> Health and Disease > Bones, Joints, and Muscles > fibromyalgia

Fibromyalgia (FM) is a common, yet little understood, muscular disorder that affects thousands of Canadians.

It affects more women than men and is marked by widespread muscle pain, fatigue, and multiple tender points on specific areas of the body. The American College of Rheumatology has established two criteria for the diagnosis of FM: a history of widespread pain lasting more than three months, and the presence of 11 or more tender points out of 18 standard sites on the body (neck, shoulders, back, hips, and upper and lower extremities).

The challenge with FM is that symptoms are not obvious, and it cannot be diagnosed by a particular blood test. For those with FM, not being understood by medical professionals can be just as painful as the symptoms of the disease.

What Causes Fibromyalgia?

While the underlying causes remain unknown, for many sufferers there is an event or experience that triggers the onset of the disease, such as an infection, emotional stress, injury or exposure to certain drugs or chemicals.

According to a 1999 research paper in the Annals of Internal Medicine, 33 percent of FM patients also suffer from multiple chemical sensitivities. Those with rheumatoid arthritis and other autoimmune diseases, such as lupus, also appear to be at greater risk of developing FM.

FM appears to be hereditary. Researchers have identified one particular gene believed to be involved in the syndrome. A four-year study being undertaken by the National Institutes of Health aims to explore this link further.

Individuals with FM have elevated levels of a chemical called substance P that is involved in sensing pain signals. They also have lower levels of serotonin and norepinephrine - two vital chemical messengers in the brain that modulate pain and mood.

A recent study undertaken by Mersin University in Turkey demonstrated that an imbalance of oxidants and antioxidants may be at play in the development of FM. Researchers from the University’s Physical Medicine and Rehabilitation Department found significantly higher levels of the oxidant malondialdehyde, and decreased levels of the antioxidant superoxide dismutase in patients with FM compared to controls.

Treatment

A comprehensive program that includes counseling (emotional support), proper nutrition, exercise, stress management, and the use of supplements to reduce symptoms and improve well-being offers the greatest benefit for FM sufferers. In some cases, medication may be required to control pain, inflammation and insomnia; however, it is always best to try the non-drug approaches first.

Since stress is known to aggravate the symptoms of FM, breathing exercises, meditation, yoga, walking, swimming, stretching, and Pilates may be beneficial.

A healthy diet filled with fresh fruit, vegetables, whole grains, lean protein, and essential fats is also very important. Alcohol, caffeine, and processed food are full of chemicals and preservatives, and should be avoided.

Nutritional Saviours

These supplements have been shown to alleviate symptoms of FM:

SAMe: Short for S-adenosylmethionine, this nutrient is involved in many biochemical reactions in the body, including the production of neurotransmitters (serotonin), antioxidants, hormones, and the sulfur-containing compounds of the joint. SAMe has been found to alleviate pain, fatigue, and stiffness, and improve mood in FM sufferers. The recommended dose is 800 mg of natural (Iso-Active) SAMe daily. It is best to choose a form that is enteric-coated. Take on an empty stomach.

5-HTP: Short for 5-hydroxytryptophan, this supplement helps to boost serotonin levels and alleviate symptoms of depression. It also helps reduce tender points, anxiety, and improve sleep quality. This supplement should not be taken with prescription antidepressants or other drugs that modify serotonin levels. Recommended dose is 100 mg three times daily.

Melatonin: This hormone is responsible for regulating our sleep cycles. A study published in Clinical Rheumatology in 2000, found that supplementing with 3 mg of melatonin at bedtime helped reduce tender points, and improve sleep.

Antioxidants: Preliminary research has found that vitamin E supplements could be helpful in improving the symptoms of FM. Considering the new research indicating oxidant-antioxidant imbalance in FM sufferers, it makes sense to consider supplementing with a good antioxidant.

Magnesium: A study undertaken by G. Abraham and J. Flechas published in the Journal of Nutritional Medicine in 1992, found that a combination of magnesium (300-600 mg) and malic acid (1200-2400 mg) helped reduce muscle pain in people with FM.

Sherry Torkos, BSc Pharm, is a pharmacist and health author who lives in the Niagara area. Visit sherrytorkos.com.

Source: alive #269, March 2005