarily painful pressure (just enough pressure to turn a fingernail white[2]) to a tender point may cause the patient to flinch or jerk back involuntarily. Note that the name, “tender point,” is misleading: a patient presenting with fibromyalgia-related tender points must actually feel pain, not just “tenderness,” on those points’ palpitation. The pain associated with tender point palpitation should feel similar to that of pressing on a serious bruise in the stages of healing.[2]

2. Where are these “tender points?”

Perhaps the most notable feature of fibromyalgia-related tender points is that they do not occur at random. There are 18 points in total (nine bilateral pairs) that have been identified across fibromyalgia patients: [2], [3], [4]
• occiput: suboccipital muscle insertions
(bilateral tender points located at the back of the neck, near the base of the skull)

• low cervical region: anterior aspects of intertransverse spaces at C5-C7 vertebrae
(bilateral tender points located at the front/sides of the neck, on either side of the larynx, well above the collarbone)

• trapezius muscle: midpoint of upper border
(bilateral tender points at the top of the upper back/shoulder; neck and upper back muscles between the shoulder blades)

• supraspinatus muscle: above medial border of scapular spine
(bilateral tender points where the back muscles connect to shoulder blades in the upper back; slightly below the trapezius points)

• second rib: upper lateral to second costochondral junction
(bilateral tender points on either side of the sternum, below the collarbone—near the second rib)

• lateral epicondyle: two cm distal to the epicondyles
(bilateral tender points just below the crease of the elbow toward the outer side of the forearm)

• gluteal: anterior fold of muscle in upper outer quadrants of buttocks
(bilateral tender points where the very top of the buttocks meets the bottom of the lower back)

• greater trochanter: posterior to greater trochanteric prominence
(bilateral tender points where the buttock muscles curve to meet the thigh—near the hip but not in the hip joint as in e.g., osteoarthritis)

• knee: medial fat pad proximal to joint line

3. Problems with trigger points as a symptom and as a diagnostic tool

Five years ago (and for at least 20 years prior), tender points were a necessary component of a clinical diagnosis of fibromyalgia (FM): in addition to widespread pain on both sides of the body lasting for at least three months, a patient needed to demonstrate sufficient pain (not just tenderness) in at least 11 of the aforementioned 18 tender point sites in order to receive a diagnosis.[5]
However, tender point exams can be too subjective and prone to error. There is not enough consistency across diagnosticians in the way exams are performed, nor is there enough consistency in patients’ reportability of pain. In addition, it is easy to mistake tender points for other issues (such as trigger points) or vice versa. One must note, for example, that tender point pain is local: even on palpitation, tender point pain should not spread to other parts of the body or trigger additional symptoms: e.g., cause nausea or a migraine headache.[2] This reaction is associated with trigger points, a symptom of myofascial pain syndrome. Myofascial trigger points often respond well to treatments such as massage and physical therapy; FM tender points, on the other hand, tend to worsen with pressure.

This issue is further compounded because many patients present with both fibromyalgia and myofascial pain syndrome—which means that identifying and classifying tender points can be extremely difficult. As a result, correctly diagnosing fibromyalgia would be incredibly difficult as well; since, according to the old criteria, lasting pain and tender point pain are the only relevant symptoms.
An additional concern is that some patients might present pain in fewer than 11 tender points, but also complain of other (e.g., cognitive or psychological) symptoms commonly associated with fibromyalgia. Under the old criteria, these patients would not receive a diagnosis. This is yet another reason that increased diagnostic attention to cognitive symptoms and decreased attention to particular pain points is an important step in working towards correctly diagnosing and helping patients.
In May of 2010, the American College of Rheumatology (ACR) proposed significant alterations to the diagnostic process for FM after Wolfe et al. performed a large-scale study of over 800 previously diagnosed fibromyalgia patients and controls. They found that, using the ACR’s old diagnostic criteria, over 25% of fibromyalgia patients would not have received a diagnosis.[6] Wolfe et al. went on to develop a new diagnostic process for the ACR that does not merely rely on tender point examinations. Instead, the two most important criteria are a widespread pain index (WPI) and a symptom severity (SS) scale. The WPI is not a tender point exam; patients are also asked about recurring, long-lasting pain in a number of different body regions. The SS scale was developed to take additional symptoms—e.g., fatigue, insomnia, cognitive problems, IBS, depression, and more—into consideration.[6]

4. Finally: what causes tender points?

The short answer: nobody knows. Doctors and researchers have come up with numerous hypotheses: genetics might pay a role; some illness and infections can trigger the onset of fibromyalgia (including tender point pain); physical or emotional trauma might also be involved. However, there are holes in each of these possibilities, and there is no established solution within the FM research and treatment community. One common explanation for fibro pain (though not tender point pain in particular) is that repetitive nerve stimulation actually alters FM patients’ brains: this alteration results in an increase in particular pain-signaling neurotransmitters, and the increase in neurotransmitter production might also cause pain receptors to become more sensitive.[1] This combined brain activity and alteration would result in a vicious cycle of pain: increasing pain-signaling neurotransmitters result in increasing sensitivity of pain receptors, meaning that the more pain signals your brain receives, the more sensitive you become to these pain signals, and so on ad infinitum. Again, though, this is only a possible explanation—and it does not account for the presence of tender points at all.
There are many possible reasons for the dearth of medical knowledge when it comes to fibromyalgia: the fact that it is far more common in women than men—that many of the associated symptoms (e.g., fatigue, “brain fog,” depression, etc.) have, for many years, been dismissed as “merely” psychological/emotional or related to other women’s issues when presented in female patients—cannot be unrelated. Still, with increased awareness of fibromyalgia, the new diagnostic criteria which place more weight on other cognitive/psychological symptoms, and similar changes, the medical community may slowly be working toward overhaul and understanding. Once fibromyalgia itself is better understood, there is hope that its symptoms—including tender points—might be explained as well.

How The Weather Affects Fibromyalgia

2019-10-04T23:03:00.003-07:00

How The Weather Affects Fibromyalgia

Many fibromyalgia sufferers report weather changes as one of the top causes of symptom flare-ups, especially muscle pain and stiffness. Interestingly, while many people with fibromyalgia report worsening of symptoms during cold weather, other fibro patients respond worse to heat. However, the validity of this claim is still up in the air, according to doctors and researchers. The connection between weather changes and fibromyalgia symptoms has been proven and disproven by multiple studies over the years—at this point, most doctors believe that reports of symptom flares as a result of weather are “all in your head.”

Until recently, most doctors thought fibromyalgia itself was “all in your head” (and, unfortunately, some still do). Once the disease became popularly accepted, studies were performed in greater numbers—most of them reinforcing the fact that fibromyalgia is a real condition. Perhaps there will be a similar progression of acceptance and evidence of the connection between fibro symptoms and weather

changes? We can only hope.

Let's discuss a few reasons why your fibro pain might be worse due to weather conditions, and I’ll provide a few strategies for coping with—or even avoiding—weather-related flares.

Possible Explanations- Why The Weather Affects Fibromyalgia Symptoms

Cold weather and muscle pain

Since fibromyalgia causes severe muscle pain, adding more muscle pain will obviously make your symptoms worse—and cold weather can do just that. How? First, when you’re cold, your muscles tend to constrict and cramp or spasm (shivering!) in an effort to warm your body. These cramps and spasms can cause muscle pain—especially in people suffering from fibromyalgia. If you have persistent or chronic pain in your muscles, then cold weather doesn't just cause short-lived muscle aches; instead, it adds to or sets off severe fibro pain.

Additionally, cold weather is usually accompanied by a drop in barometric pressure. When the air pressure decreases, the fluid and soft tissue surrounding your joints—usually held in place by outside pressure—are allowed to expand. As they expand, this fluid and soft tissue press directly against your joints, causing joint pain and even related muscle pain. As described above, the resulting pain is generally much worse in fibro (and arthritis) sufferers.

Hot weather and muscle pain

According to Lynne Matallana, founder and president of the National Fibromyalgia Association, fibromyalgia patients aren’t able to adjust as easily to temperature changes as non-sufferers, or to sufficiently regulate their body temperature. This difficulty regulating body temperature to can lead to problems in hot weather, because people with fibromyalgia aren’t able to sweat as much or as easily as others. If you don’t sweat enough, your body temperature can rise to a dangerous degree, causing severe muscle pain (and other issues).

Additionally, fibromyalgia is often associated with sleep disorders: specifically, difficulty getting quality, restful sleep (or difficulty sleeping at all). Naturally, this symptom can make other symptoms, such as pain and fatigue, even worse. In hot weather, it’s difficult for anyone to sleep: so, if hot weather worsens your fibro-related sleeping problem, this might help explain increased pain.

The effect of increased nerve fibers

According to a 2013 study, people suffering from fibromyalgia have significantly increased numbers of sensory nerve fibers (often responsible for sending pain signals to the brain) in the blood vessels of the palms of their hands. Though this finding isn’t fully understood, it does offer a possible explanation for fibro pain that’s increased by cold weather. In warm temperatures, these blood vessels are less active, as they don’t have to work to warm up the body. In cold weather, though, their activity increases significantly; this means that their nerve fibers signal much more frequently, possibly causing increased pain in those people who already have an abnormally high number of nerve fibers.

Another possibility is that extra nerve fibers cause blood vessels in the hand to interfere with overall blood flow throughout the body. If your muscles don’t get enough fresh, oxygen-rich blood, or can’t get rid of old blood fast enough, this can cause severe muscle pain. Again, these hypotheses haven’t been confirmed, but they do offer exciting possibilities for further research and eventual prevention.

Coping mechanisms- How to Minimize The Weather's Affect On Fibromyalgia

Many of these tips may seem obvious, but they’re important to remember: if you prepare yourself for weather changes, you might even be able to avoid your usual symptom flares.

For cold weather

If cold weather usually increases your pain, this probably means you’re dealing with extra tight or cramped muscles. To help or even avoid these symptoms, your goal is to do everything you can to keep your muscles loose and relaxed. Taking long hot showers or baths, or even wearing heat packs throughout the day, can significantly help relax your muscles. Yoga can also stretch your muscles and improve circulation—remember, your circulation helps regulate your body temperature and is generally compromised in people with fibromyalgia.

There are also indirect ways in which cold weather can increase your symptoms. Fibromyalgia patients have many nutrient deficiencies, including vitamin D—and, if you’re staying inside more often during the cold winter months, you’re getting even less vitamin D than usual. This means that taking a vitamin D supplement might help your symptoms—especially during the winter, but also throughout the rest of the year. (This is true of the other supplements mentioned by the University of Maryland Medical Center as well, such as alpha lipoic acid and malic acid.

Additionally, cold, dark months can cause or increase depression. While fibromyalgia is not caused by depression, the two conditions are related, and increased depression can increase your other symptoms as well. To help with seasonal depression, you can buy a special light box meant to help symptoms of SAD (seasonal affective disorder).

For hot weather

If hot weather tends to worsen your symptoms, this means you’re dealing with high body temperatures and possibly dehydration. In this case, try to stay as cool as possible through other means: stay in air-conditioned buildings when possible; take cold showers, go swimming, and wear cold packs or cool, damp cloths; and be sure to drink plenty of cool water.

Though you can’t change the weather, you can change your responses to it. Additionally, taking vitamins and supplements to correct for nutrient deficiencies can help your symptoms all year round—this improves your chances of avoiding symptom flares, no matter the weather.

The number 1 recommended supplement for relief from fibromyalgia pain is made by the Fibromyalgia Treatment Group and comes with a 100% Money Back Guarantee for 1 year! Check out Fibrolief now and try the FREE TRIAL while supplies last!

Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy

2019-10-03T10:30:00.001-07:00

Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary Strategy

A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.

1. Introduction

Fibromyalgia syndrome (FMS) is a challenging, complex, heterogeneous, chronic, and often disabling disorder (1, 2). Its pathophysiology is still poorly understood (1, 3, 4). Chronic musculoskeletal widespread pain, fatigue, non-restorative sleep, mood disturbances, and cognitive impairments characterize this condition (1, 2). Furthermore, a constellation of comorbidities, only apparently not connected, afflicts the patients (2–8), and have a clear common denominator in serotonin (5-HT). The symptoms can range from mild to severe, determining in the worst cases an invalidating condition that dominates daily life (9). They may lead to an occupational and social disability with associated direct and indirect economic costs (10).

Even if pain is the core symptom in FMS, non-painful symptoms may also impact the quality of life of patients. Recognizing those symptoms may be difficult in the absence of other apparent organic diseases. This makes FMS a real challenge for physicians and healthcare professionals.

We report the first case of controlled remission of symptoms in FMS, following a novel metabolic approach. The therapeutic protocol is a strict diet, focused on the withdrawal of food components that may interfere with the absorption of l-tryptophan (Trp), 5-HT precursor (11).

2. Case Presentation

2.1. Patient Presentation

The patient is a 34-year-old woman, body mass index 18, Caucasian, high level instruction.

2.2. Old Past History

The patient’s past history, ex post relevant for FMS differential diagnosis, includes irritable bowel syndrome-constipation (IBS-c), bloating, dismenorrhea experienced since adolescence, Raynaud’s phenomenon, trapezium contractures, leg and foot cramps, especially at night or waking up in the morning.

2.3. Past History

The onset of lower back pain, restless legs, and morning stiffness occurred few months after a surgery. The symptoms were first described as mild in severity, particularly concerning pain, and erratic. One-year later, lower back pain and hip pain forced the patient to bed rest. Non-steroidal anti-inflammatory drugs (i.e., ibuprofen) and muscle relaxants (i.e., thiocolchicoside) were prescribed by the primary care clinician, and led to mild effects. Magnetic resonance imaging and X-ray investigations revealed a lumbar disk hernia and no lesions or abnormalities at hips. One-year later, during autumn temperatures decrease a further episode of lower back pain and stiffness occurred forcing the patient to bed rest for more than 2 weeks. Previous treatment had no effectiveness and corticosteroid drug (i.e., prednisone) led to no appreciable relief. Pain was in part relieved by gabapentin, but only with slow dynamics and with collateral effects of suicidal thoughts and mental confusion.

Further magnetic resonance and X-ray investigations confirmed the previous diagnosis with no new data to explain relapse worsening. Similar symptoms of lower back pain during the following 2 years were attributed to the same cause. These episodes recurred three to four times a year, affecting life quality and mobility, and forcing patient to bed. Intriguingly, the worst episodes appeared to correlate to decreasing temperatures of the autumn.

2.4. Recent Past History

The symptoms increased slightly, but progressively with unpredictable and fluctuating nature. Morning stiffness required more than 40 min to get up while awakening. Fatigue unrelieved by rest, low back pain, migrant aches in the joints, musculoskeletal widespread pain, short-term memory loss, concentration difficulties, and forgetfulness were the major symptoms. The evaluation of her thyroid function did not reveal any abnormality [i.e., thyrotropin (THS) was within the normal range of 0.270–4.200 μU/ml, with a value of 2.54]. A modest improvement was observed during summer and hot weather conditions, but the unpredictable character of the symptoms made the patient feeling insecure and anxious. These had considerable impact on the everyday life, affecting social interaction and professional performance. She appeared healthy when compared with others: being doubted, because of the invisible nature of her pain, had an additional negative impact on the patient’s well-being.

2.5. Differential Diagnosis

A deterioration of the patient’s conditions began with a severe worsening of morning stiffness and lower back pain, leading to disabling conditions, and forcing the patient at bed rest with severe aches. This was described as a “torture-like experience,” without any respite for a period of 48 h. The concomitant onset of such a pain to both hips and to the right shoulder led to investigate for rheumatic diseases and to the hypothesis of FMS.

During a first visit of a specialist in rheumatology, the tender points of FMS were assessed (11/18). Blood testing was then performed: rheumatoid factor, anti-nuclear antibodies, anti-nDNA antibodies research, anti-ENA antibodies, and anti-cyclic citrullinated peptide antibodies were all negative. Erythrocyte sedimentation rate was 8 mm/h (normal range: 2–20), C-reactive protein 0.1 mg/dL (normal range: 0.0–0.5), creatine kinase 92 IU/L (normal range: 30–150), and rheumatoid factor 8 IU/mL (normal range: 0–14). Complete blood count was in the normal range.

On a visit by a second specialist in rheumatology, tender points were accessed again, and the differential diagnosis of FMS was made. This was based on the presence of tender point sensitivity (14/18), widespread chronic pain for longer than 3 months, morning stiffness, non-restorative sleep, depression, anxiety, leg and foot cramps, chest pain, tachycardia, hypersensitivity to cold, cognitive impairment as forgetfulness and low concentration, irritable bowel syndrome-constipation (IBS-c), prickling sensations at fingers and toes, bloating, and hyperhidrosis.

The ineffectiveness of pharmacological therapies in FMS came to patient’s knowledge (1). The patient refused the proposed muscle relaxant drug (i.e., tizanidine) on the basis of its unproven effectiveness (1), and she also refused the proposed selective serotonin–norepinephrine re-uptake inhibitor (SNRI) (i.e., duloxetine) (12) on the basis of awareness of collateral effects (13) and development of pharmacological addiction. The patient generally feared collateral effects of the drug treatments, and she was rather interested in the novel metabolic approach for the symptomatic remission in FMS (11).

3. Therapeutic Protocol

3.1. Guidelines (11)

The therapeutic protocol is a strict diet. It was devised to facilitate Trp absorption, and thus guarantee its bioavailability as a substrate for 5-HT synthesis. In order to sustain 5-HT synthesis, it is mandatory to remove molecules that could negatively affect the fate of Trp in the gastrointestinal tract. The core of this approach is the exclusion of some carbohydrates from the diet and the proper intake of Trp with food (11). Because of fructose is a high reactive sugar (14), limiting the intake of fructose as much as possible is the essential point, including fructose chains, such as fructans and inulins, and some other molecules that do not have specific transport systems (e.g., sorbitol). Glutamate and aspartame should also be excluded (11).

3.2. Diet

The patient’s diet includes eggs, meat, fish, clams, potatoes, carrots, celery, spinaches, beets, chards, dark chocolates (at least 70 + % cacao), rice, millet, carob powder, walnuts, extra virgin oil, grape seed oil, thyme, sage, rosemary, coffee, green tea, and small amount of almonds. Almonds, despite containing fructose, still belong to the patient’s diet, as they are well tolerated in small amount, suggested to be consumed together with a glucose source, typically rice or potatoes to activate GLUT2 transporter as remarked in Ref. (11).

Any food, beverage, or herb not in the previous list and not according to treatment guidelines is excluded from the diet protocol. Particularly, processed food containing artificial sweeteners, high fructose corn syrup, sorbitol, glutamate, and aspartame must be excluded: among others soft drinks, fruit juices and the majority of confectionery (11). Food containing free fructose, such as honey and fruits, must be removed from patient’s diet. Most legumes, wheat and most cereals, and many vegetables that contain fructans and inulins (15) must also be removed (11). Attention must also be paid to the excipients in pharmacological preparations, pills, syrups, and solutions (16).

Compared with the previous patient’s diet, the one proposed here does not affect the total daily energy intake (2,200–2,400 kcal/day), but the nutritional profile concerning a reduction in carbohydrates, fibers, and an increase in protein and fat intake. The patient’s diet is thus composed of 31–36% carbohydrates, 30–32% fats, 25–27% proteins, and 9–10% fibers. The previous diet was mainly a Mediterranean diet. It was rich in vegetables, fresh fruits, dried fruit, cereals, and legumes. It contained a moderate amount of fish, meat, dairy products, eggs, nuts, and sweets. Its proportion of nutrients was: 55–56% carbohydrates, 30–32% fats, 17–18% proteins, and 16–18% fibers.

3.3. Therapeutic Approach

In order to assess her dietary intake, the patient was asked to keep a food diary. This method requires the subject to list the consumed food and the state of health, reporting the presence of symptoms: widespread pain, fatigue, morning stiffness, bowel function, headaches, sleep quality, cramps, prickling sensation at fingers and toes, mood changes, anxiety, and depressive mood among others. This method allows to evaluate compliance with the diet guidelines and the impact of diet modifications based on symptoms. It makes the patient an active subject to fight against the disease. This approach highly contributes to patient’s motivation and compliance with protocol as it makes the patient conscious of her power on the control of symptoms.

3.4. Patient Clinical Response

The growing severity of symptoms highly motivated the patient to strictly follow the diet guidelines. For a complete picture, the patient had already been on a lactose-free diet for 3 years and on a pork meat-free diet for 5 years.

Dietary modifications resulted in a rapid improvement of the patient’s condition after only a few days up to the full resolution of the majority of symptoms in few weeks. Symptoms of depression disappeared. Fatigue unrelieved when rest disappeared and she regained restorative sleep. Chronic musculoskeletal widespread pain and morning stiffness had a marked improvement up to no longer present. She recovered her energy and vitality. She got completely independent in all the activities of her daily life as before the onset of the disease by solving the occupational and social disabilities.

The patient broke the dietary protocol: not admitted foods were arbitrarily, deliberately, and voluntarily assumed (for instance, among others: eating a pear, or a fig, or an onion, or asparagus). It plays as negative control. It is significant for three different reasons: to exclude a major placebo component in the remission of symptoms, to evaluate the short-term effectiveness of the treatment, and to validate the protocol as a final cure or a remission protocol. The recurrence of symptoms is correlated with diet faults. The treatment leads to a remission but it is not a final cure.

Two months after the beginning of the diet the patient was vastly improved in every aspect. She regained her positive mental outlook. She returned to full employment. She recovered her energy and vitality as she did not since years.

3.5. Subsequent Course

12 months after the differential diagnosis and 10 months after the beginning of the diet modification the patient is still on diet. Marked not keeping occurred few times, being she well aware of the consequent recurrence of symptoms: when isolated, little faults trigger little symptoms; nevertheless, repeated and continuing faults have the potential for leading to the previous chronic condition of pain, fatigue, and mood symptoms. Moreover, being pain-free, the patient started physical aerobic exercise which she was unable to perform before due to stiffness and widespread musculoskeletal pain. Some comorbidities did not completely solve: sensitivity to cold, hypersensitivity to odors and noise, dysmenorrhea, and memory lapses are still present.

4. Discussion

4.1. FMS Burden

Fibromyalgia syndrome is really a challenging, insidious, and disabling disease that afflicts patients and their relatives as a real burden in everyday life (10). Epidemiological data clearly demonstrate the socio-economical burden associated with FMS and the urgency of effective answers (4, 10, 17–19). The diagnosis often delayed may exacerbate patient’s conditions. Being doubted due to the invisibility of pain is perceived as a “double burden.” Unfortunately, it is a common condition among patients (9).

Despite the large number of pharmacological and non-pharmacological clinical trials and studies performed, since nineties, an effective cure still lacks (1). The crucial role of 5-HT in FMS is no more a matter of debate. It has been clearly observed in experimental studies, although still not fully understood in its pathophysiological mechanism. Low levels of 5-HT and/or of its precursor Trp were variably observed in such studies, early during 1990s (20–22) and more recently (7, 23, 24). The introduction of selective serotonin re-uptake inhibitors (SSRIs) and SNRIs as a pharmacological therapy in FMS was the consequence in the clinical practice (3, 6, 25–29). Besides Trp, low levels of other essential aminoacids (30, 31) and altered aminoacid homeostasis (32) have been reported in patients with FMS as compared to the general population: anyway, these findings did not translate into an effective cure (1). Surprisingly, the “2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria” (33) did not contain any explicit reference to blood testing in this direction.

4.2. The Novel Remission Protocol Beyond the State of the Art

In this scenario, where the challenge for physicians and healthcare systems to face FMS is clear and still open (1), we report the first case of controlled remission in FMS following a novel metabolic approach (11). This report shows the crucial role of diet in FMS, and food choice as a key strategy for its management. The marked improvements of the patient’s clinical condition open great perspectives to face up FMS burden giving the patients an effective strategy. Intrinsically, a withdrawal approach avoids the potential side-effects associated with pharmacological therapies [i.e., SSRIs and SNRIs (13, 34–36), muscle relaxants, and the interactions among them]. The effectiveness-to-cost ratio of this approach is evident. It is a low risk and accessible therapeutic approach with virtually no costs for the treatment itself, than those related to possible vitamin and mineral salt supplements, and blood testing to evaluate their levels. The economic perspective could be relevant bearing in mind the significant number of patients.

Dietary modifications in FMS are not a new approach: different diets were attempted in the past, variably focused on the elimination of certain food or chemical additives (37). Nevertheless, the therapeutic approaches proposed till now often did not ground on a solid theory which is able to fully predict and explain the experimental outcomes.

4.3. The Possible Role of the Placebo and Nocebo Effects

As in any therapeutic approach implemented for chronic pain, a significant placebo response should be considered. The placebo effect is reported in FMS (38, 39). Breaking the diet protocol with not admitted food aims to exclude the remission of symptoms by a main placebo contribution. Although the placebo component could not be excluded at all a priori, the occurrence of an ad hoc nocebo effect precisely correlated with diet faults (i.e., voluntary breaks of protocol guidelines and accidental mistakes) is highly improbable.

4.4. Diet Management and Implementation in the Clinical Practice

It is already known that nonimmunologically mediated adverse reactions to food, which resolved following dietary elimination, are then reproduced by food challenge (40). Clinical improvement was reported after dietary treatment for fructose malabsorption in irritable bowel syndrome (IBS) patients by different studies (41, 42); particularly, a significant reduction of symptoms and improvements in the quality of life proportionate to the amount of eliminated fructose was reported by Choi et al. (43). The human capacity for fructose absorption is widely variable (44); incomplete fructose absorption can occur with doses as low as 5 g in individual considered as health subjects (45). Some authors report that patients with IBS associated with fructose malabsorption can tolerate 10–15 g of fructose per day (46). It is reasonable to suppose that a threshold exists in patients with FMS too, and that the tolerated amount of fructose and of the other not admitted molecules could be related to the severity of the patient’s conditions. The threshold can be very low: the patient reports that even very low amounts of free fructose are able to trigger the symptoms. In severe conditions, a compromise could not be possible at all, and a complete fructose-free diet is the suggestion. A patient-to-patient tailored approach is the best implementation in the clinical practice.

This report supports the protocol intrinsically effective for the remission of symptoms in FMS. It is a matter of fact that adherence to the protocol is correlated with symptomatic improvements and non-adherence with the recurrence of symptoms.

Because of the abundance of fructose in our food supply (as it is present not only in the form of simple monosaccharide, but also in the form of fructose chains), a strict fructose-free and fructan-free diet is binding, and maybe not required once patients experience sufficient relief from their symptoms. Particularly, in not severe conditions, a “re-introduction phase” could be approached by introducing into the diet small amounts of not admitted food, one at a time, in order to determine exactly how much fructose and the other not admitted molecules can be tolerated, to have the least restrictive diet, while keeping symptoms under control. This way, partial compliance with protocol guidelines may be a personal compromise to control the symptoms to a satisfactory level, while minimizing the social limitations that dietary restrictions impose.

The co-ingestion of glucose could be in principle beneficial to allow the presence of small amount of fructose in the diet (11). As previously mentioned, it activates the GLUT2 co-transporter, reducing the non-absorbed fructose (47, 48).

The difficulty of adhering to such restricted diet might be the criticism of it. Nevertheless, compliance with protocol guidelines demonstrates a high symptomatic improvement, being this way an incentive to be on diet. Diet modifications, that improved health condition in an IBS cohort of patients, reveal the willingness and the ability of patients to maintain dietary restrictions to avoid painful meal-related events (49). Patient’s dietary education contributes to the compliance with diet too, so that proper training and active involvement in the way to remission are crucial for successful and durable results.

5. Conclusion

This report shows a remarkable clinical improvement in FMS by a strict exclusion diet: remission of depression, pain, stiffness, chronic fatigue, and non-restorative sleep. This result opens new perspectives in the treatment of FMS solving the substantial functional limitations experienced by patients, virtually requiring no costs for the treatment itself. It could be an important point to be considered by healthcare systems, because of the incidence of FMS. The costs associated with the treatment are related to blood investigations and supplements of vitamins and mineral salts in case of deficiencies. Moreover, a dietary strategy has intrinsically no side-effects associated with pharmacological therapies.

A preliminary patient’s training should be considered, in order to gain proper knowledge of the protocol guidelines; it is important that patients can correlate the voluntary or chance failures to the recurrence of symptoms in order to avoid the gate of the “positive feedback loop.”

Because of its efficacy on symptoms, the absence of drug side-effects and its low cost, this approach could be an effective and accessible answer to the burden of FMS, at least to give patients a respite. A pilot study is required to ground this metabolic approach in FMS, and to finally evaluate its inclusion in the guidelines for clinical management.

2019-10-01T21:25:00.002-07:00

Fibromyalgia: What Happens When My Hair Hurts?

If you have fibromyalgia, you may notice that your hair hurts. Loss of hair is just one symptom of fibromyalgia out of many. Several common symptoms include fatigue, brain fog, digestive issues, depression, muscle, and joint issues, and chronic pain. Fibromyalgia is a condition in which people experience widespread chronic pain throughout the body. Widespread pain caused by fibromyalgia occurs on both sides of the body and both above and below the waist. The brain processes abnormal pain signals, which creates the widespread pain and makes it heightened.

Hair loss and hair pain are possible if you have fibromyalgia. Before reading the following article, make sure to contact your doctor if you have any questions or concerns. This article is simply discussing why your hair hurts in relation to fibromyalgia.

HAIR LOSS

Many people who have fibromyalgia experience hair loss. Hair loss or thinning can be one symptom of fibromyalgia. Hair pain may also arise, which is discussed further in this article.

WHY AM I LOSING SO MUCH HAIR?

So, why are you experiencing hair loss? Here are a few possible reasons:

Medication: One reason why you may have hair loss is due to medications for fibromyalgia. If you start a new medication and notice you are losing more hair, make sure to speak to your doctor.

High Stress: Another reason may be due to times of high stress. During times of high stress or symptom flares, individuals with fibromyalgia can experience unusual hair loss or widespread thinning. The good news is that stress-induced hair loss is reversible and can be treated.

Thyroid Dysfunction: Hair loss may be due to thyroid dysfunction. Thyroid dysfunction is thought to be more common in people who have fibromyalgia. Check your thyroid hormone levels and speak to your doctor for more information concerning thyroid dysfunction.

Autoimmune Issues: If you are experiencing hair loss in multiple spots, you may be experiencing autoimmune issues. Hair loss occurs as several coin-shaped bald spots, which is also known as alopecia.

TREATING HAIR LOSS

Although there is no proven treatment for preventing hair loss before it falls out, there is good news. Luckily, hair grows back, and there are several steps you can take to help treat hair loss. It is important to not allow yourself to get more stressed. Instead, stay calm and look into the different approaches to treatment.

To treat hair thinning and hair loss, one option is to optimize overall nutritional support. This is especially good for stress-induced hair loss cases. Low iron negatively affects hair growth. Try taking an iron tablet. Another resource to try is Energy Revitalization System vitamin powder. However, keep in mind too much of anything is never a good thing. Too much iron can result in dangerous levels of excess iron in the body.

Another way to treat hair loss that is caused by high levels of stress is to optimize thyroid function. As mentioned earlier, thyroid dysfunction is more common in people who have fibromyalgia. In order to check your thyroid hormone levels, speak to your doctor.

HAIR PAIN

Several people who have fibromyalgia also experience the symptom of hair pain. In fact, several accounts say that the head gets so sensitive that it is difficult to touch the hair. There are many stories online that include people from the fibromyalgia community who report a burning sensation. The painful sensation comes and goes but makes it hard for people to touch their hair, much less wash or brush it.

People who have fibromyalgia ask whether or not there are steps to take to ease the pain. There are recommendations, such as leaving your hair down. Putting hair up in a ponytail or bun may create even more pain. If you need to put your hair up, it is recommended to use hair elastic scrunchies. Another possibility is to cut or shave your hair.

WHY DOES MY SCALP HURT?

When hair loss or hair thinning occurs pain may arise from the scalp muscles being too tight. Allodynia, or pain caused by touching the skin, is a nuisance, which is why treatment is important.

TREATMENT

Certain medications can help ease the scalp pain caused by fibromyalgia. According to Dr. Teitelbaum, there are steps you can take to address the hair pain symptom. Ultram and Neurontin are low-cost generics that can be used. Additionally, there is End Pain by Enzymatic Therapy and Curamin by EuroPharma. If you are experiencing other symptoms or have questions and concerns, it is important to contact your doctor.

FIBROMYALGIA and other forms of chronic pain may be caused by insulin resistance, groundbreaking new research suggests. And, scientists say, the agonising condition could be treated using a common diabetes drug.

2019-10-01T10:57:00.001-07:00

RADICAL STEP

Hope for fibromyalgia sufferers as experts discover common diabetes drug ‘eradicates pain’

Chronic pain could be related to insulin resistance, scientists have found

FIBROMYALGIA and other forms of chronic pain may be caused by insulin resistance, groundbreaking new research suggests.

And, scientists say, the agonising condition could be treated using a common diabetes drug.

A blood test for diabetes offers fresh hope to fibromyalgia sufferers who may see their pain reduced by taking metformin

A team of scientists from the University of Texas hopes the discovery could lead to a revolutionary shift in how chronic pain is treated - potentially saving billions in painkillers.

They were able to identify people with fibromyalgia using a common blood test (called A1c) for insulin resistance - or pre-diabetes.

Metformin 'dramatically reduced pain'

They then treated the fibromyalgia patients with metformin - a drug developed to combat insulin resistance in diabetics.

They found that all the patients experienced a reduction in their pain.

The fibromyalgia patients involved in the study were divided into age groups.

Researchers found that the blood glucose levels of all the fibromyalgia patients were significantly higher than in normal people.

Neurology professor Dr. Miguel Pappolla said that his group was puzzled as to why previous studies had overlooked that connection.

"The main reason for this oversight is that about half of fibromyalgia patients have A1c (blood glucose) values currently considered within the normal range," he explained.

"However, this is the first study to analyse these levels normalised for the person's age, as optimal A1c levels do vary throughout life.

"Adjustment for the patients' age was critical in highlighting the differences between patients and control subjects."

Earlier studies have found a connection between insulin resistance and dysfunction within the brain's small blood vessels, but up until now, no one has bothered to investigate whether that's linked to fibromyalgia.

Insulin resistance is 'the missing link'

"Since this issue is also present in fibromyalgia, we investigated whether insulin resistance is the missing link in this disorder," Dr. Pappolla added.

"We showed that most - if not all - patients with fibromyalgia can be identified by their A1c levels, which reflects average blood sugar levels over the past two to three months."

He said people with pre-diabetes who had slightly higher A1c values had a higher risk of developing brain pain - a hallmark of fibromyalgia and other chronic pain disorders.

Fibromyalgia is one of the most common chronic pain conditions.

Lady Gaga, Morgan Freeman, Sinead O'Connor all suffer from the debilitating condition which up until now has had no cure.

Chesterfield woman's fibromyalgia petition sparks Westminster debate

2019-10-01T07:23:00.001-07:00

MPs will discuss fibromyalgia during a debate in Westminster after a Chesterfield woman started a petition about the devastating illness.

Adrienne Lakin's online petition - which urges the Government to recognise fibromyalgia as a disability and also calls for better treatment and support for sufferers - has been signed by more than 110,000 people.

Fibromyalgia is a long-term condition which causes pain all over the body and a number of other issues including fatigue, irritable bowel syndrome and problems with memory and concentration.

Under the Equality Act, the illness is deemed as an impairment rather than a disability.

Twenty-six-year-old Adrienne - whose petition is backed by Chesterfield MP Toby Perkins - has suffered with the symptoms of fibromyalgia since she was 16.

She said: "I'd like to thank everyone who has signed and supported the petition and I'm so pleased that the issue of fibromyalgia will be discussed in Westminster.

"Whatever the outcome is, it will really help to raise awareness about this horrible condition."

Describing how fibromyalgia affects her, Adrienne, of Hall View, Newbold, said: "I’m always hurting - I'm on more than 30 tablets a day.

"It's completely changed my life.

"I always used to be out socialising but I can't do that anymore.

"I absolutely hate fibromyalgia."

Mr Perkins said: "I’ve been working closely with Adrienne and I've been successful in securing next Tuesday's debate about fibromyalgia in Westminster on the back of her petition.

"Fibromyalgia is a horrible hidden illness which affects many people in my constituency.

"In its response we hope the Government will say what it will do to increase awareness about fibromyalgia and how it will help sufferers – including when they come to claim benefits."

To sign Adrienne's petition, visit http://www.change.org/p/uk-parliament-make-fibromyalgia-a-disability

New book from Mayo Clinic Press helps fibromyalgia patients find solutions to better health

2019-10-01T01:36:00.000-07:00

New book from Mayo Clinic Press helps fibromyalgia patients find solutions to better health

Fibromyalgia, a disorder that causes pain, fatigue, chronic headaches and a host of other symptoms, is often misunderstood by patients, families and health care providers. A new book from Mayo Clinic Press aims to change that.

"Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life," by Andy Abril, M.D., a Mayo Clinic rheumatologist, and Barbara Bruce, Ph.D., a Mayo Clinic psychologist, aims to dispel myths about fibromyalgia and offer practical strategies for patients to manage it successfully. Drawing on decades of Mayo Clinic research and clinical expertise, the book is a resource to help people with fibromyalgia find solutions that lead to better health. Drs. Abril and Bruce are based at Mayo Clinic in Florida.

The 272-page paperback is the first under the imprint Mayo Clinic Press. Mayo Clinic has issued health-oriented books for consumers with other publishers for many years, self-publishing books such as "The Mayo Clinic Family Health Book." Mayo Clinic Press will publish new titles on important health issues, and its books will be distributed by Simon & Schuster Inc.

Fibromyalgia is a disorder that commonly involves aches and pain in all parts of the body, often with fatigue, sleep, memory and mood issues. Symptoms also may include tension headaches, irritable bowel syndrome, anxiety and depression. Women are more likely to develop fibromyalgia than men.

Medications can help control symptoms, and many patients also have found exercise, relaxation and stress reduction measures helpful, Dr. Abril says.

"Many patients are struggling to get through their daily activities because of their symptoms," says Dr. Bruce. "They don't know what's wrong with them or how to make it better. They just want their lives back. Fibromyalgia doesn't have to define a person's life, and we can offer help and hope."

The authors share personal stories of patients who have lived with fibromyalgia and found that relief and management of symptoms is possible. The book outlines comprehensive treatment options based on the latest research, with actionable steps to reduce pain and other symptoms.

"Mayo Clinic Guide to Fibromyalgia: Strategies to Take Back Your Life" is available online and in retail outlets nationwide. Proceeds from the book will support medical education and research at Mayo Clinic.

PET Scans show Fibromyalgia Patients have Inflammation in the Brain

2019-09-30T08:17:00.003-07:00

Fibromyalgia patients often hear the words “You look so good. How can you be ill?” Or maybe the insensitive words “fibromyalgia is all in your head”. Ongoing and recent research; however, validates the reality of this invisible illness. This information allows individuals with fibromyalgia and other similar invisible illnesses to press on beyond doubt and find validation for their complex illnesses. Even more important, understanding recent research helps provide direction and identifies natural choices for healthy pain management with fibromyalgia.

What is inflammation?

Inflammation is part of the body’s healing process. Without inflammation, infections and wounds would not heal. But inflammation can also be potentially harmful. There are two types of inflammation, acute and chronic. Acute inflammation comes on suddenly from an injury or infection. It presents classic symptoms such as swelling, redness and pain.

Acute inflammation is momentary, lasting from a few days to a couple of weeks, depending on the origin of the inflammation. Chronic inflammation is long-term inflammation that lasts for months and years. It comes about slowly and sets the stage for chronic diseases. Heart disease, autoimmune diseases, neurological diseases, diabetes, cancer, Alzheimer’s, arthritis and many other conditions are linked to chronic inflammation.

Research teams find widespread inflammation in the brains of fibromyalgia patients

PET imaging studies reveal elevated glial activation, correlation with fatigue levels. A study has documented for the first time widespread inflammation in the brains of patients with the poorly understood condition called fibromyalgia.

A study by Massachusetts General Hospital (MGH) researchers — collaborating with a team at the Karolinska Institutet in Sweden — has documented for the first time widespread inflammation in the brains of patients with the poorly understood condition called fibromyalgia. Their report has been published online in the journal Brain, Behavior and Immunity.

“We don’t have good treatment options for fibromyalgia, so identifying a potential treatment target could lead to the development of innovative, more effective therapies,” says Marco Loggia, PhD, of the MGH-based Martinos Center for Biomedical Imaging, co-senior author of the report. “And finding objective neurochemical changes in the brains of patients with fibromyalgia should help reduce the persistent stigma that many patients face, often being told their symptoms are imaginary and there’s nothing really wrong with them.”

The current study provides evidence of elevated TSPO binding, as measured with CPBR28 PET, in patients with fibromyalgia (FM) compared to healthy controls (HC). This marker of glial activation was increased in several brain regions implicated in FM pathology from previous neuroimaging studies. We also report positive associations between TSPO PET signal in several of these regions and subjective ratings of fatigue, one of the most common symptoms reported by FM patients (Clauw, 2014, Wolfe et al., 2011). Our observations are supportive of a role for neuroimmune/glial activation in FM pathology.

These results conform to a body of clinical data suggesting a possible association between neuroinflammation and FM. Several studies of FM patients demonstrated elevated CSF levels of molecules implicated in neuroglial signaling, such as fractalkine and IL-8. You can read this complete research paper.

Fibromyalgia and Neuroinflammation

Inflammation has become an increasingly important topic in fibromyalgia. It’s clear that “central sensitization” – an increase in pain sensitivity engineered by the central nervous system is present in fibromyalgia (and other chronic pain disorders). Pro-inflammatory nerve factors are produced by an inflammatory process, those nerve factors send the pain-producing nerves into a tizzy and could be the cause of that central sensitization.

Neuroinflammation then is a major possibility in FM, but measuring it hasn’t been easy. Only recently have brain imaging techniques been developed that might be able to measure the neuroinflammation that’s present in FM. This study tried to get at the question of neuroinflammation in a different way. In recent times there has been increased interest in the various cells of the brain that play a role in inflammation and hypersensitivity.

One such cell that is known to play a central role in the inflammatory responses in the brain is microglia. The brain has quite a dense population of them. But before we look more into the role of microglia in brain inflammation and hyper-reaction, let us understand more about inflammation and relation between brain and peripheral inflammatory diseases. After all, FM is commonly initiated by a health condition that affects peripheral organs.

Mechanism of inflammation

Inflammation is a defensive mechanism. Once the body faces any infective agent or local trauma, it is recognized and practically eaten up (infective agent, debris, other foreign material) by the cells called macrophages. Macrophages also play a central role in initiating an immune response, and they do it by secreting cytokines and chemokines.

Chemokines are the messengers that attract other types of defensive cells to the area, while cytokines are more complex messengers that send the information about the stress and attack to various cells and parts of the body. Soon after the initial inflammatory reaction, sickness ensues, resulting in elevated body temperature, pain, and loss of interest in everything around.

It is a time when our brain centers come into action. It is the specific centers in the brain that elevate the body temperature so that to control the microbial growth (increase in body temperature is regulated defensive mechanism). Our brain tries to conserve energy by forcing us to take rest, reduce social interaction, physical activities.

We know that irrespective of the location of the inflammatory response, the brain plays a central role in controlling various responses. It raises the question about the mechanism underlying the information exchange between the point of inflammation (which may often be far away from the brain) and brain. That happens in two ways, firstly, through the messengers called cytokines, and secondly, through the inputs from the nerves

Treatment to lower neuroinflammation

We already have some proofs that treatments that specially lower inflammation levels in the brain can decrease fibromyalgia symptoms. Many of what we think of as anti-inflammatory medications (like ibuprofen or other non-steroidal anti-inflammatories) doesn’t work well on brain inflammation, but there are some treatments that do. Low-dose naltrexone (LDN) is the most efficient, which is a medication but mainly prescribed by alternative medicine providers, as most western medicine doctors are not well-known to its use for pain.

An opiate-blocking medication is known as Naltrexone that is prescribed in higher doses (50mg) to treat opiate and alcohol dependence. LDN lowers inflammation in the central nervous system when consumed at very low doses (1–5mg dosage range).

There are specific receptors on the immune cells in the brain called glial cells, LDN acts on them and tells them to go back into hibernation and stop releasing inflammatory chemicals. In two studies done at Stanford University LDN was shown to appreciably reduce fibromyalgia pain, and also lessened pain hypersensivity.

Herbal treatment to treat inflammation

Turmeric: For hundreds of years this yellow spice has been used as an anti-inflammatory in ayurvedic medicine. The active constituent is a chemical called curcumin, which research has shown to have anti-inflammatory effects in the brain.

Green tea: A chemical called EGCG (-)-epigallocatechin-3-gallate is shown to be “strongly defensive against inflammation, oxidative damage, and cell death” in the brain. It is extracted from green tea.

Cruciferous vegetables: Sulforaphane is an extract from broccoli and it protects against brain inflammation and decreases injury to neurons.

Anti-inflammatory supplements include:

>>>omega-3 fatty acids
>>>turmeric >>>ginger
>>>coQ10
>>>rhodiola rosea

Many doctors recommend anti-inflammatory diet for inflammatory conditions, but we do not have enough research on it. People often start with strictly limited diet, because everyone’s inflammatory triggers are not same, then add back in one type of food at a time, to check which foods are problematic.

Source: https://fibromyalgiaresources.com/pet-scans-fibromyalgia-patients/?fbclid=IwAR3WGJihtWX6cDT4aBoq5yNS-Tz0d6YMTWVdPS6jtWKDQcK8XOO8OUkgipY

The Seven Stages of Fibromyalgia. What is your Stage?

2019-09-30T08:11:00.002-07:00

Stage 1

You started experiencing pain and fatigue more than before, you’re not sure what is going on but you hurt and you are tired. You can hold a job, you can make it through your day, but you know something isn’t right… so it’s something you’re going to start researching.

Stage 2

You are in pain a lot, sometimes taking an anti-inflammatory drug or what have you. You do not get much relief, and you have accepted the fact this is something you are going to have for a while. you feel a lot of pain and you are exhausted almost every day, but for the most part you keep going and hold down a job, can still go to events, spend time with your friends and loved ones, and have some good time here and there.

Stage 3

You are in constant pain, you are constantly tired, you wonder whether you will be ever able to function normally again. You are considering not working, because you no longer have the energy you once had, you come home from work and all you can do is rest. You have to turn down invitations, you have no energy left and you have to rest up just to go back tomorrow. In this stage you start to feel more alone, and more and more people are beginning to think you whine too much. This stage can last a long time, perhaps years.

Stage 4

You are in unrelenting pain all the time, good days are few and far between. You are calling into work sick more than you even make it in. You are in bed a good portion of your day. When you do have a good day you take advantage of it, and do as much as you can, all the things you have left in the past weeks you cram into your day, knowing well that tomorrow you will be paying for it. Your flares last for days. By this time your friends make plans without you, they already know your excuses and are nearly certain you will not be able to join in. Your family begins to think you are using fibromyalgia as an excuse to not do things because stages 1-3 you were able to do much of what you just can’t do now. They think you are using your illness as an excuse, you feel alone, isolated, worried, emotional, sad. This stage can last years.

Stage 5

You have already been let go or have quit your job, you are asking questions about permanent disability and how long it takes to get it. You have heard horror stories about people being denied and the process taking years. You are struggling to make ends meet. Maybe have a person who takes care of you. You spend a lot of your day in bed, although you still take advantage of that one good day once in a while. You are sore, very sore, you cry a lot, you feel like a prisoner in your own body. By this time you have already explained to your friends that it still feels good to be invited even if you don’t go. You have found that the only people that can relate to you are in a similar predicament. You wish your friends and family could understand.

Stage 6

You may or may not still be waiting for disability pension. You cannot hold down a job. Fibromyalgia is now your lifestyle, most of your friends are living with fibromyalgia themselves, everything you do takes all your precious energy, simple daily tasks you took for granted in earlier stages, going to the bathroom, washing your hair, taking a shower, getting dressed, tying your shoes, take all you can give. You get irritated by your hair or clothes touching your skin, you have no energy or desire to put on “your face” before going out, no energy to keep a neat home. With all the medication you are on now or have tried, you are dealing with side effects and constant pain.

You are a human and still enjoy some things, like watching TV. You try to stay current on any news regarding fibromyalgia, in hopes they are closer to finding a cure. Most of your old friends are not around anymore, they have things to do. You need to rest a lot. It’s easy to feel overwhelmed in this stage because things are piling up around you: bills, laundry, dishes. You do a little every day, you push yourself so you don’t feel like your day was wasted in bed, you feel guilty that you no longer pull your own weight in the house. Your kids, spouse or family do things for you more than ever. They try to do it in a nice manner but you still feel like a burden, you can’t remember anything, cannot recall names or dates and you lose your train of thought mid-sentence. Also, you know more about fibromyalgia in this stage then your own doctor and basically laugh when trying a new medication. You are without hope, the same drill as before, same results, nothing helps much.

Stage 7

Anger and Refusal

It sort of is for most of us. We don’t think I will every yield to this horror, and we will continue to search for answers for reasons. its all can do. I refuse to believe this horror of an illness just randomly happens.

The original post that inspired this page was written by Angela Wise and posted on her page in 2014

Reference: www.life-enthusiast.com

How to relieve fibromyalgia pain

2019-09-30T01:40:00.003-07:00

Doctors are still unsure about what causes fibromyalgia, a condition where a person feels pain despite having no signs of physical injuries or inflammation. However, there is a wide range of natural and medical treatments available that may help with the symptoms.

This article looks at the various ways a person can relieve the pain of fibromyalgia using medical treatments, medications, home remedies, and natural products.

Medical treatments

Some prescription medications can help with the pain of fibromyalgia. These include:

1. Over-the-counter pain medication

Over-the-counter (OTC) pain relievers, including aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as Naproxen, may help a person to manage fibromyalgia pain. Some people find that OTC versions of these drugs work well. When these medications are not effective, a doctor may prescribe stronger pain medication.

2. Fibromyalgia drugs

The U.S. Food and Drug Administration (FDA) has approved three drugs specifically for treating fibromyalgia. Those include:

pregabalin (Lyrica), which may calm overactive nerves
duloxetine (Cymbalta), a drug that acts on brain chemicals called serotonin and norepinephrine to dampen pain signals
milnacipran (Savella), which also acts on serotonin and norepinephrine to reduce pain

A 2018 study, for instance, shows that people using pregabalin reported improvements in pain, quality of life, mood, and sleep.

People with fibromyalgia may need to try several drugs or different dosages before they find the right combination for them. Talk to a doctor about any side effects, and ask how long it will take the medication to work. Some drugs require several weeks to become fully effective.

3. Antidepressants

Some research suggests that low levels of the chemical serotonin make people more vulnerable to fibromyalgia. Selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels, may help with some fibromyalgia symptoms.

Also, living with fibromyalgia can lead to depression and anxiety. Some people find that taking antidepressants improves their mood, which helps them better manage pain.

4. Sleeping medications

Many people with fibromyalgia struggle to sleep at night. Sleep deprivation can make the pain worse. When home treatments, such as going to bed at the same time each night and investing in a comfortable mattress fail, doctors may prescribe sleeping medications.

5. Narcotic pain medication

Narcotic pain relievers called opioids change the way the brain responds to pain. They can relieve many types of pain, although their effectiveness for fibromyalgia pain is unclear.

A 2018 study found that the fibromyalgia drugs containing pregabalin worked better for pain relief than opioids. Because opioids can be addictive, it is essential to talk to a healthcare provider about the benefits and risks of these drugs and to consider other treatments first.

6. Non-narcotic pain medication

Some doctors prescribe non-narcotic pain relievers, such as Tramadol, to help with the pain of fibromyalgia. These drugs can be effective but can also be addictive. It is essential to monitor the dosage and to consider other strategies for long-term pain management.

How to Treat Fibromyalgia

2019-09-30T01:37:00.001-07:00

Fibromyalgia and pain

Fibromyalgia (FM) is a condition that causes musculoskeletal pain, fatigue, and localized tenderness. The cause of FM is unknown, but genetics may play a role. Symptoms can develop after:

psychological stress
physical trauma
an injury
an illness

Other symptoms may include depression, poor concentration, and headaches.

Treating pain, fatigue, and other symptoms is key. Fortunately, several options are available to help ease and manage FM symptoms and improve your quality of life.

Ways to treat fibromyalgia pain

FM pain can be minor or serious enough to interfere with daily activities. Thankfully, treatment can help manage pain.

1. Pain relievers

Medication is an option to reduce FM pain. Your doctor may recommend over-the-counter (OTC) pain relievers such as aspirin, ibuprofen, and naproxen sodium. These medications can help:

reduce inflammation
minimize muscular aches
improve sleep quality
2. Antidepressants

These can help ease pain and fatigue. Discuss the possible side effects of using antidepressants for FM with your doctor. For some people, antidepressants can cause a variety of unpleasant side effects such as nausea, weight gain, and loss of sexual desire.

3. Anticonvulsants

These seizure medications may also help reduce pain. The U.S. Food and Drug Administration approved pregabalin (Lyrica), the first anti-seizure drug for FM treatment. Gabapentin, which reduces nerve pain, may be suggested. But these medications come with possible side effects including:
- dizziness
- weight gain
- swelling
- dry mouth
4. Yoga

Research has shown that people with FM who participated in yoga classes experienced improved mood and less pain and fatigue. The classes included:
- gentle poses
- meditation
- breathing exercises
- group discussions
Try taking a yoga class. The practice increases muscle strength, incorporates meditation, and teaches different relaxation techniques. Just be sure to let the instructor know about your condition, so they can adjust the poses as needed for you.

5. Acupuncture

You may want to try acupuncture for pain relief. It involves pricking the skin with needles to:
- promote natural self-healing
- encourage a change in blood flow
- change the levels of neurotransmitters in your brain
- treat a variety of health conditions like chronic pain
A study in the Journal of Rehabilitative Medicine found that people with FM who received acupuncture benefited from pain relief for at least two years, compared to those who didn’t. For those who cannot tolerate the needles, acupressure may be an option.

The risks of acupuncture include soreness, minor bleeding, and bruising after treatment. Always make sure your acupuncturist is licensed to decrease risk of infection from unsterilized needles.

6. Physical therapy

Physical therapy techniques aim to improve your range of motion and strengthen the muscles. This can also help reduce FM pain. Your therapist will tailor a program to help manage specific symptoms. They can also teach self-care techniques, including FM education, to help you manage the fatigue and pain on your own. Research shows that pain management education can lead to increased performance during exercise.

How can I treat fibromyalgia fatigue?

Fatigue is a common symptom of fibromyalgia. You may wake up in the mornings tired despite sleeping through the night. Simple everyday activities can be exhausting. Options for treating FM fatigue include:

7. Vitamin D

People with FM often have low levels of vitamin D. In a 2013 study, researchers found that people with FM felt physically better and experienced less fatigue when they took vitamin D supplements. Talk to your doctor before taking vitamin D supplements, as too much can be toxic.

8. Exercise

Exercise is also an effective way to combat tiredness and improve your energy levels. Exercise increases the brain’s production of endorphins, improves sleep, and reduces depression. Suggested activities for people with FM include walking, biking, and swimming. For some, getting started is difficult with widespread pain; start slow and increase gradually. While this article presents options to consider trying, exercise is the only solution that continues to show benefit in controlled trials.
What are other alternative treatments for fibromyalgia?

You can incorporate alternative treatments to ease FM symptoms. Talk to your doctor about the following options.

9. Medical marijuana

Medical marijuana can ease symptoms of fibromyalgia. One study found that people with FM who took medicinal cannabis experienced:
- a reduction of pain and stiffness
- enhanced relaxation
- an increase in sleepiness
- feelings of well-being
- improved mental health
More research is needed about the benefits of medical marijuana for FM. Side effects can include unfocused judgment and concentration, and long-term effects need further research.

10. Biofeedback

Biofeedback is about learning how to control your body functions. This can help reduce muscle tension and FM pain. There are no side effects associated with this technique, but some people can feel overwhelmed or exhausted after a session. Speak with your doctor to see if you’re a good candidate for biofeedback.

11. Tai chi

This mind-body technique involves deep breathing, meditation, and controlled movements. Tai chi can improve muscle strength, balance, and stamina. It’s not strenuous, but you can develop sore muscles or sprains if you overdo it.

12. Massage therapy

Massages can relax your muscles, improve range of motion, and reduce stress and anxiety. You could experience temporary bruising, swelling, and pain if your therapist applies too much pressure.

13. Cognitive behavior therapy (CBT)

The basis of CBT is about helping people set realistic goals. Patients work on identifying dysfunctional thought patterns and developing techniques to manage negative thoughts. The techniques you learn through CBT can help to reduce or minimize your FM pain.