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Fibromyalgia
31st May, 2022

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An overview of fibromyalgia

Fibromyalgia is a chronic illness characterised by widespread pain and tenderness (sensitivity to touch) and is often accompanied by other symptoms such as fatigue, intestinal disorders and alterations in sleep and mood.

Fibromyalgia affects at least 1 in 40 people worldwide and usually develops between the ages of 25 and 55, although children can also develop it. It occurs more frequently in females than males (9:1).

The causes of fibromyalgia are complex and not fully understood. However, it is known that changes in the central nervous system give rise to abnormal pain processing and perception. Additionally, damage and impaired function within mitochondria (the powerhouses within cells that produce energy) contributes to pain and fatigue. Evidence suggests inflammatory, immune, endocrine, genetic, and psychosocial factors may play a role.

Although not currently classified as an autoimmune disease, it commonly occurs alongside other autoimmune conditions such as systemic lupus erythematosus (SLE), rheumatoid arthritis and Hashimoto's thyroiditis.

A rheumatologist typically diagnoses fibromyalgia after ruling out other causes when a patient experiences widespread pain for at least three months, with additional symptoms of fatigue, waking unrefreshed and cognitive (memory or thought) problems. "Widespread" is defined as pain on both sides of the body, above and below the waist.

Currently, there is no cure for fibromyalgia, and treatment focuses on improving symptoms with pharmaceutical drugs (antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics and anticonvulsants), non-drug interventions (exercise and massage) and psychological therapy.

 

Potential triggers

  • Genetic predisposition
  • Nutrient deficiencies
  • Chronic stress
  • Physical trauma or injury
  • Emotional trauma
  • Chronic inflammation
  • Changes in gastrointestinal microbiome
  • Intestinal permeability (“leaky gut”)
  • Toxin exposure
  • Impaired thyroid function
  • Autoimmune disease

 

Signs and symptoms

Musculoskeletal

Muscle pain, multiple tender points, joint stiffness, cramping, fatigue, restless legs, jaw pain

Neurological

Concentration and memory problems (sometimes called “fibro fog”), anxiety, depression, sleep problems, dizziness, numbness

Digestive

Abdominal pain, bloating, nausea, irritable bowel syndrome

Reproductive

Menstrual pain

Eyes

Sensitivity to light, blurred vision

Skin

Rashes, crawling sensation under skin, dry skin

 

Long term holistic treatment aims

  • Improve quality of life by addressing the predominant symptoms (pain, fatigue, altered mood and sleep, brain fog).
  • Address underlying mitochondrial, neuroendocrine, and immune changes.
  • Support the nervous system if stress is ongoing.

 

Nutritional recommendations

Please contact your health professional for the prescription of herbal and nutritional remedies.

5-Hydroxytryptophan
(5-HTP)
  • 5-HTP is a building block of serotonin; low serotonin levels and its precursor L-tryptophan are observed in fibromyalgia. 5-HTP Improves pain, insomnia, depression, and anxiety.

Acetyl-L-carnitine
  • Assists with mitochondrial activity, energy production and is neuroprotective.
  • Shown to alleviate depression and reduce pain in fibromyalgia patients.

B vitamins
  • Essential for energy production, neurotransmitter synthesis, and immune function; may attenuate fibromyalgia symptoms, including muscle pain and fatigue.

Coenzyme Q10
(CoQ10)
  • Powerful antioxidant, essential for mitochondrial function and energy production.
  • May improve mitochondrial function, reduce oxidative stress, and improve pain and fatigue.

Magnesium
  • Serum magnesium levels are lower in fibromyalgia patients.
  • Magnesium, combined with other treatments, improves fibromyalgia symptoms.

Omega-3 fatty acids
  • May improve pain, fatigue, and depression in fibromyalgia patients by reducing inflammation.

Palmitoylethanolamide
(PEA)
  • Improves pain symptoms, reduces pain intensity, and improves quality of life when used as an add on to conventional treatment in fibromyalgia.

S-adenosylmethionine
(SAMe)
  • Involved in metabolism of neurotransmitters; anti-inflammatory; antidepressant; analgesic.
  • Improves pain, fatigue, mood, and sleep in clinical studies.

Vitamin D
  • Plays key roles in immune modulation, controlling inflammation and muscle health.
  • Lower serum levels are associated with pain, anxiety, and depression in fibromyalgia patients.

 

Herbal recommendations

Regulate stress
  • Withania, Rhodiola, Korean Ginseng, Siberian Ginseng, Rehmannia, Licorice

Muscle spasm & cramps
  • Cramp Bark, Kava, Jamaican Dogwood

Nervous system
  • Passionflower, Lavender, Skull Cap, Lemon Balm

Improve sleep
  • Hops, Passionflower, Valerian, Zizyphus

Pain & inflammation
  • Corydalis, California Poppy, Turmeric, Boswellia, Cat’s Claw

Support mood
  • St John’s Wort, Lavender

Address underlying viral infections
  • Garlic, Rosemary, Thyme, Myrrh, St John’s Wort

 

Diet & Lifestyle recommendations

General dietary advice
  • A diet rich in plant antioxidants may reduce symptoms associated with fibromyalgia. Include fresh fruit, raw and cooked vegetables, healthy fats in the form of extra virgin olive oil, nuts, seeds,
  • herbs, and spices.

Dietary exclusions
  • Glutamate and aspartame may act as excitatory neurotransmitters and enhance transmission of pain signals in fibromyalgia patients. Minimise foods containing these, such as monosodium glutamate (MSG), soft drinks containing aspartame, chocolate, caffeine, and food colouring.
  • Fibromyalgia patients often have irritable bowel syndrome and may benefit from a gluten free or low-FODMAPs diet.

Mind-body therapies
  • Can reduce stress and help to improve mood and sleep e.g. tai chi, qi gong, yoga, meditation, mindfulness or psychological therapies.

Acupuncture
  • Can help to improve pain, stiffness, fatigue, sleep and overall wellbeing.

Manual therapies
  • Regular massage improves symptoms, especially pain, anxiety, and depression.

Exercise
  • Engage in regular physical activity, starting slowly and gradually increasing intensity over time.
  • Increasing physical activity including aerobic exercise, strengthening, and pool-based exercises can reduce pain and improve quality of life.

 

Seek Medical Care

Treatment recommendations should not replace medical treatment. Consult your primary healthcare professional to check drug and herb/nutrient interactions or if you have concerns about fibromyalgia related symptoms.

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