Over 5 million Americans know what it is like to suffer from fibromyalgia. This disorder is characterized by widespread musculoskeletal pain but often it is accompanied by fatigue, sleep, memory and mood issues. Unfortunately, fibromyalgia is a great example of how putting a label on a condition does very little to actual treat it. Truthfully, there really is no definitive diagnosis of fibromyalgia, it is based mainly on the opinion of the provider. Fibromyalgia is really a collection of symptoms that could have many different causes.
In functional medicine, we never want to diagnose a name we want to diagnose a dysfunctional process. Many of the people that suffer from fibromyalgia do not realize that there are natural approaches for fixing the condition and that the natural approaches can be more effective. It is very common for fibromyalgia patients to also suffer from chronic fatigue, IBS, sleep dysfunction, hormone imbalances, and depression. Therefore, it is necessary for the provider to understand that all of these symptoms may be related and that there may be common underlying causes to all of these symptoms.
Typical treatment for fibromyalgia usually involves anti-inflammatory medications, anti-depressants, anti-seizure, or some combination of all three. These medications may provide some relief, but most patients are still often dealing with chronic daily pain, in addition to lack of energy and excitement for a fulfilling life.
In order to treat fibromyalgia the following issues need to be addressed:
- Neurotransmitter Imbalances
- Neuroinflammation
- Lack of movement
The following article will discuss some of the natural approaches required to address the above causes of fibromyalgia.
Neurotransmitter Imbalances
Two of the most common medications for fibromyalgia are anti-depressants and anti-anxiety drugs. These medications attempt to improve the effectiveness of your body’s neurotransmitters; namely Serotonin and GABA. But many people do not realize that there are natural approaches for increasing the availability of these neurotransmitters.
Serotonin
Many anti-depressants are considered Serotonin Reuptake Inhibitors (SSRIs). The purpose of these meds is to increase the amount of available serotonin in your nervous system. Serotonin is considered the feel good neurotransmitter. Symptoms of low serotonin can be:
- Loss of pleasure in hobbies and interests
- Feelings of inner rage and anger
- Feelings of depression
- Difficulty finding joy from life’s pleasures
- Depression when it is cloudy
- Loss of enthusiasm for favorite activities
- Not enjoying your favorite foods
- Unable to sleep
One key aspect of serotonin deficiency that is rarely discussed is that 90% of your serotonin is made in your gut; therefore a digestive dysfunction may very well be causing you to have low serotonin. Other causes may be B-vitamin, Mg, or Zinc deficiency, lack of exercise, lack of brain stimulation, hormone imbalance (particularly estrogen) or lack of sunlight (sunlight does way more than just increase Vitamin D). If you have fibromyalgia and you received a benefit from Cymbalta or Lexapro, then you need to ask yourself why, and try to explore possible solutions for improving your serotonin status.
GABA
Anti-anxiety medications are considered GABA-ergic drugs, and they are popular medications such as Neurontin, Lyrica, Xanax, and Ambien. GABA is the main inhibitory neurotransmitter in the central nervous system. One way to think of fibromyalgia is that the nerve fibers are over-excited and GABA will help calm down this excitability. Patients with low GABA can have the following symptoms:
- Difficulty sleeping
- Panic Attacks
- Hard to turn off your brain
- Can’t relax
- Easily overwhelmed
However, there can be a variety of causes why someone will have low GABA. Gluten sensitivity is common among patients with low GABA. This is because gluten interferes with the enzyme needed to make GABA. In addition, when the enzyme to make GABA is inefficient, the problem is compounded because patients will end up with not only low GABA but also excess Glutamate. Glutamate is an excitatory neurotransmitter and in excess it is very neurotoxic. This is why people get headaches from Chinese food with MSG. Therefore, patients with fibromyalgia should have strict avoidance of MSG and Aspartame because if this neurotoxic effect.
Hormone issues are often accompanied by GABA dysfunction. Many females suffer from estrogen dominance or another way of saying low progesterone. Progesterone and GABA worked together, therefore a patient may have GABA issues being driven from progesterone imbalances.
Other causes of GABA dysfunction are anemia, poor energy production, dysfunctional Ammonia metabolism (often driven from poor gut function), poor blood sugar metabolism, and toxicity.
Key supplements that I frequently use to improve GABA status are Magnesium, Valerian Root, B6, Ashwagandha, Theanine, and Taurine.
Neuroinflammation
Another common medication for fibromyalgia are NSAIDs (Non-Steroidal Anti-Inflammatories, ex. Tylenol, Ibuprofen, Aleve). However, long term use of these medications can lead to many problems and they are definitely not addressing the cause. For more information please see the article, How Does Ibuprofen Work?
The most important thing to understanding chronic inflammation is to understand that it is a reflection of immune dysfunction. And the most common causes of immune dysfunction are:
- Poor Diet – a diet high in processed foods (refined carbohydrates, industrial seed oils) predisposes an individual to inflammation
- Dysbiosis – chronic infections are often at the root of chronic immune dysfunction
- Food Allergies/Sensitivities – often driven from leaky gut syndrome, where your body ignites its inflammatory process caused from undigested protein particles.
- Toxic overload – living in a toxic environment, could be a moldy house or poor water/air quality can wreak havoc on your immune responses
- Stress / Overtraining – working too hard without sufficient time to recover will over time impair your immune function
Any chronic inflammatory disease is often dealing with at least one of the above problems. With fibromyalgia one of the unique aspects of the syndrome is that it has a tendency to create inflammation on the nerves not just the muscular tissue. Therefore, key supplements for nerve health are:
- DHA – fish oil supplements will contain DHA, but you will be better served taking one that has more DHA than EPA, my two favorites are Tuna Oil from Standard Process and ProDHA from Nordic Naturals
- Arachidonic Acid – a key component of the brain, the best sources of this are from organic/pasture raised meat and dairy
- Magnesium – similar to GABA, magnesium will help calm down neurosensitivity
- Resveratrol / Curcumin – these two bioflavonoids are great anti-inflammatories
Exercise / Movement
The last key component for dealing with fibromyalgia is exercise but more importantly movement. Fibromyalgia could be considered a condition where there is no inhibition of nociceptors to the brain. Nociceptors are the nerve fibers that sense tissue damaging stimuli. Think of when you hit your finger with a hammer, that is an excessive stimulation of nociceptors. Also, when hit your finger you will instinctively shake your hand, this occurs because this will stimulate mechanoreceptors. Mechanoreceptors travel to the brain faster than nociceptors and will block nociceptor signals from getting to the brain.
One of the best ways to stimulate mechanoreceptors is through exercise and movement. Early on, gentle movement practices will be more beneficial because most fibromyalgia patients will have difficulty meeting the metabolic demand for more strenuous activity. Activities such as Yoga, Qi Gong, Pool Exercises, but also just walking is a great pain reliever and healer to the nervous system.
Conclusion
This article is not intended to be an all-inclusive look at fibromyalgia but it is intended to make the patient aware that in order to fix a fibromyalgia condition many different aspects of health need to be addressed. There will never be a fibromyalgia pill that cures the disease, because there are too many root causes that drive the condition. Also, if you have been labelled with fibromyalgia don’t use the condition as an excuse to be in constant pain and not participant in activities, use the diagnosis as a wake up call that you need to change your habits and work with a professional who can guide you along the way.
For more information on how my treatment can help with this condition please contact my office.