Fibromyalgia Pain Causes "Fibro Brain Fog"

Brain fog or diminished mental clarity is a common complaint from patients with fibromyalgia. 

The traditional drugs of choice for fibromyalgia include NSAIDS, antidepressants, anticonvulsant medications, muscle relaxants, tranquilizers, and pain medications. These drugs may provide short-term relief but their results are often fleeting and their side-effects are detrimental. It’s not unusual for FMS patients to be taking twelve or more prescription drugs, many of which contribute to erratic behavior. 

A new study finds that the degree of cognitive impairment for fibromyalgia patients is linked to the level of pain that they experience.

The study was led by Dr. Gustavo Reyes Del Paso of the University of Jaén, and presented at the Sixth World Congress of the World Institute of Pain. His team wanted to examine the connection between fibromyalgia and cognitive impairment, which has not been closely studied.

Fibromyalgia is often associated with depression, and anxiety. But a few studies have found that cognitive function – or how well the brain works – is not related to emotional disorders.

The researchers compared 35 fibromyalgia patients with 29 healthy people. Both groups were tested on a series of tests that measured how they performed on an arithmetic task. At the same time, their mental and cardiovascular states were assessed.

The fibromyalgia patients did worse across the board on the task. However, patients who were taking opiates to treat pain did significantly more calculations than those who weren't on medication.

The study builds on the mounting evidence that chronic pain is a critical factor in cognitive abilities.

Depression, anxiety, and other emotional disorders common in people with fibromyalgia play a secondary role when it comes to the brain.

Urinary Tract Infections and Fibromyalgia Part II Interstitial Cystitis

Recurrent UTI symptoms may point at a problem known as interstitial cystitis (IC).

Interstitial cystitis is a chronic inflammatory condition of the bladder that causes frequent, urgent, and painful urination and pelvic discomfort. The lining of the bladder breaks down, allowing toxins to irritate the bladder wall, and the bladder becomes inflamed and tender and does not store urine well. The condition does not respond to antibiotics, since it is not associated with a bacterial infection like is UTI. Like UTI, IC is much more common among women than among men. Although the disease previously was believed to be a condition of menopausal women, growing numbers of men and women are being diagnosed in their 20s and younger. Data released just this year suggests that up to 12% of women may have early symptoms of IC.

Symptoms: The symptoms of IC are basically the symptoms of UTI, only more stubborn. IC is often misdiagnosed as UTI, until it refuses to respond to antibiotics. IC symptoms may also initially be attributed to prostatitis or epididymitis (in men) and endometriosis or uterine fibroids (in women).

Causes: The cause of interstitial cystitis is unknown, though several theories are being investigated, including autoimmune, neurological, allergic, and genetic. Regardless of the disease’s origin, IC patients clearly struggle with a damaged bladder lining. When this protective coating is compromised, urinary chemicals can leak into surrounding tissues, causing pain, inflammation, and urinary symptoms.

Diagnosis: IC diagnosis has been greatly simplified in recent years with the development of two new methodologies. The “Pelvic Pain Urgency/Frequency (PUF) Patient Survey,” created by C. Lowell Parsons, is a short questionnaire that helps doctors identify if pelvic pain could be coming from the bladder. The KCL test, also called the potassium sensitivity test, uses a mild potassium solution to test the integrity of the bladder wall. Though the latter is not specific for IC, it has been determined helpful in predicting the use of compounds designed to help repair the bladder lining.

Previously, IC was diagnosed by visual examination of the bladder wall after stretching it. This test, however, can contribute to the development of small hemorrhages, making IC worse. Thus, a diagnosis of IC is made by excluding other illnesses and reviewing a patient’s clinical symptoms.

Treatment of the bladder lining: Traditional medications work to repair and hopefully rebuild the wounded bladder lining, allowing for a reduction in symptoms. But FDA-approved therapies for IC have had recent setbacks in various research studies. Elmiron (pentosan polysulfate) is supposed to provide a protective coating in the bladder. But data released in late 2005 by Alza Pharmaceuticals suggests that 84% of Elmiron is eliminated—intact—in the feces. Another 6% is excreted in the urine. DMSO, a wood-pulp extract, can be instilled directly into the bladder via a catheter, yet it is much less frequently used in urology clinics. Research studies presented at recent conferences of the American Urological Association have demonstrated that at the FDA-approved dosage of a 50% solution of DMSO, irreversible muscle contractions and damage may occur. DMSO therapy has yielded mixed results, and long-term benefits appear fleeting.

Recently, the use of a new therapeutic instillation—implemented like DMSO—has generated considerable excitement in the IC community. And rightly so. Published studies report a 90% effectiveness in reducing symptoms. This treatment is called a “rescue instillation” and can be conducted with any number of “cocktails” to treat specific symptoms.

Another bladder-coating treatment, Cystistat, is believed to replace the deficient layer on the bladder wall. The primary component of Cystistat is sodium hyaluronate, a derivative of hyaluronic acid, which occurs naturally in the fluids of the eye, in the joints, and in the bladder-lining layer that is deficient in many patients with interstitial cystitis. This layer is believed to provide the bladder wall with a protective coating. Cystistat, however, is still in the process of approval and not yet available to the public.

Treatment of the pelvic floor: Pelvic-floor dysfunction may also be a contributing factor to IC symptoms. Thus most major IC clinics now evaluate the pelvic floor and/or refer patients directly to a physical therapist for a prompt treatment of pelvic floor muscle tension or weakness. The tension is often described as a burning sensation, particularly in the vagina.

Muscle tension is the primary cause of pain and discomfort in IC patients who experience pain during intercourse. Tender trigger points (small tight bundles of muscle) may also be found in the pelvic floor.

Exercises such as Kegels can be helpful as they strengthen the muscles, but they can provoke pain and additional muscle tension. A specially trained physical therapist can provide direct, specific evaluation of the muscles, both externally and internally.

Bladder distention (a procedure done under general anesthesia that stretches the bladder capacity) has shown some success in reducing urinary frequency and giving pain relief to patients. Unfortunately, the relief achieved by bladder distentions is only temporary (weeks or months) and consequently is not really viable as a long-term treatment for IC. It is generally only used in extreme cases.

Pain control is important in the treatment of IC, as the pain of this condition has been rated equivalent to cancer pain. A variety of traditional pain medications, including opiates, can be used to treat the varying degrees of pain. Electronic pain-killing options include TENS (a machine that sends electrical impulses to the skin through sticky pads) and PTNS (similar to a TENS treatment, except a needle is used).

Natural Remedies For IC

Alkalinizing the urine through diet seems to help reduce the burning pain and urinary urgency of IC in some patients. See the facing page for a list of common foods that seem to make IC worse. I know that the list can be intimidating, but I encourage my cystitis patients to conduct a modified elimination diet for 2–3 weeks, avoiding all the foods above. Then they challenge one of these foods at a time. If you do this, be sure to keep a food diary to keep up with what you learn about your body.

For more information about IC and your diet, visit www.ic-network.com/handbook and click under “Living with IC—Diet.”

Prelief by AkPharma, Inc. is calcium glycerophosphate, a food-grade mineral classified as a dietary supplement. It’s a natural
treatment for IC and also a good source of calcium. In a retrospective study conducted by AkPharma, over 200 patients consumed acidic foods and beverages with and without Prelief. Seventy percent of the patients had a reduction in IC pain and discomfort with the use of Prelief when consuming acidic foods. Sixty-one percent of them reported a reduction in urinary urgency after using Prelief. For more information or to order Prelief, visit www.prelief.com or call 1-800-994-4711.

Bioflavonoids are naturally occurring substances that act as mast-cell inhibitors (similar to an antihistamine), anti-inflammatories, and antioxidants. Since IC is associated with an increased number and activation of mast cells and inflammation in some patients, it has been suggested that bioflavonoids—quercetin in particular—have potential in the treatment of IC.

Cysta-Q, distributed by Farr Labs, is a quercetin-based dietary supplement that was specifically developed to target the symptoms of IC. Cysta-Q also contains bromelain, papain, nonacidic cranberry powder, nonacidic black cohosh, skull cap, wood betony, passionflower, and valerian in order to enhance the effectiveness of the quercetin. The quercetin used in Cysta-Q is derived from grape skin, onion skin, grapefruit rind and green algae. Initial studies have shown promise, but additional research is needed to access the long-term benefits of this natural formula. To find out more about Cysta-Q, visit www.CystaQ.com or call 1-877-284-3976.

Polysaccharides are long chains of sugar molecules. These naturally occurring substances may work by replacing the defective lining in the bladder, and they are thought to have a protective effect on the bladder. Elmiron is a synthetic polysaccharide. Examples of natural polysaccharides include glucosamine, chondroitin, marshmallow root, spirulina, and aloe vera. Desert Harvest, Inc., manufacturers a special IC-specific formula of aloe vera available in capsule form. It contains freeze-dried, whole-leaf aloe vera with no additives or fillers. Desert Harvest designed a double-blind, placebo-controlled study in which patients ingested three capsules twice a day with eight oz. of liquid for three months. Of the eight patients who completed the study, seven received relief from at least some of their symptoms. Of those seven, four experienced significant relief from all or most of their symptoms. Only one patient had no response after completing all six months of the study. For more information about Desert Harvest Aloe Vera products, visit www.desertharvest.com or call 1-800-222-3901.

Algonot-Plus combines polysaccharides (glucosamine and chondroitin) with quercetin and also adds an organic, unrefined olive seed oil from the island of Crete which increases absorption and adds its own antioxidants.

No formal research on this combined type of treatment for IC has yet been published, but several studies indicate that these supplements may be helpful, on their own, in the treatment of IC.
Glucosamine and chondroitin have previously been given to many IC patients in an open-label study with very good results when taken for a few months.

TC Theoharides, MD, and Grannum Sant, MD, have been involved in IC research and patient care for over 10 years. Their recent studies are encouraging for the benefits of combined therapies such as Algonot-Plus. For more information on Algonot-Plus, visit www.algonot.com, or call 1-800-254-6668.

 This information is taken from my book Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome.

Learn more at www.getfibrobooks.com

Urinary Tract Infections and Fibromyalgia

Urinary tract disorders are another “layer of the onion” that might need to be peeled away to make you better. Of my FMS patients, 25% have chronic UTIs or interstitial cystitis. Individuals with fibromyalgia and CFS often have problems with their urinary system. They may experience chronic urinary tract infections (UTIs), interstitial cystitis, incontinence (involuntary loss of urine), and urinary retention (inability to pass urine).

Urinary Tract Infections

UTIs are more common in women who are sexually active, people with diabetes, and people with sickle-cell disease or anatomical malformations of the urinary tract. Also, women are more prone to UTIs than males, since a women’s urethra is much shorter and closer to the anus than a man’s. This is why proper hygiene is so important in females. UTI can be especially dangerous for infants and can cause permanent renal damage.

Symptoms and signs include painful, hesitant, frequent urination and high temperature lasting for more than three days. Nausea and vomiting along with pain and temperature may indicate a more complicated UTI, in which a kidney is infected.

Some urinary tract infections are asymptomatic. Others may have quite dramatic symptoms including confusion and associated falls, which are common for elderly patients with UTI who show up at the emergency room.

Diagnosis

The diagnosis of UTI is confirmed by a urine culture. A negative urine culture suggests the presence of other illness, such as chlamydia or gonorrhea.

Causes

Common organisms that cause UTIs include E. coli and S. saprophyticus. Less common organisms include P. mirabilis, K. pneumoniae, and Enterococcus spp.

Over 90% of UTIs are caused by E. coli. This bacteria is normally found in everyone’s gut and, with the exception of a few rare dangerous forms, it is a healthy part of our normal bowel bacteria. The problems begins when E. coli escapes the bowel and enters the bladder. The bladder is able to remove most infections through the process of urination, but E. coli are quite resilient and able to use projections to help them stick to the bladder wall.

Prevention of UTIs

• Drink 70 ounces of water a day.

• Avoid excess alcohol and caffeinated beverages.

• Don’t resist the urge to urinate; visit the bathroom as soon as you feel compelled.

• If you have frequent UTIs, avoid taking baths; take showers instead.

• Practice good hygiene by wiping from the front to the back to avoid contamination of the urinary tract.

• Sexually active women—and to a lesser extent, men—should urinate within 15 minutes after sexual intercourse to allow the flow of urine to expel the bacteria before specialized extensions anchor the bacteria to the walls of the urethra.

• Clean the urethral meatus (the opening of the urethra) after intercourse.

• Clean genital areas prior to and after sexual intercourse.

Conventional Medical Treatment

Most uncomplicated UTIs can be easily treated with oral antibiotics such as trimethoprim, cephalosporins, Macrodantin, or a fluoroquinolone (such as ciprofloxacin or levofloxacin).

Symptoms consistent with pyelonephritis, a serious kidney infection, may call for intravenous antibiotics.

Patients with recurrent UTIs may need further investigation such as ultrasound scans of the kidneys and bladder or intravenous urography (X-rays of the urinary system following injection of contrast material).

Often, long courses of low-dose antibiotics are prescribed to help prevent otherwise unexplained cases of recurring UTI.

Natural Treatment

Taking antibiotics will usually kill the bacteria that is causing a bladder infection, but will also kill the healthy “good bacteria” in your body. Always combat this side effect of antibiotics by taking probiotics along with them, 12 hours apart from each other.

Another option, which I prefer, is to try natural remedies before resorting to antibiotic therapy. If the symptoms don’t clear up within a couple days, then you can always start antibiotic therapy then. Natural therapies can also be used while you’re waiting for your tests results to confirm a UTI.

• Cranberry juice can end a UTI. In addition to acidifying urine, cranberries contain substances that inhibit bacteria from attaching to the bladder lining and, as such, promote the flushing out of bacteria with the urine stream. Dosage is one to two cups of pure cranberry juice (no sugar added) or 2–4 cranberry capsules (standardized to 11%–12% quinic acid) a day for 1–2 weeks. This may well be all you need to eliminate a UTI.

• D-mannose is a naturally occurring sugar similar in structure to glucose but metabolized differently. (Because the body metabolizes only small amounts of D-mannose and excretes the rest in the urine, it doesn’t interfere with blood-sugar regulation, even in diabetics.) Though D-mannose doesn’t kill bacteria, it prevents bacteria from attaching to the bladder wall. D-mannose is safe, even for long-term use, although most people will only need it for a few days. Those who have frequent recurrent bladder infections may choose to take it on a daily basis. I’ve found it to be the best option for stubborn, chronic UTIs.

More About NutraSweet and Other Sweeteners

More About NutraSweet and Other Sweeteners

NutraSweet (Aspartame)

Aspartame has been associated with a multitude of health risks and has largely lost favor around the world. Consider that the FDA had its concerns and denied approval of aspartame for 16 years before it finally gave in to political/economic pressure. This controversial artificial sweetener was approved through an interesting chain of events. When then-president Ronald Reagan brought Don Rumsfeld, former CEO of the aspartame manufacturer, Monsanto, to Washington, a new FDA commissioner was also hastily appointed. The new commissioner approved the artificial sweetener and then went on to become a consultant for NutraSweet’s public-relations firm, receiving $1,000 a day for the next 10 years!

Aspartame, commonly known as NutraSweet or Equal, is an artificial sweetener. The body breaks it down into methanol and formaldehyde to metabolize it. Methanol toxicity causes depression, brain fog, mood changes, insomnia, seizures, and similar symptoms associated with multiple sclerosis. Formaldehyde is grouped into the same class of drugs as cyanide and arsenic. When the temperature of aspartame exceeds 86 degrees F, the wood alcohol in it is turned into formaldehyde and then into formic acid. Formic acid is the poison contained in the sting of a fire ant.

There are over 92 symptoms documented from using aspartame.

Brown or Raw Sugar

It is often said that brown sugar is a healthier option than white sugar. But you can chalk that claim up to clever marketing. In reality, brown sugar is most often just ordinary table sugar that is turned brown by the reintroduction of molasses. (Normally, molasses is separated and removed when sugar is created from sugarcane plants.) In some cases, brown sugar—particularly when it is referred to as “raw sugar”—is merely sugar that has not been fully refined. But more often than not, manufacturers prefer to reintroduce molasses to fine white sugar, creating a mixture with 5%–10% molasses. This process allows them to better control the color and size of the crystals in the final product.

Because of its molasses content, brown sugar or raw sugar does contain certain minerals not present in white sugar: calcium, potassium, iron, and magnesium. But since these minerals are present in only minuscule amounts, there is no real health benefit to using brown sugar.

An Unexpected Immune Zapper: Splenda

A study done at Duke University and published recently in the Journal of Toxicology and Environmental Health has some interesting news about the sugar substitute known as Splenda (sucralose). Splenda is an artificial sweetener derived from raffinose, a starch derived from sugar beets. The chemical sucralose, which contains chlorine, is marketed this way: “It comes from sugar, so it tastes like sugar.” But it isn’t natural at all. According to the study, the use of Splenda has several effects on the body:

• It reduces the amount of good bacteria in the intestines by 50%. The bacteria in your bowels, some 100 trillion of them—about three pounds worth—outnumber the cells in your body by a factor of 10 to one. These bacteria, also called gut flora, line your intestinal tract and serve as your first line of defense against potential pathogens (viruses, bad bacteria, and yeast). They play a crucial role in establishing an overall healthy immune system. When bad bacteria and or yeast become overgrown in your intestinal tract, you have a condition called dysbiosis. Dysbiosis has been linked with disorders like yeast infections, irritable bowel syndrome, and autoimmune disorders—including rheumatoid arthritis.

• It increases the pH level in the intestines. The stomach needs an acidic environment in order to digest food and destroy potentially harmful pathogens, including unwanted bacteria and yeast. Low stomach acid triggers a chain reaction of digestive disorders, including malabsorption. Foods may be incompletely digested and subsequently absorbed into the bloodstream, where they can lead to food allergies, triggering pain and inflammation throughout the body.

• It contributes to increases in body weight.

The study researched male rats over a period of 12 weeks.

A Natural Alternative: Stevia

For a healthy alternative to sugar, my first choice is the natural sweetener Stevia. It is a South American herb that has been used as a sweetener by the Guarani Indians of Paraguay for hundreds of years. The leaves of the small, green Stevia rebaudiana plant have a delicious and refreshing taste that can be 30 times sweeter than sugar, so a little goes a long way. For more info, visit www.stevia.com. You can find Stevia at any health-food store. While it may take time to get used to its taste, it won’t deplete your good bacteria (like Splenda), increase your risk of cancer (like Sweet’N Low), or cause neurotoxicity (like NutraSweet).

OK so push comes to shove and you can’t find Stevia when out on the town-use Sweet'N Low.

Yes, Sweet'N Low. I know it is supposed to cause cancer and kill you in a single teaspoon, but this a myth not the truth. The truth is that the cancers where only seen in mice who were fed tons, truck loads of this stuff over   a short period of time. I don’t think you’d ingest this much in a life span. But again my first choice is Stevia.

Fibromyalgia, GI Stress and Low Thyroid Function

For 90 percent of Americans, hypothyroidism is caused by Hashimoto’s, an autoimmune thyroid disease. Considering most of the immune system is situated in the gastrointestinal (GI) tract, poor gut health may play a significant role in triggering and exacerbating autoimmune diseases including Hashimoto’s thyroiditis.

GI or Gut Flora and Thyroid Hormones

Our digestive tracts contain an array of good bacteria that contribute to our overall health in a number of ways. One way is in the production of active thyroid hormones. A staggering 20 percent of thyroid function depends on a sufficient supply of healthy gut bacteria to convert inactive T4 to active T3 hormone.

Poor diet, antibiotics, non steroidal anti inflammatory drugs (NSAIDs), antacids, and other drugs can initiate dysbiosis, an overabundance of bad bacteria. This bad bacteria will crowd out the beneficial or “good” bacteria, hampering the production of active thyroid hormone.

Studies show that bacterial gut infections reduce thyroid hormone levels, dull thyroid hormone receptor sites, increase the amount of inactive T3 hormone, decrease thyroid stimulating hormone (TSH), and promote autoimmune thyroid disorders. Maintaining healthy gut flora and addressing bacterial overgrowth is an important component of good thyroid function.

Being tested for gluten intolerance and or avoiding gluten can be helpful (see past blog), so can taking probiotics on a daily basis.

Or bodies and systems really are connected and this is why you can’t treat one part of the body (system) and ignore the rest of the body. A holistic approach is always best.