Fibromyalgia – Myth and Truth

At the risk of upsetting a lot of people, I am going to say right out of the gate that I am of the opinion that Fibromyalgia is not actually a condition or syndrome. Rather, it is simply a label that is placed on individuals that have an integrated array of symptoms and no one knows or can clearly identify what the source of the issues actually is.

I have had the pleasure of working with many clients who were diagnosed with Fibromyalgia over the last 16 years. In all cases, my clients were placed on a variety of medications (one client was on 17 different medications) and in the vast majority of cases, no one inquired into my client’s nutrition and/or lifestyle habits. While that is not at all surprising, what I have come to learn in working with Fibromyalgia cases is that the Foundation Principles have to be addressed in order to overcome this pain “syndrome” – more on those factors a little later in this post.

So what is Fibromyalgia?

Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain. The pain associated with fibromyalgia is described as a constant dull ache, typically arising from muscles.

Diagnosis

According to the National Fibromyalgia Association, currently there are no laboratory tests available for diagnosing fibromyalgia. Physicians must rely on patient histories, symptom reports, a physical examination, and an accurate manual tender point examination (which very few can carry out accurately according to some recent research). I have learned that this physical exam is based on the standardized American College of Rheumatology (ACR) criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.

To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:

• Widespread pain in all four quadrants of the body for a minimum duration of three months

• Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied.

I can tell you from my personal experience, about 98% of my chronic pain clients fall into the above 2 categories quite easily. Do they all have Fibromyalgia? My opinion – nope!

Symptoms of Fibromyalgia (according to National Fibromyalgia Association)

Pain

The pain of fibromyalgia is profound, chronic and widespread. It can migrate to all parts of the body and vary in intensity. FM pain has been described as stabbing and shooting pain and deep muscular aching, throbbing, and twitching. Neurological complaints such as numbness, tingling, and burning are often present and add to the discomfort of the patient. The severity of the pain and stiffness is often worse in the morning. Aggravating factors that affect pain include cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.

Fatigue

Fatigue is the number 1 reason for physician visits in the world today, however, the fatigue of FM is much more than being tired after a particularly busy day or after a sleepless night. The fatigue of FM is an all-encompassing exhaustion that can interfere with occupational, personal, social or educational activities. Symptoms include profound exhaustion and poor stamina in Activities of Daily Living (ADL).

Sleep Issues

Many fibromyalgia patients have an associated sleep disorder that prevents them from getting deep, restful, restorative sleep. Medical researchers have documented specific and distinctive abnormalities in the Stage 4 deep sleep of FM patients.

Other symptoms/overlapping conditions

Additional symptoms associated with Fibromyalgia include but are not limited to: irritable bowel and bladder (IBS), headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud’s Syndrome, neurological symptoms, and impaired coordination.
Some Interesting Research

The main cause of fibromyalgia has been postulated and investigated very extensively by a number of physicians and researchers. According to Dr. John C. Lowe, fibromyalgia is caused by inadequate thyroid hormone regulation of cell function. Dr. Lowe details his research and experience, and the research of others in his ground-breaking work, a 1, 260 page book entitled The Metabolic Treatment of Fibromyalgia.

Dr. Lowe sites studies by several research teams that indicate that 90% of fibromyalgia patients have underlying thyroid diseases. Studies by researchers in the U.S., France, Germany, and Italy show that these thyroid diseases include primary and central hypothyroidism and peripheral cellular resistance to thyroid hormone.

It’s important to note, however, that most patients’ fibromyalgia symptoms caused by thyroid disease are compounded by other metabolism-impeding factors. The most common factors are poor diet, nutritional deficiencies, poor physical fitness, and metabolism-impairing drugs.

Dr. Lowe has also headed up a research team with the Fibromyalgia Research Foundation which conducted double-blind, placebo-controlled, crossover studies. In them, they tested the effects of T3 and placebos on fibromyalgia symptoms. They report being able to repeatedly turn the patients’ symptoms off and on by switching them from T3 to placebos, much like turning the flow of water off and on by switching a faucet handle one way and then the other. Additional research cited by Dr. Lowe includes the following:

• A study showed that thyroid hormone’s effectiveness at relieving fibromyalgia symptoms isn’t a placebo effect. This study was the first to show long-term effectiveness of a fibromyalgia treatment. The study was a 1-to-5-year follow-up comparing untreated patients to patients treated with metabolic therapy including thyroid hormone. We matched 20 fibromyalgia patients who hadn’t undergone treatment with 20 fibromyalgia patients who had. We matched them by sex, thyroid status, and the time since their first evaluation.

• They first evaluated all the patients 1-to-5 years before the follow-up study began. They compared those baseline measures with the follow-up measures for each group. Treated patients had improved on all measures of fibromyalgia, and they had decreased their drug use. Untreated patients didn’t improve at all, and they were using more drugs. The fact that treated fibromyalgia patients maintained their improvement 1-to-5 years compared to matched untreated patients compels us to formulate a conclusion: Relieving inadequate thyroid hormone regulation produces long-term recovery from fibromyalgia symptoms. That the recovery is not due to a placebo effect is evident from patients’ improvement lasting from 1-to-5 years—a span of time that outlast that of documented placebo effects.

In addition to all of the above, compared to other people, the fibromyalgia patient has an extremely high level of substance P in his/her spinal cord. Substance P is a chemical that increases pain perception. It amplifies pain perception so much that the patient perceives as painful something that ordinarily is not, such as the pressure of a mattress on his/her back and buttocks.

• There has been research to suggest that Thyroid hormone inhibits the production of substance P in the spinal cord. When researchers create hypothyroidism in laboratory animals, substance P production is no longer inhibited. The level of substance P then rises steeply in the animals’ spinal cords. The high level magnifies the animals’ perception of pain, and like fibromyalgia patients, the animals perceive as painful something that ordinarily is not, such as a light squeeze of a rat’s tail. In humans, the increased pain perception is experienced as chronic widespread aches and pains.

What else could it be?

While I do like the research that Dr. Lowe presents in his book and on his website (www.drlowe.com), I am of the opinion that Fibromyalgia has to do with much more than just thyroid dysfunction (and an expanded look at the research of Lowe and others indicates this as well). Why? The thyroid is a very complicated gland and is impacted by a number of other glands and issues. These include, but are not limited to:

• Issues anywhere within the H-P-T-A-G-G Axes
The thyroid communicates with your hypothalamus, pituitary gland, adrenal glands, gut function, and gonads (testicles/ovaries) just to name a few.

* Estrogen dominance/progesterone deficiency.
Excess or unopposed estrogen is a key inhibitor of thyroid function.  As well, a sluggish thyroid will decrease the liver’s ability to detoxify excess estrogen thus perpetuating a negative cycle that cripples the  body’s energy production leading to chronic fatigue.

• The thyroid is also impacted by the health and function of the liver. This is where the body converts T4 to T3, the active form of thyroid hormone. A lesser amount of that conversion also occurs in the kidneys and the gut.

• Several minerals are necessary for the production of thyroid hormone, T4. These minerals include iodine, iron, manganese, zinc, copper, chromium, selenium, cobalt, and possibly other ultra trace minerals. These minerals and other nutrients which work with these minerals must be in the diet or can be supplemented.

• One major mineral, selenium, is necessary for formation of an enzyme called 5’ deiodinase enzyme, which converts T4 into T3.

• Copper is also necessary for suppressing the production of immune system malfunctions which cause autoimmune Graves’ disease, and appears to have other critical functions in preventing hyperthyroidism.

• Other minerals, including potassium, sodium, calcium, and magnesium, regulate the passage of minerals and T3 through cell membranes. Imbalances of these “gateway minerals” can limit T4 production by interfering with the transport of minerals into the thyroid cells and can also limit the amount of T3 which gets into the body’s cells, thereby limiting the rate of metabolism. T3 is a big player in regulating metabolism.

• Macronutrients – proteins and fats need to be present for the minerals to work properly to perform normal endocrine functions optimally.

• Issues with mineral deficiencies can often be traced to hydrochloric acid deficiency (hypo- or achlorhydria), which is necessary for proper digestion of foods.

• Issues in the small intestine, such as leaky gut syndrome (increased intestinal permeability) can also lead to the mineral issues mentioned above. The majority of your nutrients are absorbed by the small intestine. If it is dysfunctional, it stands to reason that mineral deficiencies are likely to result.

• Food intolerances can be a potential etiological factor in thyroid disease in which auto-immunity is implicated. This is particularly the case in Hashimoto’s Disease, which is now the leading cause of hypothyroidism in the United States.  The key here is to identify the “why?” behind the food intolerance.  What is actually causing one to be intolerant to a given food?

• Women are more likely to be diagnosed with Fibromyalgia than men (interestingly, they are also more effected by hypothyroidism than men are). This is likely due to a hormonal link.  In addition, consider this:

Many women, at the advice of their physician regarding osteopenia and osteoporosis, supplement their diets pretty heavily with various forms of calcium thinking this will protect their bones. However, in order for calcium to be adequately assimilated into the skeletal structure, magnesium levels must be optimal and adequate saturated fats have to be “on board” as well. Up to 83% of the population is magnesium deficient; and how many women do you know run around on low-fat diets because they have been brain-washed by politically correct nutrition into believing that saturated fat is bad for you and should be avoided? Potential magnesium deficiency and avoidance of high-quality saturated fats leads to an accumulation of this supplemented calcium in the soft-tissues of the body. This encourages muscular contraction, spasm, trigger point development, and ultimately, musculoskeletal pain. Just a theory of mine and I have no “significant scientific literature” to back that up (sadly, I only have human physiology to back that up), but it does sound pretty good right?

•The potential sources of Fibromyalgia could go on and on, but I will stop them here.

So What Do You Do?

The solution is to figure out why the individual has Fibromyalgia. You can put 100 Fibromyalgia patients in a room and they are all likely to have the “condition” for slightly different reasons. There is no “end-all-be-all” when it comes to how to overcome FM.

Education on all Foundation Principles – Breathing, Hydration, Nutrition, Movement, Sleep, and Thoughts – must be implemented on an individual case basis if results are to materialize long term. I have used these Foundation Principles to address the “issues” mentioned above to help my clients return to a pain-free and functional lifestyle.

Nutrition must be customized to the physiology of the individual in question. On top of that nutritional needs of the individual will change as they go through the peaks and valleys of the process of creating health. Food selection, meal frequency, and macronutrient ratios all must be completely customized to the individual in question. All of these things are covered in my Food First Program.

I hope some aspect of this offering has led to more questions, got your wheels turning, and has you ready to get out there and do some more homework and arrive at your own conclusions about how to stop Fibromyalgia in its’ tracks.

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