Fibromyalgia is a soft tissue, non-articular rheumatic
syndrome with symptoms of chronic aches, pains and stiffness,
with trigger points or specific sites of exaggerated
tenderness. With as much as 4 percent of the population
suffering from this disease, modern medical science has yet to
find a cure or even to treat this problem effectively.
Fibromyalgia bears a striking resemblance to chronic
fatigue syndrome (CFS) and mainly affects women aged 25 to 50,
with the female-to-male ratio being approximately 5:1.
Fibromyalgia symptoms may be triggered by a number of factors,
including overexertion, stress, lack of exercise, anxiety,
depression, lack of sleep, trauma, extreme temperature and/or
humidity changes and infectious diseases. Fibromyalgia
diagnosis is based on specific site tenderness points, which
are assessed by a variety of techniques. These tender points,
18, are located on positions on the body that have been most
frequently reported to cause problems in fibromyalgia
patients.
The American College of Rheumatology has developed several
criteria for assessment of fibromyalgia patients:
* Diffused musculoskeletal pain for at least three months.
* Stiffness that worsens in the morning.
* Tenderness to palpation of at least 11 of the 18 tender
points.
* Sleep disturbances.
* Fatigue and/or anxiety.
* Depression.
* Gastroentestinal disturbances.
* Subjective soft tissue disturbances.
* Cardiovascular complaints (dizziness, palpitations.
Possible causes Studies have shown that victims of
fibromyalgia appear to have microcirculatory problems, along
with mitochondrial damage and abnormally low phosphate levels,
suggesting an energy-deficient state of the muscular [tissue.sup.(1)(2)].
Muscle hypoxia may develop, leading to fatigue and other
symptoms, such as pain. Glucose has the primary function of
providing fuel for the body. It does this in two ways. First,
through glycolysis or the breakdown of glucose into pyruvic
acid and at times lactic acid (anaerobically produced). The
second pathway is the conversion of pyruvic acid, in the
presence of oxygen, to carbon dioxide and water. A by-product
of this conversion is the production of ATP in the Krebs
cycle. Under various stresses, the amount of ATP production
may not be able to keep up with the demand, thereby causing
fatigue, muscular aches and other problems. Because the Krebs
cycle is relatively slow in production, the glycolytic pathway
is utilized by the body in many situations to produce energy;
however, this leads to a production of dlactic acid, which
diffuses and accumulates into the muscular tissue. Fatigue
usually is correlated with the depletion of glycogen stores
and an increase in lactic acid buildup. These are hallmark
traits in individuals suffering from symptoms of fibromyalgia.
Recent evidence suggests that magnesium deficiency may be
crucial in development of symptoms of [fibromyalgia.sup.3].
Magnesium is necessary in most biochemical processes,
including ATP synthesis and subsequent cellular energy
production. Mitochondrial uptake and accumulation of magnesium
are directly related to the uptake of phosphate required for
ADP phosphorylation. Of particular interest is that magnesium
is necessary in aluminum detoxification in the body, and
aluminum inhibits glycolysis and oxidative phosphorylation,
resulting in decreased intramitochondrial ATP production.
Additionally, due to its high affinity for phosphate groups,
aluminum blocks the absorption and utilization of phosphates
vital to the synthesis of ATP. Aluminum toxicity is known to
cause metabolic disturbances and has been implicated in
Alzheimer's disease, and detoxification is critical to keep
the body and mind healthy. Researchers have found that in
addition to adequate amounts of magnesium supplemented in the
diet, malic acid supplementation may also be beneficial in
improving the symptoms of aluminum toxicity and fibromyalgia [specifically.sup.(3)(4)].
Also, irritable bowel syndrome, which is a smooth muscle
dysfunction specifically in the gut causing diarrhea, cramps
or dry constipation, has been implicated in fibromyalgia. IBS
individuals report bloating and a feeling of fullness or
stretching. Fibromyalgia patients frequently complain of GI
disturbances, commonly caused by IBS. Proper nutrition and
dietary supplementation is imperative in improving symptoms of
IBS and fibromyalgia. Leaky gut syndrome is a condition that
may cause IBS, and also needs to be addressed in the
fibromyalgia patient. This syndrome is the erosion of the
microvilli of the mucosal lining, allowing larger than normal
molecules, such as proteins, to enter the bloodstream, causing
fatigue and resulting muscular pain among other problems.
Candida overgrowth is common in leaky gut syndrome, caused by
various factors, including antibiotic use. The use of NSAIDs,
aspirin and other acidic medications may also contribute to
leaky gut syndrome. Correction of these problems is essential
in treating the fibromyalgia patient.
Improvement of the underlying metabolic and physiological
imbalances, including leaky gut syndrome, IBS and magnesium
deficiency, is essential.
The following protocol may be effective in relieving the
symptoms of fibromyalgia.
* Beta-Glucan, preferably yeast derived, between 100 and
400mg daily depending upon severity of symptoms.
* A quality multivitamin daily.
* Acidophilus/bifidus: Adults: one-half teaspoonful mixed
in juice or water.
* Magnesium malate: 1,200-2,400 mg daily in divided doses.
* Adrenal complex tablet (with B complex): 1 tablet 2-3
times daily.
* Antioxidants (use at least two of the following): Green
tea, 100-300 mg bid, standardized to 50 percent or more
polyphenols and 40-65 percent catechin fraction per dose.
Coenzyme Q1O, 50-100 mg daily.
* Alpha-lipoic acid, 100 mg daily.
* Vitamin E, 4001U daily.
* Curcumin (Turmeric), 300 mg bid-tid, standardized to 90
percent curcuminoids/dose.
* Bilberry, 80-240 mg daily in divided doses, standardized
to 25 percent anthocyanidins/dose.
Be sure that an appropriate diet of plenty of fresh fruits
and vegetables (organically grown, if possible) and limited
refined foods and sugars is followed. Good sources of dietary
magnesium include: * Soybean products. * Whole wheat flour
(not in hypersensitive individuals). * Buckwheat flour. *
Almonds. * Cashews. * Rice. * Most legumes.
Many prescription medications may aggravate the symptoms of
fibromyalgia, and appropriate counseling and alerting the
physician is necessary in patients presenting symptoms of
fibromyalgia. Medications include: * Antibiotics--causes
imbalance in normal microflora, leading to leaky gut syndrome.
* NSAIDs/ASA--causes gut erosion and irritable bowel syndrome.
* Anticholinergic agents--dry secretions, increasing
constipation. * Oral contraceptives. * Diuretics.
If properly diagnosed, and with appropriate diet and
dietary supplementation, fibromyalgia can be effectively
controlled, allowing millions of suffering individuals to live
pain-free, productive and fulfilling lives.
References: 1. G. Ferracopoili, et al., "Neuroendocrinologic
Findings in Primary Fibromyalgia (Soft Tissue Chronic Pain
Syndrome) and in Other Chronic Rheumatic Conditions," J
Rheumatology 17(1990): 1241-54. 2. A.T. Masi, et al.
"Concepts of Illness m Populations as Applied to
Fibromyalgia Syndrome," Am J Med 51(1986): 19-25. 3. G.
E. Abraham, et al.,
"Management of Fibromyalgia: Rationale for the Use of
Magnesium and Malic Acid," J Nutri Med 3 (1992): 49-50.
4. J. L. Domingo, et al.,
"Citric, Malic, and Succinic Acids as Possible
Alternatives to Deferoxamine in Aluminum Toxicity," Clin
Tox 26 (1,2) (1988): 67-79.
