Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (137 page)

Fibromyalgia responds well to the DIGIN model presented in this book. Look and look to discover the underlying issues for your fibromyalgia. Find the levers that will help you rebalance. These will be different for each person.

Fibromyalgia can be a physical manifestation of emotional trauma. Statistically people with fibromyalgia have a higher history of chronic stress and emotional, physical, and/or sexual trauma than people without fibromyalgia. People with fibromyalgia often report a traumatic event that triggered initial symptoms: emotional or physical stress, an accident, or a severe infectious illness. This is often accompanied by insomnia due to hypervigilance of the immune system (see
Chapter 9
). Lack of sleep is associated with a dysfunction of the hippocampus, which can manifest as short-term memory loss and cognitive impairment. These are also classic fibromyalgia symptoms.

Fibromyalgia shares many symptoms with chronic fatigue syndrome, though it is classified as its own disease. People with fibromyalgia, unlike those with chronic fatigue syndrome, usually do not have low acetylcarnitine levels or have a viral infection as a trigger. Recent studies indicate that myofascial pain, fibromyalgia, and CFIDS are on a continuum of the same disease path, with myofascial pain being the mildest, fibromyalgia moderate, and CFIDS the most severe.

Other medical conditions that can masquerade as fibromyalgia include hypothyroidism; anemia; rheumatoid arthritis; Lyme disease; other rheumatic disorders such as ankylosing spondylitis, multiple sclerosis, and Sjögren’s disease; and cancers. Dysbiosis, postviral immune suppression, and blood sugar imbalances can also contribute to muscle tenderness. These can all be screened with simple medical testing.

Dr. Mark Pimental reports that 78 percent of people with fibromyalgia have small intestinal bacterial overgrowth (SIBO). When SIBO is treated, fibromyalgia symptoms improve greatly. This is discussed in the sections on IBS and chronic fatigue syndrome.

Nutrient deficiencies play a role in fibromyalgia. Without proper nutrients, energy production in the mitochondria doesn’t work correctly. Doing nutritional testing and organic acid testing can help you to optimize your nutritional status.

It’s important to be checked for vitamin D status. About half of all people with fibromyalgia are deficient in this nutrient. Vitamin D deficiencies affect about one-third of Caucasians, two-thirds of Hispanics, and 90 percent of people of African descent. Sometimes, just optimizing vitamin D levels can “cure” fibromyalgia. Ask your doctor to check your 25-OH vitamin D level. Normal levels are between 32 and 100 ng/ml. Optimal levels are probably between 60 and 100 ng/ml. People make vitamin D from sunlight, but in northern climates or if people aren’t outdoors, they don’t make nearly enough. The best food source is cold-water fish, such as salmon, sardines, mackerel, and herring. Vitamin D also helps facilitate magnesium absorption. An increased need for magnesium is found in most people with fibromyalgia.

Use of a single supplement may bring some relief, but a total program is necessary to bring dramatic relief and true healing. Taking coenzyme Q10; vitamins B
₁
, B
₆
, and arginine; 5-hydroxytryptophan (5-HTP); S-adenosylmethionine (SAMe); essential fatty acids; antioxidants; niacin; and magnesium malate (magnesium plus malic acid), in addition to a hypoallergenic diet has been shown to have positive effects. Acupuncture has been proven useful in treating fibromyalgia. Chiropractic or osteopathic adjustments and massage treatments may also be of help.

People with fibromyalgia have an increased need for antioxidants. Use of anti-oxidant supplements and increasing fruits, vegetables, nuts, seeds, and whole foods can reduce inflammation and free radical damage.

People with fibromyalgia are generally put on anti-inflammatory drugs and antidepressants. One study showed that 90 percent of people treated with anti-inflammatory drugs were still symptomatic after three years. Conventional medical therapies for fibromyalgia usually are unsuccessful in the long term because they fail to address possible underlying causes of the illness. Food and environmental sensitivities, candida, toxicity, unresolved emotional issues, and/or parasites can be causal factors in fibromyalgia. A stool test may be useful in diagnosing the cause of fibromyalgia. When the underlying problem has been identified and treated, fibromyalgia resolves.

A small but promising study was done with 32 people who had fibromyalgia for 5 to 10 years. There were 25 active participants and seven controls. The participants were tested for food and environmental sensitivities with the Elisa/Act test and given dietary restrictions. They were put on a detoxification program and personalized nutritional therapies to meet their needs and stimulate repair of cells and tissues. The final component was stress management, with recommendations for relaxation training, exercise, and biofeedback. In 6 to 12 weeks, these people showed a reduction of 80 to 90 percent in their symptoms. They also showed a significant
reduction in the number of foods and environmental sensitivities in repeated testing. More research needs to be done in this area.

Nutritional therapies have been successful in the reduction of symptoms. In a study, 50 people with either CFIDS or fibromyalgia were given products made by Mannatech, a multilevel supplement company, including freeze-dried aloe, plant-derived saccharides with freeze-dried fruits and vegetables, and a wild yam product with multivitamins and minerals. Although all subjects in the study had undergone previous unsuccessful medical treatment, a remarkable reduction in symptoms was noted, with continued improvement over the nine-month test period. Although this was a small, preliminary study, it shows promise for the nutritional approach to fibromyalgia and CFIDS.

One approach to fibromyalgia is the use of guaifenesin, a gout medication. Endocrinologist R. Paul St. Amand, M.D., believes that people with fibromyalgia have calcium phosphate deposits on muscles, tendons, and ligaments. St. Amand developed his theory after observing a high level of dental calculus (calcium phosphate deposits) among his fibromyalgia patients. His therapy (which includes a healing crisis, or a period of worsening of symptoms before improvement) begins with a dose of 300 mg of guaifenesin per day. He reports this working in 20 percent of his patients, but if no healing crisis occurs after two weeks, St. Amand increases the dose to 600 mg daily. At this level, another 50 percent of his patients improve, while the remaining 30 percent seem to require higher doses. Typically, if this protocol is going to work, you’ll see a change within two months of treatment. The longer you’ve had the disease, the longer you need to stay on the medication. While doing this therapy, avoid all salicylates, because they negate the treatment. This would include aspirin; herbs such as willow bark and aloe; and some common products such as topical pain-relieving cream, some mouthwashes, eyeliner, and some herbal hairsprays. As guaifenesin is a weak antigout medication with few side effects, the therapy certainly seems worth trying. I know several people who have tried this approach.

Zhang and colleagues report that guaifenesin is a muscle relaxant and is used as an anesthetic to treat the symptoms of fibromyalgia. His group measured specific cytokines in people with fibromyalgia who had taken guaifenesin for at least three months, in people with fibromyalgia who did not take guaifenesin, in family members of people with fibromyalgia, and with controls. People with fibromyalgia had higher levels of inflammatory cytokines, which is to be expected. There were specific differences in which cytokines were elevated in the various groups. More work needs to be done in this area.

Functional Laboratory Testing

Breath test for SIBO

Organic acid testing

Nutritional analysis

Adrenal stress testing (salivary DHEA and cortisol)

Elisa/Act food and environmental sensitivity testing

Oxidative stress evaluation

Provocation testing for heavy metals