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MoonDragon's Health Information & Discussion
FIBROMYALGIA SYNDROME

BASIC INFORMATION

"For Informational Use Only"
For more detailed information contact your health care provider
about options that may be available for your specific situation.

DESCRIPTION

  • Fibromyalgia is considered a rheumatic disorder characterized by chronic achy muscular pain that has not obvious physical cause. It most commonly affects the lower back, the neck, the shoulders, the back of the head, the upper chest, and/or the thighs, although any area or areas of the body may be involved. Along with tissue pain and tenderness, chronic fatigue is often associated with this disorder.

    The pain of fibromyalgia is more than normal muscle aches common after physical exertion. Fibromyalgia often can be severe enough to disrupt a person's daily work and activities.

  • Fibromyalgia has been recognized as a medical disorder only since the 1980s, although there is evidence it may have existed for centuries.

    FREQUENT SIGNS AND SYMPTOMS

  • Widespread, chronic muscle and joint pain is the most universal symptom in the diagnosis. The pain usually develops gradually. The pain is described as burning, throbbing, shooting, and stabbing.

  • The pain and stiffness is often greater in the morning than at other times of day, and it may be accompanied by chronic headaches, strange sensations in the skin ( Raynaud's Syndrome), insomnia, depression, irritable bowel syndrome (present in about 1/2 of those with fibromyalgia) which may include diarrhea or constipation, and temporomandibular joint syndrome (TMJ).

  • Other symptoms often experienced by people with fibromyalgia include:
    • Premenstrual syndrome.
    • Painful periods.
    • Anxiety.
    • Palpitations.
    • Memory impairment and difficulty concentrating.
    • Irritable bladder.
    • Skin sensitivities, tingling sensation in hands.
    • Dry eyes and mouth.
    • A need for frequent changes in eyeglass prescription.
    • Dizziness.
    • Impaired coordination.

  • Activities, such as lifting and climbing stairs, are often very difficult and painful.

  • Depression is frequently part of the picture as well.

  • Widespread pain that has been present for at least 3 months. To be considered "widespread," the pain must be both above and below the waist and on both sides of the body.

    tender points

  • The most distinctive feature of fibromyalgia is the existence of certain "tender points" - nine pairs (18 points) of specific spots where the muscles are abnormally tender to the touch:
    • Around the lower vertebra of the neck.
    • At the insertion of the second rib, just to the right and left of the breastbone (sternum) about 2 inches (5.08 cm) below the collarbone.
    • Around the upper part of the thigh bone, on the outer upper leg just behind the bony part of the hips (this point is easier to find when standing).
    • In the middle (inside) of the knee joint.
    • In muscles connected to the base of the skull, just behind the ear.
    • In muscles of the neck and upper back, about halfway between the base of the neck and the tip of the shoulder.
    • In muscles of the mid-back, at the spot where the back muscles attach to the shoulder blade, just below the point above.
    • On the side of the elbow, on each forearm just and to the outside of the crease of the elbow.
    • In the upper and outer right and left muscles of the buttocks.

    To clearly diagnose fibromyalgia, a person must have pain at 11 or more of the 18 tender points. In practice, however, many people with fibromyalgia have less than 11 tender points. It is now recognized that some people with fibromyalgia having less than 11 tender points will have most of the other known symptoms.

  • Most people with fibromyalgia also have an associated sleep disorder known as alpha-EEG anomaly. In this disorder, the individual's deep sleep periods are interrupted by bouts of waking-type brain activity, resulting in poor sleep. Some people with fibromyalgia are plagued by other sleep disorders as well, such as sleep apnea, restless leg syndrome, bruxism, and sleep myoclonus (a sudden rapid contraction of a muscle or a group of muscles during sleep or as one is falling asleep). Not surprisingly, given all of these sleep difficulties, people with fibromyalgia often suffer from chronic fatigue that can range from mild to incapacitating.

  • This disorder is much more common in females than in males, and most often begins in young adulthood. In most cases, symptoms come on gradually and slowly increase in intensity. They can be triggered (or made worse) by a number of different factors, including:
    • Overexertion.
    • Stress.
    • Lack of exercise.
    • Anxiety.
    • Depression.
    • Lack of sleep.
    • Trauma.
    • Extremes in temperature and/or humidity.
    • Infectious illness.

  • In majority of cases, symptoms are severe enough to interfere with normal daily activities. A significant number of people with fibromyalgia are actually disabled by the condition.

    CAUSES

  • The cause or causes of fibromyalgia are not known. Some evidence points to a problem with the immune system since certain immunologic abnormalities are common among people with this disorder. Their significance and relationship to the syndrome are not understood, however.

  • A disturbance in brain chemistry may also be involved. Many people who develop fibromyalgia have a history of clinical depression. An imbalance in brain chemicals that control mood can also cause an unrestful sleep cycle. This leads to fatigue and a lowered tolerance for pain, which in turn leads to tender points and widespread pain in the muscles and soft tissues. Once this occurs, a person becomes less physically active, and the muscles and tissues become more sensitive and painful and more easily injured or irritated.

  • May be due to an imbalance of hormones released by the pituitary gland, which can cause fatigue, water retention, and muscle and joint pain.

  • May be associated with nerve cells in the spinal cord and brain, which can be more sensitive to pain in people who develop fibromyalgia. This may occur from changes in chemicals in the brain or spinal cord that regulate pain. As a result, the person senses pain more easily, and widespread muscle pain occurs.

  • May be caused by below-normal levels of growth hormone in their bodies. Growth hormone deficiency has been associated with low energy, muscle weakness, sensitivity to cold, weakened ability to remember and think, and other problems.

  • Other possible causes that have been proposed include:
    • Infection with the Epstein-Barr virus (EBV), the virus that causes infectious mononucleosis.
    • Candida albicans (yeast) infection.
    • Chronic mercery poisoning from amalgam dental fillings.
    • Anemia.
    • Parasites.
    • Hypoglycemia.
    • Hypothyroidism.

  • Some experts believe that fibromyalgia, muscle pain predominates over fatigue, whereas in CFS, fatigue predominates over pain.

  • Regardless of what causes it, fibromyalgia seems to involve a cycle of increased sensitivity to pain and decreased physical activity.
    • Increasing pain makes a person less physically active.
    • Muscles that are not exercised regularly are more likely to be injured during activity. It is also possible that people with fibromyalgia are more sensitive to pain or have muscles that are more easily irritated or injured.
    • The irritated or injured muscles are painful. Some health care providers think the muscles of people with fibromyalgia remain sore because they do not repair themselves as well as the muscles of people who do not have this syndrome.
    • Muscle pain, sometimes occurring together with disrupted sleep and daytime fatigue, leads to less and less activity.

    RISK

    Certain factors may increase the risk of developing fibromyalgia.

    Fibromyalgia sometimes occurs with other muscle or joint diseases or chronic pain conditions. This can make fibromyalgia difficult to diagnose.

    If you already have fibromyalgia, you may be more likely to have recurring symptoms or persistent pain if you:

    • Have episodes of emotional or physical stress.
    • Had more than 11 tender points on your initial assessment.
    • Have had symptoms of pain for more than 10 years.
    • Have sleep disturbance.
    • Have psychological symptoms such as anxiety or depression.

    PREVENTIVE MEASURES

  • Currently, fibromyalgia can be neither prevented nor cured. However, prompt treatment of your symptoms may help reduce the length of the flare-up.

    EXPECTED OUTCOME

  • Fibromyalgia can sometimes feel like the flu. You may experience body aches, tiredness, and intestinal discomfort, such as diarrhea. The pain in your joints and muscles may become especially bothersome at night, waking you from sleep. In the morning, you may feel very stiff and sore. You may have trouble concentrating due to fatigue. These symptoms may last from days to months. The initial site of your pain may expand if your symptoms last a long time.

    People with fibromyalgia have periods when their symptoms become worse and periods when they have no symptoms. Flare-ups of fatigue and muscle and joint aches are common, especially following physical or emotional stress.

    Although fibromyalgia is a long-lasting (chronic) condition, the symptoms usually can be managed with home treatment, especially exercise. Treatment with medications may be helpful when sleep problems, severe pain, or depression develop. Unfortunately, some people may not respond to any treatment measures.

    While there is no cure for fibromyalgia, most symptoms can be controlled through self-care methods at home. Fortunately, the condition does not cause damage to muscles, joints, or internal organs. Most people with fibromyalgia adjust to their symptoms and are able to continue working and with daily activities. However, there are a small number of people who may have to adjust their work and lifestyles due to the severity of their symptoms.

    TREATMENT

    DIAGNOSIS

    Fibromyalgia can be difficult to diagnose because its symptoms are similar to many other disorders and diseases. There are no lab tests to diagnose fibromyalgia. It is often diagnosed after other conditions have been ruled out. Your health care provider will take your medical history and do a physical exam. Fibromyalgia is diagnosed when:

    Fibromyalgia is not a psychological condition, although it has some psychological components. As with many conditions that cause chronic pain, anxiety and depression are common in people with fibromyalgia and may make symptoms worse.

    STANDARD MEDICAL TREATMENT

    While there is no specific cure for fibromyalgia, symptoms of this syndrome can be treated. If you have fibromyalgia, taking an active role in your treatment is very important to managing your condition. There is no surgical treatment for fibromyalgia.

    Treatment may be different for each individual. It can include:

    Research is ongoing to understand the cause of fibromyalgia and its cure.

    Because symptoms of fibromyalgia mimic so many other disorders, other conditions with similar symptoms often must be eliminated before fibromyalgia can be properly diagnosed.

    Many conditions are reported either to be associated with fibromyalgia or to share similar symptoms. Because there are so many other conditions with similar symptoms, diagnosing fibromyalgia can be difficult. Some of these disorders include:

  • Many people with fibromyalgia report that their muscle pain is made worse by cold or damp weather, poor sleep, fatigue, stress, overexertion, and anxiety. The skin may also be ultrasensitive, reacting to a firm touch with tingling, numbness or a "pins and needles" sensation.

    Treatment is focused on managing pain, fatigue, depression, and other symptoms common in fibromyalgia in an attempt to break the cycle of increased sensitivity to pain and decreased physical activity.

    While there is no one standard medical treatment for fibromyalgia, the basic goals of treatment are to:

    • Learn about fibromyalgia.
    • Start a program of physical exercise.
    • Relieve sleep problems.
    • Relieve pain and stiffness.
    • Reduce stress and avoid other factors that worsen symptoms.

    Treatment may include:

    • Medications to help you sleep better.
    • Medications to help relieve muscle and joint pain.
    • Exercise therapy to help relieve sore muscles and increase energy.
    • Improving sleep may also help with muscle and joint pain.

    Fibromyalgia can affect mood and lead to depression or anxiety. These problems are common in people with this disorder and may require specific treatment.

    Many people with fibromyalgia have other joint or muscle diseases (such as rheumatoid arthritis or lupus) that need to be treated as well.

    Although exercise seems to help most people with fibromyalgia, no one particular treatment stands out as the most effective. The kind of treatment you need or want may be based on:

    • The severity of your symptoms.
    • Whether the condition is disrupting your daily life.
    • What kinds of changes in your life you are willing and able to make.

    Because the symptoms of fibromyalgia can come and go, you may find it difficult to judge whether a particular treatment is really working. Different people may respond differently to each type of treatment.

    It may take time and you may have to try several different treatments to find an approach that works for you.

    MEDICATION

    Medications do not cure fibromyalgia. However, some medications may help improve fibromyalgia symptoms, especially muscle pain and frequent waking during the night. Not all people with fibromyalgia will need, want, or benefit from medications, but people with more severe pain, sleep problems, or depression that disturbs their daily life may find them helpful.

    Antidepressants and pain relievers are often used to treat symptoms of fibromyalgia. This does not mean that the condition is "all in your head." Antidepressants may help by improving sleep, mood, or by blocking pain signals. Many people with fibromyalgia appear to benefit from the use of these medications.

    Often, medications may be combined (such as fluoxetine and amitriptyline) for the most effective treatment of symptoms of pain and sleep disruptions. Certain types of antidepressants may be used to improve sleep, relieve pain, and in some cases treat depression:

    In general, medications are not very useful for the long-term treatment of fibromyalgia. They may help break the cycle of pain and sleep problems when symptoms flare up, but they usually are part of a larger treatment plan that focuses on exercise and other types of treatment.

    HOME TREATMENT

    Although fibromyalgia is a chronic disease, there is much you can do to relieve and control your symptoms.

    Home treatment is the most important part of treating fibromyalgia and focuses on:

    The best results occur when you take an active, committed role in your own treatment. You may need to adjust your lifestyle to fit home treatment into your daily routine. It may take time to find an approach that works for you. Try to be patient, and keep in mind that consistent home treatment usually can help relieve or control symptoms of fibromyalgia.

    ALTERNATIVE TREATMENTS

    A variety of other treatments have been used for conditions that cause chronic pain. Most of these complementary or alternative therapies are not proven treatments for fibromyalgia; however, they may be helpful for some people when symptoms flare up and may improve quality of life.

    Studies show that certain relaxation techniques may be effective in relieving pain caused by fibromyalgia, including:

    Other treatments that may be used to treat fibromyalgia include:

    • Physical therapy. Physical therapy is the treatment of a disease or condition by physical or mechanical means, such as through exercise, heat, or electrical current. A physical therapist provides these treatments and will also provide education, instruction, and support for recovery.

      The purpose of physical therapy is to decrease pain and allow you to gradually return to your normal activities. Physical therapy can reduce pain in the soft tissues (such as the muscles, ligaments, and tendons), improve function, and build muscle strength. A health care provider or physical therapist will design a program specific to your normal level of activity, physical fitness, and severity of pain.

      Physical therapy techniques may include:

      • Stretching, to reduce stress on joints.
      • Manual therapy, to improve or maintain range of motion.
      • Heat therapy, to improve blood circulation to the muscles and other soft tissues.
      • Ice therapy, to reduce swelling and relieve pain.
      • Exercise, to strengthen muscles.

    • Massage therapy. Massage involves applying pressure to the soft tissues of the body, such as the muscles. The theory is that massage may be helpful in reducing tension and pain, improving circulation, and encouraging relaxation. Massage is usually done by applying pressure with the hands, but it can also be done using the forearms, elbows, or feet. Massage techniques can affect the muscles, circulation, nervous system, and other systems of the body. There are at least 80 different types of massage. Some are gentle, and some are very active and intense.

      For example, Swedish massage is very gentle and is often used to promote relaxation, improve circulation, and relieve muscle tension. Long, gliding strokes and kneading and tapping techniques are used on the top layer of muscles in the direction of blood flow to the heart. This may also include moving the joints gently to improve range of motion.

      Deep tissue massage is more active and intense. It is used to treat long-lasting (chronic) muscle tension. Slow strokes are applied (with the fingers, thumbs, and elbows) using intense pressure to reach deeper layers of the muscles than those reached with a Swedish massage technique.

      Some people feel that massage works because the touch is healing. Touch also communicates a sense of caring.

      Massage is used to promote relaxation and relieve pain. It is also used to relieve muscle tension and may improve circulation, relieve pressure on nerves, and restore normal joint movement. Most studies on massage provide good evidence that massage reduces anxiety. There is also some evidence that shows massage improves blood circulation and decreases muscle tension. However, there is little reliable evidence that massage reduces pain, improves movement, or improves athletic performance.

      When done properly, massage is considered safe. Certification by the American Massage Therapy Association ensures a certain level of training and the use of certain practice guidelines. Keep in mind that massage may be expensive, is generally not covered by insurance, and requires a time commitment.

      Massage is a popular therapy for both relaxation and to treat many different health conditions. Massage therapists can be found in most areas. Your health care provider or another health professional may be able to provide referrals. Massage is not a substitute for prescribed physical therapy.

      The American Massage Therapy Association also provides information and referrals. You may contact the association by phone at (847) 864-0123, writing to American Massage Therapy Association, 820 Davis Street, Suite 100, Evanston, IL 60201-4444 or by visiting their website at www.amtamassage.org. See Massage Therapy for more information.

    • Injection of trigger points with a numbing drug (anesthetic).

    Other types of complementary therapies sometimes used to treat fibromyalgia include:

    • Dietary supplements. A dietary supplement is something that is found in foods (such as meats, grains, fruits, or vegetables) and therefore can be sold to the public without testing and approval from the U.S. Food and Drug Administration. See below for helpful dietary supplements. Because there is no testing or regulation of dietary supplements, it is not known how safe and effective melatonin or many other dietary supplements are. There is also no guarantee of the purity of supplements, for example, how much of a supplement is melatonin and how much of it is other substances or "fillers." Obtain your supplements from reliable sources.

    • Vitamins. Vitamins are special chemicals the body needs in small amounts. They work in a variety of ways, mostly as "helpers." For example, many of the B vitamins help the body use protein, fats, and carbohydrates properly. Vitamins do not provide energy (they are not a source of calories), but they are essential for the body to function properly.

      Vitamins are divided into two categories:

      • Water-soluble vitamins include all the B vitamins and vitamin C. Water-soluble vitamins travel freely through the body, and excess amounts are excreted easily by the kidneys. The body needs water-soluble vitamins in frequent, small doses, and they are unlikely to reach toxic levels.

      • Fat-soluble vitamins include vitamins A, D, E, and K. Fat-soluble vitamins, however, are stored in the body's cells and are not excreted as easily. They do not need to be consumed as frequently as water-soluble vitamins (although adequate amounts are needed), and they are more likely to reach toxic levels if consumed in excess.

    • Herbal products. See below for recommended herbs that can be used to help treat fibromyalgia.

    • Reflexology, which is the practice of applying pressure to points on the body that benefit other parts of the body.

    • Chiropractic therapy. A chiropractor is a health professional who uses a system of therapy based on the theory that a person's health is generally determined by the condition of the nervous system and how it relates to the spine and the muscles.

      Many chiropractors use spinal manipulation to relieve back pain. Spinal manipulation is done through a variety of techniques. For example, the practitioner may use his or her fingers or hands to apply pressure to and move the vertebrae slightly beyond their normal range of motion. Treatment may also involve careful twisting of the head, shoulders, and hips. Heat, ice, corsets, ultrasound, strength and conditioning exercises, biofeedback, and relaxation therapy may be used to supplement spinal manipulation. Some chiropractors use X-rays to diagnose conditions. Some use diet and physical therapy along with spinal manipulation. Chiropractic therapy does not use medications or surgery to treat conditions. Spinal manipulation must be done by a specially trained, licensed practitioner, usually a chiropractor or an osteopathic physician.

    In general, complementary or alternative treatments are not harmful, and you may find one or more of them helpful in relieving some of your symptoms. Keep in mind that there is only limited information about the effectiveness of these treatments (and others about which you may have heard) for treating fibromyalgia. Before trying any treatment, consider asking your health care provider these questions:

    • Is it safe? Talk with your health care provider about the safety and potential side effects of the treatment and/or medication. Remember that fibromyalgia does not physically harm you or damage your body. A treatment or a medication that could be harmful and may or may not improve your symptoms may not be worth the risk.

    • Does it work? Because the symptoms of fibromyalgia can come and go, you may find it difficult to judge whether a particular treatment is really working. A treatment that works for one person may not work for you. It may take time, and you may have to try several different treatments to find an approach that works for you.

    • How much does it cost? An expensive, unproven treatment that may or may not help you may not be worth the high cost. Keep in mind that when you get better after treatment, the treatment is not always the reason for the improvement. Symptoms sometimes improve on their own.

    ACTIVITY

  • Maintain a regular program of moderate exercise. A daily walk followed by some gentle stretching exercise is good. If you have been sedentary before, start slowly and be careful not to overexert yourself. This can aggravate symptoms. Keep in mind that what you need is some amount of daily exercise, not a strenuous workout two or three times a week. Once your body is accustomed to regular exercise, symptoms are likely to improve.

  • Be sure to give your body sufficient rest. Set aside at least 8 hours for sleep each night.

  • Take a hot shower or a bath upon arising to stimulate circulation and help relieve morning stiffness. Or alternate between hot water and cold water while showering. Recent studies have shown cold showers to be beneficial for relieving the pain of fibromyalgia.

    DIET

  • Eat a well balanced diet of 50 percent raw foods and fresh "live" juices. The diet should consist mostly of vegetables, fruits, whole grains (primarily millet and brown rice), raw nuts and seeds, skinless turkey or chicken, and deep water fish. These quality foods supply nutrients that renew energy and build immunity.

  • Eat four to five small meals daily to keep a steady supply of protein and carbohydrates available for proper muscle function. If the body does not have enough fuel for energy, it will rob the muscles of essential nutrients, causing muscle wasting and pain.

  • Drink plenty of liquids to help flush out toxins. The best choices are steam-distilled or quality bottled spring water and herbal teas. Fresh vegetable juices supply necessary vitamins and minerals.

  • Limit your intake of green peppers, eggplant, tomatoes, and white potatoes. These foods contain solanine, which interferes with enzymes in the muscles, and may cause pain and discomfort.

  • Do not eat meat, dairy products, or any other foods that are high in saturated fats. saturated fats raise cholesterol levels and interfere with circulation. They also promote the inflammatory response and increase pain. Also avoid fried foods, processed foods, shellfish, and white flour products such as bread and pasta.

  • Do not consume any caffeine, alcohol, or sugar. Eating sugar in any form - including fructose and honey - promotes fatigue, increases pain, and disturbs sleep. If these substances have been a regular part of your diet, your symptoms may actually get worse for a short period as a result of the "withdrawal" effect, but after that, you should experience a noticeable improvement in your condition.

  • Avoid brewer's yeast and wheat until your symptoms improve.

  • Take chlorophyll in tablet form or in "green drinks" such as Kyo-Green from Wakunaga of America. Spiru-tein from Nature's Plus is a good protein drink to use between meals to aid in maintaining energy levels and to reduce muscle pain. See Therapeutic Liquids and Drinks and Juicing for Nutrition for more information.

    HERBS

  • Astragalus and echinacea enhance immune function.

  • Black walnut and garlic aid in removing parasites.

  • Teas brewed from burdock root, dandelion, and red clover promote healing by cleansing the bloodstream and enhancing immune function. Combine or alternate these herbal teas, and drink 4-6 cups daily.

  • Topical applications of cayenne (capsicum) powder mixed with wintergreen oil can help relieve muscle pain. Cayenne contains capsaicin, a substance that appears to inhibit the release of neurotransmitters responsible for communicating pain sensations. Use 1 part cayenne powder to 3 parts wintergreen oil. Cayenne can also be taken orally, in capsule form.

  • Ginkgo biloba improves circulation and brain function.

  • Licorice root supports the glandular system. Caution: If overused, licorice can elevate blood pressure . Do not use this herb on a daily basis for more than 7 days in a row. Avoid it if you have high-blood pressure (hypertension).

  • Milk thistle protects the liver.

  • Pau d'arco, taken in tea or table form, is good for treating candida infection.

  • Skullcap and valerian root improve sleep.

    Nutrients
    SupplementSuggested DosageComments
    Essential
    Coenzyme Q10 75 mg daily. Improves oxygenation of tissues, enhances the effectiveness of the immune system, and protects the heart.
    Acidophilus (Kyo-Dophilus from Wakunaga, Bifido Factor from Natren) As directed on label. Candida infection is common in people with fibromyalgia. Acidophilus replaces "friendly" bacteria destroyed by candida.
    Lecithin As directed on label, with meals. Promotes energy, enhances immunity, aids in brain function, and improves circulation.
    Malic acid
    And
    Magnesium    		 As directed on label. Involved in energy production in many cells of the body, including the muscle cells. Needed for sugar metabolism.
    Manganese 5 mg daily. Take separately from calcium. Influences the metabolic rate by its involvement in the pituitary-hypothalamic-thyroid axis.
    Proteolytic enzymes
    Or
    Infla-Zyme Forte from American Biologics
    Or
    Wobenzym N from Marlyn Nutraceuticals    		 As directed on label, 6 times daily, with meals, between meals, and at bedtime. Reduces inflammation and improves absorption of foods, especially protein, which is needed for tissue repair.
    Vitamin A 25,000 IU daily for 1 month, then slowly reduce to 10,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily. Powerful free radical scavenger that protect the body's cells and enhance immune function. Use emulsion forms for easier assimilation.
    And
    Vitamin E    		 800 IU daily for 1 month, then slowly reduce to 400 IU daily. Powerful free radical scavenger that protect the body's cells and enhance immune function. Use emulsion forms for easier assimilation.
    Or
    ACES+Zinc from Carlson Labs    		 As directed on label. Contains vitamins A, C, and E plus the minerals selenium and zinc to protect immune function.
    Vitamin C with bioflavonoids 5,000-10,000 mg daily, in divided doses. Has a powerful antiviral effect and increases the body's energy level. Use a buffered form.
    Very Important
    Vitamin B complex injections
    Plus extra
    Vitamin B6 (pyridoxine)
    And
    Vitamin B12
    Plus
    Raw liver extract    		 B complex: 2 cc twice weekly for 1 month or as prescribed by health care provider.

    B6: 1/4 cc twice weekly for 1 month or as prescribed by health care provider.

    Vitamin B12: 1 cc twice weekly for 1 month or as prescribed by health care provider.

    Raw liver extract: 2 cc twice weekly for 1 month or as prescribed by health care provider.    		 Essential for increased energy and normal brain function. Injections (under health care provider's supervision) are best. All injections can be combined in a single syringe.
    Or
    Vitamin B complex    		 100 mg 3 times daily, with meals. If injections are not available, or once the course of injections has been completed, use a sublingual form.
    Dimethylglycine (DMG) ( Aangamik DMG from FoodScience Labs) 50 mg 3 times daily. Enhances oxygen utilization by the muscles and destroys free radicals that can damage cells.
    Free-form amino acid complex As directed on label. To supply protein essential for repair and rebuilding of muscle tissue and for proper brain function. Use a formula containing all the essential amino acids.
    Grape seed extract As directed on label. A powerful antioxidant that protects the muscles from free radical damage and enhances immunity.
    Garlic (Kyolic) 2 capsules 3 times daily, with meals. Promotes immune function and increases energy. Also destroys common parasites.
    Plus
    Kyo-Green from Wakunaga    		 As directed on label. To improve digestion and cleanse the bloodstream.
    Important
    Calcium
    And
    Magnesium    		 2,000 mg daily.

    1,000 mg daily.    		 Needed to balance with magnesium.

    Needed for proper functioning of all muscles, including the heart; relieves muscle spasms and pain. Deficiency is common in people with this disorder.
    Or
    Bone Support from Synergy Plus    		 As directed on label. Contains calcium and magnesium plus other minerals to aid absorption.
    Capricin from Probiologic As directed on label. To combat candida, which is associated with fibromyalgia.
    DL-Phenylalanine (DPLA) 500 mg daily every other week. Can be very effective for controlling pain. Also increases mental alertness. Caution: Do not take this supplement if you are pregnant or nursing, or suffer from panic attacks, diabetes, high blood pressure, or PKU.
    Essential fatty acids (black currant seed oil, flaxseed oil, and primrose oil are good sources) As directed on label 3 times daily, with meals. Protects against cell damage. Helps to reduce pain and fatigue.
    Gamma-aminobutyric acid (GABA)
    Or
    GABA Plus from Twinlab    		 As directed on label.

    As directed on label.    		 For proper control of brain function and to control anxiety.

    Contains a combination of GABA, inositol and niacinamide.
    L-Leucine
    Plus
    L-Isoleucine
    And
    L-Valine    		 500 mg daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B6 and 100 mg vitamin C for better absorption. These amino acids are found primarily in muscle tissue. They are available in combination formulas. See Amino Acids Index for more information.
    L-Tyrosine 500 mg daily, at bedtime. Helps to relieve depression and aids in relaxing the muscles. Caution: Do not take this supplement if you are taking an MAO inhibitor drug.
    Melatonin As directed on label, 2 hours or less before bedtime. Promotes sound sleep. A sustained release formula is best.
    Multivitamin and mineral complex
    Plus
    Natural carotenoids (Advanced Carotenoid Complex from Solgar)    		 As directed on label.

    15,000 IU daily.    		 All nutrients are necessary in balance. Use a high-potency hypoallergenic formula.
    Ocu-Care from Nature's Plus As directed on label. Contains essential nutrients to protect and nourish the eyes.
    Raw Thymus
    And
    Raw Spleen Glandulars
    Plus
    Multiglandular complex    		 As directed on label.

    As directed on label.

    As directed on label.    		 To boost the immune system. See Glandular Therapy for more information.
    Taurine 500 mg daily, on an empty stomach. An important antioxidant and immune system regulator necessary for white blood cell activation and neurological function.
    Vanadyl sulfate As directed on label. Protects the muscles and reduces overall body fatigue.

    CONSIDERATIONS & HELPFUL INFORMATION

  • Chronic pain sufferers, especially those with fibromyalgia and chronic fatigue syndrome, tend to be deficient in magnesium.

  • Common pain killers such as aspirin, acetaminophen, and ibuprofen are not usually effective at relieving the pain of fibromyalgia. Other approaches, including attention to diet, exercise, and nutritional supplementation are more likely to be of benefit.

  • Many different disorders can cause symptoms similar to those of fibromyalgia, including anemia, depression, hepatitis, and Lyme disease, among others. Anyone who experiences muscular pain and/or fatigue that persists for longer than a week or two should consult a health care provider. There may be an underlying medical disorder that requires treatment.

  • Recent research points to the possible involvement of chemical and/or food sensitivities in fibromyalgia, chronic fatigue syndrome, and the pain associated with these disorders. This would hardly be surprising, as humans have been exposed to more chemicals in the last 50 years than in all the rest of our history combined.

  • Because malabsorption problems are common in this disorder, all nutrients are needed in greater than normal amounts, and a proper diet is essential. Colon cleansing may be recommended to rid the gastrointestinal tract of mucus and debris, and so improve nutrient absorption. See Colon Cleansing Therapy for more information.

  • Many health care providers prescribe low-dose antidepressants for fibromyalgia. These drugs can be beneficial in some cases, but can also cause a number of side effects, such as drowsiness. Other medical treatments that may or may not be of help to any given individual include muscle relaxants and/or local anesthetic sprays or injections for relief of pain. The antianxiety drug Lorazepam (Ativan) is sometimes prescribed as well. This drug can cause a loss of equilibrium.

  • Physical therapy, relaxation techniques, exercise therapy, massage therapy, deep heat therapy, and biofeedback are all helpful in some cases. Massage therapy is particularly beneficial for improved muscle function and pain relief. If you are diagnosed with fibromyalgia, it is wise to seek out a health care provider who has specific experience in the management and treatment of this condition.

  • Food allergies can exacerbate the discomfort of many disorders. See Allergies for more information.

  • See Chronic Fatigue Syndrome and Depression for more information about these conditions.

  • See Pain Control Therapies for more information.

      Fibromyalgia Network
      P.O. Box 31750
      Tucson, AZ 85751
      Phone: 1-800-853-2929
      Web Address: http://www.fmnetnews.com/

      The Fibromyalgia Network provides educational materials on fibromyalgia syndrome and chronic fatigue syndrome.

      Arthritis Foundation
      P.O. Box 7669
      Atlanta, GA 30357-0669
      Phone: 1-800-283-7800
      Phone: (404) 872-7100
      Web Address: http://www.arthritis.org

      The Arthritis Foundation provides grants to help find a cure, prevention, or better treatment for arthritis. It also provides a large number of community-based services nationwide to make living with arthritis easier, including self-help courses; water and land-based exercise classes; support groups; home study groups; instructional videotapes; public forums; free educational brochures and booklets; the national, bimonthly consumer magazine Arthritis Today

      National Fibromyalgia Research Association (NFRA)
      P.O. Box 500
      Salem, OR 97302
      Web Address: http://www.nfra.net/IntrNfra.htm

      This organization is involved in making the public, the medical community, and the government more aware of fibromyalgia. Its Web site is also a good source of information.

    NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...

  • You have had the following symptoms for at least 3 months without an obvious cause. They may be signs of fibromyalgia, especially if they have developed gradually:
    • Widespread muscle tenderness and pain, particularly on both sides of the body and both above and below the waist.
    • Disturbed sleep (tossing, turning, waking up frequently during the night) and waking up feeling tired and unrested.
    • Muscle and joint stiffness that doesn't get better when you move around.
    • Depression.

    It is normal to have sore muscles when you overexert yourself. This pain usually will go away after a couple of days. If you think you are injured and the muscle or joint pain does not go away in a few days, talk with your health care provider.

    Not every health care provider will be comfortable diagnosing or treating the symptoms of fibromyalgia because it is still not a well-defined disorder. Be sure to seek a health care provider who is sensitive to your chronic pain, fatigue, and other symptoms associated with fibromyalgia. Those health professionals with the most experience in treating fibromyalgia include:

    • Rheumatologists.
    • Pain management specialists.

    Other health professionals who may be able to manage your fibromyalgia include:

    • Family practitioners.
    • Internists.
    • Nurse practitioners.
    • Physician's assistants.

    It can be helpful to participate in a multidisciplinary pain management program. This program includes a team comprised of your health care providers, counselors, nurses, and pharmacists who will help you develop a strategy for pain management. Your personal program may include medications, complementary therapies, diet, exercise, and counseling.

  • Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
      -- by Phyllis A. Balch, James F. Balch

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