Treating and Beating Fibromyalgia With Orthomolecular Medicine

Dr. Janet Travell, White House physician for Presidents John F. Kennedy and Lyndon B. Johnson, and Professor Emeritus of Internal Medicine at George Washington University, co-wrote Myofascial Pain and Dysfunction: The Trigger Point Manual, which is acknowledged as the authoritative work on muscle pain. In one chapter alone, 317 studies are referenced showing that problems such as hormonal, vitamin, and mineral deficiencies can contribute to muscle pain and soreness.

Vitamins, minerals, amino acids, essential fatty acids, and certain enzymes, when properly supplemented, can provide profoundly beneficial results for those suffering from poor health. 

Below is a sample listing of essential nutrients and their contributions to the treatment of FMS and CFS.

• Vitamin E helps to relieve pain in CFS patients. It can also improve nighttime leg cramps, which interfere with sleep.

• Vitamin C boosts the immune system by increasing natural-killer (NK) cells, B cells, and T cells.

• Magnesium and malic acid have been found by controlled
studies to be effective in relieving the symptoms of FMS. Magnesium is essential to healthy muscle function, and, working with malic acid, it increases cellular energy, reduces pain, and enhances immune function by increasing NK cells. Magnesium is also a natural muscle relaxant and critical for the relief of muscle pain.

• Inositol enhances the immune system by increasing NK cells.

• Selenium supports the immune system by enhancing antibody production.

• Vitamin D regulates many immune functions.

• Amino acids, such as glycine, serine, taurine, and tyrosine, are essential for the production of energy in the body and for brain function.

• Zinc supports the immune system by enhancing white-blood-cell activity and supporting healthy antigen-antibody binding.

But I Already Take Vitamins

You might be thinking, I’ve taken  vitamins for years, and I haven’t noticed a difference. You probably haven’t been taking enough to even make a dent in your deficiencies. If you compare Centrum or One-A-Day vitamins to the Essential Therapeutics multivitamin and mineral formulas, including the CFS/Fibromyalgia formula, you’ll notice that our specially designed vitamins have 50 times—and in some cases, 100 times—the recommended daily allowance (RDA). 

This is because the RDA is an outdated system that does not take into account the depletion of our nutrient-rich top soil, environmental pollutants, chemical food processing, the addition of artificial ingredients, and the increased demands placed on an individual’s homeostatic system in the 21st century.

So nearly as criminal as not recommending vitamin and mineral supplements is the recommendation of them based on the RDA. It was never intended to advance health, only to prevent deficiency diseases like scurvy and rickets. 

Taking the minimum amount of a nutrient to prevent gross deficiency doesn’t help those people who want to be truly healthy and not just free of severe symptoms. And optimal health should be the goal for all of us.

The key to reversing disease and the unwanted symptoms, pain, fatigue, depression, poor sleep, etc. is to take the RIGHT DOSE AND RIGHT COMBINATION of optimal daily allowance nutrients. The reason my patients see such a drastic improvement on the CFS/Fibromyalgia Jump Start supplements.

Are these higher doses safe?

One of the arguments against megavitamin treatment is that a high dose of certain vitamins are toxic and may cause certain adverse reactions. Let me present some statistics to you and let you decide for yourself.

The American Medical Association reports that death from medical errors is now the third leading cause of death in the United States, behind only heart disease and cancer. As reported in JAMA,
over 250,000 Americans die each year from medical therapies, including at least 113,000 from the negative effects of prescription medications.

The total number of deaths from vitamin/mineral therapy during the years of 1983 to 1990 was zero.

what is orthomolecular medicine?

When we establish nutritional deficiencies, our health suffers. Man-made chemicals (synthetic prescription drugs) can’t correct these deficiencies, but a nutritional-replacement therapeutic program can. This is the very premise of orthomolecular medicine, which means, “right molecules in the right concentration.”

Linus Pauling, two-time winner of the Nobel Prize, is regarded as one of the greatest biochemists of our times. He defines orthomolecular medicine as “the preservation of good health and the treatment of disease by varying the concentrations in the human body of substances that are normally present in the body.” This concept involves a medical approach based on the physiological and enzymatic actions of specific nutrients present in the body, such as vitamins, minerals, and amino acids. The idea that to beat a disease one has simply to “get healthy” may seem trivial to those with such life-robbing illnesses as FMS and CFS. Still, it’s hard to argue with the results.

Synthetic drugs may be helpful at times, but they always have an inherent ability to cause harm. Not only are nutrients such as vitamins, minerals, amino acids, and essential fatty acids unharmful, the body depends on them for survival. The body knows what to do with—and depends on—vitamin B6. The same certainly can’t be said for Lyrica. The World Health Organization’s definition of health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” These words advocate to us the need to correct the biochemical causes of disease rather than merely covering up the symptoms with drugs.

The Centers for Medicare and Medicaid stated in a recent report that the nation spent $140.6 billion in the year 2000 on prescription drugs. And of course this number is rapidly escalating; over one billion prescriptions were written last year. But even though the United States spends more money on health care per capita than any other country in the world, The World Health Organization ranks the overall health of the United States as 15th among the 25 industrialized countries.

Even with this dismal ranking, things in the United States are changing. A new paradigm is emerging, one based on taking responsibility for our own health through abstinence from dangerous habits—like nicotine, trans-fats, sedentary lifestyles, and excessive stress—and through proactive behavior like regular exercise, healthy diet decisions, and optimal nutritional supplementation.

You can reverse fibromyalgia and get your life back. It won’t happen with a magic new drug though, that is a dead end (see Lyrica, Savella, and Cymbalta). Having specialized in treating fibromyalgia for almost 14 years I know orthomolecular medicine is the only true way to beat fibromyalgia.

Study Links Obesity and Fibromyalgia

The purpose of the study, conducted by University of Utah researchers, was to evaluate the relationship between fibromyalgia and obesity. They hypothesized that obesity significantly adds to the disease and disability burden of the condition. Two hundred fifteen fibromyalgia patients were evaluated in the study and given several physical tests to measure strength, flexibility, range of motion, and strength. Heart rates and sleep quality also were assessed.

The authors reported that consistent with previous studies, obesity is common among those with fibromyalgia. Half the study sample was obese and an additional thirty percent were overweight. Also consistent with previous findings, obese patients in this study showed increased pain sensitivity, which was more pronounced in lower body areas. The obese patients also had impaired flexibility in the lower body and reduced strength.

The study concluded that obesity is a common comorbidity of fibromyalgia that may compromise clinical outcomes. The adverse impact of obesity is evidenced by hyperalgesia, disability, impaired quality of life and sleep problems. The authors also noted that recent evidence suggests weight loss improves fibromyalgia symptoms, perhaps resulting from patients adopting healthier lifestyles and taking more positive attitudes toward symptom management, and overall quality of life.

In recent years, scientists have looked at fat cells and their surrounding cells not just as yellow blobs that make our clothes too tight, but more as an organ, or neighboring bodies of organic fatty tissue. The fat cells, or “adipocytes,” within this tissue have several functions, such as pumping out vital energy-producing fatty acids, storing fatty acids for future use, and secreting hormones that regulate body weight. But unfortunately, among the obese, they’re a source of inflammatory chemicals.

My thoughts-first not everyone with fibromyalgia is obese, true many are but one third of Americans are overweight so this is no big surprise. Second if anything- being overweight is a result of fibromyalgia not the cause of fibromyalgia. Fibromyalgia lowers a person’s metabolism (low thyroid). Those with fibromyalgia become less active as their energy levels decrease and painful flares from over activity, including exercise, increases.

What needs to be clear about this study is that fat cells store inflammatory chemicals, the more fat cells you have the more inflammatory chemicals you have-and of course the pain you experience.

Dietary Changes Can Help Reduce Inflammation

To reduce degenerative disease, it’s necessary to avoid pro-inflammatory foods and rely exclusively on anti-inflammatory foods:

Pro-inflammatory foods to avoid:

* Red meats from corn-fed, antibiotic/hormone-laden animals (choose grass fed livestock when possible)

* Saturated fats such as lard and over consumption of meat fats

* Fried foods

* Partially hydrogenated (trans fats) found in margarines, chips, candies, cereals and baked goods

* Cooking oils that are exclusively corn, safflower, sunflower or soy based

* Soft drinks (both high sugar and diet varieties)

* Excess sugar (both from heavily processed sources, such as candy and from naturally occurring sources such as fruit juice)

Reduce Sugar Consumption

Sugary foods quickly elevate blood sugar, creating an insulin release along with free radicals that oxidize fats. When oxidized, the fats form plaque deposits in our arteries, leading to disease. Thus, a diet high in sweets, pasta, fruit juices, cereals and even rice cakes can actually lead to heart disease. Insulin release also increases stored body fat and release of pro-inflammatory chemicals causing cell damage and accelerated aging.

Anti-inflammatory foods and dietary supplements to include:

* Foods high in omega-3 fatty acids, especially cold water, wild-caught fish (or fish oil    supplements)

* Raw nuts and seeds (especially pecans, almonds, walnuts and flaxseeds)

* Dark green vegetables (especially kale, seaweed and greens)

* Antioxidants in supplement form (especially vitamins C and E, and qurcetin)

* Zinc taken in supplement form, which assists healing and reduces inflammation

   Extra virgin organic olive oil is good anti-inflammatory oil

Stress and Fibromyalgia

A survey by The Fibromyalgia Network reports that 62% of their respondents list physical or emotional stress as the initiating factor in their acquiring fibromyalgia.

I believe chronic stress is the underlying catalyst for the onset of HPA dysfunction and fibromyalgia. Several studies have demonstrated how chronic stress undermines the normal hypothalamic-pituitary-adrenal axis (HPA) function.

When explaining the role of stress in fibromyalgia, I find the following analogy helps put stress and fibromyalgia into perspective.

“We are all born with a stress coping savings account. This account is filled with numerous chemicals we use to help us deal with daily stress-serotonin, norepinephrine, cortisol, magnesium, and other important hormones and nutrients al help counter stress. The more stress we encounter, the more stress coping chemicals we use. We replenish our stress coping savings account with adequate rest. Consistent deep restorative sleep ensures we are making more deposits than withdrawals from our stress coping account.

Since fibromyalgia patients struggle with getting a consistent good nights sleep they eventually bankrupt their stress coping account. Once tyour stress coping savings account is depleted poor health and the many symptoms associated with fibromyalgia, pain, fatigue, brain fog, anxiety, depression, low thyroid, etc. start to raise their ugly heads.

With so many different symptoms, it’s no surprise that fibromyalgia and CFS patients are typically taking 6–12 different prescription drugs. Lyrica, Elavil, Klonopin, Paxil, Effexor, Xanax, Trazadone, Neurontin, Zanaflex, Ambien, Lunesta, Cymbalta,  and Provigil have all been heralded as “the drug” for fibromyalgia. Some of these are helpful, some worthless, and some really dangerous.

Drug management alone typically fails to yield lasting relief from the most common fibromyalgia and CFS symptoms, and patients’ and doctors’ optimism over a new drug treatment eventually gives way to this sad reality. Oh well, a new drug with an even larger marketing budget is on the horizon. (Forgive my cynicism. I’ve just seen this situation so many times!)

After seventeen years of specializing in treating and beating fibromyalgia I’ve learned that traditional medicine alone yields little if any long-term results.

The best hope for those with fibromyalgia is to find and work with a doctor who practices integrative medicine-combining judicious use of prescription drugs (short-term if possible) and natural therapies (vitamins, minerals, and other nutrients).

Combining prescription drugs (when needed) with natural supplements allows the symptoms associated with fibromyalgia to be corrected, not just covered-up.

Hang in there-you can beat fibromyalgia. Don’t give up.

Fibromyalgia and Atypical Antidepressants

Atypical antipsychotics remained the top-selling class of medicines in the United States with $14.6 billion in sales, about equal to 2008 revenue.

Atypical antidepressant drugs including Zyprexa and Abilify are being aggressively marketed "off label" for all sorts of ailments including fibromyalgia. There is a growing campaign of propaganda to make folks think they are bi-polar and need these drugs. Not a week goes by that I don't encounter a patient with fibromyalgia who has been placed on one of these mind numbing drugs.

Atypical Antidepressants are Dangerous

Researchers have already reported that newer antipsychotics are associated with an increased risk of diabetes. The Food and Drug Administration put out warnings on this danger in 2004.

According to the new study, published in the Archives of General Psychiatry, patients taking antipsychotics tended to gain weight after one month and had increases in their cholesterol levels after three to four months.

Obesity, high cholesterol, and diabetes all increase the risk of heart disease.

"This change in risk is evident early in the course of treatment, within several weeks of continuous use, but may continue to alter over several years," Foley told Reuters Health in an email. The "risk varies depending on the specific drug taken and how long it is taken for," she added.

About one in 100 adults in the U.S. has schizophrenia, according to the National Institute of Mental Health.

But antipsychotic drugs are also given to some patients with bipolar disorder, personality disorders, or anxiety, general depression, ADHD, fibromyalgia, and other "off label" targeted conditions.

The drugs in Foley's study included Janssen's Risperdal, and Lilly's Zyprexa, among others.

Foley and her team looked at 25 previous studies that had tracked risk factors for heart disease in patients taking older or newer antipsychotics. These included high blood pressure, cholesterol levels, and body weight.

They found that across all the studies, six to seven of every 10 people on antipsychotics were overweight after six months. Before taking the drugs, only about four of every 10 were overweight, the same as in the general population.

Fibromyalgia isn't caused by a drug deficiency, certainly not one as dangerous as Abilify or Zyprexa.

You  can read my article on atypical antipsychotic drugs-Abilify and Zyprexa by clicking on this link http://www.theamericanchiropractor.com/interviews/item/4886-the-evolution-of-mood-disorder-wonder-drugs.html

New Criteria for Diagnosing Fibromyalgia

Fibromyalgia may be under-diagnosed in both men and women because of the reliance on 11 tender points which is broad but ineffective approach for diagnosing fibromyalgia.

Consequently, fibromyalgia diagnosis in practice has often been a symptom-based diagnosis. The new criteria will standardize a symptom-based diagnosis so that all doctors are using the same process.

The tender point test is being replaced with a widespread pain index and a symptom severity scale. 

The widespread pain index score is determined by counting the number of areas on the body where the patient has felt pain in the last week. The checklist includes 19 specified areas.

The symptom severity score is determined by rating on a scale of zero to three, three being the most pervasive, the severity of three common symptoms: fatigue, waking unrefreshed and cognitive symptoms. An additional three points can be added to account for the extent of additional symptoms such as numbness, dizziness, nausea, irritable bowel syndrome or depression. The final score is between 0 and 12.

To meet the criteria for a diagnosis of fibromyalgia a patient would have seven or more pain areas and a symptom severity score of five or more; or three to six pain areas and a symptom severity score of nine or more.

Some criteria will remain unchanged. The symptoms must have been present for at least three months, and the patient does not have a disorder that would otherwise explain the pain.

You can read more about how I diagnose fibromyalgia by visiting my website www.treatingandbeating.com

Fibromyalgia Sufferers Don't Give Up!

Fibromyalgia takes it's toll on you. Traditional medicine alone is in effective and most doctors don't really know how to treat it. It takes on average 7 years and 12 doctors before ever getting the correct diagnosis of fibromyalgia. It is no wonder that those with fibromyalgia feel hopeless and contemplate giving up on daily basis. 

Don't give up! 

I just got off the phone with a lady in Canada who has been battling fibromyalgia for 20 years. She's numerous drugs, therapies, supplements, and diets-nothing has yielded long-term relief. After 3 weeks of following the sleep protocol in my Treating and Beating Fibromyalgia video series, she reports she feels better than she's felt in 20 years. Re-establishing deep restorative sleep is the key for reversing fibromyalgia. You can read about my sleep protocol for fibromyalgia on my website www.treatingandbeating.com. 

I encourage you to keep seeking out the right doctor, protocol, therapy, shaman, prayer circle-whatever works. Just don't give up!

Anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart, that's true strength.
-- Author Unknown


I love this story, one I shared in Health Matters newsletter. Here it is again.

A little girl had been shopping with her Mom in Target. She must have been 6 years old, this beautiful red haired, freckle faced image of innocence. It was pouring outside. The kind of rain that gushes over the top of rain gutters, so much in a hurry to hit the earth it has no time to flow down the spout. We all stood there under the awning and just inside the door of the Target.

We waited, some patiently, others irritated because nature messed up their hurried day. I am always mesmerized by rainfall. I got lost in the sound and sight of the heavens washing away the dirt and dust of the world. Memories of running, splashing so carefree as a child came pouring in as a welcome reprieve from the worries of my day.

The little voice was so sweet as it broke the hypnotic trance we were all caught in, "Mom, let's run through the rain," she said. "What?" Mom asked.

"Let's run through the rain!" She repeated.

"No, honey. We'll wait until it slows down a bit," Mom replied.

This young child waited about another minute and repeated, "Mom, let's run through the rain."

"We'll get soaked if we do," Mom said.

"No, we won't, Mom. That's not what you said this morning," the young girl said as she tugged at her Mom's arm.

"This morning? When did I say we could run through the rain and not get wet?"

"Don't you remember? When you were talking to Daddy about his cancer, you said, 'If God can get us through this, he can get us through anything!'"

The entire crowd stopped dead silent. I swear you couldn't hear anything but the rain. We all stood silently. No one came or left in the next few minutes. Mom paused and thought for a moment about what she would say. Now some would laugh it off and scold her for being silly. Some might even ignore what was said. But this was a moment of affirmation in a young child's life. A time when innocent trust can be nurtured so that it will bloom into faith.

"Honey, you are absolutely right. Let's run through the rain. If God let's us get wet, well maybe we just needed washing," Mom said.

Then off they ran. We all stood watching, smiling and laughing as they darted past the cars and yes, through the puddles. They held their shopping bags over their heads just in case. They got soaked. But they were followed by a few who screamed and laughed like children all the way to their cars.

And yes, I did. I ran. I got wet. I needed washing.

Circumstances or people can take away your material possessions, they can take away your money, and they can take away your health. But no one can ever take away your precious memories... So, don't forget to make time and take opportunities to make memories everyday. To everything there is a season and a time to every purpose under heaven.

I hope you still take the time to run through the rain.

Author unknown

Danger-These Drugs Are A Disaster For Your Health

Benzodiazepines

These medications are usually used as sleep and anti-anxiety medication, they include Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), Restoril (temazepam), BuSpar (buspirone hydrochloride), Tranxene (clorazepate dipotassium), Serax (oxazepam),
Librium (chlordiazepoxide), Tegretol (carbamazepine), Valium (diazepam), Trileptal (oxcarbazepine), Seroquel (quetiapine), Risperdal (risperidone), and Symbyax (olanzapine and fluoxetine HCl).

Benzodiazepines are addictive, and patients build up a tolerance so that the drugs eventually lose effectiveness as a sleep aid. Addiction may occur in as little as two weeks.

The big problem with these medications, though, are the side effects, many of which mirror the symptoms of fibromyalgia and CFS. And they don’t promote deep, restorative sleep, so they are definitely not worth the risk.

Benzodiazepines depress the central nervous system and act on the neurotransmitter GABA (gamma-amino butyric acid). GABA acts as a calming chemical as it transmits messages from one cell to another. So directly or indirectly, these drugs influence almost every brain function and most other bodily systems, including those of the nervous, neuromuscular, endocrine, and gastrointestinal systems. It’s no wonder their side effects are so severe.

Benzodiazepines should be weaned off, starting as soon as possible. Be sure to work with a medical doctor as you wean off, and take it slow to avoid terrible withdrawal symptoms.

Potential side effects of benzodiazepines: Poor sleep; seizures; mania; depression and suicidal thoughts; tinnitus (ringing in the ears); transient amnesia; dizziness; agitation; disorientation; low blood pressure; nausea or vomiting; fluid retention; muscular incoordination and tremors; sexual dysfunction; prolonged drowsiness or a trance-like state; fatigue; headaches; body aches and pains; chills; runny nose; cough; congestion; difficulty breathing; feelings of discouragement, sadness, or emptiness; diarrhea; difficulty swallowing; vision and voice changes; and a host of others.

The crippling side effects and addictive nature of these drugs have been known for at least 40 years, yet doctors continue to prescribe them at an ever-increasing rate, especially for seniors. Surveys show that over 5.6 million adults over the age of 65 are now taking benzodiazepines. A mouth-dropping 50% of all women 60 and older will be prescribed a benzodiazepine drug.

And since addiction often occurs within four weeks of starting these drugs, the majority of these folks are now dependent on them.

Tolerance to the hypnotic (sleep) effects of these drugs may occur within one week. Symptoms of tolerance are identical to drug-withdrawal symptoms and may include anxiety, panic, severe insomnia, muscle pain and stiffness, depression, suicidal thoughts, rage, heart and lung problems, and agoraphobia (extreme fear of public or crowded spaces).

Tragically, only 10%–30% of people are able to successfully stop taking these drugs. The rest are addicted for life.

Please avoid these drugs if possible. Seek out alternatives, preferably over the counter natural amino acid therapy (5HTP, SAMe, L-Theanine, etc.) when facing anxiety disorder. For sleep related issues try over the counter 5HTP and or melatonin. You can read more about mood and sleep disorders at www.treatingandbeating.com

Fish Oils Help Prevent and Reverse Depression

Fish Oils Help Prevent and Reverse Depression

Omega-3 fatty acids may help alleviate depression but only when a particular type of fatty acid called DHA is used in the right ratio with another fatty acid known as EPA, a new study suggests.

The researchers analyzed the results of some 15 previous controlled clinical trials on the use of omega-3s -- commonly found in oily fish or in fish oil supplements -- to treat depressed people.

They found that when used by itself, DHA (docosahexaenoic acid) alone did not seem to offer any benefit. However, DHA combined with a rather high dose of EPA (eicosapentenoic acid) did improve depressive symptoms.


I recommend taking 2 grams of fish oil a day. If you experience an unpleasant aftertaste try freezing the fish oil capsules and the be sure to take with food.

Traditional Medicine Offers Little for Fibromyalgia

With so many different symptoms, it’s no surprise that fibromyalgia and CFS patients are typically taking 6–12 different prescription drugs. Lyrica, Elavil, Klonopin, Paxil, Effexor, Xanax, Trazadone, Neurontin, Zanaflex, Ambien, Lunesta, Cymbalta,  and Provigil have all been heralded as “the drug” for fibromyalgia. 

Some of these are helpful, some worthless, and some really dangerous.

Drug management alone typically fails to yield lasting relief from the most common fibromyalgia and CFS symptoms, and patients’ and doctors’ optimism over a new drug treatment eventually gives way to this sad reality. Oh well, a new drug with an even larger marketing budget is on the horizon. (Forgive my cynicism. I’ve just seen this situation so many times!)

Many of the most commonly prescribed drugs for fibromyalgia have side effects that are similar or identical to the symptoms of FMS and CFS. These similarities can cause a lot of confusion when doctors are trying to determine the effectiveness of treatment. Ambien, for instance, can cause flu-like symptoms, achy muscle pain, sore throat, and fatigue. Sounds like CFS, doesn’t it?

Tranquilizers are often prescribed for restless leg syndrome; achy, tight muscles; and sleep problems. But these drugs deplete the sleep hormone melatonin, which then leads to a disruption of a person’s circadian rhythm (sleep-wake cycle). Instead of promoting deep restorative sleep, these drugs prevent it!

It’s important to realize that your drug or drugs may be causing or contributing to some or all of your symptoms. 

I spend a great deal of time with my new patients reviewing and discussing their current drugs—how they interact with each other, and the potential side effects. I often find that by asking the right question, I can help the patient realize that her symptoms began or worsened soon after the drug treatment began.

Sometimes, though, I do find drug-induced symptoms that began months after the start of the drug treatment. Drugs deplete essential nutrients that the body needs to properly function, but it can take weeks, months, or even years for the drug to fully deplete the nutrient and for you to see the side effects surface.

Still, not everyone can be drug free, and most of my patients are on at least one prescription medication. But the least offensive drug should be used—sparingly—and only to manage symptoms unresponsive to more natural therapies.

A study conducted by the Mayo Foundation for Medical Education and Research demonstrates the need the limitations of traditional medicine alone for treating fibromyalgia.

Thirty-nine patients with FMS were interviewed about their symptoms. Twenty-nine were interviewed again 10 years later. Of these 29 (mean age 55 at second interview), all had persistence of the same FMS symptoms. 

Moderate to severe pain or stiffness was reported in 55% of patients, moderate to a great deal of sleep difficulty was noted in 48%, and moderate to extreme fatigue was noted in 59%. These symptoms showed little change from earlier surveys. 

The surprising finding was that 79% of the patients were still taking medications to control symptoms. 

We can conclude that the medications weren’t making a significant impact.

Conventional medical treatments for FMS and CFS is a controversial topic, and I certainly have no desire to offend the many brilliant medical doctors out there. 

Still, in my experience, most traditional doctors continue to rely on prescription medications to treat fibromyalgia, even though their own studies show them to be ineffective and potentially dangerous. 

They still just don’t get it. Those with fibromyalgia and CFS are sick and they want to feel well, not drugged.

Just try to find a doctor who really knows anything about these illnesses. Most don’t. It’s even harder to find one who is having any lasting success treating these illnesses. How many folks with fibromyalgia get well under the care of a traditional rheumatologist? 

I rest my case.

I speak to fibromyalgia support groups across North America, and I can tell you what the answer is: very few. The three-month wait for a new patient appointment typically ends in a two-hour interview and exam followed by a 10 minute visit to discuss test results, and then several prescription drugs and a follow-up appointment every 3–6 months.

And let’s face it, those with fibromyalgia are medical misfits, they don’t usually respond to medications like other folks. The ACR has, like many physicians, thrown up their hands and admitted they have little if anything to offer for those suffering from fibromyalgia. They focus more on helping their patients “cope.” At least they’re honest about their limitations.

Treating and Beating Fibromyalgia

Note this is an abbreviated version of my feature article that appeared in the November issue of the medical journal "Townsend Letter for Doctors and Patients."

Fibromyalgia syndrome (FMS) is an illness characterized by diffuse muscle pain, poor sleep, and unrelenting fatigue.

Individuals with fibromyalgia may also experience headaches, anxiety, depression, poor memory, numbness and tingling in the extremities, cold hands and feet, irritable bowel syndrome, lowered immune function, and chemical sensitivities. Over 10 million Americans suffer with fibromyalgia; ninety percent of them are women between 25 and 45 years old. 1

Fibromyalgia is now thought to arise from a miscommunication between the nerve impulses of the central nervous system. The neurons, which supply the brain, become more excitable, exaggerating the pain sensation. This over-amplication of pain is referred to as "central sensitization". 19

Fibromyalgia patients have a reduction in their pain threshold (allodynia), an increased response to painful stimuli (hyperalgesia) and an increase in the duration of pain after nociceptor stimulation (persistent pain).

Individuals with fibromyalgia syndrome have low levels of serotonin, a 4-fold increase in nerve growth factor, and elevated levels of substance P.20 Nerve growth factor (NGF) is a member of a family of peptides known as the neurotrophins. The exposure of nociceptive sensory neurons to NGF leads to up-regulation of substance P in sensory neurons. 21

Substance P, the neuropeptide in spinal fluid, is a neurotransmitter that is released when axons are stimulated. Increased levels of substance P increase the sensitivity of nerves to pain or heighten awareness of pain. Although it’s not fully understood, fibromyalgia patients have an imbalance of the hypothalamus-pituitary-adrenal  (HPA) axis. This imbalance creates hormonal inconsistencies, which disrupt the body’s ability to maintain homeostasis.

Many of the most common fibromyalgia symptoms including widespread muscle pain, fatigue, poor sleep, gastrointestinal problems, and depression regularly occur in people with various neuroendocrine disorders, including those manifested by HPA dysfunction. 22

Researchers believe suppression of the HPA (quite likely from chronic stress), which results in lowering human growth hormone (HGH), dehydroepiandrosterone (DHEA), cortisol, and other hormones, is aggravated by the chronic pain and poor sleep associated with fibromyalgia. 23, 24

Hypothalamus-Pituitary-Adrenal Axis (HPA) Dysfunction 

The main function of the hypothalamus is homeostasis, or maintaining the body's status quo.

The hypothalamus receives and transmits messages from the nervous system and hormonally through the circulatory system. Because of its broad sphere of influence, the hypothalamus could be considered the body’s master computer. The hypothalamus receives continuous input about the state of the body, and must be able to initiate compensatory changes if anything drifts out of line.

The Hypothalamus regulates such bodily functions as:

1. Blood pressure- is often low in those with fibromyalgia.

2. Digestion- bloating, gas, indigestion, and reflux are common in FMS patients.

4. Circadian rhythms (sleep/wake cycle)- which is consistently disrupted in FMS.

6. Sex drive- loss of libido is a common complaint for FMS patients.

7. Body temperature-   is often low in FMS patients.

8. Balance and coordination- FMS patients have balance and coordination problems.

9. Heart rate- mitral valve prolapse (MVP) and heart arrhythmias are a common finding in FMS patients.

10. Sweating- it’s not unusual for FMS patients to experience excessive sweating.

11. Adrenal hormones- are consistently low in FMS patients.

12. Thyroid hormones and metabolism-hypothyroid is a common finding in FMS patients.

Recent studies show that over 43% of FMS patients have low thyroid function. It's estimated that those with FMS are 10 to 250,000 times more likely to suffer from thyroid dysfunction.25

Stress and Fibromyalgia

A survey by The Fibromyalgia Network reports that 62% of their respondents list physical or emotional stress as the initiating factor in their acquiring fibromyalgia. 32

I believe chronic stress is the underlying catalyst for the onset of HPA dysfunction and fibromyalgia. Several studies have demonstrated how chronic stress undermines the normal hypothalamic-pituitary-adrenal axis (HPA) function.33

When explaining the role of stress in fibromyalgia, I find the following analogy helps put stress and fibromyalgia into perspective.

“We are all born with a stress coping savings account. This account is filled with numerous chemicals we use to help us deal with daily stress-serotonin, norepinephrine, cortisol, magnesium, and other important hormones and nutrients. The more stress we encounter, the more stress coping chemicals we use. We replenish our stress coping savings account with adequate rest. Consistent deep restorative sleep ensures we are making more deposits than withdrawals from our stress coping account.

Since fibromyalgia patients struggle with getting a consistent good nights sleep they eventually bankrupt their stress coping account.

The Importance of a Good Night’s Sleep

Studies have shown that individuals who were prevented from going into deep sleep for a period of a week develop the same symptoms associated with FMS and CFS; diffuse pain, fatigue, depression, anxiety, irritability, stomach disturbances, and headaches. 34,35.

Sleep deprivation markedly increases inflammatory cytokines (pain causing chemicals)—by a whopping 40%. 36

Serotonin

Serotonin helps regulate sleep, digestion, pain, mood, and mental clarity.37

Serotonin helps:

1. Raise the pain threshold (have less pain), by blocking substance P.

2. You fall asleep and stay asleep through the night.

3. Regulate moods. “The happy hormone” reduces anxiety and reduces depression.

4. Reduce sugar cravings and over-eating.

5. Increase a person’s mental abilities.

6. Regulate normal gut motility (transportation of food-stuff) and reverse irritable bowel syndrome (IBS).

Surveys have shown that as many as 73% of FMS patients have irritable bowel syndrome.

You have more serotonin receptors in your intestinal tract than you do in your brain.

Emotionally stressful situations cause the body to release adrenaline, cortisol and insulin. These stress hormones stimulate the brain to secrete serotonin. Long term stress and poor dietary habits can deplete the body’s serotonin stores.38

Tryptophan, 5 Hydroxytryptophan  (5HTP) and Serotonin

Individuals with fibromyalgia have low levels of tryptophan38, serotonin39, and

5-HTP.40 Studies show that fibromyalgia patients have higher levels of metabolites in the kynurenine pathway, which diverts tryptophan away from serotonin production.41

Tryptophan is one of eight essential amino acids. Tryptophan is absorbed from the gut into the bloodstream and then dispersed throughout the body. Ninety percent of tryptophan is used for protein synthesis, one percent is converted to serotonin, and the balance is used to make niacin. In the formation of serotonin, tryptophan is hydroxylated to 5-hydroxy-tryptophan (5-HTP) by tryptophan hydroxylase.

5-HTP is converted to serotonin by the decarboxylase enzyme, which is vitamin B6 dependent.

Selective Serotonin Reuptake Inhibitor (SSRI) Medications

Prescription antidepressants can be helpful. However, antidepressant drugs have potential side effects including anxiety, depression, fatigue, decreased sex drive, and disruption of normal circadian rhythms.42

SSRI’s are supposed to help a patient hang onto and use their naturally occurring stores of the brain chemical serotonin. It’s like using a gasoline additive to help increase the efficiency of your cars fuel.

Most of the patients I see with fibromyalgia are running on fumes and a gasoline additive won’t help. 

Please keep in mind that several studies show that between 19-70% of those taking antidepressant medications do just as well by taking a placebo or sugar pill.43

I recommend my patients boost their serotonin levels by taking 5HTP.

5HTP and Depression

Studies (including double-blind) comparing SSRI and tricyclic antidepressants to 5HTP have consistently shown that 5HTP is as good if not better than prescription medications in treating mood disorders. Furthermore, 5HTP doesn’t have some of the more troubling side effects associated with prescription medications. 44, 45

5HTP and Sleep

5HTP has been shown to be beneficial in treating insomnia, especially in improving sleep quality by increasing REM sleep and increases the body’s production of melatonin by 200%. 46,47

5HTP and Fibromyalgia

Double-blind placebo-controlled trials have shown that patients with FMS were able to see the following benefits from taking 5HTP: 48.

• decreased pain.

• improved sleep.

• less tender points.

• less morning stiffness.

• less anxiety.

• improved moods in general, including in those with clinical depression. 49

• increased energy.

Irritable Bowel Syndrome, 5HTP and Serotonin

There are more serotonin receptors in the intestinal tract than there are in the brain. This is one reason people get butterflies in their stomach when they get nervous.50

Serotonin controls how fast or how slow food moves through the intestinal tract.51, 52

It’s common for the symptoms associated with IBS, diarrhea and constipation, to disappear within 1–2 weeks once serotonin levels are normalized with 5HTP replacement therapy.

My 5HTP and Sleep Restoration Protocol

I instruct my patients to take 50mg of 5HTP 30 minutes before bed on an empty stomach (90 minutes after or 30 minutes before eating), with 4 ounces of grape juice. I know 5HTP doesn’t have to compete with other amino acids to cross the blood brain barrier, but this routine seems to heighten the effect of 5HTP.

One of three things will happen when taking 5HTP.

1. The patient falls asleep within 30 minutes and sleeps through the night. If so, they stay on this dose until their next scheduled visit with me (typically 2 weeks).

2. Nothing happens. This is typical response to such a low dose. The patient should add an additional

50 mg. each night (up to a max of 300 mg.) until they fall asleep within 30 minutes and sleep through the night.

3. Instead of making the patient sleepy, the first dose makes them more alert. This occurs more often in CFS and chemical sensitivity patients who have a sluggish liver. If this happens, they’re to discontinue taking 5HTP at bedtime and instead take 50 mg. with food for 1–2 days. Taking 5HTP with food seems to help slow down it’s absorption, allowing the liver to process it more effectively. Taking 5HTP with food will not (usually) make a person sleepy. After 1-2 days on 5HTP with no further problems, they should increase to 100 mg. of 5HTP with each meal (300mg a day).

Can patients take 5HTP along with antidepressant medications?

Yes, patients can take 5HTP with antidepressant medications. I’ve treated thousands of patients with amino acid replacement therapy, 95% of which were already taking antidepressants when they come to see me. I’ve never had a patient report a problem with combing 5HTP with prescription drugs. It can happen, but I believe it to be rare.

Can patients take 5HTP with sleep medications?

Yes. I don’t recommend patients discontinue taking their sleep medications. Instead I suggest they start using 5HTP and increase the bedtime dose until they sleep through the night. At some point they should be able to work with their doctor and slowly wean off the prescription sleep medication. Remember all prescription sleep medications have side effects. No one has an Ambien deficiency, however, fibromyalgia patients certainly have 5HTP and serotonin deficiencies, which need to be corrected.

What if my patient is taking a prescription sleep medication and sleeping through the night?

Prescription drugs that promote deep restorative sleep include Ambien, Elavil, Trazadone, Flexeril, and Lunesta. These medications can be helpful. However, these medications have potential side effects that may cause the very symptoms associated with fibromyalgia. Ambien may cause short-term memory loss, fatigue, depression, and flu-like aches and pains.

Other common sleep inducing drugs, including benzodiazepines (Klonopin, Ativan, etc.), muscle relaxants (Zanaflex), Neurontin, and Lyrica don't promote deep delta wave sleep and therefore are not recommended. Remember the reason they’re taking these prescription drugs is because they have a serotonin (and perhaps a melatonin) deficiency, not a drug deficiency. You want them to build up their serotonin levels so that eventually they may not need prescription sleep medications. You should have them add 5HTP (50 mg.) three times daily with food. If no problems arise after 2–3 days, they should then increase to 100 mg. with each meal.

What if someone has a serotonin syndrome reaction?

A serotonin syndrome may occur if a person gets too much serotonin. This can cause rapid heartbeat, increased pulse rate, elevated blood pressure, agitation, and in its worst-case scenario, life threatening irregular heartbeats (arrhythmia).

I’ve recommended 5HTP to thousands of individuals over the last 7 years, rarely have I encountered a problem. I always start with a low dose (50 mg.) and warn the patient to stop taking it at bedtime if she has a funny reaction.

What are some of the other potential side effects of 5HTP?

Other than some patients becoming more alert when taking 5HTP at bedtime, I have had very few complaints from patients. The literature reports that individuals may have transient headaches and nausea from taking 5HTP. I have had less than half a dozen patients have one of these side effects. The headaches and any nausea usually go away after a couple of days.

What do you do when your patient still can’t fall asleep and sleep through the night even when taking 300mg of 5HTP?

If after two weeks, someone is not falling asleep and staying asleep through the night, I add melatonin. First, I make sure she is taking 5HTP as she should be and at the maximum dose of 300mg.

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