Treatment of Fibromyalgia

Studies have shown that conventional treatment of fibromyalgia using the multidisciplinary treatment protocol had only a success rate of 40 to 50%.  In contrast, alternative medicine methods (from the anti-aging medicine branch) allow the treatment success rate now to be 85 to 90%. In order to achieve this a thorough assessment of the hormone status is done and missing hormones are replaced with bioidentical hormones, as described below. It certainly is important to be aware that there are various degrees of severity of fibromyalgia, which correlate with various degrees of hormone and nutritional deficiencies. It is important to realize that this affects brain hormones and the hormones of the body. Whatever is missing has to be supplemented in natural form (bioidentical hormones). I will deal with both treatment approaches under separate headings, but point out that for best results they should be combined.

Multidisciplinary approach treating fibromyalgia

Treatment of fibromyalgia consists of a multidisciplinary approach, where the various factors that are observed in the patient are addressed. For example, the sleeping disturbance, if present, is treated with cyclobenzaprine (brand name: Flexeril, Flexitec) at bedtime. As an illustration, this medication, which is an tricyclic antidepressant, is used mainly as a muscle relaxant, but has been found to restore abnormal sleep patterns in fibromyalgia patients.

Another medication that can be used for this is the antidepressant trazodone ( brand name: Desyrel, Trazorel), which when taken at bedtime seems to help not only to normalize the sleeping pattern, but also lift the mood (antidepressant effect) and in addition helps with some of the myalgias (painful muscles).

Multidisciplinary treatment approach for fibromyalgia

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–muscle deconditioning : swimming, aquatherapy, walking, and mild stretching exercises

–muscle spasm and tender spots : 1) Local heat treatments, massage treatment, chiropractic adjustment, physiotherapy, aquatherapy 2) trigger point injections by the physician

–sleep disorder : cyclobenzaprine (brand name: Flexeril, Flexitec) or trazodone (brand name: Desyrel, Trazorel), however see remarks on the use of conventional drugs under “Alternative Medicine Treatment” below

–moderate depression : SSRI antidepressant medication (but see remarks on the use of conventional drugs under “Alternative Medicine Treatment” below). Psychological counseling, cognitive therapy

–anxiety : yoga, meditation, self-hypnosis, prayer, cognitive and behavior therapy, psychological counseling; bioidentical hormone replacement will often also treat anxiety naturally (see Ref.8)

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Treatment Of Fibromyalgia

By the same token, many of the SSRI antidepressants have a similar effect as trazodone. They also help to lift depression, which is another symptom complex that the physician will treat. In like manner physical activities in the form of swimming, aqua-therapy, walking, and mild stretching exercises are instituted. Often it might be best to do this as part of a local fibromyalgia support group, as motivation could otherwise be a problem. Local heat treatments, massage therapy, minor chiropractic adjustments for spinal malalignments are all useful modalities as is physiotherapy for flare-ups of the muscle aches and pains. Trigger point injections by the physician with 1% Xylocaine (occasionally with a small amount of cortisone mixed in) may be very useful for more painful muscles.

Relaxation exercises

Equally important, meditation, self-hypnosis, yoga, cognitive and behavior modification therapy are all useful adjunctive methods to help with the associated anxiety and depression along the medications mentioned above. Generally speaking, these latter methods help with coping strategies in the treatment of fibromyalgia (Ref. 4).

Alternative Medicine Treatment of Fibromyalgia

It is important to realize according to the interviews with a number of anti-aging doctors contained in Suzanne Somers’ book “Breakthrough” (Ref.8) fibromyalgia is often associated with hypothyroidism and may include other hormone weaknesses (weak adrenal glands, low human growth hormone levels) and also often low steroid hormones (testosterone, estradiol, progesterone). This can be determined with appropriate blood tests (T3, T4, 24 hour urine for cortisol, DHEA, IGF-1), which your regular physician may not be comfortable ordering. However, any of the anti-aging physicians listed in the back of Ref.8 would have no problems ordering and treating this.
Here are the major treatment steps using an anti-aging type approach for the treatment of fibromyalgia:

Healthy diet, regular exercise

First, this new approach to treat fibromyalgia puts emphasis on detoxifying the body, starting a low carbohydrate diet, exercising regularly and keeping you away from as many conventional drugs as possible including antidepressants (including trazodone mentioned above). The reason for this is that all of the hormones including the brain hormone serotonin need to be balanced to treat fibromyalgia successfully.

Natural treatment of insomnia

Second, insomnia is treated with a combination of melatonin capsules in the dosage range of 3 mg to 15 mg at bedtime. Dr. Lichten (Ref. 9) treats insomnia with a combination of L-Tryptophan 500 mg to 1000 mg combined with 125-250 mg of sublingual GABA at bedtime. The physician may want to combine these supplements with melatonin. Dr. Lichten treats with GABA only for 5 to 6 nights per week as tolerance can quickly develop through saturation of GABA receptors in the brain. But by taking a GABA rest for 1 to 2 days in a week the receptors reset themselves. Treating insomnia is an important step in treatment of fibromyalgia.

Magnesium supplementation

Third, another important point to note is that magnesium deficiency leads to increased anxiety and restless leg syndrome. In addition, chronic insomnia also depletes the cells’ magnesium content (Ref.9). Dr. Lichten recommends taking 1000 mg of magnesium supplements daily. Alternatively a couple of teaspoons of milk of magnesia will also provide the body with the equivalent of magnesium and keep the bowels regulated at the same time. In summary, taking care of supplying the body with magnesium is important for the treatment of fibromyalgia.

Vitamin D3 supplementation

Also, vitamin D3 sublingual drops at a dose of 1000 mg to 5000 mg have a very beneficial effect on getting a good night’s sleep. However, we do know from the more recent literature that higher doses of vitamin D3 help prevent diabetes, cancer, and treat chronic muscle aches and pains, particularly of the fibromyalgia type (Ref. 9). Dr. Lichten recommends that your doctor should order a 25-hydroxyvitamin D level initially and bring this up to and above 50-60 ng/mL with vitamin D3 drop supplementation. In short, taking mega doses of vitamin D3 is important for the successful treatment of fibromyalgia.

Hormone deficiencies

Furthermore, fibromyalgia patients often have abnormal saliva hormone tests. Above all, the physician will find that there are deficiencies in some of the anabolic type hormones (thyroid hormones, testosterone, human growth hormone and DHEA). Of course, whatever hormone is weak needs to be replaced by bio-identical hormones (Ref. 10 and 11). Postmenopausal women need estradiol and progesterone (menopause), males need testosterone replacement (see here: male menopause). If IGF-1 tests are below 80 ng/mL, this indicates a growth hormone deficiency. In such cases the treating physician starts somatotropin (brand name: Saizen) with a low dose of 1 international unit per day subcutaneously for 5 to 7 days per week (Ref. 9). As a matter of fact, Dr. Lichten describes several cases of astounding recoveries from fibromyalgia using low dose human growth hormone injections. Treating hormone deficiencies with bioidentical hormones is an important step with the treatment of fibromyalgia.

Supplements for treatment of fibromyalgia

Finally, nutraceuticals (high dose vitamins and minerals as described under vitamins, minerals and supplements) are also required to stimulate the mitochondria to supply the body’s cells with adequate energy. Inasmuch as the digestive tract is slow pancreatic enzymes as supplements can improve the absorption of food, vitamins and supplements (Ref. 9).
3 supplements in particular warrant attention: First, Co-Q10 (400mg per day) will supply the body with more energy. Ref. 12 has shown that patients with fibromyalgia have a deficiency in the Co-Q10 metabolism and would therefore benefit from supplementation. Second, D-Ribose is the agent that warrants supplementation as Ref. 13. shows. The dosage is 5 Grams three times daily with meals. Third, the supplement Pyrroloquinoline-quinone (PQQ) has multiple stabilizing effects (Ref. 14). In essence, studies have shown that PQQ stimulates growth of new mitochondria (Ref. 15) and therefore would be useful to help aching muscles in fibromyalgia.

Regular exercises

After all, exercise should now be possible as the muscle aches are under control and this should consist of a regular walking program, swimming, ballroom dancing etc. This is important as exercise releases endorphins from the brain. Given these points the endorphin release helps to control the muscle aches and pains of fibromyalgia. Yoga exercises, meditation, prayer and self-hypnosis treatments will help to overcome anger and resentments that would otherwise feed into the adrenalin release/muscle tension cycle. You need to be patient to benefit from all of these treatment factors. It often takes 6 to 12 months for a good response (Ref. 9, 10, 11). In conclusion, regular exercises are an important ingredient of the treatment of fibromyalgia.

Detoxification

Detoxification of the body from lead, mercury and other heavy metals by intravenous treatments (Glutathione 750 mg to 1250 mg, mixed with 10,000 mg of vitamin C in Ringer’s lactate) and given in intervals twice per week up to 20 to 30 treatments in total will help the patient to regain a lot of the lost energy. This intravenous treatment can also been augmented by adding a number of minerals (called “Myer’s cocktail, thanks to en.wikipedia.org for this link”), which helps to balance the cell metabolism. This latter treatment is particularly important in those cases where fibromyalgia presents with irritable bowel syndrome. In these cases there can be malabsorption of minerals and nutrients and Myer’s cocktail can lead to remarkable improvements.

Fibromyalgia patients should follow all of these points in combination.  They should co-ordinate this with the items under “multidisciplinary treatment of fibromyalgia” to get the best possible treatment success.

References

1. G.Littlejohn  Aust Fam Physician 2001 Apr;30(4):327-333.
2. LS Brecher et al. J Am Osteopath Assoc 2001 Apr;101(4 Suppl Pt 2):S12-17.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 59.
4. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 6. Fibromyalgia Syndrome.
5. B Mukerji et al. Angiology 1995 May;46(5):425-430.
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
8. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
9. Dr. Edward M. Lichten: Textbook of bio-identical hormones. ©2007 Foundation for Anti-Aging Research, Birmingham, Michigan, USA

More references:

10. Dr. Michael E. Platt: The Miracle of Bio-Identical Hormones; 2nd edition, © 2007 Clancy Lane Publishing, Rancho Mirage, Ca/USA
11. Dr. Daniel G. Amen: Magnificent Mind at any Age; © 2008 Three Rivers Press, New York, USA
12. http://www.ncbi.nlm.nih.gov/pubmed/22342824 (April 2012, original from Spain): Fibromyalgia associated with deficiency of Co-Q10.
13. http://www.ncbi.nlm.nih.gov/pubmed/17109576 (Nov. 2006): “The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study”.
14. http://www.ncbi.nlm.nih.gov/pubmed/22581337 : “Pyrroloquinoline-quinone and its versatile roles in biological processes.” (June 2012).
15. http://www.ncbi.nlm.nih.gov/pubmed/19861415 “Pyrroloquinoline quinone stimulates mitochondrial biogenesis through cAMP response element-binding protein phosphorylation and increased PGC-1alpha expression.” (Jan. 2010).