Fibromyalgia or FMS (Fibromyalgia Syndrome)
FMS occurs 80 percent of the time in women between the ages of 25-60. It is a common disorder affecting tens of millions of people worldwide, but is very complex and not well understood. The cause of FMS is not known.
All people with fibromyalgia have widespread, significant pain. Other symptoms that may accompany FMS are:
Unrestoring sleep
Body Stiffness
Headache
Dysmenorrhea (Painful menstrual periods)
Irritable bowel, with bouts of diarrhea and/or constipation
Decreased ability to concentrate
Mood disorders
Restless leg syndrome
Bladder and urinary issues
Numbness and/or tingling (parathesias) in different parts of the body
Varying degrees of sexual dysfunction
Some studies have shown that 50% of people suffering with FMS and take no medications will go into full remission within 2 years. Though theories abound as to the cause(s) of FMS none have been proven. While discussion of the theories is interesting, it is not definitive, therefore I would prefer to discuss treatment options that have shown success in some sufferers.
Conventional treatments:
Non-Steroidal anti-inflammatory drugs (NSAIDs) can help with the pain but are not good long-term solutions.
Antidepressants -- Selective serotonin reuptake inhibitor drugs (SSRI's) like Prozac or Paxil as well as tricylic antidepressants like Elavil help some people treat the pain as well as, the low energy and sleeping problems. Many people however experience side-effects such as constipation, dry mouth, low libido, weight gain, etc. and don't like the way they feel when using these drugs.
Sleeping Aides -- Drugs like Ambien can help with the insomnia but patients can feel drowsy in the morning and many develop tolerances to these drugs.
Prescription drugs approved for the treatment of FMS -- Lyrica, Cymbalta, and Savella. Lyrica may improve daily function in some FMS patients.
The most common side-effects of Lyrica are:
· Dizziness -- in up to 45 percent of people
· Drowsiness -- up to 28 percent
· Coordination problems -- up to 20 percent
· Significant weight gain -- up to 16 percent
· Dry mouth -- up to 15 percent
· Infections -- up to 14 percent
· Headaches -- up to 14 percent
· Accidental injury -- up to 11 percent
· Shakiness (tremors) -- up to 11 percent.
Alternative treatment options for Fibromyalgia
It is important to note that the following alternative treatment options for FMS have been studied in only small groups of patients. While some have shown success, it is difficult to know in what percentage of people they will work with out larger studies being done.
1. Oxidative stress is elevated in FMS sufferers. - Taking supplemental antioxidants vitamin C, E and herbal supplements like grape seed extract, curcumin, and resveratrol help to decrease damage done by free radicals. High levels of oxidative stress markers are found in FMS patients.
2. Omega-3 fish oils -- May help to reduce inflammation associated with FMS. 1500-3000 mg/day of combined EPA and DHA found in these oils is a reasonable dose.
3. Magnesium and malic acid -- Found in several, small human studies to reduce the pain and several other symptoms of FMS. 500 mg/day of magnesium and 1500 mg/day of Malic acid (malate) are the recommended doses.
4. D-Ribose -- Some human studies have shown the D-Ribose a 5 carbon-sugar that is structurally related to ATP the energy forming molecule in our cells, helps with re-establishing energy and reducing pain. It can be purchased as a powder and mixed into liquids. It is also very effective for energizing the heart as well. 3 grams per day is the recommended dose.
5. 5-hydroxytrytophan (5-HTP) -- A precursor to serotonin and has been found in human studies to help with the symptoms of FMS at a dose of 100 mg 3X per day. 5-HTP has also been shown to help with sleep, migraine headaches and weight loss. Some people react negatively with headaches to 5-HTP so pay attention to how you feel while taking it. Results could take several weeks. (do not use 5-HTP is you are taking anti-depressants).
6. Melatonin -- Some FMS sufferers have been found to be low in melatonin a brain hormone that helps with sleep. Start with 1 mg per night of melatonin to see if your FMS related insomnia improves as well as other symptoms. If tolerated and more is necessary, increase to 6mg per night.
7. Acetyl-L-carnitine -- 500 mg/day for ten weeks was found to decrease muscle pain and improve over-all health and well being in FMS sufferers.
8. Mild Exercise -- 30-45 minutes of walking everyday has been shown to reduce the symptoms of FMS.
Combining these options? There are pros and cons to combining these options all at one time. The pro would be that you have more mechanisms working for you that might generate results more quickly and powerfully.
The con is that they could interact with one another and cause minor side-effects. Also, if they work, you won't know which one worked or if they were all actually necessary.
Here is what I suggest: Unless there is a specific one that you want to try by itself to see how it works for you, I would combine #1,2,3,4, 7, and 8. Give them 1-2 months to see if they help you to improve.
If they really help, do not change a thing. It you get partial help but sleep continues to be a problem then add 1mg of melatonin at night. If it helps you sleep better then stay with that dose.
If it didn't help you to sleep better but you didn't feel any adverse effects, increase to 2 mg and go up to 6 mg if you need to. Discontinue if you get headaches or dreams that upset you.
Good luck, I hope you found this fibromyalgia review to be helpful.
Curt Hendrix, M.S. C.C.N. C.N.S
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