As we covered last week, Fibromyalgia differs from other pain conditions, such as rheumatoid and osteo arthritis, in that the pain originates in the brain versus the perceived site of pain. It is for this reason that NSAIDS and the majority of prescription pain medications—targeting the perceived site of pain in the muscle, versus the actual origin of pain in the brain—are ineffective for treating Fibro pain. In addition, commonly used medications such as Ibuprofen damage the stomach lining and can lead to the formation of stomach ulcers, whereas the active ingredient in Tylenol—acetaminophen—depletes the body of glutathione, an essential amino acid and antioxidant.
Compounding the problem is the fact that many prescription pain medications carry side effects that mimic the symptoms of Fibromyalgia, to include fatigue, muscle spasms, impaired memory and cognitive functions. Fortunately, there are many natural remedies that have proved safe and effective for treating Fibromyalgia pain, as Dr. Jacob Teitelbaum outlines in his book, From Fatigued to Fantastic (2007).
Rhus toxicodendron is a homeopathic remedy that is inexpensive and side-effect-free. Though it is likely not sufficient alone for long-term pain management, it is an excellent place to start, and can be used in conjunction with more aggressive pain management therapies.
Herbs such as wild lettuce, Jamaican dogwood, passionflower, and valerian root have a calming effect that is non-sedating and effectively relieves muscle pain and pain-related anxiety. Similarly, boswellia, cherry fruit, and willow bark—from which Aspirin is made—can decrease inflammation by inhibiting the enzyme cyclooxygenase (COX), while ginger inhibits the production of Substance P, the spinal fluid that allows for transmission of pain signals to and from the brain.
The combination of ribose and magnesium, found in supplements such as Ribose Cardio, can effectively relieve pain and support mitochondrial function production of ATP, the body’s primary energy source. Meanwhile, tryptophan—a powerful amino acid—works by raising the body’s serotonin levels, which in turn relieves pain, and essential fatty acids such as omega-6 and omega-3 have anti-inflamatory effects. EFAs are involved in hormone production, fluid balance, cell-membrane formation and support of the body’s immune system. Interestingly, symptoms of deficiency mirror many Fibromyalgia and Chronic Fatigue symptoms, such as sluggishness, memory loss, muscles aches, brittle nails and hair, GI upset, depression and moodiness.
While the side effects of many prescription drugs are not worth the benefits, a select few have proven to be effective and relatively light in experienced side-effects. Prescription pain medications such as Neurontin, Gabitril, and Lyrica work by increasing the body’s response to gamma-aminobutyric-acid (GABA)—often referred to as the “calming neurotransmitter.” Similarly, anti-depressants such as Cymbalta, Effexor, Paxil and Zoloft increase the production of serotonin while inhibiting Substance P spinal fluid. Essentially, these medications are effective because they target the brain’s pain-response center versus the perceived site of pain, and are most effective when taken in conjunction with natural and homeopathic remedies.
The natural and prescriptive remedies described above are designed to support the S.H.I.N.E protocol, to include Sleep, Hormone balance, Immunity support, Nutrition and Exercise. Next week, we will take a closer look at S.H.I.N.E, and the additional corresponding therapies our clinic provides.
Dr. Teitelbaum, Jacob. From Fatigued to Fantastic! 3rd ed. Garden City Park, NY: Avery Pub. Group, 2007. Print.
Once thought to be muscular in nature, Fibromyalgia Syndrome (FMS) is a neurological disorder that involves the brain’s communication with the body’s pain receptors, via the spinal cord. Essentially, it is like the volume in the part of the brain that perceives pain is “turned up,” causing even mild stimulus, such as light touch, to register as painful. Fibromyalgia affects primarily women, ages 40-60, though some men, young adults, and teenage children may be affected as well. Characteristic symptoms include widespread pain and extreme sensitivity to touch, in addition to fatigue, disturbed sleep patterns, impaired memory and the ability to focus.
While the pain of osteoarthritis is due to the breakdown of cartilage around the joints and supporting muscle tissues, rheumatoid arthritis is an auto-immune disease characterized by stiffness and inflammation of muscles and joints. By contrast, the pain of Fibromyalgia comes and goes, often moves throughout the body, and is unrelated to inflammation or the wear and tear of age. It is for this reason that FMS patients gain little relief from traditional drug therapies.
In a study conducted by the Mayo Foundation for Education and Research, 39 FMS patients were interviewed with regard to their symptoms and corresponding 6-12 prescription medications. Ten years later, 29 of these patients were interviewed again. While 55% reported severe pain and stiffness, 48% reported disturbed sleep, and 59% reported persistent, extreme fatigue, an overwhelming 79% were still taking the same or similar medications as they were 10 years ago.
In addition to being ineffective, prescription medications may also deplete the body of essential nutrients—the ramifications of which may take years to manifest—as well as the sleep hormone melatonin, which further contributes to disrupted sleep patterns. In fact, the majority of prescribed medications come with side-effects that mimic the symptoms they are meant to relieve—fatigue, pain, brain fog—yet patients continue to take them because the alternative if giving up.
Or so they think. Here at Restorative Health Clinic, we are happy to offer another alternative: recovery! By approaching the condition from a holistic perspective that accounts for all aspects of the patient’s lifestyle—to include nutrition, supplementation, exercise, sleep, and work patterns—our naturopathic physicians lend the necessary support for patients to manage their symptoms and embark on the long journey back to health. Read next week for further information on specific therapies available to our patients, to include supplemental, injection, and intravenous therapies.
GABA is a brain hormone that promotes feeling of calmness and alert relaxation. The GABA system is at the center of fighting anxiety and keeping feelings of overwhelm at bay.
The very fact that anti-anxiety medicine like clonazepam, diazepam and alprazolam are some of the most frequently prescribed drugs, indicate that GABA system dysfunction is very prevalent today.
Symptoms associated with decreased GABA or imbalances in the GABA system:
- Feelings of anxiousness or panic without reason
- Feelings of dread
- Inner tension, easy excitability and inner restlessness
- Feeling overwhelmed without reason
- Restless mind
- Cannot turn off your mind when it is time to relax or sleep
- Concern or worry about things that are not significant
- Anxiety and inability to concentrate due to your mind jumping around
Drinking teas, black or green, and eating fermented foods help boost GABA activity in the brain, and focused supplementation has been shown to make a tremendous difference not only in calming feelings of anxiety and restlessness, but increasing brain levels of GABA.
GABA system dysfunction is dependent upon many modern lifestyle factors, which can be identified and corrected with appropriate lifestyle and focused GABA system specific nutrients for a steady and calm emotional state.
Dopamine is the hormone of contentment and feeling centered. Feelings of discontent, hopelessness, decreased stress tolerance and volatile temper is a sure indication that your dopamine system may not be functioning as well as it should to ground you.
Adventure seeking, habitual overuse of anything – chocolate, sugar, alcohol or other substances – may also be related to low dopamine.
Dopaminergic neurons in the spinal cord are important in pain modulation and have been found dysfunctional in conditions like fibromyalgia with much body pain.
Movement disorders like Parkinsons disease are strongly linked to low dopamine levels in the central nervous system.
Symptoms of low dopamine or decreased dopamine activity include:
- Decreased motivation for tasks
- Trouble starting and finishing tasks
- Feelings of worthlessness
- Feelings of hopelessness
- Losing temper over small things
- Can’t handle stress
- Anger and agression while under stress
- Tendency to isolate yourself
- Lack of concern for people you are close to
The body makes dopamine from the amino acid L-Tyrosine, then turns it into L-Dopa, which is the direct precursor to dopamine.
Iron is essential for effective formation of dopamine in the brain, iron is needed to convert tyrosine into DOPA, in addition, you need Vit B6, folic acid and oxygen.
If you are iron deficient or anemic, you may want to optimize your iron levels in addition to supporting dopamine pathways with precursors.
Testing in addition to thorough symptomatic analysis may help you diagnose dopamine deficiency, which can be treated through a systems based approach, correction of nutritional deficiencies and other factors influencing dopamine system dysfunction.
Werner Vosloo ND, MHom
In addition to lower cortisol levels in the morning and throughout the day [in patients who really need higher levels to support them through their daily stress and pain], Fibromyalgia patients demonstrate decreased cortisol receptor sensitivity. This adds insult to the injury.
To achieve the same cortisol-mediated stress, blood sugar and energy metabolism support, fibromyalgia patients need higher levels of circulating cortisol than average patients. Lower cortisol levels plus compromised cortisol receptor sensitivity accounts for much of the symptom load exhibited by fibromyalgia patients, esp as relates to day-night rhythm problems, increased perceptions of stress and decreased stress tolerance with anxiety during stressful situations.
Yet again, this situation need not be an obstacle to better health. Moderately increasing cortisol levels through micro-dosing with appropriate hormone therapy makes the world of difference with anxiety, sleep and day-to-day function.
Reduced and disturbed glucocorticoid sensitivity was observed in fibromyalgia patients. The very interesting observation in this study, in addition to the disturbed cortisol receptor function, that fibromyalgia patient’s ACTH did not increase during pain pressure point threshold testing: cortisol did increase 3 times [from the pain of the test] and IL-6 increased 4 times [an inflammatory hormone that is problematic in FMS].
Fibromyalgia patients exhibited changes in glucocorticoid receptor (GR) affinity and disturbances associated with loss of hypothalamic-pituitary-adrenal (HPA) axis resiliency. There is a lower expression of corticosteroid receptors in FM patients when compared to healthy controls.
“…..Increased resiliency and sensitivity of the stress system is probably related to stimulation of Glucocorticoid Receptor-alpha synthesis by the components of the treatment.” The conclusion of this study is that due to changes in cortisol receptor sensitivity, Fibromyalgia patients improved in many respects, including pain threshold and resilience of the stress system.
Werner Vosloo ND, MHom