Fibro Friends

Fibromyalgia Strategies for Healing

I am weary of reading about studies on the cause of fibromyalgia pain. Theories about altered pain perception, disordered sleep and immune dysregulation, etc might be interesting to a medical scientist but they are not particularly helpful for a person suffering from fibromyalgia. What is needed is a list of strategies that are helpful for patients keeping in mind that each person is unique and what might help one person may not help another. There are no absolutes when it comes to health and this is particular true of complex conditions such as fibromyalgia and chronic fatigue syndrome. My suggestions are based on my personal experience of living  with fibromyalgia pain for twelve years and ultimately finding treatments that resulted in significant reversal of my symptoms, communicating with others from my blog “Fibro Friends” for the past seven years, and sharing information with other patients I met at a fibromyalgia clinic where I spent three months. 

1. Rest & Pacing

Most fibromyalgia patients report improvement from symptoms from resting and not “over doing” it physically. This is easier said than done because the threshold of activities that one can “get away with” varies from day to day and set backs occur after the fact. Nonetheless learning to pace one’s activities and adhering to a schedule of activity interspersed with rest is a good strategy. I personally adhere to a strict bedtime and meal schedule and take a short nap every afternoon after lunch.

2. Avoid Drugs

Impaired detoxification is common in persons with fibromyalgia and avoidance of stimulants, depressants, pharmaceutical drugs and toxic chemicals can make a big difference in feeling better. This includes alcohol, caffeine, sugar, pain relievers and additives in processed food. Unfortunately many physicians prescribe drugs for pain, depression and sleep, which become less effective with time and in the long run make a patient worse. Particularly dangerous are the drugs Lyrica and Neurotin, which cause cognitive impairments and have severe withdrawal symptoms.

3. Treat Small Intestine Bacterial Overgrowth (SIBO)

Many Persons with fibromyalgia have gastrointestinal issues or Irritable Bowel Syndrome caused by an overgrowth of bacteria in the small intestine. SIBO creates a condition of toxemia that overwhelms the liver’s detoxification capacity and leads to nutritional deficiencies and is a major cause of fibromyalgia pain.  It is diagnosed with a breath test that measures hydrogen and methane gas and is treated with specific antibiotics, diet and prokenetic drugs to stimulate gut motility. For more information on this disorder go to: http://www.siboinfo.com and read my post http://fibrofriends.typepad.com/fibro_friends/2014/07/small-intestine-bacterial-overgrowth-a-complication-of-chronic-fatigue-and-fibromyalgia-syndromes.html.

4. Serotonin Deficiency

Many people with fibromyalgia have low levels of serotonin. This can be diagnosed with a laboratory test that measures neurotransmitters (Pharmasan Labs). Low levels of serotonin impair gut motility, disturb sleep, affect mood and appetite, cause fatigue and affect cardiovascular function. Supplementation with 5HTP can increase serotonin levels. Recommended dosage is 100 mg. 3X/day for 5 weeks to see improvements. 

5. Gentle Physical Therapies

Traditional deep tissue massage is often too strong for fibromyalgia patients but more gentle forms of physical therapy can be helpful. I recommend BowenWork and Feldenkrais training. Both therapies are very gentle and remarkably effective methods of relieving pain and improving physical function.  Bowen Work stimulates healing through subtle moves that release tension in specific areas of the body and Feldenkrais addresses patterns of movement and posture that can cause pain. For more information and to locate a practitioner go to: [email protected] and  www.feldenkrais.com.

6. Hydrotherapy

Warm showers finishing or alternating with brief cold showers can take the edge of fibromyalgia muscle pain and help with circulation. When I was sick with fibro I took 4-5 showers a day and when I had a bad night I would get up in the middle of the night and take an additional shower. It was especially helpful for me take a shower before bedtime, a practice I still maintain. Whole body cryotherapy in a cryosauna is also very effective at relieving symptoms. Some people report benefits from taking warm baths and infrared saunas. 

7. Temperature Regulation

Many people with FSM are sensitive to temperature extremes and vacillate between feeling too hot or cold. It can be helpful to wear layers of clothing to help regulate one's body temperature, to avoid temperature extremes and drafts. Wool is a particular good fabric for regulating body temperature. I sleep with a wool filled comforter and on a wool filled mattress pad, and sleep in wool long underwear made by Ibex, which is very soft.

8. Chiropractic Adjustments

Many fibromyalgia patients benefit from regular chiropractic adjustments that provide some relief from muscle and nerve pain.

9. Low Histamine Diet

Studies show that many people with fibromyalgia have problems with mast cell activation and are particularly sensitive to histamine. Avoiding foods with high levels of histamine can make a big difference and prevent fibro flares as well as migraine headaches. These foods include alcohol, black tea, fermented foods, cured and aged meats and cheeses, tomatoes, pineapples and citrus fruit. Some people have low levels of diamine oxidase or DAO, the enzyme that breaks down histamine in foods. Along with following a low histamine diet, taking a DAO supplement 15 minutes before each meal may also be helpful

10. Supplements

The supplement industry is rife with claims of various supplements for Fibromyalgia Syndrome. There are only three supplements that I know of that are truly beneficial for fibromaylgia patients. They are magnesium, which helps with constipation and tense muscles, malic acid found in apple cider vinegar, which can help reduce small intestinal bacterial overgrowth, and ginger root, which helps digestion and is also a potent antihistamine that can help sleep.

11. Exercise

Exercise is a tricky and sometimes impossible activity for persons with fibromyalgia depending on the severity of the condition. Overdoing it can result in a flare-up of symptoms and compound pain and exhaustion so one needs to try to stay withing one's threshold of tolerance. Stretching is particularly bad for the adhersions that build up in the connective tissues in fibromyalgia however mild exercise and movement such as walking, Tai Chi or Qugong well within the limits of one's capacity for exertion can be beneficial. Wearing compresion garments while exercising may be helpful. I also highly recommend The Miracle Ball Method, a program of "unexercises" developed by Elaine Petrone to heal chronic pain. www.elainepetrone.com

12. Hormone Replacement

Fibromyalgia Syndrome occurs frequently in women who are perimenopausal or postmenopausal. Declining estrogen levels are associated with lower production of diamine oxidase, the enzyme that breaks down histamine in foods, and a decreased ability to utilize magnesium that is essential for muscle function and recovery. Some women with fibromyalgia experience improvement in their condition by taking the female hormone estrogen.

13. Oral Systemic Balance

Many persons with fibromyalgia have TMJ symptoms and breathing difficulties. Specially designed oral appliances fabricated and adjusted by dentists can improve breathing, restore balance to the nervous system, improve posture and relieve TMJ and body pain. The therapy is very expensive and time consuming however I believe that it addresses a key source of stress for those suffering from both Chronic Fatigue and Fibromyalgia Syndromes. For more information go to: http://www.oralsystembiology.com and read my post http://fibrofriends.typepad.com/fibro_friends/oral_systemic_balance/

New Study Finds Major Pathology in Fibromyalgia Patients

Scientists at Integrated Tissue Dynamics (http://www.Intidyn.com) and Albany Medical College have discovered a pathology in the skin of  fibromyalgia patients involving the nerve endings to a type of blood vessel called arteriole-venule shunts that plays an important role in the regulation of blood flow. In the human body blood flows from the heart through arteries which divide up into smaller arteries called arterioles and ultimately into capillaries to supply tissues with nutrition, eliminate waste and regulate temperature. From the capillaries the blood returns to small veins called venules which then connect to larger veins traveling back to the heart. Arteriole-venule shunts or AVS are small valves that connect arterioles to venules. When the AVS are closed blood flow is forced into the capillaries in order to dissipate heat; when the AVS are open blood flow is diverted from the capillaries to conserve heat. In this way the AVS function as a thermostat in regulating body temperature.

There are two kinds of nerve supply which control whether the AVS valves are open or closed: sympathetic and sensory. Sympathetic nerve supply can activate the muscle in the wall of the AVS to constrict (close).  Sensory nerve supply operate in two directions causing the AVS to constrict and to dialate (close and open). The sensory nerve supply has two functions: it regulates blood flow; and it allows the body to feel contact and temperature through the skin and to experience pain when there is tissue damage. Molecular characteristics of the sympathetic and sensory fibers indicate they communicate and regulate each other. The Albany Med and Intidyn team of scientists discovered that the AVS in the hands of fibomyalgia patients have an extremely excessive amount of sensory fibers. They postulated that this could interfere with the regulation of blood flow through the body and result in a lack proper nutrition to the muscles during exercise causing the wide spread pain and fatigue symptomatic of fibromyalgia. Abnormalities in the AVS may also explain why persons with fibromyalgia have difficulty regulating body temperature with low tolerance for extreme hot and cold temperatures.

This recent research is a welcome development in the understanding of fibromyalgia and hopefully will help debunk any lingering myths that fibromyalgic pain is psychological. I have personally suspected that fibromyalgia muscle pain had something to do with poor blood flow and/or low blood volume for some time. Chiropractic adjustments and Whole Body Cryotherapy are two of the most effective treatments for relief of fibromyalgia pain most likely because they stimulate blood flow without aggravating the inflammation in the muscle fascia. I think that future research will show abnormalities not only in the amount of sensory fibers in AVS but in the entire cadiovascular system of persons with fibromyalgia which is essentially "sluggish" or operating in "low gear".

There is a lot of research establishing cardiovascular irregularities in persons with Chronic Fatigue Syndrome, a closely related disorder to Fibromyalgia Syndrome. These include a blood pressure regulation abnormality called neurally mediated hypo tension; abnormal oscillating T-waves of the heart on 24 hour EKG Holter monitor demonstrating abnormal left ventricular myocardial function; low levels of circulating blood volume and Red Blood Cell mass; and low cardiac output. For more information on this read my post http://fibrofriends.typepad.com/fibro_friends/2013/05/cardiovascular-abnormalities-in-chronic-fatigue-syndrome.html Dr. Paul Cheney one of the leading CFS researchers and physicians uses heart ultra sound equipment as an important diagnostic tool and can identify patterns indicative of the condition. I suspect that one would find similar patterns in persons with fibromyalgia.

One of the most significant treatments for helping persons with chronic fatigue and fibromyalgia syndrome is Oral Systemic Balance because it directly affects the cardiovascular system. Developed by a TMJ dentist named Farrand Robson, the therapy employs oral appliance to improve a person's ability to breathe which allows the body to heal on many different levels. Initially working with heart rate variability and then EKG as diagnostic tools Robson ascertained that the autonomic nervous system and more specifically the heart compensates for restrictions in the air passage or throat because when he makes changes to an appliance he observes positive changes in heart function. In the past year Dr. Farrand Robson has made significant advancements in Oral Systemic Balance since he started working with a heart ultrasound machine as a diagnostic tool. 

My personal health recovery has benefited most from Oral Systemic Balance. Five years ago it brought me out of the "black hole" my health had declined into but I did not get completely well. Two months ago I began my second phase of Oral Systemic Balance treatments with the addition of the heart ultra sound and I am progressing further. I no longer have fatigue or fibromyalgia pain with everyday acitivities although I still cannot exercise regularly; my sleep is much better but is still disturbed; and my hypersensitivities to food are still a problem. It will be interesting to see how much more recovery I get from OSB over the coming months. Although addressing breathing problems with OSB has been the most helpful for me I have also benefited from LENS neurofeedback, female hormone replacement, Wilson's Thyroid Syndrome protocol, a strict diet and detox work. Chronic fatigue and fibromyalgia syndromes are multifacted conditions which I suspect usually involve chronic infections. The road to recovery is not a clear and easy one but with the advancements in medical research we are getting closer to understanding and effectively treating these conditions. 

Fibromyalgia - A Syndrome of Variations

Fibromyalgia Syndrome is a complex debilitating health disorder which is characterized primarily by widespread musculoskeletal pain and is often accompanied by a range of other symptoms including fatigue, sleep disturbances, gastrointestinal problems, thyroid dysfunction, headaches, and brain fog. There is historical evidence that this condition has been in existence for hundreds of years but only in the last 25 years has fibromyalgia achieved recognition from the medical community as a distinct disorder.

In 1990 the American College of Rheumatology (ACR) came up with a definition of fibromyalgia which stated that widespread pain should occur on both sides of the body, above and below the waist, and include axial pain (along the spin); and they identified 18 trigger or tender points, of which at least 11 should be painful to pressure. This definition was a good starting point but is not universally accepted today as the understanding of this complex disorder keeps evolving. After a study completed in 2010 the ACR changed their definition of fibromyalgia to identify non-tender point diagnostic criteria including fatigue, waking unrefreshed, and cognitive symptoms, as well as and other somatic symptoms; and it developed a severity scale of symptoms. 

Adding to the confusion over the diagnosis of fibromyalgia is its similarity to other overlapping conditions particularly Chronic Fatigue Syndrome but also Irritable Bowel Syndrome, chronic Lyme disease, allergies, and food and chemical sensitivities. The reality is that each individual with fibromyalgia and chronic fatigue syndrome presents a unique presentation of symptoms based on their particular history. Healing requires identifying and treating the underlying stressors that led to the condition; and restoring normal levels of functioning that have down regulated in response to those stressors. These stressors may include impaired breathing, toxic overload, emotional stress, physical trauma, menopause, infections, and small intestinal bacterial overgrowth. For more on this read my post "What Causes Chronic Fatigue and Fibromyalgia Syndromes". http://fibrofriends.typepad.com/fibro_friends/2010/08/what-causes-chronic-fatigue-and-fibromyalgia-syndromes.html

One of the big misnomers about fibromyalgia is that exercise is beneficial. Although a certain amount of movement is always good for well being, increasing the demands of the muscles with weight bearing and repetitive activity beyond a person's recovery threshold will result in muscle injury and pain. In every survey I have seen of patients with fibromyalgia the number one helpful thing was rest, not exercise. Another misnomer is that fibromyalgia is caused by not getting adequate sleep particularly in the deep REM stage. It is true that most if not all fibromyalgia patients suffer from insomnia but disordered sleep in my opinion is a symptom of the syndrome not a cause. Unfortunately there are no effective medicines that alleviate the inflammation in the muscle fascia and pharmaceutical sleep aids become less effective over time and worsen the condition as they further suppress the system. 

In the vast number of books and articles on fibromyalgia there are as many theories and recommended treatments as there are variations in the disorder itself. My personal favorite book is Leon Chaitow's "Fibromyalgia Syndrome - A Practitioner's Guide To Treatment" because it presents a comprehensive overview of research, theories and treatments with chapters by different clinicians and therapists. Chaitow maintains a global perspective on the syndrome that is rare. He writes:

"Any attempt to reduce the complexity of FMS is laudable. However, there is a risk that such an attempt at reductionist reclassification may lead to the bigger picture being overlooked. ...many apparent 'causes' are in fact symptoms, evidence of a breakdown in homeostasis or of homeostasis in action."  "Treatment strategies will be based on any unique, idiosyncratic combination of inherited and acquired features that can be identified. Whatever is identified, the bottom line in therapeutic endeavours which aim to enhance health has to be to work with the self-regulating mechanisms of the body, in order to 'lighten' the adaptive load and enhance functional ability to cope with the load, to allow healing and regeneration". [1]

It appears that there are four distinct variations or forms of musculoskeletal pain in persons with fibromyalgia although they are seldom delineated by medical "experts" most likely because many patients have more than one of these forms concurrently. Understanding the particular type of fibromyalgia pain one is suffering from is important if one is to find appropriate treatments.

The first form of fibromyalgia pain is the severe full body pain caused by spine trauma. The pain is described as burning, sharp and aching, is not alleviated by narcotic or opioid medication, and is emotionally very distressing. This type of fibromyalgia is typically triggered by some kind of physical trauma such as an accident or surgery. Dr. Carolyn McMaken has developed an effective treatment protocol using Frequency Specific Microcurrent that has successfully resolved this condition for many individuals. For more information go to: www.frequencyspecific.com. Chiropractors employing a technique involving frequent neck adjustments called Neuro-Resetting Technique or Neurological Relief Center Technique have also accomplished similar results. 

The second form of fibromyalgia pain occurs when muscles are unable to recover or adequately repair themselves from daily activity resulting in injury and pain in the connective tissue or fascia. The pain is described as dull and improves with rest and applications of cold. It is similar to post exercise muscle soreness or "Delayed Onset Muscle Soreness" that occurs in healthy individuals that are strained by over use but in fibromyalgia any repetitive movement is essentially damaging. This is the type of fibromyalgia which I refer to as "fibromyalgia muscle dysfunction" and write about in my post "Fibromyalgia - A perspective on Muscle Dysfunction and Effective Treatments.  http://fibrofriends.typepad.com/fibro_friends/2011/10/f.html   An excellent analysis of this muscle pain is written by Ginevra Liptan, MD in the chapter entitled "Fascia is the Source of Muscle Pain" in her book Figuring Out Fibromyalgia.[2]  Effective therapies are treating Small Intestinal Bacterial Overgrowth, testosterone and female hormone replacement, compressions garments, Oral Systemic Balance, whole body cryotherapy, EMG biofeedback training, and various forms of physical therapies including Bowen work and myofascial release. 

The third form of fibromyalgia pain is an all over body achiness accompanied by extreme fatigue. The pain is reminiscent of having the flu, is often episodic, and improves with applications of heat. This is a caused by a supressed immune system that is overtaxed by food and chemical allergies, and/or  chronic infections such as Lyme disease, small intestinal bacterial overgrowth (SIBO) and parasites. Effective treatments include identifying and treating chronic infections and bacterial overgrowth with antibiotics; identifying and eliminating allergens; and improving the immune system with therapies such as Human Probiotics, the Marshall Protocol and Oral Systemic Balance. 

The fourth and final form of fibromyalgia pain is referred to as central sensitization or spinal cord hyper-reactivity and is the result of a system that has gotten so stressed and exhausted by any of the previous forms or combinations of forms of fibromyalgia that the entire nervous system goes into a state of chronic sympathetic arousal. People with fibromyalgia can become hyper-reactive to any number of things including noise, light, physical touch, temperature changes, and they develop a chronic agitation of the nerves and corresponding trigger points up and down the entire spine. Effective treatments include using some of the previously discussed therapies appropriate to the individual's condition; and retraining the nervous system through biofeedback self-regulating skills and neurofeedback which I describe in my post "Biofeedback Therapies for CFS and FMS". http://fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html . A "mind/body" approach for dealing with chronic pain is a program developed Dr. Howard Schubiner. http://www.unlearnyourpain.com

It is important to note that any form of fibromyalgia when accompanied by gastrointestinal problems such as Irritable Bowel Syndrome may be the result of an overgrowth of bacteria in the small intestine. This condition overwhelms the liver's detoxifying resulting in a condition of toxemia that can cause a heightened sensitivity to pain, malabsorption of nutrients critical for mitochondrial function, and impaired muscle metabolism.[3] Small Intestinal Bacterial Overgrowth or SIBO is diagnosed with a hydrogen and methane breath test and treated with appropriate antibiotics. http://www.siboinfo.com and read my post http://fibrofriends.typepad.com/fibro_friends/2014/07/small-intestine-bacterial-overgrowth-a-complication-of-chronic-fatigue-and-fibromyalgia-syndromes.html 

I suffered from chronic fatigue syndrome for 28 years but was able to live a fairly functional life due to stress management, diet, moderate exercise, meditation, yoga and years of biofeedback and neurofeedback training. At the onset of menopause however my health took a turn for the worse and I developed fibromyalgia muscle dysfunction that made it impossible to continue being active physically. At this lowest point of my life physically I was unable to sleep for more than 20 minutes at a stretch, felt light headed when I stood up, was injuring my muscles doing very low level tasks, had a chronically dry mouth, alternated between feeling hot and cold, had poor digestion, and extreme fatigue. I never developed brain fog or central sensitization which I attribute to years of biofeedback and neurofeedback training and my continuous involvement in music.

My personal recovery is a result of number of cutting edge therapies that are not included in Chaitow's book and most of the literature on these syndromes. Of primary importance to my recovery was Oral Systemic Balance (OSB) which successfully corrected a breathing problem using custom designed oral appliances. (Chaitow attributes breathing problems in fibromyalgia to hyperventilation and bad breathing habits when in fact these problems are primarily structural having to do with the anatomy of the tongue, teeth and mouth) Treating Small Intestinal Bacterial Overgrowth was also key for me as it completely resolved the muscle soreness I experienced after exertion. Other important therapies for me included addressing Wilson's Low Body Temperature Syndrome, a condition of thyroid dysfunction triggered by long term stress, by taking for a period of time incremental amounts of T3 allowed my body temperature to return to normal; LENS neurofeedback which helped heal post traumatic brain damage and emotional trauma from living with chronic illness; female hormone replacement therapy; and Whole Body Cryotherapy. These and other effective therapies are outlined  with links to more in depth posts and websites in my opening post "Chronic Fatigue & Fibromyalgia Syndromes -Strategies for Healing"  http://fibrofriends.typepad.com/fibro_friends/2011/05/chro.html 

____________________________________________________________________

^{[1] Chaitow, Leon. Fibromyalgia Syndrome A Practitioners Guide. Churchill Livingston Elsevier. 2010.}      

^{[2] Liptan, Ginevra. Figuring Out Fibromyalgia. Visceral Books, LLC. 2011.}

[3] Vasquez, Alex. Migraine Headaches, Hypothyroidism, & Fibromylaiga. OptimalHealth Research.com 2011         

 

Fibromyalgia - A Perspective on Muscle Dysfunction and Effective Treatments

Fibromyalgia Syndrome remains a mysterious conglomeration of symptoms for which there is no definitive cause or treatment. The muscle condition characteristic of fibromyalgia is particularly poorly understood. To add to the confusion fibromyalgia patients are often referred to rheumatologists for diagnosis and treatment despite the fact that fibromyalgia is not an autoimmune disease or condition of inflammation that responds to anti inflammatory drugs or steroids. So what exactly is fibromyalgia?

“Fibro” refers to the fibers of the muscle tissue. “Myalgia” means pain in the soft or connective tissue of the muscles; tendons, which attach the muscles to the bones; and ligaments, which attach the bones to other bones. Myalgia is also referred to as “Soft Tissue Rheumatism” or "non-articular (not in the joints) rheumatism.  It is most commonly caused by the overuse or stretching of a specific muscle or group of muscles that occur in conditions such as tendonitis or carpal tunnel.  In the case of fibromyalgia syndrome the condition is systemic occurring on both sides of the body above and below the waist. The muscles in fibromyalgia patients are not able to recover adequately from everyday exertion. This results in pain, adhesion, and injury in the muscle tissue or fascia. When a person with fibromyalgia forces their muscles to work they develop sore spots called trigger or tender points. These points are felt as painful lumps or nodules that can be palpated by an experienced physical therapist or physician. A number of doctors who specialize in fibromyalgia believe that the cause of painful trigger points is metastatic calcium produced by chronically contracted muscles which cannot receive proper blood flow. The tissues become hypoxic (less than normal amounts of oxygen in the tissues) and contract further setting the calcium more permanently within the soft tissues.  Severely impaired fibromyalgia patients have large lumps of calcium deposits sometimes referred to as scar tissue at their trigger points. Rheumatologists have identified 18 specific trigger or tender points that they use to diagnose fibromyalgia. According to The American College of Rheumatology a person should have pain in a least 11 of 18 tender points to be diagnosed with fibromyalgia while other doctors think one can have fewer points. The truth is that there is a lot of variation in the symptoms of fibromyalgia patients and in one patient from time to time as the severity of the condition fluctuates.

One thing that all fibromyalgia patients have in common is that when they push their muscles beyond a certain threshold their condition worsens. The threshold varies from patient to patient and day to day in an individual patient. A severely ill patient will aggravate their condition by trying to perform simple tasks such as walking, climbing stairs or doing light housework. A less severe patient may lead a relatively functional life but their condition is aggravated by more rigorous activities such as exercise or gardening. One of the major misnomers of fibromyalgia is that exercise is beneficial. A certain amount of movement helps with the condition because it increases blood flow to the damaged tissue however increasing the demands of muscles beyond a person’s threshold with weight bearing and repetitive activity will result in a relapse in muscle injury and pain. Persons with fibromyalgia refer to a relapse as a “flare” which can aggravate into full body pain lasting several days or weeks. Severely ill fibromyalgia patients are in a flare all the time or as they say “24/7”.

The pain caused by the muscle condition of fibromyalgia ranges from mild discomfort to severe pain depending on the individual. The pain does not respond to anti-inflammatory drugs and is only marginally treatable with narcotic painkillers. Unfortunately many fibromyalgia patients end up on an illusive course of taking increasing amounts of drugs for pain relief which have horrible side effects. The only sure way to limit the pain is to limit one’s activities and to give the muscles plenty of rest after exertion. Other palliative measures include cold and heat therapy; wearing compression garments such as socks, tights and sleeves when active; and very gentle bodywork such as Feldenkrais, Myofascial Release and Bowen Work. When my fibromyalgia is bad I put ice packs on the muscles I use each day. I also take lots of alternating hot and cold showers. The relief is temporary but is a useful coping tool to manage my pain.  I also adopted a lifestyle where I constantly rotate my activities, never using any one set of muscles for more than 15 minutes. 

Dr. Paul Whitcomb a chiropractor was able to help many fibromyalgia patients at his clinic by doing frequent adjustments to the top vertebrae of the spine, which resulted in dampening the agitated nervous system. For a fortunate few the results were long lasting. For others including myself the relief was temporary. Check my post “Paul Whitcomb – Friend or Foe” http://fibrofriends.typepad.com/fibro_friends/2008/08/paul-whitcomb---friend-or-foe-1.html.  I have since discovered a gentle movement employed by Bowen Work and cranial sacral therapists at the base of the head that calms the nerves to the peripheral muscles, basically accomplishing the same thing that Whitcomb did with a lot less force and without hurting the neck. However as with Whitcomb's technique the effects are temporary. 

Dr. Byron Hyde, one of the premier medical doctors and researchers on chronic fatigue syndrome and related disorders defines fibromyalgia as "a pathological hyper-elasticity of the peripheral vascular system or anything that causes this pathological expansion". A subset of people with fibromyalgia have an excessive amount of elasticity in their connective tissue due to a genetic disorder called Ehlers-Danlos Syndrome that manifests itself in lax or hypermobile joints, ligaments and skin. For the majority of people with fibromyalgia hyper-elasticity is caused by dysautonmia - a term describing malfunction of the autonomic nervous system that controls heart rate, blood pressure, digestive tact peristalsis, and most importantly blood volume, which is typically low. 

Some fibromyalgia patients respond to large doses of magnesium, which relax the muscles and counters their tendency to over contract. I have a friend who manages her condition quite well simply taking magnesium supplements. Trans dermal application of magnesium are thought to be even more effective. A good source for magnesium oil, gel, lotion and flakes that are absorbed through the skin is http://www.ancient-minerals.com. Fibromyalgia patients have also reported a benefit from taking vitamin D and amino acids (see my post "Protein Deficiency" fibrofriends.typepad.com/fibro_friends/2009/01/protein-deficiency-fibromyalgia.html ), which many people are deficient in and can contribute to muscle pain and weakness. 

Dr. R. Paul St. Amand promotes the treatment of fibromyalgia with the expectorant guaifenesin commonly found in over the counter cold remedies. St. Amand  believes that the retention of calcium in the cells of fibromyalgia is a result of an inability to produce energy or ATP (adenosine triphospate - a biochemical term for cellular energy) and an abnormality in phosphate excretion. His protocol, which involves taking regular doses of guaifenesin and avoiding products that contain salicylates has been helpful for some fibromyalgia patients. For more information go to: www.fibromyalgiatreatment.com. An interesting article by Mark London that thoroughly researches the use of guaifenesin for fibromyalgia can by found at http://web.mit.edu/london/www/guai.html.  According to London’s research guaifenesin acts as a muscle relaxant by depressing transmission of nerve impulses in the central nervous system.

Dr. Samuel Yue, a medical doctor in Minnesota believes that fibromyalgia is caused by a systemic deficit of relaxin hormone or the inability of the body to utilize this hormone. This hormone, which is associated with pregnancy when it is produced in large amounts is necessary to maintain the integrity of collagen and connective tissues of the body. He prescribes the hormone relaxin, which has been helpful for some fibromyalgia patients in releasing sustained muscle contractions and the resolution of their tender points. The hormone is available in a supplement form called “Vitalaxin” developed by Dr. Yue and is available from numerous supplement supply companies. 

In 1994 researchers at the University of Texas discovered an elevation in the level of the neurotransmitter Substance P in the spinal fluid of patients suffering from FMS. Substance P is a 11-amnio acid neuropeptide that is distributed throughout the peripheral and central nervous systems and is localized in the primary sensory neurons and the neurons intrinsic to the gastrointestinal tract. Researchers at Viral Immune Pathology (www.vipdx.com) have developed a test for cerebral spinal fluid, which measures the amount of Substance P in patients and is a reliable diagnostic marker to differentiate between CFS and FMS. 

A 2002 study by a team of researchers at Oregon Health and Science University led by Robert Bennett, MD found that persons with fibromyalgia have an inability to secrete growth hormone during exercise. They surmised that another hypothalamic hormone – somatostatin – was probably blocking the release of growth hormone. This is a manifestation of a disordered hypothalamic-pituitary-adrenal (HPA) axis found in persons with Chronic Fatigue and Fibromyalgia Syndromes. Treatment with daily Human Growth Hormone injections is expensive but has been reported to improve quality of life and energy level, reduce pain, and improve exercise capacity and muscle strength. An inexpensive, safe alternative to HGH injections is a homeopathic HGH spray reported by some to have positive results. Go to:www.drmaxpowers.com.

A couple of interesting scientific studies were conducted on the muscle; and collagen and muscle pathology in fibromyalgia patients by the Parker Institue, Department of Rheumatolgy and the Danish National Library of Science and Medicine in Copenhagen, Denmark. They found that fibromyalgia patients had a significantly lower amount of intramuscular collagen that may lower the threshold for muscle micro-injury and thereby result in nonspecific signs of muscle pathology. Studies on muscle metabolism in fibromyalgia patients showed that there is a defect that is not seen at rest and when the patient is working at a submaximal load, but is seen under maximal loading and under static contraction. Blood flow did not increase as the load increased indicating a disturbed local regulation of microcirculation; lower levels of ATP and phosphocreatine were found in muscle biopsies of fibromyalgia patients; and fibromyalgia patients had EMG activity between muscle contractions indicating a prolonged relaxation or recovery time in patients with fibromyalgia.  http://rheumatology.oxfordjournals.org/content/43/1/27

Muscle Dysfunction in Fibromyalgia may be the result of low cardiac output and problems with microcirculation found in the overlapping condition Chronic Fatigue Syndrome. A growing body of research has found has found many abnormalities in the cardiovascular system of persons with Chronic Fatigue Syndrome. For more on this read my post "Cardiovascular Abnormalities in CFS"  http://fibrofriends.typepad.com/fibro_friends/2013/03/cardiovascular-abnormalities-in-chronic-fatigue-syndrome.html These abnormalities can lead to exercise intolerance and fibromyalgic pain. More women suffer from Fibromyalgia Syndrome than men although Chronic Fatigue Syndrome occurs in equal proportions in both sexes. This may be because men have a higher capillary cross-sectional area or more capillaries than women.  

Breathing and air passage problems can cause cardiovascular dysfunction in persons with chronic fatigue and fibromaylgia syndromes. This can improve with Oral Systemic Balance, a therapy developed by a TMJ dentist named Dr. Farrand Robson that uses oral appliances or mouth pieces to facilitate ease of breathing and balance to the autonomic nervous system. Through heart ultra sound, EKG, and heart rate variability testing Robson has established a direct correlation between restrictions in the air passage and changes in heart functions and he is successful at improving oral and cardiovascular function through adaptations to the contours and positions of his appliances. Oral Systemic Balance provided the foundation for my personal recovery from both chronic fatigue and fibromyalgia syndromes, however full recovery required the addition of several other therapies.  To read more about Oral Systemic Balance and my experience go to following posts: http://fibrofriends.typepad.com/fibro_friends/2010/02/oral-systemic-b.html and http://fibrofriends.typepad.com/fibro_friends/2014/01/oral-systemic-balance-the-second-chapter.html

The field of neurofeedback specifically addresses dysfunction of the Central Nervous System and offers a lot of promise for those suffering from fibromyalgia as well as many other chronic disorders. Some people have reported good results from doing programs of EEG biofeedback or neurofeedback training. The patient sits in a comfortable chair with sensors placed on either side of the scalp, which are attached to a computer that picks up brain wave activity. Feedback is produced through visualization on a computer monitor and sound and is monitored by a neurofeedback technician. The patient receives positive feedback when it moves towards a more balanced and flexible pattern. 

An entirely different form of neurofeedback called “Low Energy Neurofeedback Systems or LENS, has been helpful for people who do not respond to neurofeedback training and achieves results in less time.  A LENS session lasts only seconds as opposed to a neurofeedback training session, which typically lasts around 45 minutes. During a LENS a person receives feedback of its own dominant brain wave frequency at a slight offset. The brain recognizes its own pattern and shifts away from it. What is unique about LENS is that the shifts are permanent and the brain reintegrates healing on its own. For more information go to: www.ochslabs.com.  

In the book "The Healing Power of Neurofeedback" by Stephen Larsen there are references to the additional benefits of surface EMG biofeedback training for fibromyalgia patients doing LENS. An electromyograph (EMG) is an instrument that uses surface electrodes to detect muscle contraction using one or more active electrodes that are placed over a target muscle and actively record the muscle tone in microvolt. Paying attention to this feedback one can manipulate and decrease agitated muscle contractions. I found an inexpensive home unit on the Internet manufactured in England by Verity Medical Let and distributed by Win Health at www.win-health.com/neurotrac_simplex.html. I began practicing for a half hour once or twice a day, training my muscles tone to decrease. Within several weeks I noticed an improvement in my muscle tone resulting in an increase in the amount of physical activity I could "get away with". Doing daily biofeedback training provides a valuable tool to help my muscles recover more quickly after exertion but it does not prevent injury from reoccurring. To read more about various forms of biofeedback and neurofeedback and my experience with them read my post "Biofeedback Therapies for CFS & FMS"  http://fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html 

Low Intenstiy/Level or "Cold" Laser Therapy is a treatment that is helpful for treating pain in some people with fibromyalgia. It involves the application of red to near infrared light produced by Low Level Lasers Diodes (LLLD) and/or Super luminous Diodes (SLD) over the skin which results in a healing response of the tissues. This healing response includes increased production of ATP, RNA and DNA synthesis, serotonin and endorphins, collagen synthesis, growth hormone and improved lymphatic drainage. I explored a form of Low Intensity Laser Therapy manufactured by a company called MediTech used by my chiropractor. The pain relief was moderate and not long lasting. For more information on light therapies and my personal experience read my post "Phototherapy - Healing with Light".  http://fibrofriends.typepad.com/fibro_friends/2010/07/phototherapy-healing-with-light.html 

The developing fields of energy medicine, which employ various forms of electrical current to help the body heal are also helpful in the treatment of fibromyalgia. These therapies employ non-invasive devices that generate low levels of electrical energy to stimulate cellular repair. Cell membranes vibrate at specific frequencies and diseased cells have weaker amplitudes and unbalanced electronic charges in the molecules often referred to as free radical damage. The therapies work by re-charging the damaged molecular systems and thus restoring balance and increased energy into body systems. Studies have demonstrated their effectiveness in healing soft tissue wounds, aiding in bone growth and repair, suppressing inflammatory responses at the cell membrane level and alleviating pain.

Dr. Carol McMakin is a chiropractor in Portland, Oregon who specializes in a treatment called Frequency Specific Microcurrent, which employs microamperage current and the resonance effects of specific frequencies on tissues and conditions to create beneficial changes in symptoms and health. FSM is effective at treating nerve and muscle pain, inflammation and scar tissue. McMakin has developed one frequency combination that has been observed to eliminate severe all body pain in fibromyalgia associated with spine trauma.  She reports success treating hundreds of fibromyalgia patients with this protocol. For more information go to: frequencyspecific.com.

Fibromyalgia when accompanied by gastrointestinal problems such as Irritable Bowel Syndrome may be the result of an overgrowth of bacteria in the small intestine. This condition overwhelms the liver's detoxifying resulting in a condition of toxemia that can cause a heightened sensitivity to pain, malabsorption of nutrients critical for mitochondrial function, and impaired muscle metabolism. Small Intestinal Bacterial Overgrowth or SIBO is diagnosed with a lactulose breath test that measures hydrogen and methane gas. Dr. Mark Pimentel, IBS researcher and director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center in Los Angeles studied a group of 42 fibromyalgia patients and found hydrogen levels during breath testing that were significantly higher than non-fibromyalgia ISB patients and healthy control patients. He reports success treating SIBO and fibromyalgia with specific antibiotics and diet. To learn more about this important component of fibromyalgia read Dr. Pimentel's book  "A New IBS Solution Bacteria-the Missing Link in Treating Irritable Bowel Syndrome" and go to http://www.siboinfo.com.  

I personally explored most of the therapies described in this post receiving in many cases improvement in my overall health but treating Small Intestinal Bacterial Overgrowth was ultimately what completely resolved my fibromyalgia muscle pain. For more on this read: http://fibrofriends.typepad.com/fibro_friends/2014/07/small-intestine-bacterial-overgrowth-a-complication-of-chronic-fatigue-and-fibromyalgia-syndromes.html  

In conclusion the condition of fibromyalgia varies from person to person, however most have in common an agitated nervous system, gastrointestinal problems and cardiovascular dysfunction resulting in a perfect storm of multiple symptoms. Recovery requires a combination of therapies that can address underlying causes of stress on the body, bring balance to the autonomic nervous system and treat complications. Just as there is no one cause of fibromyalgia, there is no one "cure" or treatment that works for everyone. Each person must find through trial and error what works for them. Considering the fact that many of the effective therapies are not covered by health insurance or even known about in the medical community, this makes the task of getting better difficult. I am hopeful that effective therapies will eventually become more available and contribute to an improved quality of life for those suffering from fibromyalgia. 

Chronic Fatigue & Fibromyalgia Syndromes - Strategies for Healing

 Every person with chronic fatigue syndrome (CFS) also known as myalgic encephalomyelitis (ME) and/or fibromyalgia syndrome (FMS) has a unique presentation of these conditions with various complications and sets of symptoms. There is no one treatment that can “cure” these syndromes or that is helpful to everyone however a combined approach of therapies can lead to an improved quality of life. Listed below are strategies and therapies that have been beneficial for myself and others.

1.   Diet and Chemical Exposure 

Impaired detoxification is common to chronic fatigue and fibromyalgia sufferers. Avoidance of stimulants, depressants, pharmaceutical drugs and toxic chemicals can make a big difference in feeling better. This includes alcohol, caffeine, sugar, pain relievers and additives in processed food. Unfortunately many physicians prescribe drugs for pain, depression and sleep, which become less effective with time and in the long run make a patient worse. The optimal diet is one that is high in protein and minimally processed: organic meats, fish, eggs and full fat dairy products, vegetables, nuts, whole grains and fruit. It is also important to consume salt and to drink plenty of water.

2.  Breathing and Oral Balance

Breathing is the underlying force of life and many people with chronic fatigue and fibromyalgia have impaired or restricted breathing contributing to poor health and pain. People with CFS/FMS are often unaware that they are surviving on less air, which does not show up in an oxygen saturation test because their bodies compensate for this with low blood pressure. This is the cause of neurally mediated hypotension and other cardiovascular irregularities common in many Chronic Fatigue patients. Oral Systemic Balance is a treatment developed by a TMJ dentist named Farrand Robson that employs oral appliances to help patients breathe better and restore balance to the autonomic nervous system. It resulted in significant improvement in my own health and provided the foundation for my recovery which I discuss in my post “Oral Systemic Balance” fibrofriends.typepad.com/fibro_friends/2010/02/oral-systemic-b.html and "Oral Systemic Balance - the Second Chapter"  http://fibrofriends.typepad.com/fibro_friends/2014/01/oral-systemic-balance-the-second-chapter.html.The treatment is time consuming and expensive however I believe that it addresses a key source of stress for those suffering from Chronic Fatigue and Fibromyalgia Syndromes. For more information go to: http://www.oralsystembiology.com.

The website www.breathing.com  has information on holistic breathing development research, education and self-help programs developed by “The Optimal Breathing Coach” Mike White. I recommend ordering the Fundamentals of Breathing Development Video and Breathing Kit, which offers an effective program of breathing exercises. 

3. Neurofeedback

Chronic Fatigue and Fibromyalgia Syndromes are conditions of neurological exhaustion and physical stress that result in dysregulation of the Central Nervous System. Dr. Len Ochs, a pioneer in the biofeedback field developed a unique form of EEG feedback or neurofeedback called Low Energy Neurofeedback System (LENS)  that has helped many people with CFS/FMS. The system operates entirely different from traditional EEG or neurofeedback training. Treatment involves very short (a few seconds per session) feedback of the dominant frequency the brain is producing at an offset. This results in the brain jumping out of its existing patterns and breaking up dysfunction. The therapy works best for those who have resolved underlying physical stressors that led to their condition i.e. obstructive breathing and infections. For more information read the book "The Healing Power of Neurofeedback" by Stephen Larsen and go to www.ochslabs.com/. For more information on LENS and my experience with this go to: fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html.

4. Thyroid Function

Most chronic fatigue and fibromyalgia patients suffer from symptoms of hypothyroidism, which include low body temperature (below 98 degrees), fatigue and constipation, even though their thyroid blood tests are normal and/or they are taking thyroid replacement. Dr. Denis Wilson discovered that this condition which is called  “Wilson’s Thyroid Syndrome”, "Wilson's Low Body Temperature Syndrome" or “Wilson’s Syndrome” can be reversed by taking for a period of time the active thyroid hormone T3. Returning my body’s temperature and thyroid function to normal was one of the big breakthroughs of my healing and I think it is an issue for many CFS/FMS patients. You can read more about this at www.wilsonssyndrome.com and in my post “Thyroid Function" fibrofriends.typepad.com/fibro_friends/2009/03/thyroid-function.html.

5. Adrenal Exhaustion

Adrenal exhaustion is common to all CFS/FMS due to the enormous stress of living with these conditions. Mainstream endocrinologists do not diagnose or treat adrenal fatigue because there is nothing fundamentally wrong with the adrenal glands i.e. cancer or autoimmune disease. Holistic and naturopathic physicians diagnose this condition through saliva tests and treat with small amount of hydrocortisol, adrenal cortical extracts or live cell therapy for a few months to give the adrenal glands a chance to recover. Taking hydrocortisol has been helpful for those suffering from severe gastrointestinal issues as well. I have benefited from this treatment for short periods of time however my symptoms of adrenal exhaustion both experientially and as measured by cortisol levels did not resolve as a result of this. My adrenal exhaustion resolved permanentely after doing a year of LENS neurofeedback. To read more on this go to my post "Adrenal Exhaustion" fibrofriends.typepad.com/fibro_friends/2008/10/adrenal-fatigue.html   

6. Gastrointestinal Problems

Many people with CFS/FMS suffer from gastrointestinal problems including constipation, loose stools, bloating, and flatulence. There are multiple causes of these symptoms including low production of stomach acid and pancreatic enzymes, intestinal parasites and Small Intestine Bacterial Overgrowth. Low production of stomach acid can improve by taking apple cider vinegar or hydrochloric acid capsules with meals; low production of pancreatic enzymes can be treated by taking digestive enzymes; and parasites and bacterial overgrowth can be treated with appropriate antibiotics or herbs.  An excellent laboratory used primarily by naturopathic or holistic physicians for diagnosing digestive problems is Diagnos-Techs, Inc in Tukwila, WA.  Small Intestinal Bacterial Overgrowth (SIBO) is diagnosed with a breath test that measures hydrogen and methane gas. SIBO is common in persons with Irritable Bowel Syndrome and fibromyalgia. For more information on this disorder go to: http://www.siboinfo.com and read my post http://fibrofriends.typepad.com/fibro_friends/2014/07/small-intestine-bacterial-overgrowth-a-complication-of-chronic-fatigue-and-fibromyalgia-syndromes.html. Agitations of the autonomic nervous system may also be responsible for many gastrointestinal issues and can resolve with Oral Systemic Balance. 

7. Biofeedback Self-Regulation Skills

Biofeedback is the process of becoming aware of various physiological functions using instruments that provide information on these systems and through practice learning to manipulate them at will. I have found two biofeedback modalities: Surface EMG and Hand-Warming to be particularly beneficial in reducing the symptoms of an agitated sympathetic nervous system. Although I have personally not been successful in using HeartMath as a biofeedback tool it has helped many other people. All modalities use instruments that are inexpensive and can be practiced on one's own. 

An electromyograph (EMG) is an instrument that uses surface electrodes to detect muscle contraction. EMG biofeedback employs this instrument to measure the surface electromyogram (SEMG) using one or more active electrodes that are placed over a target muscle and actively record the muscle tone in micro volts. Paying attention to this feedback one can manipulate and decrease agitated muscle contractions. The therapy is particular helpful for fibromyalgia, which often manifests itself as a condition of hypertoned muscles that over contract. By placing electrodes on the tender or trigger points one can learn to retrain the muscles to relax. Surface EMG is also helpful for tension headaches, repetitive strain injuries and general calming of the nervous system. An inexpensive home unit can be purchased from Win Health www.win-health.com/neurotrac_simplex.html.

Hand-Warming or temperature biofeedback is a self-regulation skill that employs a feedback thermometer that detects skin temperature with a sensor that is attached to a finger. Paying attention to this feedback one can manipulate circulation to the extremities of the body which is often shunted in response to stress. The skill is helpful for preventing migraine headaches, arresting night sweats and general calming of the nervous system. An inexpensive Indoor/Outdoor thermometer can be purchased at a hardware or electronics store such as Radio Shack for this purpose using First Aid tape to affix the "outdoor" temperature sensor to one's finger.

HeartMath is a company that has developed a heart rate variability (HRV) biofeedback technology called emWave which analyzes the beat to beat changes in the time intervals between heart beats, a measure of physiological stress. The program teaches the user to create positive heart rhythms that have a calming and balancing effect on the brain and entire body. Mastering this "coherence" technique through a three step process and the visual and auditory feedback from the emWave can improve health, energy, mental clarity and emotional balance and is particularly helpful for improving sleep. The emWave Coherence System is available as a computer application or a hand held device. For more information go to: www.heartmath.com. 

To read more about biofeedback treatments for CFS and my personal experience exploring them go to: fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html. 

8. Mind Body Therapies

The physical symptoms of chronic fatigue and fibromyaliga may be compounded or even rooted in emotional stress and past traumas. A number of "mind body" therapies have proven to be helpful for many suffering from these conditions. 

Ashok Gupta thinks that CFS and FMS are conditioned syndromes where the brain is stuck in a state of hyper arousal. He developed a program that retrains the amygdala, the part of the brain responsible for the "fight or flight" or stress response. His program called Amygdal Retraining Programme is available in workshops, webinars and home study DVD. http://www.guptaprogramme.com 

Dr. Howard Schubiner has developed a 4-week educational course for treating chronic pain in persons with "Mind Body Syndrome" that has helped many persons diagnosed with FMS. www.unlearnyourpain.com

Emotional Freedom Technique (EFT) is a technique that combines Chinese acupressure and modern psychology by tapping on various meridian points while speaking phrases that target physical and emotional stress. This simple technique has helped many individuals process and resolve these problems.  http://www.thetappingsolution.com

9. Oxidative Therapies

 Dr. Majid Ali, a leader in the field of Integrative Medicine believes that all the symptoms of fibromyalgia and chronic fatigue syndromes are caused by cellular oxygen deprivation and dysfunctional oxygen metabolism. His website that discusses this theory is: www.majidali.com/oygenand.htm. 

Oxidative therapies that have helped persons with CFS and FMS include ozone therapy, hyperbaric oxygen, and Exercise with Oxygen Therapy. The therapies are thought to increase oxygen levels in the mitochondria, tissues and cells; stimulate the production of white blood cells necessary to fight infections; and eliminate toxins. Ozone therapy is administered from a generator through rectal or vaginal insufflation, intervenous injections or through autohemotherapy which involves removing about one half pint of blood from the patient, adding ozone and oxygen to the blood and infusing the blood back to the patient. Hyperbaric oxygen therapy (HBOT) involves breathing pure or 100% oxygen in a sealed chamber that is pressurized at 1 & 1/2 to 3 times normal atmospheric pressure. Exercise with Oxygen Therapy (EWOT) involves exercising for 15-30 minutes a day while breathing high flow oxygen produced by an oxygen generator. 

NanoVi is an innovative biophysics technology that produces a bio-identical signal known as reactive oxygen species (ROS) that initiates an oxidative response without introducing extra oxygen to the body. The therapy reverses free radical damage and increases cellular activities including energy production detoxification and healing. http://www.eng3corp.com

10. Whole Body Cryotherapy

CryoTherapy is a cold therapy that effectively reduces inflammation, muscle soreness, and pain. Treatments consist of standing in a cold chamber for 2 and a half to 3 minutes where liquid nitrogen lowers the surrounding air to minus 260 degrees F. It is used by athletes to recover faster and to heal from injuries. It is also effective in treating chronic inflammatory and degenerative conditions including fibromyalgia and chronic fatigue syndromes. Not only does the therapy decrease the pain associated with these conditions but it also can provide the catalyst for the body to reset its physiology and heal. For more information read my post fibrofriends.typepad.com/fibro_friends/2012/08/whole-body-cryotherapy.html and go to: http://lifeofmillennium.com

11. Frequency Specific Microcurrent

Frequency Specific Microcurrent is a system of treatment using microamperage current and the resonance effects of frequencies on tissues and conditions to create beneficial changes in symptoms and health. FSM is effective at treating nerve and muscle pain, inflammation and scar tissue. There is one frequency combination that has been observed to eliminate pain in fibromyalgia associated with spine trauma. Another frequency combination eliminates pain that manifests itself as chronic Delayed Onset Muscle Soreness. For more information go to: www.frequencyspecific.com and read the post "Frequency Specific Microcurent" http://fibrofriends.typepad.com/fibro_friends/2012/01/freq.html.

12. Hormone Replacement Therapy

Hormone replacement therapy or HRT involves the supplementation of the female hormones estrogen and progesterone for the relief of menopausal symptoms. Fibromyalgia Syndrome occurs most often in women who are perimenopausal or postmenopausal which suggests that decreasing female reproductive hormone levels may be involved in the development of this condition.  HRT is helpful as an adjunct therapy for many women suffering from fibromyalgia. For more on this go to: http://fibrofriends.typepad.com/fibro_friends/2012/02/hormone-replacement-therapy-an-effective-adjunct-treatment-for-fibromyalgia-and-chronic-fatigue-synd.html Women as well as men may also benefit from taking testosterone which declines with age in both sexes.

13. Allergies

Identifying "hidden" food and chemical allergens and eliminating them can make a significant difference in the health of persons with chronic illness including chronic fatigue and fibromyalgia. The enzyme-linked immunosorbant assay/activated lymphocyte cytotoxicity test or ELISA/ACT is a valuable diagnostic test as well as the exclusion diet. Some persons have reported a relief from fibromyalgia-like symptoms by avoiding night shade vegetables.  

14. Low Dose Naltrexone (LDN)

The drug Naltrexone was originally approved in a high dose for the purpose of helping heroin or opium addicts by blocking opioid receptors. When taken at a much smaller dose it has the effect of boosting a body's immune system by causing an increase in endorphin and enkephalin production. LDN is helpful for a variety of conditions that are triggered by a deficiency of endorphins including cancer, Irritable Bowel Syndrome, HIV/AIDS and autoimmune diseases as well as persons with CFS and FMS. LDN is safe, inexpensive and has no reported side effects. For more information go to: http://lowdosenaltrexone.org/ and read my post http://fibrofriends.typepad.com/fibro_friends/2011/10/low-dose-naltrexone.html

15 Earthing/Grounding 

Earthing is the practice of connecting with the energy emanating from the surface of the earth by standing or walking barefoot on the ground; or through the use of floor pads and conductive bed sheets linked by a wire to a ground rod outside or plugged into a wall outlet with a ground system. Reported benefits of Earthing on a regular basis include improved sleep, increased energy, improvement or elimination of symptoms of auto immune and inflammatory disorders, accelerated recovery from intense physical activity, normalization of the body's biological rhythms, reduction of jet lag, relief from hormonal and menstrual symptoms, and protection against environmental electromagnetic fields (EMFs). Some persons with CFS and FMS have reported dramatic improvements in their conditions especially in the area of sleep from Earthing. Others including myself appear to be hyper sensitive to Earthing products, which aggravate symptoms. To learn more about this read my post on Earthing at: fibrofriends.typepad.com/fibro_friends/2011/01/earthing-healing-from-the-ground-up.html . For more information and to order Earthing products go to: www.earthing.com. 

16. Electromagnetic Pollution

Many chronically ill persons including those with CFS & FSM are sensitive to environmental stresses from man-made radio frequencies (RFs) and electromagnetic fields (EMFs). They may be sick due to living in close proximity to a cellular tower; and may be particularly sensitive to the radiation coming from wireless devices, computers and microwave transmissions including microwave ovens and cell phones. Safe Living Technologies Inc. is a company that provides a lot of good information on the subject as well as technology and products to evaluate and protect your home from electromagnetic radiation. http://safelivingtechnologies.ca/  There are a number of other companies that sell products that claim to provide protection from the adverse effects of "electrosmog" including www.earthing.com (see strategy #6), http://earthcalm.com/ and http://mystressblocker.com however their effectiveness varies with each individual and the science behind them is controversial. The MRS2000 is a pulsed electromagnetic field therapy (PEMF) device designed for personal use that simulates earth based frequencies using more sophisticated and expensive technology. A good site for information on this is: http://gaiaresonance.com. I discuss electromagnetic pollution and PEMF therapies in my post:   http://fibrofriends.typepad.com/fibro_friends/2011/03/energy-medicine-of-the-future.html  .

17. Low Intensity Laser Therapy

Low Intensity Laser Therapy also known as Cold Laser Therapy and Phototherapy is a noninvasive therapy that utilizes light emissions from a laser diode or super luminous diodes to help facilitate healing and relieve pain in injured or damaged tissues. It has proven to be effective in a variety of conditions including tendonitis, musculoskeletal injuries, wounds, rheumatoid arthritis and diabetic neuropathy.  I used a system facilitated by a chiropractor called BioFlex Professional System manufactured by Meditech International Inc. www.bioflexlaser.com which was moderately helpful for my fibromyalgia muscle pain and plantar fasciitis. To read more about laser therapy go to: fibrofriends.typepad.com/fibro_friends/2010/07/phototherapy-healing-with-light.html 

18. Glutathione

Glutathione is the master antioxidant found in every cell of the body. It is responsible for transporting proteins between cells, detoxifying chemicals and environmental pollutants, activating the immune system and regenerating a variety of other antioxidants. Chronic Fatigue and Fibromyalgia patients have low levels of glutathione and this causes some of the symptoms associated with the disorder including brain fog. Taking glutathione orally is ineffective because it is destroyed by stomach acid. Some physicians treat chronically ill patients with glutathione injections or include glutathione in a intravenous solution with vitamins and minerals. These therapies are expensive and their effects immediate and short term. There are supplements that can increase the production of glutathione including vitamin C, alpha lipoic acid, milk thistle and N-acetyl cysteine. Dr. Robert Keller, a doctor who treated many chronic fatigue and fibromyalgia patients developed after 10 years of research a glutathione optimizer, which is a patented formula of supplements called MAXGXL. To order his original formula go to: http://robkellermd.com/link.php?go=glutathione.html&affid=67246. A more recently developed product produced by Max International Corporation called MaxONE contains RiboCeine, a patented combination of D-Ribose and L-Cysteine developed after 25 years of research by the Japanese scientist Dr. Nagasawa. RiboCeine has also shown to be effective in raising glutathione levels. For more information go to: www.maxgxl.com.

Another nutritional product sold through network marketing that can boost glutathione is Immunocal. This patented natural protein derived from whey helps the immune system and supplies the body with amino acids.  http://www.immunotec.com/IRL/Public/en/USA/ShowItemDetails.wcp?&Item=00010000

An alternative method is using a nonotechnology homeopathic patch that stimulates acupuncture points to increase the production of glutathione. For more information go to: www.lifewave.com. 

 To learn about my experience exploring the detoxification issue go to fibrofriends.typepad.com/fibro_friends/2009/05/detoxification.html.

To download interesting articles written by Rich Van Konynenburg, Ph.D.,an independent researcher about the role of glutathione depletion in Chronic Fatigue Syndrome" go to: www.aboutmecfs.org/Trt/TrtGSHIntro.aspxaboutmecfs.org/Trt/TrtGSHIntro.aspx.

19. Protein Deficiency 

Fibromyalgia patients have chronically low levels of amino acids and are deficient in systemic protein, which provide the materials to maintain, protect and repair body functions. This is most likely due to low production of stomach acid and digestive enzymes, and inflammation in the gastrointestinal tract, which makes it difficult to completely digest protein, carbohydrates and fats. Increasing stomach acid by taking hydrochloric acid capusules or apple cider vinegar with or before meals and taking digestive enzymes after meals can improve the body's digestion and its production of amino acids. Alternatively one can purchase amino acids in the form of dietary supplements. A chiropractor named Dr. Brice Vickery has developed a patented formula of amino acids called “Platinum Plus Essential Amino Acids” that is beneficial in addressing protein deficiency and improves many of the symptoms of fibromyalgia. To learn more about this read my post “Protein Deficiency” fibrofriends.typepad.com/fibro_friends/2009/01/protein-deficiency-fibromyalgia.html.You can order the amino acids at: www.supernutrient.com. Some persons with fibromyalgia have reported an improvement in sleep and pain by taking collagen hydrolysat, a food supplement made from an animal collagen protein formula, manufactured by Nutr-Diem, Inc. under the brand name "Colorad". 

20. Infections & Complicating Conditions 

CFS/FMS patients are prone to a variety of infections and conditions including yeast overgrowth or candida, intestinal parasites, heavy metal toxicity and mercury poisoning, viral, retroviral and mycoplasma infections, and Lyme disease and its co-infections. This is due to lack of oxygen, inflammation in the gastrointestinal tract, low levels of stomach acid, depletion of glutathione and stress. These conditions can be treated by a good holistic physician using herbs, courses of antibiotics and probiotics. An interesting website that discusses research on chronic infections is www.immed.org. Fry Laboratories is an idependent clinical diagnostic and research laboratory dedicated to the study of chronic disease that provides testing for pathogens associated with these conditions. http://www.frylabs.com To read about other approaches to improving the immune system read the post "Unconventional Approaches for Improving the Immune System"  http://fibrofriends.typepad.com/fibro_friends/2013/05/unconventional-approaches-to-improving-the-immune-system.html 

21. Atlas Profilax

Atlas Profilax is a physical therapy developed in Switzerland by Rene-Claudius Shumperli, which employs a vibrating instrument that massages the sub-occipital muscles of the neck. This results in a freeing and relocating the first cervical vertebra or atlas. The treatment is gentle, safe and usually permanent typically requiring only one session. Cost for the treatment and follow-ups is $250. Although the treatment was not helpful for me, I know of a few people who got significant improvement in fibromyalgia symptoms from it. To read about their experiences check out the post "Atlas Profilax" fibrofriends.typepad.com/fibro_friends/2008/10/atlas-profilax.html . For more information on the procedure and to find a practitioner go to: www.atlasprofilax.ch/.

22. Lymphatic Dysfunction 

The lymphatic system is a specialized component of the circulatory system which functions to remove excess fluids from body tissues, absorb fatty acids and produce immune cells. FMS patients have a sluggish or restricted flow of lymph resulting in mild edema. Some people have experienced a decrease of symptoms by taking decongestants and expectorants such as guaifenesin. An alternative treatment is using an electronic vibrational massage instrument called Lymph Star Pro that facilitates lymph drainage. The device is manufactured by Arcturus Star Products www.arcturusstar.com.  Low Intensity Laser Therapy (see strategy #6) and EMG biofeedback (strategy #5) are also therapeutic for lymph function.

23. Physical Therapies

I have explored a variety of physical modalities extensively in my search for better health including many kinds of acupuncture, massage, Rolfing, cranial sacral work, Tragger, chiropractic, Reiki, etc. I have found two forms of physical therapy to be particularly beneficial: Feldenkrais and Bowen Work.  Both these therapies are very gentle and noninvasive which is important for CFS/FMS patients who can overreact to more aggressive treatments. Feldenkrais addresses patterns of movement and posture that can cause pain. Its practitioners are well educated and can help individuals attain the most efficient and stress free way to move, stand and sit as well as an overall awareness of one’s body. For more information and to locate a practitioner go to: www.feldenkrais.com. Bowen Work stimulates healing through subtle moves that release tension in specific areas of the body and restore physical balance. For more information and to locate a practitioner go to: [email protected]. Both therapies activate the sympathetic nervous system and are excellent adjuncts to healing. Many people including myself also benefit from regular chiropractic adjustments. I also highly recommend The Miracle Ball Method, a program of "unexercises" developed by Elaine Petrone to heal chronic pain. www.elainepetrone.com

Exercise is a tricky and sometimes impossible activity for persons with CFS/FMS depending on the severity of the condition. Overdoing it can result in a flare-up of symptoms and compound the exhaustive state. Mild exercise and movement such as walking, yoga and Tai Chi well within the limits of one's capacity for exertion however are beneficial.

24.  Stress Management

The challenge of living with conditions that cause ongoing fatigue, pain and insomnia is huge. Persons with CFS/FMS are under incredible stress physically and therefore have a low tolerance for additional stress in their personal lives. They need to learn to pace their activities and to make good decisions whenever possible about relationships, work and lifestyle that minimize personal stress. I have been very fortunate to have people in my life who are supportive and understanding and to not have to solely support myself financially. I have benefited from learning meditation, relaxation and biofeedback self regulation skills.  I also have built into my schedule a half hour “nap” after lunch that is a lifesaver.

What Causes Chronic Fatigue and Fibromyalgia Syndromes?

Chronic Fatigue and Fibromyalgia Syndromes are complex overlapping health conditions for which there is currently no medical consensus on their causes or treatment. Each person with these syndromes presents a unique set of symptoms and complications that include but are not limited to severe fatigue, headaches, disordered sleep, chronic flu-like symptoms, muscle aches, gastrointestinal problems, cognitive issues also known as brain fog, night sweats, dry mouth and eyes, visual disturbances, allergies and hypersensitivities.  These symptoms present clues to what is contributing to the poor health of individual sufferers but to understand the entire puzzle one must view the syndromes as a whole. 

When I think about the majority of health professionals who study and treat chronic fatigue and fibromyalgia I am reminded of the story of the blind men and an elephant. In this tale, which originated in India, a group of blind men touch an elephant to learn what it is like. Each one touches a different part. When they compare notes on what they felt they are in complete disagreement. The man who feels a leg says the elephant is like a pillar; the one who feels the tail says the elephant is like a rope; the one who feels the trunk says the elephant is like a tree branch; the one who feels the tusk says the elephant is like a solid pipe; the one who feels the ear says the elephant is like a hand fan; and the one who feels the belly says the elephant is like a wall. A wise man explains to them that they are all right and that the reason every one is arriving at a different conclusion is because each one has touched a different part of the elephant.

Likewise in chronic fatigue and fibromyalgia syndromes, there are many theories about these conditions based on the particularly symptoms that one is focused on. Some of the possible causes that are attributed to these syndromes are: damage to the mitochondria, gastrointestinal issues including leaky gut syndrome, upper spinal cervical stenosis, glutathione deficiency, physical trauma and injury, impaired detoxification and liver function, traumatic injury to the hypothalamus-pituitary-adrenal axis, heart dysfunction or low cardiac output, conditioned trauma in the amygdala part of the brain, chronic infections including Lyme disease, intestinal parasites, mycoplasma and the XMRV retro virus, low levels of serotonin, hyper elastic connective tissue, vagus nerve dysfunction, low levels of acetylcholine, heavy metal and other chemical toxicities, chronic mast cell activation (MCAS), small intestinal bacterial overgrowth (SIBO), magnetic or electron deficiency, lymphatic dysfunction, problems with methylation, protein or amino acid deficiencies, adrenal exhaustion, and thyroid dysfunction. It is true that all these things are part of the “elephant”, just like the blind men correctly described the part of the elephant that they felt, but to really understand what is going on one must look at the syndrome as a whole.

It is my opinion that there is no single cause of chronic fatigue and fibromyalgia syndromes. These disorders are manifestations of a body that has been stressed by a number of causes and reaches a point at which it can no longer accommodate for them. The body responds to this crisis by downgrading functions to conserve energy, which can affect nearly every organ and system of the body and results in profound fatigue that is not relieved by rest. Typically persons with CFS have low blood pressure, low blood volume, a low body temperature and a slow pulse.  In his book The Tipping Point  Malcolm Gladwell describes how contrary to what most people think, change in health, nature, technology and society often happens not gradually but quickly at one dramatic moment and that little causes can have big effects. The “Tipping Point” is the moment of critical mass, the threshold or boiling point when sudden change occurs or the straw that breaks the camels back. When a person becomes ill with CFS or FMS the individual causes may have been present or accumulating for some time, but the onset of the condition is usually sudden. It is important to note that this particular response of down regulating physical functions is unique to persons with CFS and FMS and may be genetic in origin.

Dr. Jacob Teitelbaum, a specialist in Chronic Fatigue and Fibromyalgia, uses an analogy of a blown fuse to describe the tipping point in these conditions. He states: “If the demands on your body are more than it can meet your body ‘blows a fuse’. The ensuing fatigue forces you to use less energy, protecting you from harm. On the other hand, although a circuit breaker may protect the circuitry in the home, it does little good if you do not know how to turn it back on or that it even exists.”

Some of the stressors that can potentially combine to cause a person to develop CFS and FMS are viral infections, accidents and physical injuries, nutritional deficiencies, impaired breathing, toxic exposure, physical abuse and injury, acute psychological stress and alcohol. In order to recover one needs to identify the particular stressors that lead to the crisis and find effective strategies to treat them. However recovery is much more complex than addressing the individual causes because the syndromes set into play a vicious cycle of exhaustion and sympathetic nervous system stimulation that is difficult to reverse. Some researchers describe CFS as a post-viral infectious disorder.

The Tipping Point for me happened in the fall of 1973 when I was a sophomore at Carleton College and had one alcoholic beverage at a dorm room party. The next day I woke up with a hangover and flu like symptoms that persisted for months. This was not a particularly stressful time of my life. I was taking a moderate course load of subjects I enjoyed, played music and exercised everyday, got plenty of sleep and ate healthy foods. I was never one who could “burn the candle at both ends”, stay up late at night, avoid meals or misuse my body. I had adopted healthy habits and routines that had thus far worked quite well for me. It came as a complete surprise when I became chronically ill and even more shocking that the medical profession had absolutely no idea what was wrong with me. 

My personal experience of living with Chronic Fatigue Syndrome was one of being besieged by one challenging set of symptoms that due to my persistence would eventually resolve only to have another set become problematic. At the beginning of my illness I suffered from severe tension headaches, which eventually resolved doing EMG biofeedback, Feldenkrais training and strict avoidance of all stimulants; and blurred vision, which improved with vision training. The next thing that dominated my condition was chronic viral infections, which I resolved through a detoxification regime that included fasting with colonics. Then I was overwhelmed for ten years with horrific night sweats, which I learned to control using a biofeedback skill called Hand Warming. In 2001 I developed fibromyalgia muscle pain which is helped with EMG biofeedback training. Thyroid issues and symptoms related to a low body temperature became a significant problem resulting in another huge search for solutions that resolved through taking compounded T3 according to the Wilson's Syndrome protocol. Throughout all of this fatigue persisted and was the common denominator. I always had an intuition that these diverse symptoms were part of the same disorder. It was as if I was struggling to hold back a dam of water. Sometimes water would escape through one hole and I would plug it up and then it would come through another hole. 

Finally in 2007 an underlying source of stress on my body was diagnosed as restricted breathing due to the fact that I have a large tongue for the size of my mouth. Once I resolved this problem with Oral Systemic Balance, the wall of water that I had been struggling to hold back finally went away and I stopped acquiring new symptoms. (To read more about this go to my post on Oral Systemic Balance at fibrofriends.typepad.com/fibro_friends/2010/02/oral-systemic-b.html.) In retrospect I realize that I was born with compromised breathing due to the anatomy of my tongue and mouth. I was able to accommodate for that with thumb sucking as a child and as an adolescent by my healthy lifestyle and management of stress. It was only at the age of 19 when certain other stressors – a flu virus and alcohol came together and tipped me over the edge to a crisis that manifested itself as Chronic Fatigue Syndrome. 

Not all of my symptoms went away with Oral Systemic Balance. I still had very disturbed sleep, hyper-reactions to foods and drugs and my muscles are slow to hell from exertion which has prevented me from returning to an active lifestyle even though I no longer had fatigue. My intuition was that although I had resolved the key stressor that lead me to develop CFS and FMS I had a lot of collateral damage to my nervous system after 35 years of living in an exhaustive, survival state. After another period of search, I found a modality of healing called Low Energy Neurofeedback System or LENS that is particularly effective in treating trauma both physical and emotional. LENS took another layer of stress off of my body evening out my energy and emotional responses. EMG biofeedback training, Low Intensity Laser Therapy, and Whole Body Cryotherapy have helped my muscle condition but only paliatively. (For more information on LENS and EMG biofeedback go to my post on "Biofeedback Therapies for Chronic Fatigue and Fibromyalgia Syndromes" at fibrofriends.typepad.com/fibro_friends/2010/05/biofeedback-therapies-for-cfs-fms.html.) 

Some prominent physicians in the holistic and environmental medicine describe persons with chronic fatigue and fibromyalgia as “canaries”.  This expression originates from the practice in early coalmines that did not have ventilation systems of bringing canaries into new coal seams. Canaries are especially sensitive to methane and carbon monoxide, which make them ideal for detecting any dangerous gas build-ups. As long as the canary kept singing, the miners knew their air supply was safe. A dead canary signaled an immediate evacuation of the coalmine. People with CFS and FMS are particularly sensitive to toxins so they serve as a warning to the effects of living in our increasingly toxic environment. Dr. Majid Ali attributes the symptoms of fibromyalgia and chronic fatigue syndromes to cellular oxygen deprivation and Dr. Dietrich Klinghardt believes that persons with these syndromes have poor detox genes. But could it be that the persons susceptible to these health problems simply do not breath as well as healthy individuals due to the structural anatomy of their mouth, tongue and throat? I personally think that improving oral function through the use of oral appliances is one of the biggest developing health sciences of our time and that in the future it will prevent and reverse many chronic illnesses; and in conjunction with other therapies particularly whole body cryotherapy and LENS neurofeedback can provide recovery for many individuals.    

At the risk of being another blind man observing the elephant from my own experience I need to state that the treatments that helped me get better may not be applicable to everyone with CFS and FMS. Each person with these conditions had a unique set of stressors that caused their illness and has a unique set of circumstances that perpetuate it. Dr. Joseph Teitelbaum, the medical director of the Fibromyalgia and Fatigue Centers (www.fibroandfatigue.com) overcame Chronic Fatigue Syndrome himself doing a variety of treatments that generally fall into the category of naturopathic medicine. He got CFS after a period of significant stress when he was taking a double load of courses in medical school, not sleeping much and eating very poorly. I am sure that the protocols that helped him get better and that he continues to research and develop work for some people, especially those whose illnesses were precipitated by a period of physical abuse.  To read more about Teitelbaum's protocols go to my post “Treating CFS & FMS with Naturopathic Medicine" at: fibrofriends.typepad.com/fibro_friends/2010/05/treating-cfs-fms-with-naturopathic-medicine.html. 

Ashok Gupta recovered from CFS using a combination of techniques that derive from mind/body therapies including Neuro-Linguistic Programming and meditation, which he refined and developed into a program called “Gupta Amygdala Retraining” (www.cfsrecovery.com). Gupta attributes the major symptoms of CFS to a vicious cycle of overactive sympathetic stimulation triggered initially by a period of acute psychological and physical stress often accompanied by a virus or toxic exposure. The amygdala is the subconscious part of the brain that responds to danger and produces a fear response also known as the “fight or flight” response. According to Gupta’s hypothesis of CFS the symptoms are perpetuated by the amygdala’s response to those symptoms. His program aims at breaking this cycle with specific conscious techniques. Gupta’s research on CFS is thorough and his hypothesis is compelling. I am sure that his program is helpful for many people however I think do not think it adequately explains everything that is going on with all persons with CFS and FMS. Unlike Gupta my illness was not precipitated by a period of psychological or physical stress. Yes there were periods of my life when I was really scared about what was happening to me physically and I worried if I was ever going to get well but I faced those fears, calmed the anxieties through counseling and soul searching and practiced meditation and biofeedback self-regulation skills. The stress of my condition continued because it was perpetuated not by my unconscious thoughts but by a very real physical stressor - an inadequate air supply.

There are many people with CFS and FMS who suffer from chronic infections that are contributing to their illnesses. Treating these infections which include chronic Lyme disease, viruses, mycoplasma fermentans, Candida, intestinal parasites, etc. can be an important part of a recovery program but the cause of CFS and FMS cannot be attributed to them solely. To read about Chronic Lyme disease and the XMRV retro-virus and my personal opinion on the significance of these infections go to: fibrofriends.typepad.com/fibro_friends/2010/03/chronic-lyme-disease-an-overlapping-condition.html and fibrofriends.typepad.com/fibro_friends/2009/11/retrovirus-linked-to-chronic-fatigue-syndrome.html.

In conclusion there is no single cause of chronic fatigue and fibromyalgia or single treatment that is helpful for everyone. These syndromes occur when a body reaches a tipping point caused by a unique set of stressors for which it can no longer accommodate. In response to this crisis the brain downgrades functions to many systems and organs of the body to conserve energy. The resulting exhaustive state triggers the sympathetic nervous system to become chronically agitated. Recovery requires treating the underlying stressors that precipitated the illness and healing the trauma to the brain that ensues from living with these conditions. Unfortunately there is no one place or medical profession that understands or can treat the entire “elephant”. This leaves the exhaustive task of pursuing effective treatments and coordinating one’s care to the individual. I believe that both chronic fatigue and fibromyalgia are reversible syndromes and that the treatments to facilitate recovery have already been discovered. It is my goal in this blog to share information about these treatments and to shed light on the whole elephant that each of us with these conditions lives with.

Treating CFS & FMS with Naturopathic Medicine

People suffering from chronic fatigue and fibromyalgia syndromes discover the limitations of mainstream medicine in diagnosing and treating their conditions and often turn to alternative or naturopathic medicine for help. In general holistic medical physicians and naturopathic physicians are much better educated about CFS and FMS than mainstream physicians and they treat these conditions seriously rather than dismissing them as psychosomatic. They are generally good listeners and more empathetic than their counterparts. 

I remember the first time I saw a naturopathic physician. I had been sick with chronic fatigue for fifteen years but had not talked to a physician about my condition in ten years. It was my first experience talking to a doctor about my health and not feeling judged or invalidated. This was in 1986 and my naturopath diagnosed me with Chronic Epstien Barr Virus - one of the early names for CFS. Up until that point I did not know of the existence of others who suffered from my particular condition and this knowledge in itself coupled by the caring nature of my naturopath was a positive development. But the naturopathic treatments prescribed to me which included immune enhancing herbs such as echinacea and nutritional support in the form of vitamin and mineral supplements made absolutely no impact on my health.

Since that time I have spent most of my health search in the alternative medical camp, trying one treatment after another many of which I have summarized in my post "What Didn't Work" fibrofriends.typepad.com/fibro_friends/2009/07/what-didnt-work.html. If nothing else pursuing these therapies gave me hope. Not trying something was for me equivalent to giving up. Every so often I checked in with the mainstream medical folks to see if they had anything to offer but they remained clueless as ever. The naturopathic folks and the mavericks on the the edge of medicine had the most chance of helping because they paid attention to the clues. I live in the Seattle area which is a hot spot for natural medicine and consulted some of the most well known practitioners in the field including Jonathan Wright MD, Dietrich Klinghardt MD, Ralph Golan MD, many graduates of Bastyr University and practitioners of Chinese medicine and acupuncture. In the end the things that made an impact on my health were not those prescribed by these practitioners but things I discovered on my own. 

Naturopathic medicine in general treats the symptoms and secondary causes of CFS and FMS with natural remedies like nutritional supplements and herbs as opposed to pharmaceutical drugs. In the absence of understanding the systemic or primary causes of these conditions this may be the best approach and can result in an improved quality of life for patients or may be all that is required for a full recovery. Since CFS and FMS present multiple symptoms and dysfunctions, alternative practitioners focus on one or two areas which they have experience treating or they believe to be a main culprit of the disorder. Examples of these are adrenal fatigue, candida overgrowth, heavy metal toxicity, intestinal parasites, food allergies, nutritional deficiencies etc. I was treated for all these conditions and spent thousands of dollars in the process with very little improvement in my health to show for it. However my understanding of my condition increased with each of these "adventures" and in the long run helped me sleuth my way to the treatments that provided real recovery.

A good summary of alternative therapies for CFS is summarized by Rich van Konynenburg at http://www.cfs-healing.info/treatment-protocols.htm.  Among the prominent doctors who developed these protocol are Dr. Majid Ali, Dr. Sarah Myhill and Dr. Joseph Teitelbaum, MD, author of the book "From Fatigued to Fantastic" and medical director of the Fibromyaliga and Fatigue Centers (www.fibroandfatigue.com). Dr. Teitelbaum's approach and that of the Fibro and Fatigue Centers is basically a combined one that addresses the individual symptoms or dysfunctions of the disorder with various therapies that originated in holistic or naturopathic medicine. He calls his approach the SHINE protocol, SHINE being the acronym for Sleep, Hormonal Dysfunction, Immune Dysfunction and Infections, Nutritional Deficiencies and Exercise. I think that Dr. Teitelbaum is a true champion for the cause of CFS and FMS and is passionate about helping those with the condition. I am sure that this approach has been helpful for many patients however in my experience and in that of many others I know, this protocol was not adequate in facilitating significant improvement in our conditions. 

Dr. Teitelbaum and other researchers think that restoring disordered sleep (the "S" in SHINE) is paramount in the treatment of CFS and FMS. They prescribe sleep aids starting with natural remedies (sedative herbs, melatonin, 5-HTP) and if these do not work prescribe pharmaceuticals (Ambien, Neurontin, Klonopin, Trazodone). Here's the problem. Many people with CFS and FMS do not get results with natural sleep remedies and build a tolerance to or cannot tolerate the side effects of pharmaceutical sleep aids. In addition many people experience a rebound in insomnia when they go off sleep aids. To learn about my personal journey down this slippery slope read my post "Waiting For Sleep" fibrofriends.typepad.com/fibro_friends/2009/10/waitin.html.

Recently I discovered a treatment for insomnia using nanotechnology homeopathic patches placed on acupressure points at night that stimulate the production of melatonin and serotonin. The patches are non-transdermal, are non-addictive and have no side effects even for highly sensitive individuals. Some individuals with CFS and FMS have reported good results although they were not helpful for me. They are produced by a company called Lifewave www.lifewave.com.

Naturopathic and holistic physicians are aware of the hormonal dysfunctions in CFS and FMS resulting from the enormous stress these conditions place on the endocrine system and what is referred to as the hypothalamus-adrenal-pituitary axis. I was diagnosed with adrenal exhaustion and low cortisol levels in 1991 by Dr. Jonathan Wright and started taking hydrocortisol and DHEA at that time. Basically I felt a little better on these hormones but eventually they became less effective. I was subsequently diagnosed with adrenal fatigue by nearly every alternative health practitioner I saw after that and tried numerous other protocols including herbs and acupuncture with limited success. I think CFS and FMS patients can get some relief from taking hydrocortisol for short periods of time (6 months) and I have definitely benefited from this (To learn about my experience read my post "Adrenal Exhaustion" fibrofriends.typepad.com/fibro_friends/2008/10/adrenal-fatigue.html) however in treating adrenal exhaustion, one is only treating a symptom. The question remains what is causing the fatigue?

I experienced a more dramatic improvement in my fatigue by addressing thyroid function with the Wilson's Syndrome protocol. This came after an exhaustive three year search into thyroid issues which you can read about in my post "Thyroid Function" fibrofriends.typepad.com/fibro_friends/2009/03/thyroid-function.html. Dr. Denis Wilson developed a breakthrough treatment for reversing the effects of a condition which was first named "Wilson's Thyroid Syndrome" and is now called "Wilson's Low Body Temperature Syndrome". Wilson observed that after periods of stress and trauma many individuals developed symptoms of hypothyroidism - fatigue, low body temperature (below 98 degrees) and constipation even though their thyroid blood tests were within the normal ranges. The symptoms of this syndrome do not improve or get worse from taking T4, the storage form of thyroid replacement, however they improve by taking T3, the active form of thyroid replacement. Wilson developed a protocol of taking T3 compounded by a pharmacy with a slow release agent in increasingly larger doses until one's body temperature rises above 98 degrees and then slowly cycling off the hormone until the body is able to maintain a normal temperature. In this way a slow metabolism that results from a stress mechanism designed by the body to conserve energy is permanently reversed. I think that many people with CFS and FMS have Wilson's Low Body Temperature Syndrome and can benefit from this therapy. Fortunately many naturopathic physicians and holistic medical doctors are trained in this protocol however others including doctors at the Fibro and Fatigue Centers continue to treat their patients condition with a combination of T4 and T3 or Amour. To learn more about Wilson's Syndrome and to find a physician trained to treat this disorder go to: www.wilsonssyndrome.com.

 In addition to adrenal and thyroid hormones naturopathic medicine also treats deficiencies in the sex hormones - estrogens, progesterone and testosterone as well as human growth hormone which is often low in CFS and FMS patients. In general these hormones decrease with age and in the case of those with CFS and FMS this loss may be accelerated due to physiological stress of the conditions. Naturopathic physicians often rely on saliva testing to assess hormone levels and obtain hormones from compounding pharmacies.

Immune Dysfunction and Infections are another area of focus in the SHINE protocol and the naturopathic treatment of CFS and FMS. Patients with CFS and FMS are prone to opportunistic infections such as intestinal parasites, candida overgrowth, chronic Lyme disease, mycoplasm, viral and retroviral infections. In general these infections are symptomatic of a person whose immune system is compromised. People with AIDS and autism for example also are susceptible to these infections. Treatment can be an important part of the recovery for many individuals and naturopathic and holistic physicians are well equipped to do this. But for some patients like myself continually chasing after infections did not provide significant improvements. As important to treating opportunistic infections is figuring out how to improve the strength of a person's immune system. Before I did Oral Systemic Balance I was prone to having intestinal parasites. My naturopath would treat one parasite successfully only to find I acquired another parasite the next time I did a stool analysis. Since I improved my breathing with Oral Systemic Balance I have not had any parasites. This I think is a result of getting a more adequate supply of oxygen and thus addressing the underlying source of stress that was compromising my immune system.

Ah Nutrition! One of the mainstays of naturopathic medicine is treating health conditions and nutritional deficiencies with nutritional supplements. Since CFS and FMS affect so many functions of health there are many symptoms one could try treating with nutritional supplements. ProHealth (www.prohealth.com) is a company that sells nutritional supplements for people with CFS and FMS. The company donates a portion of its sales to organizations focused on finding effective treatments and its website contains a lot of valuable information. Their catalog of supplements is huge and demonstrates just how vast the inventory is of things that might be beneficial. Taking nutritional supplements may initially produce some positive results and can serve to "jump start" the system but the effects are often not lasting. Here's why I think this may occur. In CFS and FMS the brain down regulates bodily functions to conserve energy in response to overwhelming physical stress and trauma for which it can no longer accommodate. (For more on this read my post "What Causes CFS & FMS" fibrofriends.typepad.com/fibro_friends/2010/06/what-causes-chronic-fatigue-and-fibromyalgia-syndromes.html). One may feel better initially from taking supplements that address some of the resulting deficiencies but then the body compensates for the supplements returning the levels to what they were previously because it is still functioning at a low level and needs to conserve energy.

Some alternative health practitioners including naturopathic and holistic physicians as well as chiropractors employ muscle testing or kinesiology to evaluate which supplements are beneficial for a patient. Originally developed in 1964 by a chiropractor named George Goodheart and called Applied Kinesiology, there are now many variations of this method of testing. Basically the practitioner accesses the patient's response to a nutrient  with a manual muscle test. Muscles become stronger in the presence of a beneficial nutritional supplement or combination of supplements, stay the same with supplements that are safe but provide no significant benefit and become weak in the presence of supplements that are harmful. I think that there is some validity to this method of evaluation but that the results can be skewed by the influence of the practitioner and other factors. I have personally never encountered a kind of muscle testing that was able to predict whether I would have a hyper-reaction to a supplement or not. The best policy is to add one new supplement at a time and assess if there is any change or improvement in one's health.

I personally have spent a small fortune on supplements of all kinds including vitamins, minerals, herbs, amino acids, etc. to virtually no avail and ditto to that for many others I know with CFS and FMS. Every few years there is some new natural substance on the market that promises to be the key to health and those of us with chronic health problems are especially susceptible to trying them. From blue green algae, to mangosteen, Siberian gingseng, mushrooms, beta carotene, colloidal silver, Sam-e, CoQ10, vitamin D, antioxidants, liquid minerals, ... the lists goes on and on. I have tried all these things as well as numerous combinations of supplements prescribed by health professionals with absolutely no benefits. A couple of exceptions are MAX GXL and Super Nutrient Amino Acids, two patented formulas of nutritional supplements which were beneficial for me short term and I discuss in other posts.  I remain open minded about the benefits of nutritional medicine but at present I am not taking any supplements. I have come to the conclusion that the best way for me to get my nutrition is through whole foods. I maintain a diet which I arrived at over the years as being the most beneficial for me. It consists primarily of whole grains, green vegetables and organic meat, fish and dairy products. I strictly avoid all forms of sugar, alcohol, caffeine and processed foods.  

The last area in the SHINE protocol is "E" for exercise. For those that are able exercise is a valuable adjunct to healing and coping with a compromised health condition. I was fortunate to be able to tolerate mild exercise for the first 28 years of my health condition when I suffered from chronic fatigue. I did a lot of walking, swimming and I had a serious yoga practice. I feel that these activities really saved my life in many ways and kept me in the best possible shape despite the challenges I lived with and the fact that my condition was generally getting worse. Then in 2001 I crossed some kind of threshold and developed fibromyalgia. I was devastated because once this happened physical exertion worsened my condition, my insomnia and my pain. I had to give up the very things that had sustained me through my illness - exercise and playing music. It was a devastating blow. Some health professionals including Teitelbaum state that fibromyalgia is the same condition as chronic fatigue syndrome except it is accompanied with widespread muscle aches and pain. This in not entirely accurate because many people with chronic fatigue syndrome have aching muscles but do not have the muscle dysfunction typical of fibromyalgia. In fibromyalgia the muscles are deficient in necessary nutrients to recover from exertion which results in pain and adhesion in the muscle tissue with use. When a person with fibromyalgia forces their muscle to work they develop sore points or trigger points. To learn more about this read my post "Fibromyalgia Muscle Dysfunction" fibrofriends.typepad.com/fibro_friends/2009/12/f.html. So despite advice by many health professionals to the contrary, exercise in general agitates the sympathetic nervous system in people with fibromyalgia and is not a good modality for healing. 

A final area in the treatment of CFS and FMS by many naturopathic health professionals, although not specifically covered in the SHINE protocol, is Detoxification. There is compelling research that shows that persons with CFS and FMS have impaired detoxification which is referred to by some as a "Methylation Cycle Block". I personally spent years pursuing various detoxification protocols with very modest improvements. After undergoing an extensive heavy metals detoxification program consulting with some of the most reputable doctors in the field my levels of mercury remained extremely high as measured by a hair analysis test three years later. Obviously the protocols did not work. To learn about my exhaustive search in this area read my post "Detoxification" fibrofriends.typepad.com/fibro_friends/2009/05/detoxification.html. I think that the detoxification problem in persons with chronic fatigue and fibromyalgia syndromes is the result of a lack of oxygen due to impaired breathing and dysfunctions of the Central Nervous System or the brain in response to overwhelming physical stress, and that no amount of nutritionally based detoxification programs can reverse this problem.  My personal recovery from chronic fatigue resulted from improving my breathing with Oral Systemic Balance, addressing the post traumatic brain injury with LENS neurofeedback, and resetting the physiology with whole body cryotherapy. At present these modalities are not yet fully understood or prescribed by naturopathic and holistic physicians. 

I am sure that there are many individuals with CFS and FMS whose conditions respond well to naturopathic medicine. Every person is unique and it is only through trial and error that one can discover what is helpful. For myself healing required me to dig deeper and find more effective, cutting edge modalities. I know that these therapies will be embraced first by the alternative medical community because its practitioners are open-minded and eventually by the mainstream medical community as well. I keep in touch with a number of my naturopathic and holistic doctors who have followed my case over the years. I continue to seek their advice and to keep them abreast of my situation. I appreciate their support and feel that they are true allies in my quest for better health. 

Here is a small sample of nutritional supplements that I tried. None produced significant improvements in the long term.