Published June 11, 2012
Fibromyalgia (FM) is a mysterious disorder, the underlying causes of which are not very clearly understood. Unfortunately, it is quite common, especially among women aged 20 to 50. Individuals affected by the disease experience long-term, widespread pain and tenderness in the joints, muscles, tendons and other soft tissues.
The condition has been extensively studied by experts across the globe for decades - many theories have been formulated, only to be refuted years later. Diagnosis is a result of exclusion, rather than defining pathophysiological characteristics.
Several hypotheses exist that link fibromyalgia to three underlying conditions:
• Oxidative stress is the stress placed on the body from exposure to radiation and other substances that cause the formation of free radicals. Oxidative stress may be reduced by increasing your antioxidant status. Free radical scavengers may be squelched with adequate intake and supplementation of vitamins A, D and E, as well glutathione and co-enzyme Q10. In fact, a 2011 study showed significant improvement of fibromyalgia symptoms with increased levels of vitamin D – in excess of 50ng/mL.
• Inflammation is the one condition that is classically blamed for the intense pain associated with fibromyalgia. Cytokines are proteins that serve as messengers between cells. Cytokines regulate various inflammatory responses and in some cases, like fibromyalgia, it is believed that certain cytokines are overproduced. This leads to increased pain signals, achiness and fatigue.
• Mitochondrial dysfunction is often observed in patients with fibromyalgia. The mitochondria are the power house of cells, specifically, muscle cells. In the mitochondria, glucose is converted to ATP (adenosine triphosphate), which is used by the muscles for energy. In many patients with fibromyalgia, the mitochondria of many cells in the body have been shown to be impaired.
Treatment options exist to address these underlying conditions, however it is often a slow process to uncover the most ideal treatment for each individual suffering from fibromyalgia:
• Mitochondrial function and the integrity of the cell membranes allow for adequate energy production as long as proper nutrients are available to the body. Simple blood tests can detect mitochondrial breakdown, while an in-depth analysis may be necessary to determine what nutrient deficiencies may be the source of impairment. Identifying these areas will allow the practitioner to make recommendations to replace the appropriate nutrients and improve energy production within the cells. Maximizing energy production remains a critical step in relieving the symptoms of fibromyalgia, as speculation runs high that fibromyalgia is heavily linked to mitochondrial dysfunction. Many basic supplements available on the market today have been utilized, successfully in the treatment of mitochondrial dysfunction, including deoxyribose, L-carnitine, magnesium, and coenzyme Q10.
• Hormone and neurotransmitter balance is vitally important in the treatment of chronic inflammatory diseases, including fibromyalgia. Neurotransmitters allow the brain to communicate to the body necessary functions within the endocrine system. Hormones act as cell regulators and allow cell to cell communication. Hormones have a direct influence on genetic cellular communication. This mechanism allows the brain to influence the body in repair, regeneration, and the maintenance of optimal health. Bioidentical hormone replacement therapy has been utilized with success to optimize communication allowing the body's natural healing process to occur.
• Supplementation is also important in the management of fibromyalgia and inflammation. Intravenous nutrient therapy has often been reported to improve the symptoms of fibromyalgia. The most common deficiencies observed in fibromyalgia patients include magnesium, 5-HTP (the precursor to the neurotransmitter, serotonin) and vitamin D. D-ribose and acetyl-L-carnitine play major roles in mitochondrial function. Therefore, supplementation of each of these is useful in the treatment of fibromyalgia.
Fibromyalgia is a complicated disease state, however, through careful assessment and use of functional testing as discussed above and appropriate protocols, treatment programs may be initiated with greater success. This disease is often chronic and becomes very frustrating to affected individuals. Taking measures to supply the body with proper nutrition and enhancing the body's communication through both hormonal and neurotransmitter balance will result in optimal outcomes in the management of fibromyalgia.