by Marcelle Pick, OB/GYN NP
I’m sure that many of you have heard about fibromyalgia. You may have symptoms of this syndrome or know someone who does. There has been a lot of misunderstanding about the causes and treatments and this has made it difficult to help women who are challenged by this disease. The cause of fibromyalgia is influenced by a number of factors. I want to encourage you to begin focusing on one or two of these to find that light within you that will begin to shine again. With renewed inspiration, I believe that you will have more energy to work on a achieving a healthy lifestyle and enjoy each and everyday.
At Women to Women, I see women who are very discouraged about the fibromyalgia advice they’ve gotten in the past. They have symptoms that are very hard to deal with on a daily basis such as sleeplessness, fatigue, and ongoing pain that is nearly unbearable. Baffled by the confusion surrounding fibromyalgia and ignored by the medical profession for years, some people still wonder if they were getting a “real” diagnosis. However, be assured that fibromyalgia is real. There are many women who deserve understanding and appropriate treatment for their life-altering symptoms. Specialists and functional practitioners are actively seeking answers to what causes fibromyalgia (and similar pain syndromes) and to find better ways to alleviate the symptoms.
What Is fibromyalgia?
Nobody is certain as to what causes fibromyalgia. It might be an energy deficit in the cells of the body, or mixed signaling among the muscles and the brain. It is known, however, that people with this condition have chronic pain in all parts of the body, and it involves a physical response to stress. The brains of patients with fibromyalgia have greater activation (shown on functional neural imaging) than patients who do not have fibromyalgia, when given the same stimulus. There is a clear physiologic difference in how fibromyalgia patients process symptoms of pain in their brains.
If you are experiencing pain and believe it could be fibromyalgia, then don’t delay and schedule an appointment with your doctor today. Fibromyalgia is strange and pain can vary, so a tender point may feel different on another day. A diagnosis of fibromyalgia is made when there are 11 of the 18 tender spots that cause extreme pain when pressed and this pain has generally been there for at least three months.
Furthermore, research indicates that exposure to physical, emotional, or environmental stressors can enhance symptoms, and one day might be worse because of extra burden placed on the body from undue stress. There are providers who don’t know how to properly locate tender points and tell the difference from trigger points related to other kinds of musculoskeletal pain. Seeing a practitioner that understands about fibromyalgia is essential when seeking help.
It is important to understand that fibromyalgia symptoms are similar to other disorders, for example, chronic fatigue syndrome, myofascial pain syndrome (from repetitive motions), various chemical sensitivities, temporomandibular joint dysfunction (a jaw disorder), interstitial cystitis (bladder infection), to name a few. This makes it harder to diagnose. And because of the number of symptoms and possible disorders, it’s difficult to follow up with appropriate treatment. I think it’s more helpful to alleviate symptoms for the patient, and not continue to search for an elusive diagnosis.
The US Food and Drug Administration (FDA) have approved several prescription drugs (Lyrica, Cymbalta, and Savella) for patients who are diagnosed with fibromyalgia. It’s a positive step in the right direction that the medical community is recognizing this disorder. However, I think that women who have symptoms of fibromyalgia need more than medication for their pain, especially because the first FDA reviewers of Lyrica (initially looked at to treat diabetic nerve pain) thought that its effects were not very impressive. In addition, Lyrica’s side effects include weight gain, swelling, dizziness, and drowsiness (the very symptoms that a fibromyalgia patient is trying to avoid!).
Having worked with fibromyalgia patients for years, it’s important to know that here is a better way to treat it without the use of drugs. I have helped many recover completely and others that are much better. Many must start by learning ways to nurture their body from the inside out. This condition is at a woman’s core, where there are many antecedent issues to look at. These may include sleep, nutrition, digestive problems, adrenal dysfunction, viruses (such as Lyme disease), other infections, and how you think and feel. It can be a challenging journey as you embark on this to feel well again. But if you are willing to dig deeper and do the work, I can promise you that you can feel well again. So let’s take a closer look at fibromyalgia and some alternatives to help you feel better naturally.
Issues related to chronic pain
There are a variety of underlying conditions that can lead to constant pain, chronic pain. These categories include nutrition, metabolism, infection, and toxic issues. Discuss these concerns with your healthcare provider.
- Hypothyroidism (low thyroid)
- Adrenal Dysfunction
- Lyme Disease or coinfections
- Hepatitis C
- Ova and parasites
- Overgrowth of bacteria in the gut
- Other infections not known or not yet understood
- Heavy metals
- Jet fuel
Adapted from Gerwin, 2005.
Causes of persistent myalgias
|Medical||Infectious diseaseInflammatory disordersImmunological/allergicNutritional disorders
Adapted from Gerwin, 2005.
It is difficult to be certain of the actual cause of fibromyalgia. If we take a closer look at your nutrition, infections you have or had in the past, hormonal imbalance, metabolic challenges, and your emotional history we have a good place to start from. The chart above lists various causes that can lead to myalgias and then are linked to fibromyalgia. It’s important for you to understand as much as possible about this disorder, to help you and your practitioner create a good treatment plan.
Stress and hormones - are they connected?
You are probably already aware that hormones are vital to your healthy lifestyle. The hypothalamus (the master gland) sends biochemical messages to your thyroid gland, your adrenal glands, and your ovaries (among others) through your pituitary gland. This will regulate your metabolic balance, your immune system, your autonomic nervous system, and more. Then your body tissues send back chemical messages to the hypothalamus. The messages and information loops influence the symptoms that are seen in fibromyalgia. Let’s explore the three locations that the hypothalamus communicates with.
Research shows that fibromyalgia patients may have disruptions in hormonal sequences. Because the hypothalamus and pituitary gland are central in governing many hormonal cascades, an imbalance in one area could easily affect the other areas. Scientists trace some of these disruptions to environmental and genetic influences, and also psychological stress.
Adapted from A. Gupta and A. Simon, 2004
Thyroid gland. When your thyroid gland is not balanced, it can actually stem from an adrenal gland imbalance. Research shows a connection between thyroid conditions and fibromyalgia, which seems to happen more often in menopausal women. The symptoms in hypothyroidism (such as low body temperature, poor immune function, fatigue, and achiness) can add to the intense symptoms of fibromyalgia. When you treat your hypothyroidism, your symptoms of fibromyalgia can improve.
Adrenal glands. A major duty of your adrenal glands is to release cortisol. You have a daily cycle of cortisol, and you also release it under stress. Fibromyalgia patients report they have a feeling of “crashing” under stress (probably because of an adrenal imbalance). Research suggests that there might be a link between emotional trauma and disrupted cortisol rhythms in people who have fibromyalgia. When you heal your toxic emotions and support your adrenal health, your stress response will improve, in addition to your symptoms of fibromyalgia.
Ovaries. Women with fibromyalgia usually have more severe symptoms premenstrually and postmenstrually. This is because estrogen, progesterone, and testosterone can affect bodily pain and fatigue. So if you can balance your hormones with thyroid, adrenal, and ovarian support, you can lessen the fibromyalgia symptoms. Remember that your fibromyalgia tends to improve as you age and your symptoms will decrease as you develop coping strategies.
Central sensitization theory and fibromyalgia
Fibromyalgia patients seem to feel more intense pain, and though it’s not understood why, there is some research that helps explain why. Scientists think that it begins in the deep tissues of the muscles and joints with a tightening of muscles, which leads to poor sleep. Without proper rest, the muscles can’t recover, and this can lead to continuous signals between your muscles and your central nervous system. Then this alters the way that your central nervous system processes outside conditions. You will feel more pain and be more sensitive. This is known as central sensitization.
An interesting thing about central sensitization is that the causes and effects of fibromyalgia are thought to be bidirectional. This means that structural imbalances can cause your muscles to tighten, while tight muscles can lead to structural imbalances. In addition, poor sleep can lead to your muscles tightening, and tight muscles can lead to poor sleep. You get the idea and can see the vicious cycle, right?
How can you stop this cycle? Two basic steps are to be sure to get good rest and be sure to get good nutrition (for the best functioning of your muscles). There are other ways to decrease your pain naturally. You might even be able to eliminate it.
What is the natural approach to treat fibromyalgia
You might take medications such as Lyrica, Cymbalta, or Savella to help treat your symptoms of fibromyalgia. While these drugs might help for a while, they are not a permanent cure. An excellent book that discusses a natural approach is From Fatigued to Fantastic! written by Dr. Jacob Teitelbaum in 2007. In the book he relates the concept of SHIN: Sleep, Hormonal imbalances, Infections, and Nutrition.
I’d like to add an E to Dr. Teitelbaum’s protocol – for Emotions. As you are aware, your emotions play a large part in the symptoms of fibromyalgia. This will now make the word SHINE. So now let’s discuss each one of these natural approaches in more detail.
Sleep. Most fibromyalgia patients say that lack of refreshing sleep is causing them major distress. Sleep is necessary to heal your muscles and your nervous system. If you think that you might have a breathing disorder that interferes with your sleep, please see a sleep specialist. You could also take 5-Hydroxytryptophan, which has shown to improve your serotonin pathways or melatonin which aids in resetting your sleep cycle. Please talk first to your healthcare provider before taking any new supplements. There are other botanical nervines (such as chamomile, passionflower, and valerian) that have also been safely used for years.
Hormonal balance. You can naturally balance your thyroid, adrenal, and ovarian hormones to make a difference in your symptoms of fibromyalgia. At Women to Women, we suggest that you try gentle phytotherapy. This will work with your metabolic pathways. For the best results, you should look for products that contain botanical nervines and/or adaptogens.
Immune health. Fibromyalgia symptoms can be caused by infectious agents (bacteria, enteroviruses, yeasts, or parasites). It’s a good idea to be sure that an infection is not present. Epstein-Barr virus, cytomegalovirus and Lyme disease are often associated with fibromyalgia and chronic fatigue syndrome. Ask your healthcare provider if you can be tested for these diseases and treated, if you have them. You might also check to see if you have allergies that enhance your symptoms. This could be sensitivity to gluten, eggs, corn, dairy, sugar, preservatives, and food additives. Try an elimination diet to determine if that will help you. It’s always a good idea to boost your immune system and you can do this by taking a probiotic supplement.
Nutrition. Eating whole, fresh foods (fruits, vegetables, and high-quality fats and protein) is the best way to support your body. If you are under stress, I also suggest that you take a pharmaceutical grade multivitamin and mineral complex with fish-oil. Remember that your muscles, nervous system, adrenal glands, immune system, and your body needs proper nutrition for their daily processes!
Some key nutrients that are helpful for fibromyalgia
- B-complex vitamins for energy, immunity, nerve, and brain function
- Magnesium for muscle energy
- Selenium for the best immune function
- Vitamin C for oxidative stress
- Fatty acids, such as omega-3 to help promote cell membranes and mood
- Vitamin D for mood, immunity, and the musculoskeletal system
- Zinc for cell health
- Iodine for thyroid health
Emotions. I’ve discovered a lot of important aspects about our bodies, throughout my years of working with patients. One of the most interesting is that for each emotion we feel (both the positive and the negative) there is a biochemical signature that occurs in our bodies. To put this in clearer terms, it means that if we hide our emotions and don’t adequately express them, then eventually the emotional issues display in physical ways. There was a 1990s study done (Adverse Childhood Event Study) that found specific evidence about how negative experiences influence health. Adults can hold onto childhood memories and resort to previous behaviors that worked then. Of course, those behaviors don’t usually work for adults. If a grown person continues to engage in child-like emotions, then he or she cannot resolve core issues. I have found that my fibromyalgia patients tend to be critical and judgmental of themselves. If they can learn to forgive and love themselves, then healing can more easily happen. There are several alternatives to help deal with emotions, such as Emotional Freedom Techniques, the Quadrinity Process, and cognitive behavioral therapy. I’ve worked with women who were willing to look at their emotional issues and develop new coping strategies and that helped improve their fibromyalgia symptoms.
We’ve discussed the SHINE protocol, but there are other natural treatment ideas that can help patients with fibromyalgia. Here are other measures to support your fibromyalgia treatment:
- Detoxification. There are toxins everywhere, and your body is constantly trying to filter them out. Fibromyalgia patients can help stimulate their natural detoxification systems with saunas, steam baths, mineral baths, and low-intensity exercise to induce sweat. In addition, you can try to be “green” at home, by reducing the toxins that are in your household.
- Exercise. If you have fibromyalgia, you may have a hard time even considering exercise because of fatigue and muscle pain, and you probably have a fairly sedentary lifestyle. It seems so hard to exercise, but if you can just get started, the positive results start right away. This is not just about fitness – it will decrease pain sensations, improve restful sleep, enhance the thought processes, and create a more positive outlook on life. Especially helpful are aquatic fitness and wellness programs (“deep-water running,” aqua-robics, isokinetics) that demonstrate great benefits for fibromyalgia. Additional research has found that whole-body vibration safely reduces pain and fatigue in fibromyalgia, better than exercise alone. Begin slowly and gently, and make a plan to continue to exercise to help with your symptoms of fibromyalgia.
- Mind-body work. There are body-awareness practices (qi gong and yoga) that help to improve “movement harmony,” in addition to breathing exercises and mindfulness meditation that help to decrease fibromyalgia symptoms. They work by calming the “noise” in your central nervous system. Other forms that you might want to try – acupuncture, biofeedback, massage, osteopathic manipulation, Feldenkrais, Alexander technique, and chiropractic. These can assist you by correcting structural imbalances and by regulating pain. There is also benefit in guided imagery exercises, such as Belleruth Naparstek’s meditation, to help with fibromyalgia and chronic fatigue.
Find hope in your own light
We all shine in a special way. You know when you experience the good days there is lots of positive energy. However, you also know the days when symptoms of fibromyalgia make you tired, discouraged, and achy. If you’ve been told that there is nothing to be done or that your symptoms aren’t real, you can be filled with negative energy. But I encourage you to know and remember you do not need to be in pain for the rest of your life and you don’t have to rely on prescription drugs to make it through the day either.
Just by reading this article and learning more about fibromyalgia is a great start. Now you understand that this is a syndrome caused and influenced by many factors. If you choose to work on one or two of these factors, you will find that you can start to SHINE again. You can renew your energy and continue to look at the aspects of your life that affect your health. Soon you’ll be enjoying a healthier and happier lifestyle.