The Mystery of Fibromyalgia


By Dr. Kenneth Orbeck

Fibromyalgia is a chronic condition often diagnosed by exclusion. It is characterized by widespread musculoskeletal pain, hypersensitivity to various stimuli, and often involves sleep disturbances and elements of fatigue. Other common symptoms of fibromyalgia include frequent headaches, difficulty concentrating, memory loss, anxiety, elements of panic disorder, irritable bowel syndrome and menstrual pain or irregularities. Fibromyalgia is all too frequently diagnosed, particularly among women, aged 20 to 50 years. Sadly, conventional therapy has not yielded an optimal response in a high portion of cases. These treatment plans generally involve analgesic therapy, antidepressants, trigger point injections and psychological counseling and stress management.

The primary treatment plan for fibromyalgia, much like the cause of the condition itself, is still in the hypothetical stages, as not all cases present exactly the same.

  • Mitochondrial function is very important in the treatment and assessment of fibromyalgia. Membrane integrity and mitochondrial function allow for adequate energy production when proper nutrients are available. Functional testing and blood work can detect mitochondrial breakdown. Specific areas of breakdown may be secondary, for example, to specific nutritional deficiencies. Identifying these areas will allow the practitioner to replace specific nutritional needs to accommodate energy production within the cell. Since fibromyalgia may involve an energy deficient state, maximizing energy production is critical. Supplements that have been shown to successfully aid mitochondrial function include deoxyribose, L-carnitine, magnesium, and coenzyme Q10.
  •  Hormone and neurotransmitter balance is vitally important in the treatment of chronic inflammatory diseases including fibromyalgia. Neurotransmitters allow the brain to communicate to the body necessary functions within the endocrine system. Hormones act as cell regulators and allow cell to cell communication. Hormones have a direct influence on genetic cellular communication. This mechanism allows the brain to influence the body in repair, regeneration and the maintenance of optimal health. Bioidentical hormone replacement therapy has been utilized in my practice with great success to optimize communication and allow the body’s natural healing process to occur.
  • Dietary factors are important in the management of fibromyalgia. Emphasizing proper nutrition, avoiding refined sugar and processed food is critical. Eliminating caffeine, alcohol and food additives is also necessary. Cooking methods are also important – cooking foods too quickly over intense heat can develop advanced glycation end products (AGEs). These products result from the interaction of reduced sugar and the protein in the food. This modified type of protein has been shown to evoke an inflammatory response. Studies have shown that when cooking at lower temperatures and in the presence of water, AGE formation is significantly reduced. Patients should be made aware of any underlying food allergies and eliminate these foods from their diet. Considering a raw food vegan diet is important as studies have shown that consumption of a raw food vegan diet for three months improves symptoms of fibromyalgia.
  • Nutritional supplementation plays a strong role in the treatment of fibromyalgia and chronic disease in general. Magnesium deficiency is often found in patients with fibromyalgia and magnesium supplementation can be beneficial. Intravenous supplementation of magnesium has been shown to improve symptoms of fibromyalgia within 48 hours. 5-HTP is a precursor to serotonin. There are suggestions that serotonin deficiency is involved in fibromyalgia pathogenesis. Since 5-HTP and antidepressants both affect serotonin, 5-HTP should be avoided or used with caution and in low doses – especially for patients taking antidepressants. Vitamin D has been shown to improve symptoms of fibromyalgia. Musculoskeletal pain is one of the manifestations of vitamin D deficiency. Although the relationship between vitamin D and fibromyalgia is uncertain, vitamin D deficiency should be evaluated and supplemented appropriately. As discussed above, fibromyalgia is often intracellular energy deficient state. Acetyl-L-carnitine is a useful supplement due to its role in mitochondrial energy production. It serves to help transport fatty acids across the mitochondrial membrane.

Fibromyalgia is a complicated disease state, however, through careful assessment and use of functional testing as discussed above and appropriate protocols, treatment programs may be initiated with greater success. This disease is often chronic and becomes very frustrating to affected individuals. Taking measures to supply the body with proper nutrition and enhancing the body’s communication through both hormonal and neurotransmitter balance will result in optimal outcomes in the management of fibromyalgia.


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