PATIENT ENQUIRY

Natural Treatments for Fibromyalgia


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What Is?
What is Fibromyalgia
How to Treat Fibromyalgia
Natural Treatments for Fibromyalgia

What is fibromyalgia syndrome?

Fibromyalgia is a pain disorder characterised by profound fatigue and chronic, widespread pain and tenderness, at ‘trigger points’, in the joints, muscles, and other soft tissues. As well as increased sensitivity to pain and sensory stimuli such as noise, heat, cold, and smells, fibromyalgia sufferers experience sleep disturbance related to pain, numbness or tingling, and cognitive dysfunction.

The name fibromyalgia comes from ‘fibro’ for fibrous tissues, ‘my’ for muscles, and ‘algia’ for pain. Primarily a central nervous system disorder, the pain results from neuro-chemical imbalances, including the initiation of inflammatory pathway in the brain, which leads to abnormal pain processing. In other words, the brain mistakenly over-reacts to pressure and exaggerates the feeling of pain.

The brain tissues of a person with fibromyalgia syndrome appears abnormal and functions incorrectly, but whether the brain abnormalities are directly responsible for the condition, or are secondary to some other cause remains unclear.

Allodynia means a heightened and painful response to a stimulus that usually does not cause pain. A person with fibromyalgia has allodynia of the soft tissues at ‘trigger points’ around the shoulders, thighs, knees, and across the lower back.

People with fibromyalgia describe the pain as diffuse aching or burning, from head to toe that varies in intensity and location, but is usually felt in the parts of the body used most. The degree of fatigue ranges from simply feeling more tired than usual without reason to complete exhaustion, which comes on suddenly.

Fibromyalgia is more common than rheumatoid arthritis and the pain can be just as severe as the pain experienced with rheumatoid arthritis. With appropriate treatment a person with mild to moderate symptoms can maintain day-to-day activities and manage a modest workload. However, a person with severe symptoms may not be able to cope daily activities such as working, looking after a family, or socialising.

Each person has his or her unique set of symptoms, which can be mild, moderate, or severe. Symptoms can present on a constant daily basis, come and go over months or weeks, and even disappear for extended periods.

Fibromyalgia can be a challenge to diagnose. Diagnostic blood tests, x-rays, or scans rely on inflammation or joint damage to diagnose pathology, but these signs aren’t present in fibromyalgia. However, these diagnostic tests are useful in ruling out other conditions that might be the cause of pain.
No cure is available for fibromyalgia, but pain medication and anti-inflammatory drugs can relieve symptoms.

What are the symptoms of fibromyalgia?

What are the symptoms of fibromyalgia?

A 2007 study classified patients into four subgroups – sensitivity to pain, comorbid pain-related depression, concomitant depression, and FM due to somatisation.

Group 1 – fibromyalgia syndrome with high pain sensitivity and no associated psychiatric condition,
Group 2 – fibromyalgia syndrome and depression related to comorbid pain
Group 3 – depression with concomitant fibromyalgia syndrome
Group 4 – somatoform pain disorder, with insufficient coping

While chronic pain and profound fatigue and the central symptoms for fibromyalgia, other symptoms include:

  • Unrefreshed sleep – waking up tired and stiff
  • Headaches – ranging from ordinary types to migraine
  • Irritable bowel – alternating diarrhoea and constipation, sometimes accompanied by gas in the abdomen or nausea
  • Cognitive disturbances – lack of concentration, temporary memory impairment, getting words mixed up (fibrofog or brainfog)
  • Clumsiness and dizziness
  • Sensitivity to changes in the weather, noise, bright lights, smoke, other environmental factors
  • Allergies
The clinical definition of fibromyalgia

The clinical definition of fibromyalgia

In 2010, The American College of Rheumatology published criteria for the clinical diagnosis of fibromyalgia and severity of classification.

Diagnosis is based on:

  • Widespread pain index ≥7 and symptom severity scale ≥5 or widespread pain index 3-6 and symptom severity scale ≥9
  • Symptoms present at a similar level for at least three months
  • Patient has no other disorder that could explain pain symptoms
What causes fibromyalgia?

What causes fibromyalgia?

Environmental factors and certain genes increase the risk of developing fibromyalgia. Fibromyalgia syndrome often develops after a trauma that triggers the condition, such as a fall or car accident, a viral infection, childbirth, a surgical procedure, or a stressful, emotional event.

The effect is disordered sensory processing. The brain registers pain when others might experience a slight ache or stiffness. It is hoped that more research will discover the cause and result in more effective treatment.

Environmental and biological triggers for fibromyalgia:

  • Weather changes
  • Extreme physical labour, overexertion
  • Mental stress
  • Viral and bacterial infections
  • Allergies

Most people with fibromyalgia are sleep deprived and miss out on important restorative sleep. Part of treatment is to improve the quality of sleep and address the lack of restorative sleep by taking medication.

Fibromyalgia is strongly associated with other medical disorders, such as chronic fatigue syndrome, multiple chemical sensitivity, and anxiety and depression. Fibromyalgia can co-occur (up to 25-65%) with other rheumatic conditions such as rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.

Gender and hormones play a role in disease development. The prevalence is much higher among women (3.4%) compared with men (0.5%).

Fibromyalgia may run in families, but no gene has been identified that makes a person more likely to develop fibromyalgia. Genes alone are unlikely to cause fibromyalgia, because of the strong association with other medical disorders.

Because hypothyroidism (underactive thyroid gland) and polymyalgia rheumatica share many of the same symptoms as fibromyalgia, a medical doctor will need to rule out these largely treatable medical conditions, in order to make a correct diagnosis.

ATP synthesis and the critical role of magnesium

ATP synthesis and the critical role of magnesium

Adenosinetriphosphate (ATP) can only be synthesised in the presence of oxygen, magnesium, substrate, adenosinediphosphate, and phosphate. Adequate amounts of each of these are needed for cell energy, healthy mitochondrial respiration, and to produce biological energy.

Deficiencies will affect the Krebs cycle – a series of chemical reactions aerobic organisms use to generate energy. The result is increased anaerobic glycolysis, increased lactic acid formation, compromised metabolism, and reduced lung capacity causing fatigue, cognitive dysfunction, and muscle pain.

Mitochondrial uptake and accumulation of magnesium are directly related to the uptake of phosphate required for ADP phosphorylation, which means that the mineral magnesium is a critical nutrient for the production of ATP. Even mild magnesium deficiencies can impair the citric acid cycle and lead to aluminium overload, which can lead to metabolic disturbances. Adequate amounts of magnesium, through diet or supplementation, will prevent the effects of aluminium toxicity and malic acid will help remove aluminium from the body.

Fibromyalgia can prove difficult to diagnose because there is no specific test and the symptoms are shared with other medical conditions. Diagnosis is usually based on a person’s symptoms and diagnostic testing to exclude other medical problems.

How is fibromyalgia diagnosed?

How is fibromyalgia diagnosed?

Physicians struggle to understand and diagnose fibromyalgia, in part because no clear cause is evident and the usual battery of diagnostic testing shows no pathological change. And many of the signs and symptoms are associated with or confused with other medical disorders, in particular in chronic fatigue syndrome (CFS).

Although classified as a musculoskeletal disorder because the effects are felt in the muscles and joints, fibromyalgia is actually a central nervous system problem. A doctor can assess symptoms and apply direct pressure to trigger points to rate tenderness. The tender point examination (tenderness in at least 11 of 18 defined points) has become the primary diagnostic factor for fibromyalgia syndrome and helps doctors to differentiate the syndrome from chronic fatigue syndrome.

International experts have agreed to a set of criteria to enable diagnosis, with the two central symptoms being pain in all four quadrants of the body for at least three months, together with pain in at least 11 out of 18 tender point sites when direct pressure is applied.

Essentially, all laboratory tests, X-rays, muscle and joint aspirations and biopsies, and CT and MRI scans no pathologic process that explains a patient’s symptoms.

Fibromyalgia facts and statistics

According to the UK Fibromyalgia Association, the prevalence of fibromyalgia at between 2.9 and 4.7%. Most people with fibromyalgia are women (female: male ratio 7:1). However, men and children also can have the disorder.

Fibromyalgia often starts in middle adulthood, but children, teenagers, and the elderly can also be affected by widespread body pain and fatigue.

Working age women with fibromyalgia hospitalised for occupational musculoskeletal disorders were almost 10 times less likely to return to work and four times less likely to retain work at one-year post hospitalisation.

While the cause for fibromyalgia remains unknown, the following have been loosely associated with disease onset:

  • Stressful or traumatic events, such as car accident, post traumatic stress disorder
  • Repetitive injury
  • Illness, such as viral infection
  • Certain diseases – SLE, CFS, rheumatoid arthritis, alkylosing spondylitis
  • Genetic predisposition – runs in families but no gene identified
  • Obesity
Glossary – fibromyalgia

Glossary

Glossary – fibromyalgia

5-hydroxytryptophan – needed to make the neurotransmitters serotonin and melatonin from tryptophan.

Acelytlcholine – a neurotransmitter in the autonomic nervous system

Adenosinetriphosphate (ATP) transports chemical energy within human cells for energy

Adenosinediphosphate (ADP) and ATP supply the energy cells need to function

Alpha lipoic acid is an organosulfur antioxidant present in most floods

Allodynia means a heightened and painful response to a stimulus

Ankylosing spondylitis – chronic inflammatory disease of the vertebral column, a type of spondyloarthritis.
Anticonvulsants or antiepileptic drug designed to prevent seizures

Anthocyanidins – subgroup of flavonoids with strong anti-oxidant properties that can theoretically support and prevent the destruction of collagen in muscles.

Australian Therapeutic Goods Association – regulatory body for therapeutic goods including medicines

Coenzyme Q10 – produced by the body, used to produce cellular energy, for growth and repair

Creatine monohydrate – produced by the body, helps to supply cellular energy

DHEA (dehydroepiandrosterone) an endogenous steroid hormone used to form oestrogen and testosterone

Fibrofog – mental confusion and forgetfulness that can accompany a flareup of symptoms, also known as brainfog.

Fibromyalgia – a person with fibromyalgia suffers with chronic body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues

Gamma-aminobutyric acid (GABA) – regulates neuronal excitability throughout the central nervous system

Krebs cycle – a series of chemical reactions aerobic organisms use to generate energy

Lactobacillus acidophilus – ‘friendly’ bacteria used to restore the normal balance of intestinal bacteria, when the immune system is weakened or imbalance of intestinal bacteria, for example after a course of antibiotics

Magnesium (Mg)– a chemical element and essential mineral nutrient. ATP must be bound to magnesium to remain biologically active for Kreb cycle

Malic acid – a dicarboxylic acid found in all fruit and many vegetables a precursor in the Kreb cycle

Manganese (Mn) – a chemical element and trace mineral needed for bone formation, skin health, glucogenesis, and a cofactor for the antioxidant superoside dismutase (MnSOD)

Narcolepsy drugs – medication used to treat a number of conditions but in particular narcolepsy, a neurological disorder that affects the control of sleep and wakefulness.

NAHD (nicotinamide adenine dinucleotide hydrogen) is an antioxidant enzyme present in human cells that facilitates the production of neurotransmitters

Osteoporosis – calcium depletion of bone making them brittle and prone to fracture

Phosphorylation – a chemical process used to produce energy, and regulate protein interactions

Phytochemicals – naturally occurring substances found in plants that are not essential nutrients but provide health benefits, such as antioxicants

Polymyalgia rheumatica – inflammatory disorder, often in older people characterized by pain and stiffness in the neck and shoulders, or hips

Probiotic – microbes added to active live cultures in yoghurt or supplements that provide health benefits

SAM-e (S-adenosylmethionine) an amino acid derivative produced by the body that provides effective pain relief and can reduce arthritic and fibromyalgia pain.

Somatoform – symptoms that mimic physical disease of injury without an obvious physical cause through diagnostic testing

Thiamine or vitamin B1 – a water-soluble B vitamin involved in many body functions, including the nervous system, muscle function, cellular energy production, and carbohydrate metabolism.

Tryptropin-releasing hormone (TRH) – hormone released by hypothalamus

Thyroid-stimulating hormone (TSH) – hormone released by pituitary gland

Thyroxin – hormone released by the thyroid

Conventional medical treatment for fibromyalgia

Fibromyalgia is one of the most common reasons for being referred
to a rheumatologist. The condition involves widespread pain accompanied by fatigue, sleep disturbance, and heightened tenderness to touch. Fibromyalgia does not involve any damage to the joints or muscles that can explain the symptoms.

Your doctor may refer you to a rheumatologist for treatment of fibromyalgia. Because rheumatologists treat other musculoskeletal conditions such as arthritis, they understand the effects of chronic pain and fatigue. Treatments aim to improve sleep, stretch muscles that have been affected by spasm, rebuild muscle symmetry, and restore stamina through exercise.

Conventional medical treatment aims to relieve pain symptoms and improve sleep quality. Not all medications work the same way for every person, so pain management can take time to achieve good results. Regular review by a medical doctor is needed, in order to ensure medication is effective.

Five types of medications are used to treat fibromyalgia – antidepressants, anticonvulsants, narcolepsy drugs, pan relievers, and sleep aides. These medications act on the brain chemistry to reduce pain, improve quality of sleep, and ease anxiety or depression.

While certain over-the-counter medications may help relieve the pain of fibromyalgia, a person with severe pain may require the expertise of a pain specialist at a hospital-based pain clinic.

Fibromyalgia patients often suffer with depression so antidepressant drugs are often prescribed to manage different aspects of the illness. Tricyclic antidepressant drugs are often prescribed as these drugs will help both sleep and pain, and can improve energy levels and a person’s capacity to function normally.

SSRI antidepressants: Prozac (fluoxetine), Zoloft (sertraline), Aropax (paroxetine)
SNRI antidepressants: Cymbalta (duloxetine), Pristiq (Desvenlafaxine), Milnacipran (savella)
Tricyclic antidepressants: Endep (amitriptyline), GenRx Clomipramine (Clomipramine)

The Australian Therapeutic Goods Association has approved Milnacipran, a mixed serotonin-norepinephrine reuptake inhibitor (SNRI), for the treatment of fibromyalgia.

Learning how to manage fibromyalgia can be the best way to deal with the condition. A combination of medication, heat, rest, exercise, and stress reduction will enable a person with fibromyalgia to retain a worthwhile life.

Getting the right support from family, friends and other people who have fibromyalgia can be invaluable. Professional counselling may help a person to cope with the changes brought on by the illness. Playing an active role in treatment, by staying informed, will maximise the benefits.

Treatment guidelines for fibromyalgia

Treatment guidelines for fibromyalgia

The European League Against Rheumatism has issued guidelines for the treatment of fibromyalgia syndrome.

Guidelines for the management of fibromyalgia syndrome:

  • Comprehensive evaluation of pain, function, and psychosocial context is needed to understand fibromyalgia syndrome completely, because it is a complex, heterogeneous condition involving abnormal pain processing and other secondary features.
  • Optimal treatment of fibromyalgia mandates a multidisciplinary approach, which should include a combination of non-pharmacologic and pharmacologic interventions. After discussion with the patient, treatment modalities should be specifically tailored based on pain intensity, function, and associated features such as depression, fatigue, and sleep disturbance.
  • Heated pool treatment, with or without exercise, is effective. Aerobic and strength training where appropriate.
  • Cognitive behavioural therapy to assist sufferers to cope with symptoms may be beneficial. Relaxation, rehabilitation, physiotherapy, psychological support, and other modalities based on the specific needs of the patient.

Self-help guidelines for managing the symptoms of fibromyalgia

Appropriate medical treatment coupled with adequate self-care will enable a person with fibromyalgia to return to normal activities. Make time to relax each day using deep-breathing exercises and meditation, as stress can trigger symptoms.

Try to retire to bed and get out of bed at the same time each day, in order to develop regular sleep patterns. Inadequate rest can trigger symptoms, because the body hasn’t had time to repair physically and mentally. Good sleep hygiene also means limiting the amount of coffee you drink and avoiding naps during the day.

Alcohol, chocolate, and nicotine are stimulants that can interfere with sleep patterns so avoid these stimulants, especially at night.

Exercise is an important part of reducing fibromyalgia symptoms. Initially, start with easy exercise in small amounts and then gradually add exercise, such as walking, into your daily routine. Walking, swimming, water aerobics, and stretching exercises are all appropriate forms of exercise that enable a person to stay active and motivated.

Fibromyalgia Australia provides a variety of information to enable a better understanding that can be shared with family, friends, and co-workers, in order to improve the support you receive from those around you.

As with any chronic disease try to look forward, not backward and focus on the positives not the negatives, in order to remain motivated. Focus on what you need to do to get better, not the cause of the problem. As medication starts to work to reduce symptoms, try to increase your level of activity. Start with things that you enjoyed most before pain and fatigue restricted your day-to-day and social activities.

Cincinnati Children’s Hospital Medical Centre researchers found that teaching teenagers coping skills to deal with the chronic pain of fibromyalgia gave them some relief from symptoms, and importantly “reduced the functional disability and symptoms of depression”.

Currently, no cure for fibromyalgia is available. Symptoms are usually permanent, but they can vary in intensity. However, a number of treatments are available to ease symptoms and improve quality of life.

Nutritional medicine treatment for fibromyalgia syndrome

Nutritional medicine treatment for fibromyalgia syndrome employs vitamin and mineral supplementation to boost the immune system, ease pain, and increase energy supply. A nutritional specialist will first take a detailed history and then assess for any nutrient deficiencies.

According to the US National Fibromyalgia Research Association, when refined sugar, caffeine, alcohol, fried foods, red meat, and processed foods are eliminated, or significantly reduced, fibromyalgia symptoms are reduced. Today’s Western diet contains many of these foods, which tend to irritate muscles and affect the immune system.

Many people with fibromyalgia are very sensitive to refined sugar. Unfortunately, many people with fibromyalgia eat high-GI carbohydrates and sugar to boost energy levels. While this provides a short-term boost, too much sugar will lead to too much insulin and eventually blood sugar becomes abnormally low, called hypoglycemia, and stress hormones are released.

Learning about and eating low-GI carbohydrates will prevent the roller coaster ride caused by high-GI carbohydrates. The elimination of refined sugar from the diet enables the body to better manage blood glucose levels, when carbohydrates are eaten.

More than 75% of people with fibromyalgia have some type of sleep disturbance. A good night’s sleep most nights is essential for the body to repair and restore, which is particularly important for a person with chronic aches and pains. A person with fibromyalgia should avoid or reduce stimulants such as caffeine, alcohol, chocolate, and refined sugar as these foods can interfere with normal sleep patterns, and enhance fatigue.

Increasing the intake of green leafy vegetables will provide optimal nutrition. When it comes to quantity, these foods offer so much benefit, eat as much as you desire, within reason. In general, try to eat at least five servings of vegetables each day (excluding potato chips or other deep fried vegetable).

The vitamins, minerals, and disease-fighting phytochemicals in leafy greens keep pain and inflammation under control and the fibre lowers cholesterol, controls blood pressure, balances glucose levels, and aids digestive health. A variety of leafy green vegetables can provide calcium, potassium, beta-carotene, folate, and vitamins A, C, E and K.

An adequate amount of lean protein, whey protein, and creatine monohydrate will help support the musculoskeletal system in its repair process. Proteins contain essential amino acids that are important for muscle health.

Avoid or reduce the amount of processed foods, which generally contain saturated and hydrogenated fats and refined sugar. Processed foods cause harm in two ways, both of which are pro-inflammatory.

An elimination diet is used to systematically evaluate whether a certain food causes or worsens symptoms. Foods that tend to provoke allergic reaction are eliminated from the diet for at least 10 days (Mel check). The most common problem foods are grains that contain gluten (wheat, rye, oats), dairy products, eggs, corn, soy and tofu, peanuts, citrus fruits, yeast, refined sugars, caffeine, alcohol. Processed foods should be avoided as they usually contain chemical additives, preservatives, artificial colourings and flavourings.

Each day, one particular food is returned to the diet to establish whether symptoms recur. The process might need to be repeated in order to clearly establish which foods are problematic.

Eating a diet of mainly raw or lightly cooked fruits and vegetables, with far less high-fat meat and more fish or lean poultry, promotes better health in general.

A vegan, gluten-free diet has been shown to help relieve pain, improve quality of sleep, and enhance overall health in fibromyalgia patients. This type of diet reduces the intake of foods known to promote inflammation due to oxidative stress and favours foods with anti-inflammatory properties that lessen free radical production and enable oxidation.

These nutritional tips may help reduce symptoms:

  • Eliminate potential food allergens – dairy, wheat (gluten), corn, soy, preservatives, food additives
  • Get tested for food allergies and intolerances
  • Eat antioxidant foods – fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as kale, spinach, and capsicum)
  • Avoid refined foods – white breads, pastas, sugar
  • Eat less red meat and more lean meat, fish, tofu, or beans for protein
  • Use healthy cooking oils – such as olive oil or coconut oil
  • Reduce or eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, margarine
  • Avoid alcohol, tobacco, and caffeine
  • Limit foods high in sugar, salt, fat, and
  • Drink at least 6 to 8 glasses of filtered water daily.

(Source: Fibromyalgia – University of Maryland Medical Center)

The role of antioxidants in fibromyalgia

The role of antioxidants in fibromyalgia

Researchers first became aware of oxidative stress when certain athletes broke down in response to intense, prolonged exercise. While there has been debate about the exact nature of oxidant production during exercise, scientists know that skeletal muscles produce reactive oxygen species (free radicals and peroxides) at rest and during exercise. The production of reactive oxygen species increases exponentially as the level of exercise increases and intense, prolonged exercise can result in oxidative damage to contracting muscles and oxygen-mediated dysfunction resulting in muscle weakness and fatigue.

When a person exercises at a mild or moderate level the body is able to handle the amount of free radicals produced. Athletes with over-training syndrome suffer the same symptoms as patients with fibromyalgia and chronic fatigue syndrome. Certain patients with fibromyalgia and CFS suffer a worsening of symptoms following exercise, even mild exercise, so their problem is likely due to oxidative stress, which also can cause degenerative diseases.

Antioxidants neutralise free-radials, and reduce free-radial damage and inflammation. A daily antioxidant formula will help reduce fibromyalgia symptoms. Coenzyme Q10 is an antioxidant that helps deliver oxygen to cells.

ACES therapy combines a daily dose of Vitamins A, C, and E, plus selenium to promote assimilation. This combination of antioxidant vitamins will protect the body from the harmful effects of free radicals. Vitamin E, in particular, improves blood flow and reduces muscular aches.

NAHD (nicotinamide adenine dinucleotide hydrogen) is an antioxidant enzyme present in human cells that facilitates the production of neurotransmitters, such as dopamine and noradrenaline. A person with fibromyalgia is likely to have low levels of neurotransmitters. NAHD can improve mental concentration, stamina, and general energy levels.

Alpha lipoic acid is an organosulfur antioxidant present in most foods, but more so in offal, spinach, broccoli, and yeast extract. Alpha lipoic acid enables the body to better utilise carbohydrates and enhances energy production.

Nutritional supplements for fibromyalgia

Nutritional supplements for fibromyalgia

A nutritional specialist can assess for nutritional deficiencies and treat with a modified diet and supplements, as necessary.

Magnesium and malic acid are precursors to the Krebs cycle, a series of chemical reactions that produce cellular energy. Even mild magnesium deficiencies can impair the citric acid cycle and lead to aluminium overload, which can lead to metabolic disturbances. Adequate amounts of magnesium in the diet or through supplementation will relieve symptoms related to aluminium toxicity, and malic acid will help remove (chelate) aluminium from the body. The addition of vitamin B6 can support this process.

Manganese (Mn) is a chemical element and trace mineral needed for bone formation, skin health, and glucogenesis, and is a cofactor for the antioxidant superoside dismutase (MnSOD). Most plant foods are an excellent source of manganese but the highest concentration is found in cloves, basil, black pepper, spinach, seaweed, kale, beet greens, oregano, peppermint, and cinnamon.

Manganese is an important trace mineral for people with CFS or fibromyalgia. Fatigue is a core symptom for both conditions and the link may relate to manganese-dependent neuroendocrine changes, in particular the hypothalamic-pituitary-thyroid axis. Thyroxin is produced by the thyroid in response to pituitary gland release of TSH in response to hypothalamus release of TRH. A metabolic deficiency due to a secondary hypothroidism (a lack of thyroxin) because of low manganese levels could explain the cyclic or constant debilitating fatigue.

Thiamine or vitamin B1 is essential for the proper metabolism of nutrients, in particular fats and protein. Humans can’t synthesise thiamine and the body doesn’t store vitamin B adequately, so we must derive thiamine from the diet. Cells need a form of thiamine to breakdown sugars and amino acids, and thiamine is needed to make gamma-aminobutyric acid (GABA) and the neurotransmitter acetylcholine. Thiamine plays an important role in the respiratory chain. The symptoms of thiamine deficiency include fatigue, insomnia, depression, numbness or tingling, cognitive disturbance, and depleted metabolism.

Medical research has found that the majority of symptoms of fibromyalgia are caused by a mild thiamine deficiency due to a dysfunction of the active transport of thiamine from the blood to the mitochondria or to enzymatic abnormalities. Although serum levels of thiamine and thiamine pyrophosphate (TPP) are normal, mild intracellular deficiencies interfere with the formation of adenosine triphosphate (ATP), which every human cell uses for energy production, through the Kreb cycle.

Ironically thiamine is found in most foods, in varying amounts, but food processing diminishes the availability in a typical Western diet. Up to 20% of people fail to meet recommended daily intake (1mg/day). Legumes, yeast, yeast extract, Brussels sprouts, brown rice, rye, oats, barley, peas, spinach, cabbage, asparagus, kale, potato, pork, liver, and flax, sesame and sunflower seeds are good sources of thiamine.

Evening primrose oil, flax seed oil, and fish oil provide omega-3 fatty acid, which the body converts into prostaglandin to relieve the inflammation associated with fibromyalgia.

Taking a combined calcium plus vitamin D supplement will maintain a healthy musculoskeletal system and help prevent.

SAM-e (S-adenosylmethionine) is an amino acid derivative synthesised by the body. It provides effective pain relief and can reduce fibromyalgia pain. Taking a SAM-e supplement is the only way to increase the amount levels in the body, because the substance can’t be derived from the food we eat. Clinical trials found that SAM-e can reduce the number of trigger points and areas of pain, lessen pain and fatigue, and improve mood in fibromyalgia patients.

Intramuscular injections of vitamin B12 and magnesium sulphate have been helpful against pain, insomnia, and fatigue. Treatment is usually for three to six months or more, and often relapses occur.

DHEA (dehydroepiandrosterone) is a hormone produced by the adrenal glands that acts as a precursor to testosterone and oestrogen. DHEA assists with muscle repair and building strength, providing energy, improving memory and mood, and slow down the aging process.

Most people with fibromyalgia complain of trouble sleeping. Regardless of the length of sleep, a person with fibromyalgia often wakes up still feeling tired. Pain and anxiety can compound sleeping problems.

Clinical trials have shown that sleep patterns observed in fibromyalgia patients significantly improved with melatonin treatment. Melatonin, an endocrine hormone released by the pineal gland, enables humans and other animals to set the daily and seasonal variations of biological functions, such as behaviour and reproduction. The natural release is dependent upon darkness; hence melatonin is an important part of falling asleep at night. Melatonin occurs naturally in pineapple, banana, oranges, oats, sweet corn, rice, tomatoes, and barley.

The body produces less melatonin as we age, so a person more than 60 years of age with insomnia will benefit from taking melatonin.

Probiotic supplementation (containing Lactobacillus acidophilus) can be used to ensure maintenance of gastrointestinal and immune health.

5-HTP (5-hydroxytryptophan) dietary supplement help raise serotonin levels in the brain. 5-HTP is an amino acid used in the production of serotonin and melatonin and may help to increase deep sleep and reduce pain, for those with fibromyalgia. In one study published in the Alternative Medicine Review, researchers found taking 5-HTP may improve some of the symptoms of fibromyalgia such as depression, anxiety, sleep disturbance, fatigue, morning stiffness, and pain control.

5-HTP is made from tryptophan, an amino acid found in turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and collard greens, and seaweed.
Eliminating problem foods can make a significant difference to symptoms, for a person with fibromyalgia. Pain, fatigue, and irritable bowel symptoms like bloating and constipation should improve.

A nutritional specialist can make sure you don’t miss out on essential nutrients when you eliminate problem foods.