One of the best ways to envision fibro is as a generalized anxiety disorder of the muscles, initially triggered by a stressful event and then perpetuated by the pain of the muscles themselves.
Let’s reiterate exactly who and what we’re treating when we treat fibromyalgia:
• A person, usually a woman, who is genetically more susceptible to stress because of an inherited low-serotonin stress buffer.
• Before her fibro started, she likely experienced a protracted period of stress–emotional or physical–which, due to her body’s constant fight-or-flight response, has tightened her muscles painfully and fatigued her stress-responding adrenal glands and thyroid.
• She now suffers widespread muscle pain, exhaustion, and unrefreshing sleep.
• Although the specific triggering events may have receded, the stress from her current fibro (unrelenting pain, exhaustion, little help from doctors) keeps everything going. In addition, she may have heightened sensitivity to other yet undiscovered (but correctable) stressors, including diet choices, weather, shifting sex hormones, job, and relationships.
With this in mind, the fibro patient arrives at WholeHealth Chicago with her sheaf of normal test results. I always appreciate having this information as it saves unnecessary repetition of tests and thus money.
Usually, three more tests are necessary:
1. Neurotransmitter profile (measures levels of serotonin, norepinephrine, and other brain chemicals).
2. Adrenal hormone profile (measures the stress hormones DHEA and cortisol).
3. Basal body temperature for thyroid testing.
4. And, if warranted, tests for food sensitivities (including gluten), vitamin D, and sex hormone levels.
Here are the first steps of non-prescription treatment:
• To raise serotonin: St. John’s wort, 5-HTP, B complex, fish oil.
• To raise norepinephrine (if low): Brain Energy, a supplement containing the building blocks of norepinephrine.
• Adren-Plus for adrenal support.
• Theanine, a natural muscle relaxant and anti-anxiety supplement.
• Magnesium, a muscle relaxant, for better sleep.
• Vitamin D, which for unknown reasons helps fibro pain.
Not-so-natural treatment:
There are simply no nutritional supplements capable of adequately controlling fibro pain. Depending on the situation, I recommend massage, chiropractic, acupuncture, or Healing Touch. Since persistent pain is one of the stressors that keeps fibro going, pain must be brought under control.
• I follow the American Pain Association recommendations of stepped pain control (start low, move up as needed) with low doses of tramadol, hydrocodone, or oxycodone. My goal is to see a fibro patient who self-scores her pain at a 9-10 level move down to a manageable 2-3 or better.
• If basal body temp is low, add natural thyroid (prescription).
• If cortisol levels are low, add cortisol (prescription).
• If sleep is a major issue, a prescription sleep med (Ambien, Lunesta, trazodone).
• If the patient is willing to try one of the new drugs for fibro, I recommend Savella, at half strength. If not tolerated, then Lyrica, again at half strength.
• If PMS is a major stressor, either progesterone (prescription) or chasteberry.
Diet is probably more of an issue with fibro than many doctors believe. More and more people (fibro or not) are being found to have gluten sensitivity, hypoglycemia (low blood sugar), or toxic food syndrome. Any of these can be a significant but hidden stressor to a fibro patient.
Hypoglycemia is an interesting trigger: every time blood sugar drops, adrenalin is released to boost it back up, but adrenalin also causes more muscles to contract. I often recommend a food sensitivity elimination-reintroduction diet using the product Xymogen I5 as a detoxifier. Also, by merely increasing protein and reducing high glycemic foods, you can treat hypoglycemia yourself.
If you have fibro, philosophically understanding what’s occurring in your body is an essential part of treatment. Once you pull back and see the larger fibro picture, you’ll realize that all your life you (and likely your mom) have been more susceptible to stress and more sensitive to physical sensation, like pain, than other people.
You’ll come to see that fibro is not a disease but a defense (Freud’s pupil Wilhelm Reich called it “character armoring”) and you’ll recognize that it won’t develop into a disease but will remain what it is–a stress response from hell–until you understand the message of this pain.
Your fibro appeared as a response to stressful factors in your life. Once you’re pain-free and doing well, fine. But if fibro symptoms start to return, don’t panic. Rather, regard them as a message that your body is perceiving stress from some source. With a “fibro-flare,” it’s fine to restart meds and supplements, but this time, press the pause button on your life. Seriously reflect on the possible source triggering the return of your symptoms. Have you been neglecting your diet? Are you in a relationship or job that somehow your body “knows” is wrong? Listen carefully for the message your body is trying to convey and act on it.
When you take steps to resolve these triggers, your muscles will slowly relax, the pain recedes, your body begins to heal, and many of the meds and supplements can be tapered off or even discontinued altogether.
Next week: Your health and the oil spill.
What a great series of information and right on. Thanks for the insight.
Chandra Klaiber, RN
Chandra Klaiber
I would be interested in more information. Actually, it makes great sense. Much of the supplimental regime I have discovered to work on my own. But I would love to get this information to my own physician. I think he would be open to it.
Pamela Kearns
Wow, this is an amazingly succinct and helpful post on fibro.
I’d like to get it into the hands of every physician who encounters patients with these symptoms.
Kudos, Dr. Edelberg!!! Please keep up the great work. Your book (The Triple Whammy Cure) is so helpful!
Gina Pera, author
Is It You, Me, or Adult with A.D.D.?
Gina Pera