What Is Fibromyalgia?
There are some days when it almost "hurts too bad to move," or
when you wake up from a full night's sleep "too tired to think
straight."
For those who suffer from Fibromyalgia Syndrome, days like these
happen on a regular basis. This throbbing, "aching all over" feeling
often seems worse in the morning. And that makes it even more difficult
to bear when you've just spent a seemingly endless night tossing
and turning because restful sleep hasn't been seen in your bedroom
for a long time. Fibromyalgia is also usually cyclical, with different
symptoms from day to day, and changes in energy levels and pain.
Sometimes everything may get worse for a while, and then there will
be days where the patient feels nearly normal and symptom free.
As the syndrome progresses, cycles of pain and fatigue may become
longer and more severe.
Fibromyalgia (FM) is a chronic musculoskeletal condition causing
widespread pain, fatigue and muscle stiffness throughout the body.
One of the most difficult things about the disorder is that the
symptoms mimic at least 46 other conditions. It is characterized
by physical oversensitivity and pain responses to a wide range of
triggers, sometimes seemingly without cause. With its wide variety
of symptoms and its undeserved reputation as a "catch-all" diagnosis,
fibromyalgia is a frustrating condition to manage.
One of the reasons is because those with fibromyalgia don't appear
sick, even though they know something is very wrong. There's no
swelling, no spots, no fever, nothing obvious, but... They are in
chronic pain. They don't sleep. They're tired. And quite often they
are a little over weight because it simply hurts too much to move,
or they find that exercise makes them tired. When they do finally
seek medical advice, the typical blood tests come back normal. Because
there is no blood test to detect FM, doctors often can't diagnose
the problem until all similar disorders that CAN be detected by
blood tests are first ruled out.
It can take up over 4 years for a diagnosis of fibromyalgia to
be made, often while the patient gets worse and worse. Friends,
family members, and even doctors may tell them that it's "all
in your head," or that they just don't want to feel good. They
may be accused of making it up, even though this condition has been
documented in largely ignored medical literature for well over a
century. The years that often pass until a proper diagnosis are
often spent bouncing from doctor to doctor, trying to find someone
familiar with fibromyalgia symptoms who won't ignore them.
Fibromyalgia affects as much as 4 percent of the U.S. adult population, making it the second most common rheumatological illness after osteoarthritis. It affects women more often than men by as much as a 10 to 1 ratio. The average age of a fibromyalgia sufferer is between 30 and 55.
It is a syndrome, not a disease, because it does not cause degeneration of body organs or tissues, nor does it deform. But the stress of living with a chronic, painful condition can be devastating ... to the patient, the family, work or social life.
Fibromyalgia Symptoms
The most common signs and symptoms of fibromyalgia are: widespread muscle pain, morning stiffness, nonrestorative sleep and daytime fatigue. Cold, damp weather and and physical activity can severely aggravate conditions.
Other common symptoms often found in fibromyalgia patients include
irritable bowel syndrome, myalgia (muscle pain), arthralgia (joint
pain), generalized muscle weakness, stiffness, numbness, swelling,
tingling, lightheadedness when standing, migraine and tension headaches.
Cognitive problems such as not being able to "think straight" or
remember things are also frequently linked to FM. These 'forgetful'
episodes of short term memory or concentration impairment are referred
to as 'fibrofog.' It's a frustrating, often scary, situation when
you find yourself unable to remember things you've known 'forever,'
like your own phone number or even your children's names.
And it's certainly not hard to see why depression and anxiety are
often common problems for those with fibromyalgia. Chronic pain
and loss of sleep can cause even the most cheerful person to experience
these feelings. And because it's often hard to diagnose, the frustration
and feelings of isolation that follow remarks like 'this is all
in your head' or 'would you like the name of a psychiatrist' often
intensifies feelings of depression and anxiety. In fact, neurotransmitter
deficiencies and imbalances are a common part of fibromyalgia. These
may have something to do with the prevalence of mood disorders,
but also sleep and digestive problems.
Another condition related to fibromyalgia is "subjective swelling,"
a feeling that an area is swollen even though there is no physical
change in the site. And the list of symptoms goes on ... TMJ (temporomandibular
joint dysfunction - a painful disorder of the jaw joints), dry eyes
and mouth, eye twitching, temperature sensitivity such as intolerance
to cold or dizzy 'fainting spells' in hot conditions, exercise intolerance,
Raynaud's Disease (sporadic attacks of blood vessel spasms resulting
in interruption of the blood flow to the fingers, toes, ears and
nose), hearing problems, mitral valve prolapse, fever, osteoarthritis,
polymyalgia rheumatica, Seasonal Affective Disorder (SAD), multiple
food and/or chemical sensitivities, Rheumatoid arthritis, Sjogren's
syndrome (systemic autoimmune disease that affects the musculoskeletal
system and organs), sore throat, swollen lymph nodes, chronic rhinitis
(runny nose), skin problems, vertigo, urinary problems, vulvar pain
syndrome (vaginal pain and spasms, painful intercourse), PMS, menstrual
cramping, eating disorders, digestive problems, weight gain, candidiasis
(yeast infections), immune system weaknesses, ADD/ADHD (Attention
Deficit Hyperactivity Disorder), Gulf War Syndrome, Post Polio Syndrome,
etc.
Nearly half of the females who have fibromyalgia also have hypoglycemia
(low blood sugar), or reactive hypoglycemia (low amounts of usable
sugar). Studies indicate that 40 percent of females have fibroglycemia
(a combination of both) and 20 percent of men with FM also have
it. Symptoms of hypoglycemia include an intense craving of sweets,
tremors, sweating, panic attacks, heart palpitations, faintness,
confusion, and frontal headaches.
Tender Points
The American College of Rheumatology bases the diagnosis of FM
upon two major criteria: 1) widespread, diffuse pain lasting at
least three months and 2) a minimum of 11 (out of 18 possible) specified
tender points throughout the body. This is the strict definition
for being included in a clinical study of fibromyalgia, but tender
points may change from time to time, and may worsen or get better
in the cyclical way that this syndrome seems to work.
These tender points will hurt when pressed, but the pressure will
not cause pain in any other part of the body. The physician applies
a standardized amount of pressure, about 4 kg (enough to turn the
thumbnail white). Remember, a tender point has to be painful at
palpation, not just "tender." When pressed, these areas
tend to feel like bruises in various stages of healing.
Also, a tender point is different from what you may know as a trigger
point. Tender points hurt, trigger points hurt and refer pain to
other body parts. Trigger points cause myofascial pain syndrome,
which often coexists with fibromyalgia, but can be treated with
massage, physical therapy, or gentle stretching. When muscles feel
hard and pressing on them causes a response elsewhere in the body,
or even nausea, trigger points are responsible. Tender points are
caused by an unknown mechanism, and their severity is often cyclic.
Tender points do not generally respond to physical therapy, often
becoming more painful with pressure.
Widespread pain is defined as having pain in both sides of the
body and pain above and below the waist. In addition, pain must
also be present in the cervical spine, anterior chest, thoracic
spine or lower back.
These tender points are located at:
- Occiput (2) - at the suboccipital muscle insertions (near the
base of the skull)
- Low cervical (2) - at the anterior aspects of the intertransverse
spaces at C5-C7 (the lower vertebra of the neck)
- Trapezius (2) - at the midpoint of the upper border (the neck,
mid back and upper back muscles between the shoulder blades)
- Supraspinatus (2) - at origins, above the scapula spine near
the medial border
- Second rib (2) - upper lateral to the second costochondral junction
(the insertion of the second rib)
- Lateral epicondyle (2) - 2 cm distal to the epicondyles (the
side of the elbow)
- Gluteal (2) - in upper outer quadrants of buttocks in anterior
fold of muscle (the upper and outer muscles of the buttocks)
- Greater trochanter (2) - posterior to the trochanteric prominence
(the upper part of the thigh)
- Knee (2) - at the medial fat pad proximal to the joint line
(the middle of the knee joint)
During guaifenisin therapy, it is recommended that these tender
points be mapped and monitored as treatment progresses.
Back to top
Fibromyalgia Causes
Although an exact cause of fibromyalgia is unknown, there are several
underlying conditions that contribute to the disorder. Treatment
is usually focused on reducing the severity of the symptoms related
to the most prominent conditions.
Not getting enough "restful" sleep is thought to be one of the
chief underlying causes of fibromyalgia. The body sleeps in stages.
Stage four is when the body should be in a deep sleep. This deep
sleep is the time that the body has set aside for healing. Tests
show that stage 4 of the sleep cycle in fibromyalgia sufferers is
interrupted. More conclusive results came about when researchers
continuously interrupted the stage 4 sleep of people who had previously
never had signs or symptoms of fibromyalgia. As a result of loss
of sleep during this critical time, those who had never suffered
with fibromyalgia before began to show signs of the disorder. These
sleep studies also suggested a direct link between fibromyalgia
and a deficiency in the Growth Hormone. This hormone is important
in muscle maintenance and repair and is secreted during sleep stage
4.
Neurotransmitter (chemicals that communicate between nerve cells)
levels in fibromyalgia patients are often disrupted, causing bodywide
imbalances. Any of the following neurotransmitters may be disrupted
in fibromyalgia, resulting in a wide range of possible symptoms,
and requiring different treatments. All of these substances work
together, starting and stopping different reactions to allow us
to respond to our environment. If they are out of balance, certain
reactions that are helpful in moderation may run out of control.
The causes of this disruption are unknown.
- Acetylcholine - This neurotransmitter controls heart contraction,
mucus production in the upper respiratory tract, digestive enzyme
secretion, sweating, and the contractions of the stomach, intestines,
and eliminatory organs. Involuntary motion and thoughts are also
associated with improper levels of acetylcholine.
- Adrenaline and Noradrenaline - These complementary neurotransmitters
are most known for their connection with stress, and the 'fight
or flight' response system. They both regulate energy consumption
in the body. Adrenaline is associated with sugar metabolism and
insulin production, and is thought to be released into the body
too quickly in response to carbohydrates in reactive hypoglycemics.
Noradrenaline inhibits digestion, and lowers the body temperature
and pain threshold. High levels of these chemicals can create
a restless, oversensitive, high anxiety state that may quickly
burn out the body's energy reserves. Low levels can cause an apathetic,
low energy state, common in fibromyalgia.
- Dopamine - This neurotransmitter controls motor activity and
concentration. Too much can cause muscle cramps and anxiety, while
too little may lead to fatigue and lethargy. ADD and ADHD, more
common in fibromyalgia patients, are sometimes associated with
low levels of dopamine in certain areas of the brain.
- GABA (gamma-amino-n-butyric acid) - GABA affects both mood and
muscle tone. Low levels can be responsible for muscle spasm and
tightness, as well as mood and memory dysfunction.
- Histamine - This chemical is released in our bodies when we
are exposed to either a trauma or a toxin. Sometimes histamine
production is too high, raising the body's alarm system when there
is no danger. This is how common allergies occur, and why antihistamines
are so effective. (A different mechanism is at work in food intolerance,
as opposed to allergy.) Excess histamine production may result
in red, watery eyes, headache, stomach upset, or low blood pressure.
- Serotonin - A disruption (usually a deficiency) of serotonin
is common in fibromyalgia. This chemical regulates mood, digestion,
weight, sleep, blood pressure, pain sensitivity, and motivation.
Individuals who are prone to migraine or nonrestorative sleep
are especially likely to have deficiencies in serotonin. SSRIs
(selective serotonin reuptake inhibitors) work by increasing levels
of this chemical, and this may be why they are effective for some
patients.
- Substance P - This chemical regulates pain sensations, stomach
contractions, blood pressure and mucus production.
- Peptides - These chemicals are related to how individuals feel
pain. Many people have heard of endorphins, which are the 'feel
good' peptides released naturally during moderate exercise. A
lack or surplus of any peptides may increase our likelihood of
experiencing pain, or reduce our resistance to pain sensations.
Additional underlying factors include deficiencies of nutrients
such as magnesium. This can cause muscle cramps upon exertion and
upon awakening. It has also been suggested that a buildup of phosphorus
in the body may be responsible for the condition. (Guaifenisin treatment
is thought to work by eliminating extra phosporus.) If that is the
case, it suggests an explanation for the normal blood test results
often received by fibromyalgia patients. Other possible causes of
fibromyalgia symptoms are hypoxia (lack of oxygen in body tissues),
muscular injury, muscular atrophy, emotional stress, digestion,
and mood disorders.
Still another possibility is the onset of infections or viral exposures.
More than half of fibromyalgia patients said this occurred prior
to the onset of their symptoms. Included among these are Lyme Disease
(infection that manifests itself as a multi-system inflammatory
disease), Human Immunodeficiency virus, Coxsackie Virus (common
source of infection in children that often causes flu-like symptoms),
Epstein-Barr (member of the herpes virus family, often associated
with chronic fatigue), or Streptococcus and Parvovirus (virus that
can cause joint pain and swelling).
Lack of regular physical exercise seems to be a factor although it is not known whether lack of conditioning promotes pain or vice versa. While exercise is often invigorating for healthy individuals, it can exhaust a fibromyalgia sufferer, sometimes for days.
Sometimes the symptoms began much earlier than the fibromyalgia
patient realizes. Thirty percent of patients remember having 'growing
pains' in childhood that seemed to disappear before puberty. These
pains seem to reappear more severely later on in adulthood.
There is also some indication that fibromyalgia can be hereditary,
as it tends to run in families. Incidence of sleep disorders, blood
sugar difficulties, headaches or migraine, ADD or ADHD, Asperger's
syndrome, irritable bowel, joint problems, and food allergy or intolerance
may all be common in the families of fibromyalgia patients. It is
unclear how these conditions interact, or what causes what, but
in fibromyalgia it often seems like several conditions pile on top
of each other.
Back to top
Standard Fibromyalgia Treatments
Prescription medications that manage the symptoms of this syndrome
are the most common method of treatment at present. None of these
treatments is a cure for fibromyalgia, but all have seen some success
in certain individuals in reducing pain, sleeplessness, ar other
discomfort. The treatment goal is usually pain or fatigue management
and allowing the individual to lead a less restricted life than
they otherwise would.
Due to the upset in neurotransmitter levels seen in fibromyalgia,
certain symptoms often respond to antidepressants. Note that this
does not imply that the condition is merely psychological, nor is
fibromyalgia the only physical condition that benefits from medications
that adjust the levels of different neurotransmitters. Antidepressants
often improve the regularity of the sleep-wake cycle and benefit
digestion. They are taken in much lower doses for fibromyalgia than
they would be if used to treat depression. Many fibromyalgics are
also quite sensitive to drugs that affect the nervous system, and
are likely to react strongly to high doses of antidepressants and
central nervous system depressants.
Something that should also be noted is that there is a difference
between physical withdrawal symptoms after long-term medication
use and psychological dependence. Physical withdrawal is a fairly
common consequence of long-term medication use, even if that medication
is necessary to manage physical discomfort. Psychological addiction
implies a desire to take a medication even when feeling healthy,
and when the symptoms it is designed to treat are not present. Actual
drug addiction rates are generally very low among patients using
medication for chronic pain.
Because of the chronic nature of fibromyalgia symptoms, individuals
with this condition may end up needing to manage ongoing pain, sleeplessness,
and severe muscle tension for long periods of time. Many medications
that affect the central nervous system are generally indicated for
acute symptoms that resolve over a period of weeks, maybe months
at most. Taking them for long periods of time increases the risk
that the body will react to removing the medication. Speak to your
doctor about drug holidays, rotation schedules, gradually decreasing
dosage to end treatment and avoid uncomfortable symptoms that may
result from the long-term use of a medication. Some medications
may also become less effective the longer they are used, and the
greater the dosage. It's very important to the continued effectiveness
of many treatments that the minimum dose needed to successfully
manage your symptoms should be used at all times.
Remember that pain control is a legitimate and important goal of
medical treatment for fibromyalgia, or any condition. Severe, chronic
pain and discomfort can be extremely disruptive to anyone's life.
While a physician should pay attention to the possibility of unwanted
side effects and dependence, the needs of the patient must be considered
on an individual basis. If a treatment is ineffective, it is the
duty of the physician to try alternate methods, and the duty of
the patient to communicate their needs clearly. Appropriate treatment
may vary widely among individuals, and it may be the case that several
treatments will need to be tried before an effective medication
with minimal unwanted side effects is found.
- Benzodiazepines (a class of antidepressants, anti-panic
agents, and muscle relaxants) - These include Ativan
(lorazepam), Valium (diazepam),
Halcion (triazolam), Restoril (temazepam), Librium
(chlordiazepoxide), Xanax
(alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam),
ProSom (estazolam), Klonopin
(clonazepam), and others. Benzodiazepines are commonly prescribed
for fibromyalgia, especially when a combination of anxiety and
sleeplessness is present along with muscle tension. They should
not generally be taken during treatment with any other antidepressant
medication and should not be mixed with narcotics or barbiturates.
Xanax may be of some use in treating irritable bowel syndrome,
and klonopin may help individuals who experience restless legs
or periodic limb movement during sleep. These medications reduce
the effectiveness of opiate, or narcotic pain medication, as they
block opiate receptors. Physical withdrawal symptoms are highly
likely with this class of medications, especially with long-term
use. If you wish to end treatment with a benzodiazepine, follow
your doctor's advice about gradually reducing your doses over
a period of time.
- Guaifenisin - This common expectorant (thins mucus, making
it easier to expel) is found in many adult and pediatric cold
medications. Some individuals finds that it reverses the symptoms
of fibromyalgia (after first increasing them), sometimes dramatically.
Guaifenisin treatment is safe enough for children, and has no
significant side effects. It's effectiveness in treating fibromyalgia
can be blocked by salicylates (aspirin like compounds producted
by plants) absorbed through the skin, or taken in herbal supplements
or extracts. While no special diet is required, avoiding plant
extracts in skin care products, cosmetics, and toothpaste are
a must. Taking herbal supplements and many teas will also block
the effects. The guaifenisin found in cough syrups, however, does
not contain high enough doses and may be adulterated with undesirable
ingredients. Some pharmacies will have 200-600 mg tablets, but
many do not carry this form. The 200 mg tablets can be ordered
without a prescription. See the links at the bottom of the page
to find doctor St. Amand's website where you can read about the
details and find safe product lists.
- Muscle Relaxants - Flexeril,
Robaxin, and Soma are all commonly prescribed as fibromyalgia
treatments and may prove effective at relieving tender points
and reducing achiness. They should be used cautiously with any
medication that may make you drowsy, though fibromyalgics are
commonly prescribed multiple central nervous system depressants.
Benzodiazepines, narcotics, tricyclic antidepressants, and Ultram
may all add to the sedative effect. Make sure that you discuss
a medication schedule with your doctor that will not leave you
oversedated.
- Narcotic pain medication - These include Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone,
acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine),
Vicodin Tuss (hydrocodone, guaifenisin), Vicodin
(hydrocodone, acetaminophen), and Vicoprofen (hydrocodone,
ibuprofen). The mild opioid Ultram
(Tramadol), has been found to be fairly effective for fibromyalgia,
and generally poses less risk of dependence and side effects than
other opiates. There are many brand names for most of these, so
look for the generic ingredients on the label. These medications
should not be mixed with barbiturates, some antidepressants, or
each other. Do not take these with cough medications containing
alcohol or a narcotic (codeine or hydrocodone), or Tylenol with
codeine. Do not mix them with over the counter pain medication
unless your doctor specifically tells you it is safe to do so.
These medications may increase constipation in some individuals.
- Non-Steroidal Anti-Inflammatories (NSAIDs) - Such as
Motrin or Advil (Ibuprofen), or Naprosyn (naproxen). These medications
can relieve pain without the strong central nervous system effects
of narcotics and barbiturates. Ibuprofen, a common over the counter
pain reliever, can be found as a generic ingredient in combination
with some narcotic pain medications. These drugs can be hard on
the liver and kidneys, and can increase the risk of ulcers or
internal bleeding. They should never be taken in combination with
aspirin, acetaminophen, or any other anti-inflammatory. You should
avoid alcohol while taking it. Be sure to speak with your doctor
about taking these drugs if you are taking blood pressure medication
or a blood thinner. These medications can worsen digestive problems
by damaging the linings of the stomach and intestines.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram), Paxil (paroxetine),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline)
may sometimes be prescribed in low doses to normalize serotonin
levels. They are usually taken in the morning, as these drugs
can cause insomnia. They may sometimes be prescribed along with
low doses of a tricyclic antidepressant, which will then be taken
at night to promote sleep. Minor weight loss is a common side
effect of these medications. If you are taking any of the triptans
(Amerge, Imitrex, Maxalt,
Zomig) for migraine, be aware that both classes of drug affect
the availability of serotonin in your body, and could increase
it to dangerous levels. This drug combination could be fatal.
Do not use supplemental 5-HTP if you take these medications.
- Sleeping pills - Whether you use an over the counter
or prescription medication for insomnia or another sleep disorder,
you should know that some of them will actually increase the likelihood
of migraine attacks (while you should be aware of the possibility,
you may not react the same to all these medications). This is
not usually the case with the newer prescription medications Ambien
(zolpidem) and Sonata
(zaleplon), though they also may result in an attack in some
individuals. Be aware that these medications should not be mixed
with either narcotic pain medications or benzodiazepines. Do not take a sleeping pill within several
hours of narcotics, and check with your doctor
or pharmacist to be sure to leave enough time between them. Do
not combine any sleeping pill with alcohol, this could result
in dangerous or fatal overdose.
- Tricyclic Antidepressants - These include Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine). These
medications may dangerously increase central nervous system suppressant
effects when taken in combination with narcotic pain medication.
They should not be mixed with alcohol, and you should not drink
excessively while they are part of your treatment. They are usually
prescribed in small doses for fibromyalgia, and taken at night
to promote restful sleep. An SSRI may be prescribed along with
them, to be taken in small doses in the morning. These are not
all the same, and may react differently for each individual. If
your doctor thinks these may help you, discuss possible complications
and interactions with other health conditions. If you plan to
quit taking them, step off your dosage gradually, or you may experience
unpleasant side effects including rebound headaches. Also be aware
that weight gain is a more likely problem with tricyclic antidepressants
than with many other treatments. If you already have a weight
problem or are prone to rapid weight fluctuation, you may want
to monitor your weight more carefully on these medications. They
also may increase carbohydrate cravings, which may account for
the effect on weight, and may be worse for individuals with reactive
hypoglycemia.
Other Medications
Some medication you might take for other conditions may not mix
well with prescription treatment for fibromyalgia symptoms, or be
effective for long term care. Be sure to read the list of drug interactions
on your package inserts, and ask your doctor or pharmacist to check
the safety of combining multiple prescription medications you may
need. As always, over the counter medications or supplements are
not beyond suspicion:
- Alcohol - It can be very dangerous to mix alcohol with
certain prescription treatments for fibromyalgia. If your pain
medication contains a barbiturate or narcotic, you could risk
dangerous slowing of the nervous system, possibly coma or death
depending on the amounts involved. It is similarly dangerous to
take alcohol with muscle relaxants, tricyclic antidepressants,
or benzodiazepines. Your doctor or pharmacist can advise you if
it is ever safe to drink during your treatment, but be aware that
alcohol is a common migraine trigger (especially red wine), and
can interfere with both digestion and deep sleep. Many reactive
hypoglycemics are unable to deal well with alcohol. Alcohol
is one of the single most dangerous drugs to mix with other drugs
or medications that act on the nervous system, and is implicated
in many cases of fatal overdose due to drug interactions. Alcohol
is especially likely to increase the likelihood of risk taking
and aggressive behavior in combination with other medications.
Many medications pose a risk of liver damage if used over long
periods of time, and excessive alcohol use can greatly increase
this risk. While moderate consumption of alcohol has been seen
to have health benefits, be aware of possible interactions, and
avoid drinking excessively.
- Aspirin (or any salicylate, such as salicylamide, or
salicylic acid) can cause kidney or liver damage when taken in
high doses, and over long periods of time, in combination with
acetaminophen. When taken in the recommended doses for a short
time, it has not been seen to produce this effect, but caution
is still advised. Aspirin has also been reported to reduce the
integrity of the upper gastrointestinal tract, particularly the
stomach, with long-term use. Fibromyalgia patients may want to
consider another treatment if they already experience digestive
problems. Do not mix aspirin with other pain relievers. If you
are taking aspirin as a preventive heart disease regimen, you
should still not take it with other pain medications; speak to
your doctor about alternate or non-interacting treatment. Vitamin
E supplements can be as effective for some individuals at preventing
heart disease at a daily dose of 400-1200 IU. If you are taking
guaifenisin, aspirin will completely block its effects.
- Antacids - As indigestion is so common to fibromyalgia,
you may find yourself resorting to antacids to reduce bloating
and gas. This can create worse issues, as these problems are often
caused by a low-acid condition in the first place. Your stomach
needs to be highly acidic in order to digest your food properly,
and to absorb minerals like calcium and magnesium (see below)
which are often deficient in fibromyalgia patients. Try looking
for a mixed enzyme supplement as a digestive aid, and add an acidophilus
supplement or live yogurt to your diet.
- Oral Contraceptives - Birth control pills can be the
cause of a number of fibromyalgia type complaints in some female
patients, though these side effects are often dismissed. Increased
migraine frequency, headaches, muscle aches, leg cramps, fatigue,
anxiety, depression, and blood sugar alterations may all result
from the use of oral contraceptives. While it's never been said
that using the pill plays any direct role in fibromyalgia in women,
some individuals find that certain symptoms clear up gradually
within a month of stopping it, and come back once they resume
use. If you suspect that side effects of your birth control option
may be contributing to your poor health, speak to your gynecologist
about trying another brand with a different, or milder, hormone
make-up. Birth control pills can be made less effective by barbiturate
sedatives and certain antibiotics, and may increase blood levels
of some antidepressants.
Back to top
Fibromyalgia Diet
While there is no specific diet for all fibromyalgia cases, different
symptoms may suggest ways of improving your health through diet.
As fibromyalgia sufferers often have one condition amplifying another
(or several others), relieving even one can increase your quality
of life, sometimes substantially.
- Food Intolerance - If your body overreacts to certain
foods, it could worsen conditions ranging from digestive troubles
(gas, bloating, constipation, or diarrhea) to fatigue, headache
or migraine, joint pain, mood disorders, muscle aches, and skin
problems. Beef, citrus, chicken, corn, dairy, eggs, gluten (protein
in wheat, barley, rye, spelt, and kamut), soy, sugar, tomatoes,
wheat, yeast, etc., are common problems for individuals with food
intolerance. Trying an elimination diet may reveal that you feel
much better after removing certain foods from your diet, often
things you eat commonly. If you avoid them for a while, you may
discover that you can eat certain ones in moderate quantities,
or that some will always produce a reaction. Rotating your diet,
and not eating too much of any one food can be beneficial for
fibromyalgia patients who identify food intolerance as a major
cause of symptoms. For guidelines on discovering any hidden allergies
and managing a balanced elimination diet, try the book 'Food Allergies
and Food Intolerance' by Brostoff and Gamlin.
- Hypoglycemia or Reactive Hypoglycemia - Sometimes called
fibroglycemia when it occurs with fibromyalgia. Reactive hypoglycemia
will not show up on a standard fasting blood test, but you could
have all the hypoglycemia symptoms; cold or tingling extremities,
dizziness, fatigue, headache, impaired thinking, irritability,
muscle weakness, palpitations, tremors, and unusual hunger or
cravings for high carbohydrate foods like sweets, bread, or pasta.
Weight gain is common, though not universal, among reactive hypoglycemics.
These symptoms may present themselves when you are hungry, or
after you have a high carbohydrate meal or snack. They may range
from mild to severe, with particularly severe symptoms usually
occurring when it's been too long since you've eaten. Individuals
may be more prone to midnight snacking, or even to compulsive,
unconscious night eating (similar to sleepwalking, see sleep
disorders fact sheet.) This is caused in part by poor tolerance
of a high carbohydrate diet, and is best managed by diets like
the Zone diet (Sears and Lawren, 1995) which balance carbohydrate
intake with lean protein and healthy fats. A diet high in refined
sugar, refined flour, and starchy foods like potatoes and pasta,
will make this condition worse, even though you may crave them.
Higher lean protein intake (fish, poultry, soy or tofu, cottage
cheese), and healthy, unprocessed fats (raw nuts or seeds, avocados,
olive oil, fish, and flaxseed) will help control the symptoms
and diminish the cravings.
- Irritable Bowel - Many fibromyalgia patients start off
getting diagnosed with irritable bowel syndrome, which is characterized
by alternating constipation and diarrhea, though one or the other
may persist for some time. A feeling of general abdominal discomfort,
persistent stomach upset, fatigue, mood disorders, or bloating
and gas may be present as well. Dairy or gluten intolerance may
contribute to this condition, you may check to see if removing
them from your diet improves matters. Also, large amounts of sugar
or sweeteners can worsen the problem, as can hard to digest foods
such as beans and cabbage. An imbalance of gut flora (beneficial
bacteria) can be responsible in some individuals, and this condition
can sometimes be much improved by eating live yogurt or taking
a live acidophilus culture if you can't tolerate dairy (only use
acidophilus cultures that require refrigeration, as the bacteria
quickly die out at room temperature). Psyllium husks, taken on
an empty stomach, and according to the package directions, can
improve regularity as well by adding needed fiber to the diet.
Exercise and plenty of plain water are recommended as long term
self care measures.
- Migraine - (See migraine
fact sheet) Migraine is a particularly severe type of headache
which is likely hereditary, and common in fibromyalgia. It is
a disorder, or biological predisposition, that causes a painful
overreaction to certain stimuli. In the early stage of a migraine,
sufferers may experience visual disturbances, fatigue, light and
noise sensitivity, nausea, disorientation, or mood changes. They
are commonly linked to food intolerance, and many individuals
find that removing a certain culprit type of food (varies from
person to person) from the diet will reduce sensitivity to former
triggers. The most common triggers are cheese, chocolate, red
wine, sugar or artificial sweeteners, sulfites, amines (found
in aged foods), and MSG. Nuts can cause migraine, but usually
not all nuts. Almonds are the most common trigger, but cashews
should be avoided because they're high in carbohydrates. Sugar
intolerance is particularly important to consider in individuals
who have symptoms of reactive hypoglycemia, and a low or no sugar,
low starch diet should be tried.
- Sleep Disorders - (See sleep
disorders fact sheet) Fibromyalgia sufferers often experience
Non-restorative sleep for a variety of causes, which makes any
physical symptoms worse. Healthy individuals deprived of restful
sleep for a while begin to develop many fibromyalgia symptoms
such as muscle aches, increased headaches, daytime fatigue, etc.
Common sleep disorders that may be present in FMS patients are
Restless Legs Syndrome (RLS) and Periodic Limb Movement During
Sleep (PLMS). With RLS, a person often feels as though their arms
and legs just can't stay still. PLMS is described as the sensation
you have when you think you have reached the last step in a flight
of stairs and you try to regain your balance when you discover
there is another step left. Both of these sleep disorders can
cause continuous arousal movements during sleep, thus keeping
you from getting the rest you need. Individuals may have excessive
REM and other brain wave patterns that disrupt their sleep, instead
of physical movements. These mini-wakenings may be completely
unconscious, and not accompanied by movement, though non-restorative
sleep can still result. Also, narcoleptic type incidents may occur
from excessive daytime sleepiness. These conditions can respond
to moderate exercise, elimination of caffeine, problem foods,
or low doses of an appropriate antidepressant (typically much
lower than required to treat depression.)
- Vulvar or Pelvic Pain - This is very common in fibromyalgia,
and can sometimes be worsened by plant estrogens. Try removing
soy from your diet, and do not take supplemental yam extracts
or primrose oil. These plants are high in what are called phytoestrogens,
or estrogen-like chemicals found naturally in plants.
- Yeast Infection - An oversensitivity to yeast, persistent
thrush, red or itchy skin, and digestive problems are all sometimes
ascribed to yeast overgrowth. There is much disagreement in medical
circles about the actual role of yeast in digestive and skin problems,
but some individuals respond very well to antifungal treatments
when all else fails (this may be due to other properties of antifungal
drugs, which can strengthen the digestive tract). If nothing else
has worked, trying a 'no sugar, no yeast' diet for a month or
more may indicate that a yeast problem is a possibility. If it
helps you feel better, you might consider extending the diet and
consulting a physician about a prescription antifungal treatment.
These medications come in oral preparations (tablets and capsules)
which should be effective in treating systemic infection, and
should work within a few weeks at most. You should be sure that
the beneficial result is not entirely related to the common fibromyalgia
difficulty in dealing with high carbohydrate foods. This symptom
will not always improve with treatment for other conditions.
A common thread in many cases of fibromyalgia seems to be a tendency
to feel better when refined sugar, caffeine, alcohol, fried foods,
red meat, and highly processed foods, are kept to a sound personal
minimum in the diet. Many people benefit from cutting out all sugar
for a month, which can severely reduce the craving for sweets, and
allow your body to better manage its sugar intake when you add it
back in. Sharply reducing your intake of caffeine in all forms,
and fried, processed fatty foods, can improve cravings for these
items in the same way and allow you to see if they are contributing
to your health problems.
Even if you do not have severe food triggers, eating a healthier
diet can have long-term benefits for any fibromyalgia sufferer.
Try supplementing your current diet with greater quantities of raw
or lightly cooked fruits and vegetables. Try substituting meats
that are high in fat with fish or lean poultry. Drink plenty of
water and take a good vitamin supplement to be sure that you are
getting proper nutrition.
Also note that non-steroidal anti-inflammatories (NSAIDs) like
aspirin, ibuprofen, or acetaminophen, can tear down the lining of
the gut and intestinal tract. They are also found combined with
narcotic pain medications, in preparations such as Vicodin or Vicoprofen.
If narcotic pain medication is a necessity for you, or you must
use it frequently, look into a medication that is not combined with
a NSAID like Vicodin Tuss. If you have any predisposition to food
intolerance or digestive disturbances, heavy use of these medications
may make them worse, and these symptoms are very common in fibromyalgia.
If you have never had digestive problems before, a steady regimen
of NSAIDs may cause them to develop. Infrequent or occasional use
should not be a problem, but consistent or daily use will likely
pose a health risk over time. NSAIDs can worsen the vitamin deficiencies
and digestive problems so common in fibromyalgia, while often doing
little to relieve pain in the long term. It may be a good idea to
minimize your use of these treatments.
Back to top
Alternative Treatments
Breathing: In proper breathing, the diaphragm and stomach
expand, and the chest stays more or less still. While most people
can get away with shallow chest breathing, if you have fibromyalgia
it may be creating muscle tension and depriving you of oxygen. It
feels odd at first, but setting aside a few minutes a day when you
can concentrate on breathing from the stomach is a good start. Eventually,
you will retrain yourself into a healthier breathing pattern.
With digestive trouble, such as irritable bowel syndrome, abdominal
breathing is very helpful if you stay with it. It provides similar
benefits to aerobic exercise in promoting strong, healthy intestines.
The constant, gentle motion of breathing gradually strengthens the
whole abdominal area.
Exercise: For fibromyalgics, extensive body-building regimens
and boot-camp style fitness programs can create complete exhaustion
where there was once only fatigue. Most fibromyalgia patients first
notice their illness when they discover with regret that they can't
be as active as they once were, gradually becoming less able to
exert themselves. Nonetheless, symptoms will progress rapidly without
exercise, leaving the need to establish a balance. Without a moderate
amount of activity, sleep and digestive cycles may slow down, leading
to insomnia and intestinal sluggishness. The important thing is
being active every day.
A good way to start is with low-impact aerobics or brisk walking,
swimming or biking. Exercises like these are easier to handle than
others that "jar" the body. If you're just starting out,
remember not to over do it. Begin with as little as five minutes
a day and gradually build up to 30 minutes three to four times weekly.
Swimming, particularly in a heated pool, is an excellent way to
combat the pain of FM. And although this type of treatment, which
allows for greater mobility with less effort, is most commonly used
for lower extremity FM pain, it is possible to treat the upper body
by doing something as simple as placing a chair in the water, setting
down, and allowing the warm waters to work their magic. Keep a daily
stretching regimen to maintain flexibility and reduce muscle cramps.
Learn some calisthenics or floor exercises that you can do at home
if you don't feel up to going out.
Resistance, or weight training, can be very beneficial if you make
sure to only exercise on 'good' days and get plenty of protein.
Slow repetitions at a comfortable weight can produce good results
without straining joints. Take 2-3 days between exercising the same
muscle group, so that you don't cause an injury. Be aware that resistance
and weight training are very healthful in combination with stretching
exercises, and that a moderate routine poses no danger of creating
outsized muscles, only improved muscle tone and firmness. Overly
muscular physiques take years of specific daily training and diet
to achieve, so you should not worry that this type of exercise will
make you 'bulk up' by accident. Often, this is a very good way to
lose excess weight, as muscle mass burns energy even when resting
and helps regulate blood sugar.
But no matter what exercise program you try, always stop and
rest immediately if you become tired. If you keep pushing, you
may find yourself unable to exercise the next day. Remember that
it's far more important to get some extra daily activity than to
prove to yourself that you can do one more repitition or walk a
few blocks farther. The bodies of individuals with fibromyalgia
often have atypical responses to exercise, becoming easily drained
and worn out instead of energized. Drink extra water, and maintain
a protein rich diet that will improve energy use and the creation
of healthy muscle tissue.
Hypnosis: Hypnosis can be highly effective for managing
sleep disorders and reducing the effects of chronic pain in fibromyalgia.
Sometimes chronic muscle tension can be released, especially if
it's worsened by anxiety and stress.
A tape promoting restful sleep played at bedtime, recorded by a
professional hypnotist, is a simple and inexpensive way to try improving
your rest.
Posture: Correct posture can help relieve some pains and
cramps, though it may require a lot of attention to maintain in
the beginning. The basic idea is to evenly distribute pressure to
both sides of the body, and not maintain unnecessary tension. It's
practically a given in fibromyalgia that there will be plenty of
muscle tension, but it can be minimized.
If you try to pay attention to your body, you will begin to notice
that slouching, holding your head forward, crossing your legs, and
standing with all your weight on one leg, cause tension and discomfort.
If you carry a wallet in your back pocket, this can create lower
back pain simply by tilting you a little to one side when seated.
If you find that you pull your shoulders up, or forward, this creates
additional tension in the shoulders and neck that can increase the
frequency and severity of headache or migraine. Relaxed shoulders
should naturally fall down and back.
When you stand, try to stand evenly, and leave the knees unlocked,
or ever so slightly bent. Just enough that in the beginning you
feel a little tension in the muscles just above the knee, but not
so much that your knees appear bent to an outside observer. This
will help relieve tension in the calves, and slowly strengthen the
muscles in the thighs. You may find that it becomes easier to maintain
correct upper body posture when the knees are relaxed, tipping the
hips back slightly. It can reduce both knee and lower back pain,
though it may feel a little uncomfortable at first. Try it every
once in a while for as long as you can stand it, until you find
that it becomes your normal standing posture.
When you sleep, pillows or rolled up towels that give support to
the knees and neck may prevent cramps from developing while you
are in bed. It's common in fibromyalgia to have a low tolerance
for uncomfortable sleep posture, and for aches, tingling, or numbness
to develop at pressure points. If you sleep on your side, extra
neck support may prevent arm and shoulder cramps, while a pillow
between the knees may maintain proper back alignment.
We don't often think of our faces as having a posture, but many
people hold their facial muscles in uncomfortable positions that
result in long-term pain. Fibromyalgia patients are especially prone
to nasty headaches that are worsened by clenched jaws and scrunched
foreheads. Try to notice your jaw more often, and see that it's
loose enough that your lips just touch. Your teeth should not be
touching each other when the jaw is relaxed.
If you find that your forehead is tight, try a little self massage
to help decrease tension, especially if you wear glasses. Use small,
circular motions, or slow, firm strokes going toward the hairline.
Commonly, a great deal of tension may be stored in the temples,
and this type of massage is very helpful for that. Also, you may
find that simply pressing and holding one or more fingers gently
and firmly into the center of the forehead just above the brow releases
tension in the forehead, and sometimes across the face.
Remember, for posture to become good all the time, it must first
become good sometimes. Check your posture several times throughout
the day. Observe how you stand, sit, and walk. It may be uncomfortable
to maintain straight alignment at first, but this is because you've
been using the wrong muscles for so long. Poor posture creates too
much tension in muscles that should be relaxed, and atrophies the
muscles that should be working. This is a common symptom in fibromyalgia,
as the posture tries to accomodate new cramps and aches. Don't become
frustrated if you find yourself slipping into habitual slouches,
just try to be more aware of it when it happens. It may take a while
to form good habits, but the results will please you.
Supplements: Certain supplements are recommended as part
of a natural preventive treatment for fibromyalgia symptoms. Please
remember that while supplements are typically very safe, not all
of them should be combined with prescription therapies or with certain
medical conditions. Certain supplements can cause adverse effects
if taken in large quantities. No food supplement should be taken
as though it were candy. Look for hypoallergenic supplements that
are labeled as being free of common allergens, as individuals with
fibromyalgia may be at increased risk of food intolenance.
These statements have not all been approved by the FDA, as per
their guidelines on food supplements, no claims are made regarding
the ability of these supplements to cure fibromyalgia or any of
its symptoms.
- 5-HTP - This supplement improves your body's ability to manufacture
serotonin, which regulates sleep and digestive cycles. This chemical
is often depleted in fibromyalgics, which may account for the
frequency of mood disorders, as serotonin levels are connected
to our sense of well-being. 5-HTP supplementation has also been
known to reduce chronic pain, though this may have something to
do with its beneficial effect on sleep. A dose of 150 mg taken
with your evening meal is recommended if you have sleep, migraine,
mood, or digestive problems. It is best absorbed when some fat
content is present in your meal (a few nuts, some salad or cooking
oil in one of the dishes, or the natural fat in some meats will
do.) This supplement may make you drowsy during the day if taken
in the morning or afternoon. 5-HTP is not recommended for use
if you currently take a selective serotonin reuptake inhibitior
like Paxil, Prozac, or Zoloft, or any other medication that changes
serotonin levels. Do not take if you use an MAO inhibitor like
Nardil or Parnate.
- Acidophilus - These are the live bacteria found in yogurt, and
in healthy digestive tracts. They are essential for the production
of B vitamins from food and for the digestion of carbohydrates.
If you suspect a yeast infection, this supplement is vital for
replacing damaged bacterial populations in the intestine. It is
also often recommended for irritable bowel and other digestive
troubles. If you suspect that you have a dairy allergy, or are
trying an elimination diet, you should look for a non-dairy supplement.
- Alpha-lipoic acid - A powerful antioxidant that aids in sugar
metabolism, helps the body recycle other antioxidants like vitamins
E and C, and aids production of glutathione and absorption of
Coenzyme Q10. This antioxidant is especially important for individuals
who experience reactive hypoglycemia, or other blood sugar difficulties.
- Amino Acid Formula (Free Form Amino Acids) - Helpful protein
for muscle and nerve repair. While eating enough lean protein
can be a challenge sometimes, a free form amino acid complex can
make sure you get a balanced amount of all the essential amino
acids. You can find this in a capsule or as a liquid; either is
fine, but avoid liquids with lots of sugar or dye additives. Individuals
with fibromyalgia may find these supplements particularly useful
because they are simple for the body to digest and absorb.
- B vitamins - These vitamins are essential for energy and are
involved in almost every function of a healthy body. Fibromyalgics
are often deficient in these nutrients, and those with a vegetarian
or low protein diet may be especially lacking. While some sources
may recommend taking a particular B vitamin in large quantities,
the B complex vitamins need to be taken in balance, with large
doses of one possibly interfering in the function of the others.
If you have severe absorption problems, getting twice weekly B
complex injections from your physician may be the most effective
option. Otherwise, you should take a balanced B complex supplement.
- Calcium and Magnesium - Calcium and magnesium are suggested
to regulate muscle tone and the transmission of nerve impulses,
they are natural muscle relaxants. If you have ever been diagnosed
with ADD, these may be helpful in aiding relaxation. Taking large
doses of calcium or magnesium by themselves for long periods of
time is not recommended. For best results, take them together,
as these minerals work together and need to be in balance. A ratio
of no more than two parts calcium to one part magnesium is common,
but some nutritionists recommend identical doses of these minerals.
Fibromyalgia patients are likely to be magnesium deficient for
reasons that are unclear. Magnesium may be especially important
for reducing muscle tenderness, so be sure to get enough, even
if you must get an additional supplement to balance all the 'extra'
calcium found in foods and supplements. While magnesium can be
taken at any time, avoid taking large doses of calcium with food,
as it may block absorption of certain minerals. Look for these
minerals in a chelate form.
- Carnitine (use L-Carnitine or Acetyl-L-Carnitine forms) - This
supplement aids fat metabolism, muscle development, and helps
improve energy levels. It is somewhere between being a B vitamin
and an amino acid. Carnitine helps your body use fat as an energy
source, aiding maintenance of a healthy weight. It is often deficient
in diets low in animal proteins, and requires sufficient B vitamin
intake for the body to create it. Supplemental L-carnitine can
be taken in doses of 1000-4,000 mg per day in divided doses.
Acetyl-L-carnitine works in a similar way to regular carnitine,
but has been suggested as a boost to the nervous system for
individuals who often experience mood and concentration problems
associated with fibromyalgia. Acetyl-L-carnitine can be taken
in doses of 500-2,000 mg along with L-carnitine. Some individuals
with fibromyalgia can experience notable improvements in concentration
and energy on a 500 mg dose of acetyl-l-carnitine, so start
with a moderate dose and note your results.
- Coenzyme Q10 (CoQ10) - Aids energy metabolism in all cells,
especially helpful to the immune and cardiovascular systems. This
vitamin is especially helpful to individuals like fibromyalgia
sufferers who are constantly in a 'low-energy' state.
- Enzymes - As an aid to digestion, these supplements assist the
body in breaking down different types of foods more easily. This
can improve absorption and reduce allergic reactions in some individuals.
Look for a multiple enzyme supplement whose enzyme components
break down all three major types of foods; starches or carbohydrates,
fat, and protein. Separate enzymes may be needed to break down
dairy products if you have difficulty with these. Pregnant or
nursing mothers, and individuals with bleeding problems, are urged
to consult their doctor or nutritionist before taking these supplements.
- Essential Fatty Acids (EFAs) - Found naturally in oily fish,
flaxseeds, avocados, raw nuts or seeds, minimally processed nut
butters, and unsaturated vegetable oils. These healthy fats improve
the health of the nervous system and are necessary for proper
brain function. EFAs are also beneficial for the joints, the skin
and hair, the intestinal lining, healthy blood pressure and cholesterol,
and relieving pain and inflammation. If you have ever been diagnosed
with attention deficit disorder (ADD), often experience 'fibrofog',
or experience skin or digestive troubles, this supplement can
be especially beneficial.
EFAs are destroyed by heat and light, so only raw, uncooked vegetable
sources are useful. (Fish oil is still beneficial after cooking
fish, but you can also get raw fish oil in capsules.) Hydrogenated
or saturated fats are not helpful, and can create damaging compounds
in the body. Encapsulated primrose oil, grapeseed oil, fish or
emu oil, or a combination EFA supplement can ensure that you get
enough of these important nutrients in your diet. If you suspect
a soy allergy, or are trying an elimination diet, avoid products
containing soybean oil. If you try an EFA supplement, always refrigerate
the container after opening, and keep bottles of flaxseed oil
refrigerated at all times. Keep flaxseed meal in a cool, dark
place before opening, and refrigerate after.
- Malic acid - Improves energy production and sugar metabolism.
It is found naturally in apples, but may also be taken as a supplement.
- SAMe (S-adenosylmethionine) - This supplement is considered
a natural way to improve mood, as well as being beneficial to
the joints and liver. It promotes antioxidant activity in the
body and is thought to aid fat metabolism. If you have ever been
diagnosed with ADD, this may be a particularly useful supplement.
It should always be taken on an empty stomach, and at least half
an hour before eating. For fibromyalgia, the recommended dose
is 200-800 mg. While SAMe is considered to be very safe, it is
not recommended for individuals with manic-depressive disorder,
individuals taking prescription antidepressants, or children under
12.
- Vitamin A and Carotenoids - Vitamin A, and the carotenoids,
are powerful antioxidants and important to the skin and eyes.
Some reports indicate that carotenoids like beta-carotene, lutein,
and lycopene among others, may be a better way to take vitamin
A, as the body can then make as much as it needs out of these
useful compounds. Vitamin A is fat soluble, which means that it
can accumulate too quickly in the body if large doses are taken.
A safe guideline is no more that 10,000 IU per day from supplements,
though larger doses are sometimes recommended for short term treatment.
You cannot overdose on supplemental carotenoids. Never exceed
10,000 IU of vitamin A daily if you are pregnant, and try to take
carotenoids instead. Diabetics and individuals with hypothyroidism
may have difficulties converting carotenoids into vitamin A, and
may strain their livers if they take high doses of carotenoids.
Vitamin A can be found naturally in dark green, leafy vegetables,
vegetables with red, orange, or yellow coloration, salmon, and
animal or fish livers.
- Vitamin E - Known to protect against heart disease and cellular
damage, vitamin E is helpful for preventing over 70 different
diseases. It is also beneficial for skin, reproductive health,
and wound healing. If taken as a supplement, use the natural d-alpha-tocopherol
form, not the synthetic dl-alpha-tocopherol form. The natural
variety is far more effective. It can be found naturally in brown
rice, eggs, kelp, liver and organ meats, milk, soybeans, sweet
potatoes, and whole wheat.
- Zinc - If you have ever been diagnosed with ADD, this may be
a useful supplement, as individuals with this condition are often
zinc deficient. Zinc promotes a healthy immune and reproductive
system, as well as being beneficial for the skin. Zinc is necessary
for the body to use the important antioxidant, vitamin E.
Tai Chi or Qi Gong: Both of these forms of exercise are
very gentle, promoting flexibility and high energy levels. They
are 'no impact,' and are widely reported to improve digestion, posture,
and restful sleep. Muscle tone usually improves as well, but not
bulk. Some Qi Gong exercises can be done from a sitting position,
very useful if one of your fibromyalgia symptoms is not being able
to stand for long periods of time. Classes can be found in most
cities.
Yoga: While yoga is excellent for increasing stamina and
muscle tone, be sure to speak to your instructor before class about
any limitations you may have. An experienced instructor can help
you get the most out of the class without hurting anything. Be especially
sure to ask about ways to relieve pressure on the knees if this
is commonly a problem for you. Eventually, continued yoga practice
may draw out the kinks in your system.
Back to top
Fibromyalgia and Children
'Growing pains' in childhood are common recollections of fibromyalgics.
They could be considered an early warning of problems to come. Often,
children aren't good at communicating about physical problems, like
achy joints, headaches, or stomach cramps. They may come to see
chronic pain as normal, but are more likely to develop behavior
disturbances, 'acting out' not emotional, but sometimes physical
pain. It may happen that they complain of physical pain to get out
of disliked activities, but are later dismissed when they are truly
uncomfortable. Sometimes it can be hard to tell whether a counselor
or a physician is the right person to consult about childhood problems.
For children with fibromyalgia type symptoms, especially if accompanied
by behavior problems or social withdrawal, removing refined sugar,
citrus fruit, and food colorings from the diet can sometimes create
improvement. With an ADD or ADHD diagnosis, wheat or dairy intolerance
should be carefully looked into, and vitamin and essential fatty
acid supplementation considered (see above). Speak with a nutritionist
about an elimination diet to find any food intolerances before they
cause chronic problems. It can be dangerous to remove too many items
from a child's menu without ensuring that any missing nutrients
are replaced, as they need balanced nutrition and a varied diet.
If a child also falls asleep during the day or seems lethargic,
an early onset sleep disorder (See sleep
disorders fact sheet) such as insomnia, sleep apnea, or restless
legs might be involved. If reactive hypoglycemia is present, it
could either cause or worsen daytime sleepiness.
If accompanied by respiratory or skin problems, runny nose, or
itchy eyes, look into various allergies that can be found on a common
skin test, like pet dander, pollen, dust, or mold. Wall-to-wall
carpeting can sometimes harbor these allergens, and be an unsuspected
source of contamination. If steam cleaning doesn't help, wood, tile,
or linoleum floors covered by washable rugs prevent allergens from
gaining a foothold in your flooring.
Guaifenisin treatment can sometimes create a dramatic improvement,
and it's often easier for children to avoid the plant extracts that
block it. It requires no special diet (unless reactive hypoglycemia
is suspected, in which case sugar and starch must be sharply reduced),
and does not have significant side effects. It is considered to
be quite safe for children, and is a common ingredient in children's
cold medication. (Note: The form found in cough syrup is no more
suitable for daily use in children than in adults, largely because
it may have other problem ingredients, including large quantities
of sweetener and food coloring. The doses are too small to be effective,
and are more expensive than buying the plain capsules from a pharmacist.)
It may be a good idea to avoid making a big deal of any special
diet to your child. With younger children especially, it may be
easier to gradually change their diet without discussion and see
how they respond. Children may be prone to see eating healthier
as a punishment, or come to think that they can blame bad behavior
on what they eat.
Fibromyalgia and Pregnancy
Some symptoms of fibromyalgia may decrease in pregnancy, thought to be attributed to increased serotonin levels. However, the tender points of this syndrome can be made worse during this time.
If you or your partner are prone to food intolerance, some evidence
suggests that avoiding allergenic foods during pregnancy and breastfeeding
may reduce the likelihood of an infant developing intolerance to
these foods. As some evidence suggests that fibromyalgia may be
hereditary, and may be worsened by food intolerance, you may want
to discuss it with a knowledgeable nutritionist.
The prescription medications used to treat fibromyalgia are largely
unsuited for pregnancy and nursing. Diet and natural food supplements
are probably the best treatment options at this time, but you should
consult your doctor or nutritionist about them. You will need additional
nutrition and protein, and there are cautions that need to be taken
with certain supplements and types of diet.
Gentle exercise classes designed for pregnancy, pool exercise,
tai chi, qi gong, or yoga (there are special yoga postures for pregnant
women) may be helpful in managing muscle tension and pain during
pregnancy.
Fibromyalgia References and Links:
Fibromyalgia.com This site has a map of the 18 tender points.
National Institutes of Health Visit their fibromyalgia resource page.
Guaifenisin
Treatment Dr. St. Amand's website, the originator of guaifenisin
therapy. Includes information on reactive hypoglycemia.
Fibromyalgia Resources
Devin Starlanyl's website. Diagnostic information and links to online
support groups. More information on myofascial pain syndrome.
This fact sheet would not have been possible without the following books:
"The Fibromyalgia Advocate" by Devin Starlanyl, M.D.
"What Your Doctor May Not Tell You About Fibromyalgia" by R. Paul St. Amand M.D. and Claudia Craig Marek
"Prescription For Nutritional Healing" by Phyllis A. Balch, CNC and James F. Balch, M.D.
"Food Allergies and Food Intolerance" by Jonathan Brostoff, M.D. and Linda Gamlin
Back to top
The information contained in this document is provided for educational purposes
and information only. It is not a
substitute for consultation with a physician or Health professional, either to diagnose
symptoms or prescribe treatment. Any dosages mentioned are general
guidelines only, please follow the directions of your doctor or
pharmacist exactly when taking medication. We have made every effort to
ensure that this information is accurate, but only your doctor,
physician or Health professional can say
if a medication, a drug alternative or drug combination, is safe for you. Information
intended for US residents only.
|
