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Emina Jasarevic, ND
To relieve fibromyalgia, follow a nutrient-rich diet and supplement with amino acids, D-ribose, and coenzyme Q10.
Muscle pain, fatigue, sleep disturbance, brain fog, anxiety, depression—these are some of the symptoms of fibromyalgia (FM). This complex, chronic pain condition has doubled in prevalence over the last decade. Over 1 million Canadians are estimated to suffer from FM, with women affected four times more often than men. Although FM is on the rise, research is surfacing to support both the theories and treatments behind this multifactorial syndrome. The good news is that we can do something about it.
The diagnosis of FM is based on a person’s symptoms and physical exam findings. There are no conventional blood tests or X-rays used, just the 1990 American College of Rheumatology’s (ACR) established guidelines, which are still used today. Included in the diagnosis of FM:
The ACR criterion focuses only on pain symptoms and disregards other important FM concerns, including fatigue, sleep disorders, stiffness, myalgias (muscle pains), headaches (often migraines), dizziness, paresthesia (tingling on the skin), gastrointestinal disturbances, memory and concentration problems, loss of libido, and various states of anxiety and depression. Current data suggests central sensitization, in which neurons in the spinal cord become hypersensitive due to inflammation and cell damage, may be involved in the way FM patients process pain. As a result, certain chemicals in the foods eaten may trigger further inflammation or a release of neurotransmitters that may exacerbate this sensitivity.
As daunting as FM may be, a good nutritional plan is the first step to getting better. There is some evidence to suggest that FM symptoms can be reduced if people eliminate foods that they are sensitive to. Food sensitivities are divided into two categories: an immediate immunoglobulin E (IgE) food reaction (allergy such as peanuts + swollen throat = hospital!) and a delayed IgE food reaction. The delayed IgE food response can occur subtly anywhere from four minutes to four days after eating. Over time and with repeated exposure, the immune system becomes sensitized (as in the central sensitization theory for FM) only to exacerbate FM symptoms.
In one study researchers reviewed 17 FM patients who eliminated offending foods from their diet. After just two weeks of avoiding certain foods “almost half the patients reported a significant reduction in pain.” The most accurate way to test for common food sensitivities is with a simple in-office blood draw offered by most naturopathic doctors.
Past and present research supports underlying nutrient deficiencies as probable causes of FM. Such deficiencies include low levels of amino acids, magnesium, coenzyme Q10, acetyl-L-carnitine, and D-ribose. Many of these nutritional deficiencies create an energy crisis in the body that contributes to the overwhelming symptoms of pain and fatigue.
The energy for mitochondria, the power producers of every cell in our body, is provided by the nucleotide, adenosine triphosphate (ATP). Research found that ATP levels were 80 percent lower in FM patients than in healthy individuals. Fortunately, ATP levels can be dramatically increased through a healthy diet and nutritional supplementation.
Amino acids are the building blocks of protein and neurotransmitters in the brain. When researchers tested 20 amino acids in FM patients compared to healthy volunteers, FM patients were low in overall amino acid levels. These deficiencies can greatly affect the sympathetic (adrenaline) nervous system, which tends to be both hyperactive (can’t fall asleep) and exhausted (tired all day) in FM patients.
Muscular changes, mitochondrial (energy) dysfunction, and oxidative stress are all present in symptoms of FM patients. Coenzyme Q10 is a strong antioxidant and is critical for energy production in the heart and skeletal muscles. A study of 37 FM patients found CoQ10 levels to be 40 percent lower, with higher levels of oxidative stress than healthy subjects.
Ribose is known as the sugar of life. D-ribose is present in all living cells and is responsible for energy production. Researchers investigated the benefits of D-ribose in 41 patients with FM and chronic fatigue syndrome. After taking D-ribose for three weeks, 66 percent of patients reported significant improvement in energy, sleep, well-being, mental clarity, and pain intensity.
Researchers are starting to examine the multiple causes underlying FM. Jacob Teitelbaum, MD, is studying hypothalamic dysfunction wherein the control centre in the brain that monitors sleep, hormone regulation, and the immune system does not work properly.
There are also more sensitive tests (saliva or urine) that actually measure the unbound (or biologically active) hormones in the body that contribute to FM symptoms. These tests more reliably demonstrate imbalances in the reproductive hormones, thyroid hormones, and adrenal hormones, and can be conducted by a naturopathic doctor. If you or someone you know has fibromyalgia, schedule time to see an ND. Have a wellness program designed for you that will get you back on track and back to living the life you deserve.
If you suffer from fibromyalgia, follow these tips to improve your health.