DESCRIPTION

Fibromyalgia Syndrome (FMS) 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.

It is estimated that around 5 to 6 million people in the United States have fibromyalgia, although some research reports even higher numbers since this condition is often misdiagnosed. Fibromyalgia manifests itself in similar ways to chronic fatigue syndrome (CFS), chemical sensitivities, rheumatoid arthritis, and chronic myofascial pain (shortened muscle fiber). As a result, it often takes a long time for a proper diagnosis to be made. In the past, FMS was known as fibrositis or fibromyositis, but both of these terms are not considered inappropriate because they imply inflammation of some sort (the suffix -itis is medical terminology for "inflammation") and inflammation is not a major factor in fibromyalgia.

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

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FREQUENT SIGNS AND SYMPTOMS

Widespread, chronic muscle and joint pain is the most universal symptom in the diagnosis. The pain usually develops gradually and intensifies over time. The pain is usually 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 often accompanies this disorder, and stress may trigger the development of problems similar to those associated with cardiovascular disease and adrenal gland disorders.

Because the immune system is typically compromised in this disorder, opportunistic viral and bacterial infections are common 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.

The most distinctive feature of fibromyalgia, one that differentiates it from similar conditions, is the existence of certain "tender points" - nine pairs (18 points) of specific spots where the muscles are abnormally tender to the touch: The 18 points tend to cluster around the neck, shoulders, chest, knees, elbows region, and hips, and include the following:

• 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. 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.

Other disorders common in people with fibromyalgia include the following:

• Chemical and/or food allergies.
• Dizziness and loss of balance.
• Extreme fatigue.
• Headaches.
• Irritable bowel syndrome (diarrhea and/or constipation, often alternating).
• Jaw pain.
• Memory loss and difficulty concentrating.
• Menstrual pain.
• Sensitivity to bright lights or loud noises.
• Skin sensitivities.
• Stiffness in the morning and, often, when walking.

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.
• Grief.
• 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.

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CAUSES

The cause or causes of fibromyalgia are not known, and there are not tests that can diagnose FMS with complete certainty.

It is thought by some that the disorder, which was only recognized as such in 1990, is caused by a disruption in the brain's ability to process pain.

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, however, are not understood.

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.

Some research has found FMS is more likely to occur in people with a history of sexual abuse, domestic violence, and even alcoholism.

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 may be related to chronic fatigue syndrome (CFS), which causes similar symptoms, except that in fibromyalgia, muscle pain predominates over fatigue, whereas in CFS, fatigue predominates over pain.

FMS has even been misdiagnosed as multiple sclerosis or Parkinson's disease.

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.

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RISK

Certain factors may increase the risk of developing fibromyalgia.

Women are affected far more often than men, although men and children also get fibromyalgia. While fibromyalgia can occur at any age, the chances of getting this disorder increase as a person ages. Those who are most likely to be diagnosed include:

• Women in their mid-30s to late 50s. Being female greatly increases your chance of developing this syndrome since fibromyalgia is much more common in females than males, and most often begins in young adulthood. In most cases, symptoms come on gradually and slowly increase in intensity.
• Men and women age 70 or older.
• People who also have an autoimmune disorder, such as lupus or rheumatoid arthritis.
• Those who have recently had an infectious disease, such as Lyme disease.
• A psychiatric condition (such as major depression) may increase your chance 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.

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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.

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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.

Because malabsorption problems are common in people with this disorder, it is best to use sublingual vitamins and other supplements because they are more easily absorbed than tablets or capsules.



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:

• A person has had widespread pain 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.



• At least 11 of 18 specific tender points are painful when pressed. (Because symptoms vary widely from person to person, some people with fibromyalgia may have fewer painful tender points.)



• Other symptoms typical of fibromyalgia, such as pain and stiffness, fatigue, disrupted sleep, depression, or headache. These may get worse with increased stress, anxiety, exertion, or changes in the weather.

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.

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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:

• Medications to help you sleep better and to relieve pain.
• Exercise therapy to help with muscle aches and stiffness.
• Counseling to help you manage chronic pain.

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:

• Irritable Bowel Syndrome (found in around one-half of those with fibromyalgia).
• Chronic Fatigue Syndrome.
• Major depressive disorder.
• Osteoarthritis.
• Interstitial cystitis (Painful Bladder Syndrome).
• Restless legs syndrome.
• Rheumatoid Arthritis.
• Polymyalgia rheumatica (PMR).
• Lupus.
• Lyme Disease (some report having had Lyme disease prior to a diagnosis of fibromyalgia).
• Hypothyroidism.
• Sjögren's syndrome.
• Raynaud's Syndrome.
• Temporomandibular Disorders (jaw problems).

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.

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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:

• Tricyclic antidepressants may improve sleep and possibly provide pain relief.



• Selective serotonin reuptake inhibitors, also called SSRIs, such as fluoxetine (for example, Prozac), paroxetine (Paxil), or sertraline (Zoloft), may reduce depression or improve sleep.



• A muscle relaxant called cyclobenzaprine (Flexeril) may also be used for pain and sleep problems. This drug is very similar to certain tricyclic antidepressants.



• Non-prescription pain relievers, such as acetaminophen (for example, Tylenol), or nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or aspirin) usually are not very helpful in treating day-to-day symptoms of fibromyalgia. However, they may be useful in reducing severe pain caused by a flare-up of symptoms. You should check with your health care provider if you need to continue taking these medications, as they may harm your stomach, kidneys, or in rare cases, your liver. Your health care provider may want to monitor you if you take NSAIDs daily.



• Stronger pain relievers (narcotics) and sleep aids that are addictive are rarely used to treat fibromyalgia because they are often ineffective, and a person can become dependent on these medications over time.

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.

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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:

• Exercising. Exercise may have the most benefit in reducing symptoms of fibromyalgia.
• Improving sleep.
• Relieving pain.
• Reducing stress.
• Learning about fibromyalgia.
• Treating nutritional deficiencies caused by malabsorption problems.

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.

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ALTERNATIVE THERAPY 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:

SAM-e is short for S-adenosylmethionine, an essential molecule naturally occurring in the cells of plants and animals. SAM-e has been used to treat depression and may also be helpful for fibromyalgia. SAM-e is not an herb. As we age, our bodies produce less SAM-e, so some think that SAM-e may be a helpful supplement when used to treat depressive symptoms. It has been available in European countries through prescription. SAM-e has been getting attention in recent years in the United States for the treatment of depression or to preserve emotional well-being, as well as for other conditions. Initial studies indicate that SAM-e may be effective in helping with depressive symptoms; however, studies are ongoing, and no clinical trials have proven SAM-e safe or effective in the treatment of depression. At present, the safety of SAM-e has not been proven. The U.S. Food and Drug Administration (FDA) does not approve or regulate the distribution of supplements in the United States. Not all formulations of SAM-e are the same. Some brands are more potent than others, depending upon the quality of the ingredients used. SAM-e can have numerous adverse side effects, including: Nausea. Diarrhea. Headache. Anxiety. Flatulence (gas). Causing a change from bouts of depression to intense periods of energy (mania). Another issue in deciding whether to use SAM-e is cost. The recommended oral dose is 200 to 800 mg twice per day. Most studies used 1,600 mg per day to get any positive effects in relieving depressive symptoms. A 1-month supply of SAM-e at 1,600 mg per day would cost about $228. Other herbal treatments are more cost-effective. INFORMATION & SAM-e PRODUCTS Herbal Remedies: Methionine / L-Methionine / S-Adenosyl Methionine (SAM-e) Information Herbal Remedies: Methionine / L-Methionine / S-Adenosyl Methionine (SAM-e) Products Herbal Remedies: SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs SAM-e was discovered in 1952 in Italy and has been researched and manufactured there. SAM-e works closely with folic acid and vitamin B-12.

BIOFEEDBACK. Biofeedback is a method of consciously controlling a body function that is normally regulated automatically by the body, such as skin temperature, muscle tension, heart rate, or blood pressure. When you are first learning biofeedback, sensors will be attached to your body and to a monitoring device. This provides instant feedback on a body function (for example, a person's skin temperature). The biofeedback therapist will then teach you physical and mental exercises that can help you control the function. The results are displayed on the monitor while the you learn how to control that function. The monitor beeps or flashes when the person achieves the desired change in that body function (such as increasing skin temperature or reducing muscle tension). Two types of biofeedback are: 1. Electromyography (EMG). This type of biofeedback uses a device that measures muscle tension while the person practices a relaxation technique, such as meditation, progressive muscle relaxation, or visualization. 2. Peripheral temperature or hand temperature biofeedback. This type of biofeedback uses a device that measures the skin temperature of the hands while the person tries to increase it, often through visualization or guided imagery. For instance, a person may listen to a tape that stirs images of blood flowing to his or her hands. Increasing blood flow to the hands makes the hands warmer. Learning biofeedback requires several sessions in a biofeedback lab or other setting. Most people can be successful at biofeedback by the time they complete 12 sessions. Home feedback units are also available. With practice, many people may be able to learn to influence their muscle tension or blood flow without the help of the feedback monitor. Biofeedback is used most often to control problems related to stress or blood flow, such as headaches, high blood pressure, sleep disorders, and Raynaud's phenomenon. It may also be used to help control long-term (chronic) pain. Biofeedback is a safe procedure. It is most effective when taught by someone well trained in biofeedback techniques. The sensors placed on the skin to measure a body function may irritate your skin. See Biofeedback Therapy for more information.

ACUPUNCTURE or ELECTROACUPUNCTURE. Acupuncture is an ancient Chinese therapy that has been used for centuries. Acupuncture is often used to relieve pain. It is based on the theory that there is energy, called chi or qi, flowing through your body. Chi is thought to flow along energy pathways called meridians. If the flow of chi is blocked or unbalanced at any point on a pathway, theoretically it may result in illness. Traditional Chinese medicine practitioners believe acupuncture unblocks and balances the flow of chi to restore health. Western medicine practitioners who have studied acupuncture theorize that acupuncture reduces pain through biological mechanisms, perhaps involving opioid peptides and stimulation of the hypothalamus and pituitary gland, or changes in neurotransmitters, hormones, or the immune function. Traditional Chinese acupuncture usually is done by inserting very thin needles into the skin at certain points on the body to stimulate energy flow along the body's energy pathways (meridians). Other types of acupuncture may use heat, pressure, or mild electrical current to stimulate energy flow along these meridians. Acupuncture is used to relieve pain and treat certain health conditions. It may be used alone or as part of a treatment program. Promising results have been found for the use of acupuncture in treating nausea and vomiting related to chemotherapy and post surgery pain. Acupuncture may be useful for other conditions such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. Acupuncture is a valuable treatment for certain health conditions and merits further use and study. In general, acupuncture is a safe treatment when done by a certified acupuncturist. You may want to see an acupuncturist who is licensed by the state regulatory board. A state license ensures that the acupuncturist has a certain level of training and follows certain practice guidelines. There may be a slight risk of infection from non-sterilized needles. However, most needles used today are disposed of after one use. See Acupuncture Therapy for more information.

MEDITATION. Meditation is the practice of focusing your attention on feeling calm and having a clear awareness about your life. The health benefits of meditation have been recognized in Eastern philosophies for thousands of years. Meditation is now widely practiced in the West, with the belief that it has positive effects on health. Two meditation techniques are most commonly used: concentrative and mindful. In concentrative meditation, you focus on a single image, sound, mantra (words spoken or sung in a pattern), or your own breathing. Mindful meditation does not focus on a single purpose; rather, you are aware of all thoughts, feelings, sounds, or images that pass through your mind. Meditation usually involves slow, regular breathing and sitting quietly for 15 to 20 minutes. Meditation is used to help treat a wide range of physical and mental problems, including: Addictive behaviors, such as drug, nicotine, and alcohol use. Immune system diseases, such as HIV and cancer. Anxiety, stress, and depression. High cholesterol and high blood pressure (hypertension). The National Institute of Health (NIH) now recommends meditation as part of the first line of treatment for mild hypertension. Pain. Most of these conditions also need conventional treatment to be successful. Meditation is not thought to have any negative side effects or complications when combined with conventional medical treatment. Meditation alone is not considered appropriate or safe for acute, life-threatening situations or in place of effective conventional treatment. Talk to your health care professional about using meditation in addition to your conventional medical treatments. Since meditation usually involves sitting quietly for a period of time and breathing deeply, anyone who cannot sit comfortably or who has respiratory problems may have difficulty practicing meditation. Some people with mental health problems, such as attention deficit hyperactivity disorder or schizophrenia, may not be able to use meditation therapy effectively. See Meditation Therapy for more information.

PRAYER or SPIRITUAL MEDITATION. Many people believe prayer, also known as spiritual meditation, is a way to communicate directly with a spiritual energy or higher being. Prayer can be silent, as in meditation, or spoken aloud in a group, as in a religious setting. Prayer may help people find an inner sense of meaning, or it may strengthen their belief in a higher being. Prayer / Spiritual Meditation may feel very supportive to people faced with life-changing problems, such as illness. Prayer can be an expression of gratitude or a sincere request for help. Prayer can be used for a positive outcome in a situation or for inner strength during difficult times in life. Many established religions view prayer as a powerful tool in helping a wide range of physical or mental problems. You do not have to belong to an organized or established religious group to use spiritual meditation. This can be done quietly in the privacy of your own home or living space and quiet time to turn your thoughts inward towards your own spiritual connections and strength. Health benefits, such as lower blood pressure, increased longevity, and reduced risk for depression, may be seen in people who regularly practice their spiritual faith or who are part of a religious community. Some people believe prayer has the power to heal physical and mental illness. Some claims for medical "miracles" have been attributed to the use of prayer. Some people, depending on their belief in prayer, may experience a feeling of inner strength or power when they engage in some form of spiritual meditation. There have been positive studies that measured the effect of prayer on a person's health. Other data are inconclusive on the effect of prayer on health care outcomes. When combined with conventional medical treatment, prayer is not thought to have any negative side effects or complications. Prayer should not replace conventional medical treatment, and prayer alone is not considered appropriate for sudden (acute), life-threatening situations.

TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS). Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses electrical current delivered through electrodes to the skin for pain relief. Electrical stimulation of the nerves may encourage the body to produce natural pain killers called endorphins, which may block the perception of pain. TENS is done with a small, battery-powered machine, called a TENS unit, about the size of a pocket radio. Usually two electrodes, wires that conduct electrical current, are connected from the machine to the skin. The electrodes are often placed on the area of pain or at a pressure point, creating a circuit of electrical impulses that travels along nerve fibers. The machine can be set for different wavelength frequency, such as a steady flow of electrical current or a burst of electrical current, and for intensity of electrical current. These settings are usually determined by your physical therapist or health care provider. After an introduction to and instruction in this therapy, TENS can be done at home. TENS is used to relieve pain for several different types of illnesses and conditions. It is used most often to treat muscle, joint, or bone problems that occur with illnesses such as osteoarthritis or fibromyalgia, or for conditions such as low back pain, neck pain, tendonitis, or bursitis. TENS has also been used to treat sudden (acute) pain, such as labor pain, and long-lasting (chronic) pain, such as cancer pain. Although TENS may help relieve pain for some people, its effectiveness has not been proven, and it is not considered to be a long-term solution to pain. TENS is generally considered safe, although the machine could harm an adult or child if misused. Have your physical therapist or health care provider show you the proper way to use the machine, and follow these instructions carefully. For more information contact your health care professional or local hospital may be able to refer you to a physical therapist experienced in using TENS. The American Physical Therapy Association can help you find a physical therapist in your area. Call toll-free at 1-800-999-APTA (1-800-999-2782), or visit its Web site at http://www.apta.org for more information. See TENS Therapy for more information.

COUNSELING, such as COGNITIVE-BEHAVIORAL THERAPY (CBT). Cognitive-behavioral therapy (CBT) is a type of counseling aimed at teaching you how to become healthier by modifying certain thought and behavior patterns. It is based on the theory that thought and behavior can affect a person's symptoms and be an obstacle to recovery. CBT can be helpful in treating a variety of problems, including depression, anxiety and panic disorders, eating disorders, chronic fatigue syndrome, and chronic pain. In CBT, you and the therapist work together to identify and change negative thinking and behavior patterns that may contribute to illness. Therapy also focuses on teaching you more positive ways of thinking about and coping with not only illness but also life events and relationships.

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.

TRIGGER POINT INJECTIONS with a numbing drug (anesthetic).

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. See below for recommended dietary supplements and nutritional suggestions. 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.

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ACTIVITY

Maintain a regular program of moderate exercise. A daily walk followed by some gentle stretching exercises 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 exercises, not a strenuous workout two or three times a week. Once you body is accustomed to regular exercise, symptoms are likely to improve. Moderate exercise and stretching help to keep muscles flexible and prevent joints from stiffening up.

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. Hot baths help to relax the muscles.

Consider trying massage therapy, which can help to relax muscles and reduce stiffness of the joints.

Have your health care provider check your thyroid function. Symptoms of hypothyroidism can mimic those of FMS.

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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.

Include pomegranates and pomegranate juice in your diet. They have anti-inflammatory and antioxidant properties.

Herbal Remedies: Pomegranate Juice Concentrate, Natural Kosher, Dynamic Health, 8 fl. oz.
This Pomegranate Juice Concentrate comes in a convenient 8 oz. size and has no preservatives and no sugar added. Pomegranate juice is a sure cure for diarrhea. If blood passes with stool in diarrhea, this too will be stopped by the use of fresh pomegranate juice. Most stomach complaints respond positively to fresh pomegranates sprinkled with salt and pepper. Pomegranates are classified as sweet, sour and sweet-sour. They are highly nutritious and contain energy-giving proteins as well as lime, iron and phosphorus. Sour and sweet-sour pomegranates are very effective in relieving gastric heat and are particularly recommended for people with a bilious nature. Complaints of chest pain and chronic cough find immediate relief with the administration of pomegranate that has been treated with almond oil. The Pomegranate (Punica granatum I.) plant is rich with antioxidants and is a natural source of Vitamin C and Iron. Since ancient times pomegranate juice has been used as a natural astringent for treating diarrhea & harmful internal parasites. The pomegranate juice is believed to provide natural anti-viral, anti-fungal, and anti-bacterial benefits. Pomegranate Juice Concentrate is rich in estrogen. A Powerful Antioxidant and Artemia. Great for the skin. A cure for diarrhea. Ingredients: Pure Pomegranate juice concentrate.

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.

Use wheatgrass retention enemas to detoxify the system. To make an enema, add 1 ounce of wheatgrass juice to 1 cup of warm water. If fresh wheatgrass is not available, use a powdered wheatgrass supplement. Use this treatment every other day for two weeks.

Herbal Remedies: Wheat Grass Powder Single Serving Packets, 15 Packets
Single serve Wheat Grass Powder is easy mixing fine ground wheat grass, box of 15 packets.

Herbal Remedies: Wheat Grass Powder, Organic, 10 oz.
This organic wheat grass powder is an exceptional fine grind that is easy to mix. Add a tablespoon of wheat grass powder with your favorite juice, water or smoothie.

Herbal Remedies: Wheat Grass, Certified Organic, Green Super Food Powder, NOW Foods, 9 oz.
Wheat Grass is a rich source of many nutrients. The whole leaf vegetable grass is then carefully dehydrated and made into a powder to ensure preservation of all its fragile nutritional elements.

Herbal Remedies: Kamut Wheat Grass (Medicago Sativa) Powder, 4 oz. Bulk
Nutritional superior, Kamut Wheat Grass has more protein, lipids, amino acids, vitamins, and minerals than common wheat.

Herbal Remedies: Progreens Powder With Advanced Probiotic, Allergy Research Group / Nutricology, 9.3 oz.
ProGreens is an all-natural blended variety of "Super Foods" that provide broad-spectrum nutritional support from certified organic grasses and natural food factors not found in isolated vitamins or mineral concentrates.

Sweet Wheat from Sweet Wheat, Inc. is a good substitute for fresh wheatgrass juice.

MoonDragon's Health Therapy: Enemas

Take chlorophyll in tablet form or in "green drinks" such as Kyo-Green from Wakunaga of America. Spirutein 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.

Spirutein is a good protein drink to take between meals. Use Spirulina, an excellent protein source. Take spirulina tablets three times a day.

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HERBS

Astragalus and Echinacea enhance immune function.

Black Walnut and Garlic aid in removing parasites.

Boswellia (Frankincense) is excellent for morning stiffness and joint pain.

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.

Calendula or Rosemary Oils (single or a combination of the two), diluted with an equal amount of water or vegetable oil and massaged into the skin, helps to relieve pain.

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.

Kava Kava decreases anxiety and elevates the mood.

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.

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NUTRITIONAL SUPPLEMENTS RECOMMENDATIONS

The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.

NUTRIENTS
Supplement	Suggested Dosage	Comments
Essential
Coenzyme Q-10	75 mg daily.	Improves oxygenation of tissues. Enhances the effectiveness of the immune system and protects the heart. CoQ10, Vegetarian Coenzyme, NOW Foods, 30 mg, 60 VCaps, CoQ10, Now Foods, 400 mg, 60 Softgels
Coenzyme A	As directed on label.	Works with Coenzyme Q-10 and aids in the removal of toxic substances from the body. Facilitates the repair of RNA and DNA. Supports the immune system's detoxification of many dangerous substances. Can streamline metabolism, ease depression and fatigue, and increase energy. Pantethine (Coenzyme A Precursor), Highly Active Form of Vitamin B-5, 300 mg, NOW Foods, 60 Softgels,
Acidophilus (Kyo-Dophilus)	As directed on label.	Candida infection is common in people with fibromyalgia. Acidophilus replaces "friendly" bacteria destroyed by candida. Use a non-dairy powder form. Acidophilus Supplement Powder, Non-Dairy, 3 oz. Bulk, Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian, Lactose Free, Strawberry Flavor, Dynamic Health, 16 fl. oz., Acidophilus Pearls, Enzymatic Therapy, 90 Pearls,
Lecithin Granules Or Capsules	1 tablespoon 3 times daily, before meals. 1,200 mg 3 times daily, with meals.	Promotes energy, enhances immunity, aids in brain function, and improves circulation. Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Identity Preserved Non-GE, 1 lb, Lecithin Liquid, NOW Foods, Vegetarian, 16 fl. oz., Lecithin Concentrate, Nature's Way, 400 mg, 100 SoftGels
Malic Acid	As directed on label.	Involved in energy production in many cells of the body, including the muscle cells. Needed for sugar metabolism. Fibromyalic Formula With Malic Acid, Orthopedic Pharmaceuticals, 120 Caps,
Magnesium	500-1,000 mg daily, in divided doses, after meals and at bedtime.	Involved in energy production in many cells of the body, including the muscle cells. Needed for sugar metabolism. Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz., Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz., Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps
Manganese	5 mg daily. Take separately from calcium.	Influences the metabolic rate by its involvement in the pituitary-hypothalamic-thyroid axis. Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz.,
Nicatinamide Adenine Dinucleotide (NADH)	10-20 mg daily with water first thing in the morning, on an empty stomach.	Studies have shown that it increases energy levels and aids in preventing depression. May take 2-3 weeks to work. NAD (Niacin), NOW Foods, 60 Lozenges,
Proteolytic Enzymes	As directed on label, 6 times daily on empty stomach. Take with meals, between meals, and at bedtime.	Reduces inflammation and improves absorption of nutrients, especially protein, which is needed for tissue repair. MetabolicZyme (Hypoallergenic), Allergy Research Group / Nutricology, 900 Tabs, Plant Enzymes, NOW Foods, Vegetarian, 120 VCaps, Enzymes, All Complete, 250 mg, 90 Caps
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 scavengers that protect the cells and enhance immune function to fight viruses. Use emulsion form for easier assimilation and greater safety at higher doses. Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels
With Mixed Carotenoid Complex	15,000 IU daily.	Powerful free radical scavengers that protect the cells and enhance immune function to fight viruses. Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels, Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
Vitamin E	Start with 800 IU daily for 1 month, then slowly reduce to 200 IU daily.	Powerful free radical scavenger that protect the body's cells and enhance immune function. Use d-alpha-tocopherol form. Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels, Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels, Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels, Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels
Or ACES+Zinc (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 energy level. Use a buffered form. Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz., Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs, Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps, The Right C, Nature's Way, 1000 mg, 120 Tabs
Very Important
Dimethylglycine (DMG)	50 mg 3 times daily.	Enhances oxygen utilization and destroys free radicals. DMG Supplement N,N Dimethyl Glycine, NOW Foods, 125 mg, 100 Caps
5-Hydroxy-L-Tryptophan (5-HTP)	50 mg daily for 1 week, then increase to 100 mg daily.	Enhances synthesis of serotonin in the brain. Excellent for pain relief. Caution: Do not use if you take an MAO inhibitor, commonly prescribed for depression. 5-HTP Supplement, Hydroxy Tryptophan, Natural Serotonin With Vitamin B-6 & C, Nature's Way, 50 mg, 60 Tabs, 5-HTP Supplement, Hydroxy Tryptophan, Vegetarian, NOW Foods, 100 mg, 120 VCaps
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. Amino 1500, Chewable Blend of 20 Amino Acids, Predigested, NOW Foods, 150 Tabs, Amino 1000 Complete, NOW Foods, 20 Amino Acids, 120 Caps
Garlic (Kyolic)	Capsules: Take 2 capsules 3 times daily. Liquid: As directed on label.	Promotes immune function and increases energy. Destroys common parasites and builds red blood cells. Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz., Garlic Bulb Cloves, Garlic Supplement, Nature's Way, 580 mg, 100 Caps, Odorless Garlic Supplement, NOW Foods, 50 mg, 250 SoftGels, Garlic Supplement, Kwai, Triple Concentrated, 180 Tabs, Every Day Garlic Supplement, Kwai, 30 Tabs, Garlic Tincture, 100% Organic, 2 fl. oz., Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic Supplements, 300 Caps, Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz., Kyolic Aged Garlic Extract, One-A-Day, Vegetarian, 1000 mg, Wakunaga Kyolic, 30 Caps, Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 Caps,
Kyo-Green (Wakunaga)	As directed on label.	Supplies balanced nutrients for quick energy. Improves digestion and cleanses the bloodstream. Green Super Food Powder, 8 oz., Wheat Grass, Certified Organic, Green Super Food Powder, NOW foods, 9 oz., Barley Grass Greens, Nature's Way, Gluten Free, 500 mg, 100 Caps, Spirulina Blue Green Algae Powder, 4 oz. Bulk,
Pycnogenol Or Grape Seed Extract	As directed on label.	Powerful antioxidants that protect the muscles from free radical damage and pass the blood-brain barrier to protect brain cells. Enhances immunity. Pycnogenol W/ Vitamin E, 100% Natural, Nature's Way, 50 mg, 30 Tabs, Grape Seed Extract, 350 mg, 90 Caps
Methylsulfonylmethane (MSM)	As directed on label.	Provides support for tendons, ligaments, and muscles. Note: Because this supplement contains sulfur, you may notice an odor to your urine. Pure MSM (Methylsulfonylmethane), 500 mg, 250 Caps, Pure MSM (Methylsulfonylmethane) Liquid, Pure Lignisul, 16 fl. oz., Pure MSM (Methylsulfonylmethane) Powder, Pure Lignisul, 4 oz.
Methylsulfonylmethane (MSM) Cream or Lotion	As directed on label.	Relieves pain. Pure MSM (Methylsulfonylmethane) Lotion, 15%, 8 fl. oz., Pure MSM (Methylsulfonylmethane) Cream, 2 oz.
S-Adenosylmethionine (SAM-e)	As directed on label.	Aids in relief of stress and depression, eases pain, and produces antioxidant effects that can improve the health of your liver. Caution: Do not use if you have manic-depressive disorder or take prescription antidepressants. SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs, SAM-e With B Vitamin Cofactors, Vegetarian, Enteric coated, NOW Foods, 200 mg, 60 Tabs
Vitamin B Complex	100 mg of each B vitamin daily, with meals 3 times daily (amounts of individual vitamins in a complex will vary). Or injections, 2 cc twice weekly or as prescribed by health care provider plus extra vitamin B-6, 1/2 cc twice weekly or as prescribed and vitamin B-12, 1 cc twice weekly or as prescribed, and liver extract, 2 cc twice weekly or as prescribed.	B vitamins are essential for increased energy levels and normal brain function. Injections are best. All injectables can be combined in a single syringe. If injections are not available or has been completed, use sublingual form for best results. Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs, Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps
Plus Extra Vitamin B-6 (Pyridoxine)	50-100 mg twice daily for 12 weeks. You can begin with 50-100 mg twice daily until symptoms improve. Then gradually lower dose by 25 mg weekly. Do not exceed this high dose amount, or nerve damage may result.	A potent diuretic and relieves nerve disorders. Note: If you take any of the B vitamins individually, take the vitamin B complex at a different time of day. Vitamin B-6 / Pyridoxine, Nature's Way, 100 mg, 100 Caps
Vitamin B-12	2,000 mcg twice daily.	To prevent anemia. A natural energy booster. All B vitamins work together. Use a lozenge or sublingual form. Vitamin B-12 Complex Liquid, NOW Foods, 2 fl. oz., Vitamin B-12, Nature's Way, 2000 mcg, 100 Sublingual Lozenges, Vitamin B-12 Liquid Supplement, 50 mcg, With Vitamin B-9 (Folic Acid), 400 mcg, 1 oz. Vitamin B-12, California Natural, 1000 mcg, 60 Tabs, Vitamin B-12 LipoSpray, NOW Foods, 2 fl. oz.
Floradix Iron Plus Herbs Or Desiccated Liver / Raw Liver Extract	As directed on label. As directed on label.	A good source of B vitamins and a nontoxic form of iron from natural food sources. Do not take an iron supplement unless prescribed by your health care provider.
Important
Calcium	2,000 mg daily.	Strengthens the nervous system. Needed for proper functioning of all muscles, including the heart; relieves muscle spasms and pain. Deficiencies are common in people with this disorder. Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz., Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz., Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 Gelcaps
Magnesium	1,000 mg daily.	Magnesium needed to balance calcium. Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz., Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz., Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps
Vitamin D	400 IU daily.	Essential for repair and healing of tissue. Works with Calcium. Vitamin D, NOW Foods, 2000 IU, 120 SoftGels, Vitamin D, NOW Foods, 1000 IU, 180 SoftGels, Dry Vitamin D, Nature's Way, 100% Natural, 400 IU, 100 Caps
Bone Support Formula	As directed on label.	Use a formula containing calcium, magnesium, plus other minerals to aid absorption. Bone Strength, NOW Foods, 240 Caps, Liquid Calcium, Magnesium & Zinc (Liquimins), Natural Pina Colada Flavor, Trace Minerals, 32 oz.,
Potassium	99 mg daily.	All nutrients are needed in balance. Vitamin and mineral deficiencies have been associated with a lack of energy. Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz., Potassium Chelate, 100% Natural, Nature's Way, 99 mg, 100 Caps, Potassium Chloride Powder, NOW Foods, Vegetarian, 8 oz.
Selenium	200 mcg daily. If you are pregnant, do not exceed 40 mcg daily.	An important antioxidant. All nutrients are needed in balance. Vitamin and mineral deficiencies have been associated with a lack of energy.Caution: Do not take supplemental selenium if you are pregnant or have heart, kidney, or liver disease. Selenium Supplement, Yeast Free, NOW Foods, 200 mcg, 180 Caps, Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz., Ionic Selenium, Trace Minerals, 300 mcg, 2 fl. oz., Selenium, 100% Natural, Nature's way, 200 mcg, 100 Caps
Zinc	50 mg daily. Do not exceed a total of 100 mg daily from all supplements.	Needed for proper function of immune system. Important in all enzyme systems and tissue repair. All nutrients are needed in balance. Vitamin and mineral deficiencies have been associated with a lack of energy. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges, Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges, Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
Plus Copper	3 mg daily.	Needed to balance with zinc. Copper Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.,
Capricin (Probiologic) Or Probiata (Wakunaga) or Similar Product	As directed on label.	To combat candida, which is associated with fibromyalgia.
Chromium	200-400 mcg daily.	To help balance blood sugar levels and aid in preventing night sweats. Helps to build and maintain muscle mass. All nutrients are needed in balance. Vitamin and mineral deficiencies have been associated with a lack of energy. Chromium Picolinate, NOW Foods, 200 mcg, 100 Caps, Ionic Chromium Supplement, Trace Minerals, 550 mcg, 2 fl. oz., Chromium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.
Creatine	As directed on label. Do not take with fruit juices, as this combination produces creatinine, which is difficult for the kidneys to process.	To combat muscle depletion. Should be used in conjunction with a balanced, nutritious diet. Creatine Monohydrate, NOW Foods, 1500 mg, 250 Tabs, Creatine Monohydrate, Pharmaceutical Grade, NOW Foods, 750 mg, 120 Caps, Micronized Creatin Monohydrate Powder, NOW Foods, Vegetarian, 21.2 oz., Creatin Overload, Creatine Supplement Powder, Hi-Tech, 1200 g
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 (Flaxseed Oil, Black Currant Seed Oil, Primrose Oil)	As directed on label 3 times daily, with meals.	Protects against cell damage. Helps reduce pain and fatigue. Ultimate Oil, Essential Fatty Acids Supplement, Nature's Secret, 90 SoftGels, Essential Fatty Acids For Baby & Children, Organic, 8 fl oz., Barlean's Flax Oil, 100% Highest Lignan Content, Organic, Pesticide & Herbicide Free, 16 fl. oz., Barlean's Flax Oil, Highest Lignan, 1000 mg, 250 Caps, Black Currant Oil, 500 mg, NOW Foods, 100 Softgels, Evening Primrose Oil With Gamma-Linolenic Acid (GLA), Barlean's, 1300 mg, 120 Softgels, Evening Primrose Oil, NOW Foods, 100% Pure, 4 fl. oz., Evening Primrose Oil, Cold Pressed, Nature's Way, 500 mg, 250 Softgels
Fibroplex (Metagenics)	As directed on label.	A formula containing vitamins B-1 and B-6 plus magnesium, manganese, and malic acid. A specialized formula that provides nutritional support for energy metabolism and neuromuscular function. Metagenics Fibroplex
Fibro-X (Olympian Labs)	As directed on label.	To relieve pain. Contains many nutrients listed in this table, plus shark cartilage.
Gamma-Aminobutyric Acid (GABA) Or GABA Plus (Twinlabs)	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. GABA (Gamma Aminobutyric Acid) Supplement, NOW Foods, 500 mg, Plus B-6, 2 mg, 100 Caps, GABA, Pharmaceutical Grade Gamma Aminobutyric Acid, 250 mg, 90 Tabs, GABA Powder, NOW Foods, 100% Pure, Vegetarian, 500 mg, 6 oz.,
Kelp Or Seaweed	As directed on label.	Contains minerals that support the thyroid. Kelp Supplement, Nature's Way, Certified, 650 mg, 100 Caps, Kelp Seaweed, Norwegian, NOW Foods, 100% Natural, 550 mg, 250 Caps, Kelp Seaweed, Norwegian Powder, 4 oz. Bulk
L-Leucine Plus L-Isoleucine And L-Valine Plus L-Carnitine	500 mg daily, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 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. Branched Chain Amino Acids, Free Form, NOW Foods, (L-Valine, L-Leucine, & L-Isoleucine), 120 Caps, Branched Chain Amino Acid Powder, NOW Foods, (L-Valine, L-Leucine, & L-Isoleucine), 12 oz., L-Carnitine, Stable Tartrate Form, NOW Foods, 500 mg, 30 Caps, L-Carnitine Liquid, Double Strength, NOW Foods, 16 fl. oz.
L-Tyrosine	500-1,000 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. L-Tyrosine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 120 Caps, L-Tyrosine Powder, Free Form, Vegetarian, NOW Foods, 4 oz.
Melatonin	As directed on label, taken 2 hours or less before bedtime.	A powerful antioxidant that also aids sleep. A natural sleep-regulating hormone that is helpful for promoting sound, restful sleep. A sustained release formula is best. Melatonin Supplement, Time Released, NOW Foods, 1 mg, 100 Tabs
Multi-Vitamin & Multi-Mineral Complex	As directed on label. Take with Carotinoid Complex.	All nutrients are needed in balance. Use a high potency, hypoallergenic formula. Vitamin and mineral deficiencies have been associated with a lack of energy. Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption), Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply),
Ocu-Care (Nature's Plus)	As directed on label.	Contains essential nutrients to protect and nourish the eyes.
Raw Glandular Complex Plus Raw Thymus And Raw Spleen Glandulars	As directed on label for each glandular.	Stimulates glandular function, especially the thymus (site of T lymphocyte production). To boost the immune system. See Gland Therapy. Immuno-Gland Plex, Organic Glandular (Hypoallergenic), Allergy Research Group/Nutricology, 60 Caps, Thymus Organic Glandular (Hypoallergenic), Allergy Research Group/Nutricology, 75 Caps
Maitake Or Shiitake Or Reishi	As directed on label. As directed on label. As directed on label.	To build immunity and boost energy levels. Mushroom Master 3 Mushroom Tincture, Red Reishi, Shiitake & Maitake Mushroom Extracts, Herbal Remedies USA, 2 fl. oz., Reishi Mushroom, Whole, 100% Organic, 4 oz., Shiitake Mushroom, Whole, 100% Organic, 4 oz., Maitake Mushroom, Whole, 100% Organic, 4 oz.
Taurine	500 mg daily, on an empty stomach.	An important antioxidant and immune system regulator necessary for white blood cell activation and neurological function. Taurine Powder, 100% Pure, Free Form, NOW Foods, 1000 mg, 8 oz., Taurine, Double Strength, Free Form Amino Acid, NOW Foods, 1000 mg, 100 Caps
Vanadyl Sulfate	As directed on label.	Protects the muscles and reduces overall body fatigue.

FIBROMYALGIA SUPPLEMENTS & PRODUCTS

Information, supplements and products for fibromyalgia syndrome, a chronic condition characterized by fatigue and extreme muscle pain.

Acai Juice Plus, Antioxidant Juice, NOW Foods, 32 oz. From Acai Palm Trees nestled deep within the lush Brazilian rainforests of the Amazon grows one of our planet's most remarkable and nutritious fruits.

Adrenals & Hypoglycemia Treatment Formula Tincture, 100% Organic, 2 fl. oz. Adrenals and Hypoglycemia Treatment Formula is used to restore energy, help regulate blood sugar and support the adrenal glands.

Alive! Whole Food Energizer Multi-Vitamin & Mineral With Naturally Occurring Iron (No Iron Added), Nature's Way, 90 Tabs No other supplement contains more life-giving nutrients than Nature's Way Alive Multi-Vitamin. Alive Multi-Vitamin is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands.

Alfalco (Alfalfa Tonic), Homeopathic Boericke & Tafel (B & T), 8 fl. oz. Alfaco, Alfalfa Tonic, relieves fatigue, stress & sleeplessness and is a natural homeopathic.

Black Seed Herbal Honey Sticks, Immune Boost Honey, 12 Each Now there is an easy, convenient way to take Black Seed Herbal Honey Sticks with you in the car, while you are at work, or even at play.

Black Seed Whole Herb Seed, 100% Pure, Non-Irradiated, 4 oz. Black Seed herb in raw form for our customers who wish to use it as a seasoning, add it to beverages, and as a nutritional supplement for humans and animals.

Blue Scullcap (Scutellaria Lateriflora), Standardized, Nature's Way, 100 mg, 60 VCaps Scullcap is most commonly used as a sedative and it can take the edge off anxiety and promote sleep for those who struggle with insomnia.

Bromelain 2000 GDU Supplement, NOW Foods, 500 mg, 90 Tabs NOW Foods Bromelain 2000 GDU is a proteolytic digestive enzyme that can enhance absorption of protein.

B-Stress Vitamin Complex With Siberian Eleuthero (Siberian Ginseng), Nature's Way, 100 Caps If you are looking for herbal stress relief, you will find B-Stress Vitamin Complex with Siberian Eleuthero, formerly Siberian Ginseng Root to be just what you are looking for.

Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz. WaterOz Ionic Calcium is a pure liquid Calcium supplement. Calcium is one of the most essential of the major biochemical elements needed in human nutrition. It is needed in every organ of the body, including the brain. Calcium is called the "knitter" because it promotes healing or knitting everywhere in the body. It is valuable for tone, power, strength, longevity, vitality, and endurance, healing of wounds, counter-acting acids, and helping regulate metabolism.

Cat's Claw Bark (Uncaria Tomentosa) Powder, 4 oz. Bulk Cat's Claw Bark (Uncaria tomentosa) was reputed to be a super drug in the Andean region of South America. It has a long history of indigenous use for arthritis and rheumatism as well as other types of inflammation associated with various stomach disorders and ulcers where it was clinically shown to be effective.

Cat's Claw Bark (Uncaria Tomentosa), Nature's Way, 485 mg, 100 Caps Cat's Claw Bark is a traditional tonic herb for well being, Cat's Claw was historically used by the indigenous people of South America to stimulate the immune system in a variety of serious ailments.

Cat's Claw Extract, Standardized, Nature's Way, 335 mg, 60 Caps Nature's Way Cat's Claw extract, also known as Una de Gato is derived from the bark of plants wild-harvested in Peru and Brazil.

Cat's Claw Tea Spice System Builder, Regular, 100% Organic, Loose Leaf, 8 oz. Reduces inflammation in arthritis, protects the body from harmful substances, supports the body while undergoing cancer treatments, helps to boost the immune system.

Cat's Claw Tincture, 100% Organic, 2 fl oz. Cat's Claw is a rain forest herb that grows in the Peruvian Amazon. It has been used by native healers for many years.

Chromium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz. WaterOz Ionic Chromium is a pure liquid chromium supplement. Chromium helps the body regulate metabolism, regulate insulin and blood sugar levels, helps the body lose weight by stimulating enzymes that metabolize glucose, burns fat. Chromium deficiencies may contribute to Infertility and decreased sperm count.

Chromium Picolinate, 100% Natural, Nature's Way, 200 mcg, 100 Caps. Nature's Way Chromium Picolinate, is 100 percent natural, patented Chromium Picolinate.

CoQ10, All Natural, Hypoallergenic, Nature's Way, 60 mg, 60 Softgels CoQ10 is vital for cellular energy production and is a powerful antioxidant and free radical scavenger.

CoQ10, NOW Foods, 400 mg, 60 Softgels As an active contributor to all aspects of cellular function, coq10 has become universally regarded as one of the most vital nutrients ever made available to the public.

Coral Calcium (Okinawa) Plus Magnesium & Vitamin D, 100% Natural, NOW Foods, 500 mg, 100 VCaps Okinawa Coral Calcium Plus with Magnesium, Vitamin D and 70 other trace minerals provides essential minerals, restores body alkalinity, supports the immune system, and is bio available for better absorption.

Damage Control Master Formula, High Potency Multi-Vitamin, 60 Packets (30 Day Supply) The Damage Control Master Formula - Pure and simply the world's most comprehensive and complete balanced high potency multi-vitamin, mineral, anti-oxidant, anti-aging, anti-stress, anti-fatigue, immune-supporting, performance-enhancing product.

Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Punch Flavor, 1000 mg, 36 Packets This excellent tasting fizzy Vitamin C drink mix is for Energy & Immune System Support, select orange, raspberry or cranberry flavor.

Enzyme PhytoNutrient (EPN) Ionic Supplement, Fully Absorbable, 16 fl. oz. WaterOz Ionic EPN is a pure liquid enzyme supplement. EPN complex is a patent-pending enzyme phytonutrient from a plant source that provides enzyme and saccharides necessary for optimal cellular communication. No combination of vitamins, minerals, amino acids or herbals can replace the necessary saccharides found in EPN.

Fibromyalic Formula With Malic Acid, Orthopedic Pharmaceuticals, 120 Caps Fibromyalic Formula contains 120 powder filled Capsugel Capsules. Fibromyalic Formula utilizes high quality raw materials and capsules from suppliers such as Capsugel, a division of Pfizer, OptiMSM from Cardinal Nutrition, PUREFLEX Glucosamine from TSI and Boswellin from Sabinsa. The products contains ingredients such as Malic Acid, CoQ10, OptiMSM, Glucosamine, Curcumin, Boswellia Serrata and other natural Cox II Inhibitors.

Fibromyalgia: A Nutritional Approach, By William Hennen, Ph.D. This booklet provides valuable information on how to effectively treat fibromyalgia through nutritional regimens, supplementation and other lifestyle changes.

Fibromyalgia (FM) Tincture, Herbal Remedies USA, 2 fl. oz. Fibromyalgia Tincture is supportive to the joints, muscles, and the nervous system. Fibromyalgia Tincture decreases pain and subtle inflammations in situations of chronic pain and fibromyalgia.

5-HTP Hydroxy Tryptophan, Vegetarian, NOW Foods, 100 mg, 120 VCaps 5-HTP also known as Hydroxy Tryptophan is an Amino Acid and precursor to serotonin, a brain chemical responsible for regulating mood, appetite, behavior, and sleep. 5HTP may help elevate mood, control appetite, and promote better sleep.

Lecithin Concentrate, Nature's Way, 400 mg, 100 Softgels Nature's Way Lecithin Supplement is 100% Natural from soy oil and it contains no artificial ingredients or preservatives.

Licorice Root, Certified, Nature's Way, 450 mg, 100 Caps Licorice Root (Glycyrrhiza Glabra) is a member of the legume family and its major constituent, glycyrrhizin, is 50 times sweeter than sucrose.

Licorice Root Tincture, 100% Organic, 2 fl. oz. Licorice root is taken orally (DGL form) for ulcers, heartburn (esophageal reflux), and mouth sores.

Magnesium Ascorbate Powder, NOW Foods, 100% Pure, 8 oz. Magnesium Ascorbate is a buffered (non-acidic) form of Vitamin C that will not contribute to gastric irritation in acid-sensitive persons.

Magnesium Citrate Complex, Nature's Way, 250 mg, 100 Caps Nature's Way Magnesium Citrate is an advanced chelate form which enhances absorption of magnesium by providing excellent solubility.

Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz. WaterOz Ionic Magnesium is a pure liquid Magnesium supplement. Magnesium is a natural tranquilizer. Called the "anti-stress mineral," it aids in relaxing nerves, relieving tension, assisting digestion, activating enzymes important for protein and carbohydrate metabolism.

Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz. WaterOz Ionic Manganese a pure liquid Manganese supplement. Manganese, also called the "brain mineral, is important in the utilization of all mental facilities and functions.

MSM (Methylsulfonylmethane), Pure Lignisul, With Vitamin C, 875 mg / 100 mg, 120 Caps MSM with Vitamin C offers support for allergies, connective tissue, joint flexibility, immune function, arthritis, osteoporosis, digestive disorders, circulation,bruising, carpal tunnel syndrome, and antioxidant protection.

MSM (Methylsulfonylmethane) Liquid, Pure Lignisul, 16 fl. oz. MSM is a non toxic physiologically active sulfur compound that may be helpful for connective tissue, cartilage, tendons, mucous membranes, nails, hair, and skin damage and repair.

MSM (Methylsulfonylmethane), Pure Lignisul, 1000 mg, 240 Caps With many benefits, MSM plays a beneficial role in connective tissue and joint flexibility, immune health, arthritis, osteoporosis, nails, fibromyalgia, muscle soreness, athletic injuries and allergies.

MSM (Methylsulfonylmethane), Pure Lignisul, 500 mg, 250 Caps MSM is a non toxic physiologically active sulfur compound that may be helpful for connective tissue, cartilage, tendons, mucous membranes, nails, hair, and skin damage and repair.

MSM (Methylsulfonylmethane), Pure Lignisul, With Glucosamine, 500 mg / 500 mg, 120 Caps MSM with Glucosamine provides nutritional support for healthy joints by lubricating, nourishing, and easing inflammation in damaged tissue and cartilage.

MSM (Methylsulfonylmethane) Lotion, (15%), 8 fl. oz. MSM Lotion contains methylsulfonylmethane, a form of sulfur, which may be helpful in treating skin disorders including acne, psoriasis, eczema, dermatitis, dandruff, scabies, diaper rash, and certain fungal infections.

MSM (Methylsulfonylmethane) Lotion With Aloe, (15%), 4 fl. oz. MSM Lotion with Aloe Vera supports healthy skin, helping to keep it moisturized and smooth throughout the day.

MSM (Methylsulfonylmethane) Powder, Pure Lignisul, 4 oz. MSM plays a beneficial role in allergies, connective tissue and joint flexibility.

MSM (Methylsulfonylmethane) Supplement, Pure Lignisul, 1000 mg, 120 Caps With Free 4 oz. Lotion Buy MSM Supplement caps and get a 4 oz Lotion free, MSM supplement plays a beneficial role in connective tissue and joint flexibility, immune health, arthritis, osteoporosis, rheumatoid arthritis, inflammation, pain, hair, skin, nails, athletic injuries, acne, wrinkles and allergies.

Natural Aspirin Alternative, White Willow Bark Extract, 390 mg, 60 Tabs Used to treat bursitis, tendonitis, headaches, osteoarthritis, dysmenorrhea, rheumatoid arthritis, back pain, toothache, and menstrual cramps, White Willow is being used by more people as a safer, natural alternative to aspirin.

Pain Free 1-2-3, A Proven Program for Eliminating Chronic Pain Now, By Jacob Teitelbaum, M.D., Paperback Conquer pain and Take your life back NOW, Dr. Jacob Teitelbaum gives several Chronic Pain Coping Technique's in his proven step-by-step program, Pain Free 1-2-3. His first hand knowledge and 30 years' experience as a pain specialist, lecturer, and researcher give him rare insight in the challenge posed by persistent, nagging chronic pain.

President's Super Energy Herbal Tea, 20 Tea Bags For normal cardiovascular, urological, neurological and sexual function and for general immunity, longevity and sharp brain power, etc.

Samento (Unicaria Tomentosa), Extra Strength (100 Times More Effective Than Regular Cat's Claw, 0.5% POA, 600 mg, 30 Caps Samento is beneficial in the treatment of a wide range of immune system related conditions; these include but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.

Samento Liquid Extract (Uncaria Tomentosa), 0.5% POA, 1 fl. oz. Beneficial in the treatment of a wide range of immune system related conditions; these include but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders and HIV infection.

Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz. WaterOz Ionic Selenium is pure liquid Selenium supplement. Selenium promotes normal body growth, enhances fertility, encourages tissue elasticity and is a potent antioxidant that naturally reduces the retention of toxic metals in the body. Selenium is crucial for the proper functioning of the heart muscle and there is evidence that it can help the body fight cancer.

Siberian Eleuthero Root, Nature's Way, 410 mg, 100 Caps Eleuthero Ginseng root (eleutherococcus senticosus), also known as Eleuthero Root or Siberian Ginseng Root, enhances physical and mental vitality and endurance.

Siberian Eleutheroccocus Senticosus (Siberian Ginseng Root) Tincture, 2 fl. oz. Siberian Ginseng root is suitable for women as well as men and improves cerebral circulation and detoxifies the blood.

St. John's Wort Herbal Tea, 20 Tea Bags St. John's Wort Herb Tea is made of wild St. John's Wort and Siberian Ginseng. These Herbs tonify the nervous system, ease anxiety and depression, and support the immune system.

St. John's Wort Tonic (Formerly Depression Tincture), 100% Organic, 2 fl. oz. St. John's Wort Supplement is found to help alleviate depression and strengthen the nervous system.

Synthovial Seven, Pure Hyaluronic Acid, 1 oz. Hyaluronic Acid (HA) has been proven by numerous medical studies to alleviate pain and suffering from arthritis of the knee and other joints.

The Miracle of MSM: The Natural Solution for Pain, By Stanley W. Jacob, M.D., Ronald M. Lawrence, M.D., & Martin Zucker Learn how to stop the pain of numerous ailments with MSM. How much, when, with what food and in what form to relieve pain in its many forms. Helpful against pain and allergies, this supplement is safe, natural and side-effect-free.

Vitamin B-1 (Thiamin HCl), 100% Natural, 100 mg, 100 Caps Vitamin B-1 (Thiamin) is the precursor to the active metabolite thiamin diphosphate, which is essential for the conversion of glucose into energy.

Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps. Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.

Vitamin E, Natural D-Alpha-Tocopherol, 400 IU, 100 Softgels Vitamin E has potent antioxidant activity, supplies oxygen to the blood, aids in strengthening capillary walls, and plays a beneficial role in cancer and cardiovascular disease prevention, anti-aging benefits, circulation, wound-healing, immune function, nervous system function, PMS, hot flushes, diabetes, vascular disease, eye health, tissue repair, athletic performance, leg cramps, skin and hair health, and alleviating fatigue.

Herbal Remedies: Fibromyalgia Syndrome Information

Herbal Remedies: Fibromyalgia Supplements, Information & Products

Herbal Remedies: Fatigue Supplements, Information & Products

Herbal Remedies: Jet Lag Information, Symptoms & Causes

Herbal Remedies: Fatigue / Extreme Exhaustion / Low Energy Levels Information

Herbal Remedies: Chronic Fatigue Syndrome (CFS) Information

MoonDragon's Health & Wellness: Fatigue

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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.

There is no FDA-approved treatment for fibromyalgia, but there are now two studies that indicate a majority of people who suffer from the disorder can find relief by taking duloxetine (Cymbalta), an antidepressant drug. A report on the latest study of the drug was reported in the medical journal Arthritis and Rheumatism. Duloxetine may be effective because it works by boosting levels of two neurotransmitters that play a role in pain processing.

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.

Studies are being conducted on the possible role of a genetic drug that interferes with the formation of adenosine triphosphate (ATP, the source of cellular energy) in this disorder.

Some experts suggest that people with fibromyalgia should avoid salt-free diets.

Plant sterols and sterolins (plant fats that are present in fruits, vegetables, seeds, and nuts) stimulate the immune system, thus helping the body fight off infection.

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 anti-anxiety drug Lorazepam (Ativan) is sometimes prescribed as well. These drugs 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.

HELPFUL ORGANIZATIONS WITH FIBROMYALGIA 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 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 does not 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.

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Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
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