Fibromyalgia is a multisystem syndrome, primarily involving widespread muscle pain, or myalgia, which can be debilitating in severity.
The pain seems to be caused by tightening and thickening of the myofascia, the thin foam or tissue that holds the muscle together.
Fibromyalgia, also called fibrositis, shares many of the same symptoms as chronic fatigue syndrome and 70% of patients diagnosed with fibromyalgia also meet the criteria for chronic fatigue syndrome. Unlike arthritis, the joints are not directly involved.
Associated pain may cause aching and burning, and the nature of the condition is unpredictable.
Although there is no known cause of fibromyalgia, its onset may be related to physical or mental stress, inadequate sleep, injury, exposure to cold, dampness, infection such as viral or Lyme, and occasionally rheumatoid arthritis.
An estimated 3 to 6 million Americans suffer from it, and 86% are women, primarily in the age group between 34 and 56.
The level of disability is severe enough that 25% of women and 27% of men affected are unable to work. Other symptoms also include widespread muscle pains, generalized fatigue and stiffness, allergies, headaches, sleep disorders, restless legs, irritable bowel, dizziness, exercise intolerance, anxiety, depression, irritability, dry eyes, carpal tunnel, tender skin, cold sensitivity, numbness and tingling, and dysmenorrhea in women. There are also anxiety, depression, and mood swings. It was first diagnosed by a physician in 1816, although it did not receive recognition by the American Medical Association until 1987.
CAUSES OF FIBROMYALGIA:
Many possible triggering events or causes have been implicated, including viral, bacterial, Lyme, or even Mycoplasma. Prior trauma such as an assault or auto accident, chemicals, food sensitivities, chronic stress, hormonal imbalances, mercury toxicity from dental amalgams, breast implants, and irregularities in muscle metabolism are seen.
Researchers have found that those with fibromyalgia have elevated amounts of neurotransmitters involved in pain responses, “substance P as well as depressed levels of a natural painkiller called serotonin.” There are also low levels of growth hormone and, at times, cortisol. Abnormal sleep patterns, particularly a decrease in slow wave and stage IV sleep is seen. In this stage, the muscles are unable to heal.
In one study, there was a possible connection between flu viruses and fibromyalgia.
Nine of ten fibromyalgia patients tested positive for antibodies due to influenza type A. Another possible cause being explored is Mycoplasmal infections. Mycoplasma is a group of microorganisms intermediate between a bacterium and virus.
Unlike virus, Mycoplasma can produce outside living cells. Unfortunately, we cannot avoid contamination with Mycoplasma, as it is found in soil, water, and many other locations in nature. Patients with dysfunctional immune systems, whether genetic or suppressed because of stress or other illness, cannot mount an effective defense and therefore may become affected.
Testing is done in combination with a direct culture and/or indirect means using blood tests.
At times, fibromyalgia patients have low levels of growth hormone and cortisol. Human growth hormone is secreted in very brief pulses during the early hours of sleep and remains in circulation for only a few minutes. After the age of twenty, the production of growth hormone decreases progressively, at an average rate of 14% per decade. Recent research indicates that irregularities in growth hormone secretion may be a factor in fibromyalgia.
Cortisol is a hormone secreted by the adrenal glands. Under conditions of chronic stress, high amounts of cortisol are released and the adrenal glands become exhausted. Imbalances in cortisol secretions are linked to lower energy, muscle dysfunction, thyroid dysfunction, immune system depression, sleep disorders, and decreased growth hormonal uptake.
In other words, people who are short on cortisol because of the problems with their adrenal glands experience the same symptoms of fibromyalgia sufferers. Studies have shown that adrenal insufficiency and stress may contribute to many of the neural hormone imbalances seen.
Fibromyalgia patients show abnormal brain waves during the deepest stage of sleep, stage IV.
This stage is important for tissue repair, the creation of antibodies, and the formation of growth hormone, which is necessary for muscle and bone health. Instead of experiencing the restorative rest that allows muscle to recover from a day of activity, fibromyalgia sufferers wake up during stage IV sleep. In fact, this lack of restful sleep is considered a major cause of symptoms associated with fibromyalgia. Buy a Zeo to measure your sleep and make sure you are in REM stages of sleep
THE CHALLENGE OF DIAGNOSING FIBROMYALGIA:
An extensive History and Physical is performed in every patient.
Substantial symptom overlap exists among chemical sensitivity, fibromyalgia, and chronic fatigue syndrome, as well as many other degenerative, autoimmune, and viral diseases.
There is no current specific diagnosis of laboratory tests to identify fibromyalgia.
The diagnosis is made by ruling out other conditions that may mimic the symptoms of fibromyalgia, including thyroid disease, adrenal disease, lupus, Lyme disease, rheumatoid arthritis, etc.
Seventy-five percent of fibromyalgia patients have some degree of hypothyroidism, reported almost thirty years ago.
The percentage is higher than that of the general population. Fibromyalgia patients were shown to have either a thyroid hormone deficiency or cellular resistance to thyroid.
Because the list of possible symptoms of fibromyalgia is long, making a differential diagnosis is difficult.
Workup for these patients is extensive, including traditional testing such as ANA, CBC, CMP, C-reactive protein, etc.
Extensive hormone levels are checked, as are toxicities such as heavy metals or pesticides. An antioxidant assay is performed and mineral levels checked. A comprehensive digestive stool analysis is also performed, as well as T cells mediated allergy.
Amino acid analysis of urine as well as antibodies to infection such as Candida, Epstein-Barr, Cytomegalovirus, herpes virus, Chlamydia, and Helicobacter might be checked. In addition, titers to Mycoplasma should be obtained.
The conventional medical solution for fibromyalgia, painkillers, is a prime example of symptom-driven treatment with little understanding of causes and equally slim chances of therapeutic success.
The symptoms of fibromyalgia are the result of underlying imbalances in the body, produced by multiple simultaneous infections and accompanying physical, mental, and environmental factors. Testing to rule out any of the previous mentioned causes is performed.
Of course, it is important to look for toxicities, nutritional deficiencies, and infections, including yeast, parasites, virus, Lyme, or its associated co-infections.
By treating these infections and boosting nutritional intake, with good diet and proper supplementation, a person can reduce the burden on the immune system.
Detoxifying the body is another important component promoting a healthy immune system and addressing other factors that may contribute to fibromyalgia. As our environment and food are increasingly saturated with chemicals, the body’s mechanisms for elimination of toxins cannot keep up with the chemical deluge.
TWO PAIN-SUPPRESSING DRUGS THAT ARE IMPORTANT TO KNOW ABOUT
LDN is starting to hold promise in helping millions of people with cancer, autoimmune disease, fibromyalgia, and a host of others.
As a pharmacologically active opioid antagonist, LDN works by blocking opioid receptors, which in turn help activate the body’s immune system. The latest research just confirmed that LDN does in fact target the opioid growth factor and receptor pathway to inhibit self-proliferation and regulates the growth of cancer cells. Furthermore, it also works through your body’s immune system by elevating endomorphins, which play a role in relief of pain, fibromyalgia, and your mood.
Typically, LDN is taken at bedtime and a few hours later, in the middle of the night, there is up regulation of the immune system and an increase in your body’s own natural opioids or endomorphins.
Low-dose naltrexone has shown promise in the treatment of various other diseases, such as hepatitis C, lupus, ulcerative colitis, chronic fatigue syndrome, irritable bowel, Alzheimer’s, Parkinson’s disease, and diabetic neuropathies. I have used it myself for twelve years and have seen good results. This can be compounded by a compounding pharmacist at 4.5 mg.
Recent studies performed at multiple universities including Stanford have shown benefit.
OXYTOCIN AND PAIN RELIEF
The hormone oxytocin is used to induce labor in pregnant women and large amounts are released during the childbirth and the uterus is stimulated to contract.
There is now evidence to show that the hormone is invaluable in healing fibromyalgia, post-traumatic stress disorder, and functional dysfunction in both men and women.
Oxytocin has also been shown to relieve stress induced by social pressure and I have found it to be very useful in the treatment of fibromyalgia.
A hormone panel is obtained in every patient and the hormones are replaced as necessary. Natural bioidentical hormones are used, such as Armour thyroid and cortisol. Melatonin, DHEA, pregnenolone, testosterone, progesterone, and estrogen are used when levels reveal a deficiency.
These hormones are used in a transdermal preparation in order to avoid first-pass liver metabolism.
Other natural substances include phosphatidyl-choline, NADH, essential fatty acids, Q-10, ribose, PQQ, cetyl myristoleate, and, at times, cayenne to deplete substance P. The patient is also counseled on diet, exercise, massage, and other modalities. Neurotransmitters are balanced in every patient. Food allergies, when appropriate, are also tested for and an elimination diet is instituted.
I USE MANY IV THERAPIES TO GET MY PATIENT FEELING BETTER QUICKER
Vitamins and Detox: Vitamins and detox are essential.
The diagnosis of fibromyalgia is difficult. The patients are evaluated for the multiple etiologies discussed above and a personalized individualized program is instituted for each patient. If you think you have fibromyalgia, please call the office for further information.