Tag Archives: fibromyalgia

Did you need that buzz and burn just to feel well… before you got fibromyalgia?

Marcusby Holistic Osteopath, Marcus Webb

Over the years of working with fibromyalgia (FM) sufferers and writing about FM stress always bobs up as a key associated factor closely followed by the inevitable cause and effect argument that tends to ensue with no one really coming out any the wiser! Naturally, suffering from a disabling, medically unexplained and often untreatable condition brings inherent stresses of its own with it, but there is some compelling data suggesting that a pre-FM state of being may exist in many sufferers that is stress sensitive and may possibly form the basis of their system breakdown that ultimately leads on to the clinical picture we know as FM.

It is not uncommon for me to hear how a FM suffer is finding it so hard to get use to a reduced level of activity after being “so busy” or “driven” in work or sports. Many FM sufferers can recall how well they use to multi-task juggling work, family life and the gym without a second thought and how they needed that ‘burn’ at the gym to feel energised and on top of life and if they missed their routine fix of exercise how flat they felt, and this was before they developed FM. The interesting thing with all these stories if just how similar they are; active, driven often very successful individuals now living lives they could never imagine; lives of pain, fatigue, loss of motivation and in many cases social isolation. Naturally, depression and stress are more than likely to develop in such circumstances but what is even more intriguing is the idea that a pre-FM state existed that actually required all the stimuli of multi-tasking, the work-buzz and the physical burn of the gym just to keep that person feeling normal. The key tipping point is when it all stopped… that’s when the system crashed and burned.

Within the FM community, how many times do we hear the story of how well everything was going before that ‘virus’ hit and confined the person to bed for some time or that ‘injury’ took the person out of circulation for a good while as it healed. Alternatively, someone’s entire life and routine could be blown out of the water by a bereavement or redundancy at work. A virus, an injury, loss/bereavement, redundancy… there are all very common triggers for FM but are they actually to blame or were they simply the catalyst that broke the behaviours that simply kept the person going? Data to support this theory does exist and revolves around exercise-based research. We now know that within a group of healthy individuals who are exposed to regular exercise some develop widespread musculoskeletal pain, fatigue and mood disturbances (the same or very similar profile to that of FM) after a brief period of the exercise withdrawal while some don’t. Even more profound was the fact that the symptomatic individuals, who appeared to suffer so badly following the withdrawal of their exercise, also displayed other typical features of FM such as altered autonomic function, reduced immune (especially NK-cell) responsiveness and other bodily reactions typical of hypothalamic-pituitary axis (HPA) dysfunction. In essence, they appeared to develop all or many of the clinical features of FM!

The authors of the study suggested that, in some, there exists a pre-existing hypo-functioning stress system that requires regular stimulus just to remain normally stimulated. This mechanism follows the principles of what is known as ‘allostasis’, in which the body seeks to maintain balance, and may explain why so many FM sufferers report living very active, stimulating and to onlookers stressful lives prior to developing FM. It appears that while they were unknowingly self-medicating with stimulus from all angles they were doing so simply to feel normal; it was the only way they could kick their hypo-functioning stress systems into life. However, with this theory comes further questions such as why do some people have hypo-functioning stress system to start with? The possible answers to this part of the puzzle may lie in the long accepted association between early life stress and a dysfunctional stress regulating systems. It is known that early life stress is strongly linked to the development of FM with the pivotal trigger being an over or under active stress regulating system; it is known that early life stress can trigger one or the other. In the case of an under active stress regulating system, having a life full of stimulus and arousal not only distracts from us from dwelling on negative life events it also stimulates the body and maintains a normal level of being. Anything that interferes with this will tip the body into a negative spiral both emotionally and physically as the full effects of the underactive HPA system kicks in. With prolonged removal from life events and routines that enhance arousal a chronic state of low HPA activity becomes the normal and the clinical picture of chronic fatigue syndrome with FM (CFS/FM) becomes established.

While this will not offer a universal explanation to the development of CFS/FM it does put forward a provocative argument for many cases and should assist in managing stress or a system that needs a bit of stress to feel normal. May be this helps to explain why some CFS/FM sufferers do so well on natural agents such as TriAdren (a special blend of standardised adrenal supporting ingredients; ginseng liquorice root and vitamin C) while others feel such a benefit from agents designed to calm an over active HPA system such as Zen-Time with Lactium. In the case of the low functioning HPA system enhancement with graded exercise and carefully balanced adrenal stimulants such as those in TriAdren help to give the lift this subset of CFS/FM sufferers need while the central nervous system calming effects of the Lactium ingredient contained in the Zen-Time formula eases the agitation and stress related symptoms that typify an over active HPA system. Either way, managing CFS/FM is an ever evolving science and art but the basic science that underpins the simple act of withdrawing exercise and observing the effects on healthy individuals has open many new angles for further study.

Learn more about TriAdren at www.supersupps.com

Learn more about Zen-Time with Lactium (and take the FREE online stress test) at www.zen-time.co.uk

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Gluten sensitivity and fibromyalgia… is there really a link?

Marcusby Holistic Osteopath, Marcus Webb

By the time you read this little article I am sure you will have heard about a study linking gluten sensitivity with fibromyalgia and reporting on how ‘remarkable clinical improvement can be achieved with a gluten-free diet in patients with fibromyalgia (FM) even if coeliac disease has been ruled out’. The conclusion also goes on to say that ‘non-coeliac gluten sensitivity may be an underlying treatable cause in FM syndrome’.

However, the plot thickens; in all 20 of the FM subjects studied biopsies of their intestine revealed a pathological change known as intraepithelial lymphocytosis, a finding the authors use to help support their hypothesis that gluten sensitivity is a causal agent and underlies FM. This cause and effect relationship that this latest study hints at does sound convincing especially when we keep in mind that intraepithelial lymphocytosis has been associated with gluten sensitivity in the past but should we be jumping to such a definitive conclusion; what about those FM patients who don’t have intraepithelial lymphocytosis, were they removed from the study because they did not respond to a gluten-free diet? Don’t get me wrong, I am not trying to discredit or down play the study or the potential benefits of a gluten free diet in cases of FM but I am aware that many FM sufferers may read this and feel that they have to follow a gluten-free diet in order to get better but before going on it may be good to lay out a little additional information about intraepithelial lymphocytosis.

Within the tissue of the gut known as (epithelial tissue) special white blood cells known as lymphocytes reside waiting like guard on duty to be triggered into life by an invading army. In the case of the gut this is would normally be a bacterial infection. In around 3% of routine biopsies increased levels of lymphocytes can be observed (ie. intraepithelial lymphocytosis) and between 9-40% of cases celiac disease has eventually been diagnosed. In some cases intraepithelial lymphocytosis occurs in other multi-system disorders such as Hashimoto’s thyroiditis, Graves’s disease, rheumatoid arthritis, psoriasis, multiple sclerosis, Systemic lupus erythematosus, ankylosing spondylitis and autoimmune enteropathy. The other cases tend to be viewed as a non-specific finding related to other health issues such as bacterial overgrowth (SEBO), inflammatory damage secondary to non-steroidal anti-inflammatory drug use or other chronic inflammatory bowel disease. In other words, the presence of intraepithelial lymphocytosis is not diagnostic of gluten sensitivity but in the absence of other causes gluten sensitivity could be a possibility since it has been reported to account for around 10% of the cases of intraepithelial lymphocytosis but it should be kept in mind that hypersensitivity to other non-gluten components of food may also trigger this tissue change. Interestingly, a good number of the 20 subjects had co-existing health problems that have also been linked with the bowel tissue chances characteristic of intraepithelial lymphocytosis such as psoriasis (in 2 cases), hypothyroidism (in 3 cases), inflammarory/irritable bowel (in 5 cases) and gastric reflux (in 10 cases) which is a problem that commonly receives PPI drug therapy. As a drug class, PPI’s are also known to trigger intraepithelial lymphocytosis. However you critique this study as much as you want but what you can’t ignore is the outcome; for many, great relief of their chronic and disabling symptoms using a drug-free approach.

For many FM sufferers having a condition that is resistant to conventional therapies places them in a real corner when it comes to treatment and management options. From my experiences working with FM/CFS sufferers we tend to do what works or what works for that person! Science tends to take its time in catching up with the clinical observations but while it is catching up in many cases there is no real harm in exploring options that appear to have some evidence to support their use such as a trial of a gluten-free diet. From the results of the current study the gluten-free diet was followed for 16 months on average but in one case (a FM sufferer for 20 years) improvement in pain, fatigue and gut symptoms were felt after just 5 months and in another case (a sufferer for 10 years) complete remission of FM and improvements in gut and migraine was also observed after just 5 months. In some cases significant improvements and a return to normal life activities and work were seen after more prolonged (over 30 months) exposure to the gluten-free diet. However you look at it, cutting the gluten has made a dramatic difference to many sufferers in this small study.

If you feel that a gluten free approach is something you fancy trying its not a diet to be taken on lightly… so many foods contain gluten! Despite this, I would advise that you seriously consider going gluten free if your FM is of long standing and you have exhausted all other approaches. Keep in mind that you may have to stick to it for many months before you feel any tangible benefits but again, for what its worth, I can support the observations that many ill-defined inflammatory and pain related conditions simply improve with the elimination of gluten.

To help get you started you should avoid Barley, bulgar wheat, couscous, durum wheat, rye, semolina, spelt, wheat, all biscuits, breads, cakes, chapattis, crackers, muffins, pastries, pizza bases, muesli, wheat based breakfast cereals and anything made from wheat, rye or barley flour. By no stretch of the imagination is this a complete gluten free diet but it’s a start and something you can instigate today. Sitting down with an experienced nutritionist or naturopath should be your next step so you can get a more complete understanding of the complete gluten free diet and what it involves. In the early days of a gluten free diet I tend to recommend the use of a special dietary enzyme supplement based in a blend of plant derived gluten splitting enzymes. In addition to the cellulose digesting enzyme known as cellulase the key ingredient in Gluten Relief is Dipeptidyl Peptidase IV (or DPP-IV for short). DPP-IV is a type of protein splitting enzyme, known as a protease, and has been shown to break down the wheat protein gluten and milk protein casein. This combines with alpha-galactosidase to aid in the digestion of long chain sugars found in beans, broccoli, cabbage, sprouts etc… Using an enzyme preparation such as Gluten Relief (by the Canadian manufacturer Natural Factors) does not replace in anyway a gluten free diet but when you are unsure or are out and about with limited choices it may help to ‘defuse’ a potential gluten containing meal.

Link to study: Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. 

Link to Gluten Relief product

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Spice up your life to cool down inflammation

There has been quite a lot of press interest in the adverse effects of certain anti-inflammatory drugs and their potential to trigger a host of unwanted side effects including heart attacks. It’s no secret that most anti-inflammatory medications can play havoc with your stomach and gut but the news that taking these drugs could cause heart complications was quite a shock to those who have come to rely on these drugs to get them through the day. Interestingly, research over the years into the spice turmeric has revealed some encouraging results when used to treat pain and inflammation. Turmeric is composed of a complex mixture of organic compounds the principle one being curcumin. Although easily confused with the spice cumin, curcumin is completely unrelated and a unique compound to the spice turmeric. It belongs to a group of compounds called curcuminoids that are responsible for the typical yellow colour of turmeric. Anyone who has seen natural turumic root in the supermarket may notice a similarity to another culinary spice, ginger root. However, this is no coincidence because turmeric and ginger both belong to the same botanical family; Zingiberaceae. Both of these spices accumulate pharmacologically important compounds within the root tissue. In the case of turmeric the compounds are known as curcuminoids where as in ginger the compounds are called gingerols. The key fact that interests us is the ability of these compound to effectively reduce inflammation and pain while sparing other tissues the hazardous side effects commonly associated with anti-inflammatory medications. This may sound a bit to good to be true but to understand how turmeric, or more specifically the curcumoid known as curcumin, achieves this we will have to discuss the inflammatory process and a bit of biochemistry!

Inflammation – the basics.

When ever we injure ourselves the body has to mend the damage. To do this, chemicals need to be released that enhance blood supply, neutralise any invading bad bacteria and stimulate the local immune reaction. Over this early (acute) phase inflammation is accompanied by pain, swelling and some heat. In the majority of cases this process is self-limiting and once the injury has been mended all the levels settle to normal along with all the related symptoms. However, this is not always the case especially if there is an ongoing irritant present such as arthritis, joint damage or autoimmune disease. In these cases the inflammation becomes chronic and the sufferer experiences daily pain and disability. Anti-inflammatory drugs can offer great relief but often at a price and their safe long term use has become questionable.

Inflammation – the chemistry

The cascade of events that eventually causes inflammation kicks off within cell membranes. A specific fatty acid, known as arachidonic acid (AA), is released from it’s bound state within the cell membrane by an enzyme (phospholipase-A2). Two key players in the inflammation story, COX and LOX, then act upon the now freed AA. The COX enzyme comes in two forms, COX1 and COX 2. When AA interacts with COX1 it produces a mixture of compounds (prostaglandins; PG’s) that protect the stomach and maintain the ability of the blood to clot. When AA interacts with COX2 in produces PG’s that signal pain and enhance inflammation. The LOX enzyme converts AA into another powerful group of inflammatory compounds known as leukortrines. Drugs that block the COX and LOX enzymes are known as anti-inflammatory drugs for this reason; they block the inflammatory cascade. However, by blocking the COX1 enzyme these drugs also block the stomach and gut protective PG’s and cause thinning and blood vessel leaks as they also block the PG’s that maintain blood clotting. As a result, specific drugs were developed that selectively block the COX2 enzyme but leave the COX1 alone. In theory, this sounded great but in reality the drugs did leave the COX1 enzyme alone in the majority of tissues except the COX1 found within the cells that line the blood vessels. These cells are called endothelial cells and the COX1 enzyme within these cells produces a special compound known as prostacyclin, which in turn maintains the smooth flowing of the blood within the blood vessels. By blocking the action of endothelial COX1 and the production of prostacyclin blood becomes stickier and prone to clotting, which explained the increased heart attack risk associated with drugs that have COX2 inhibitor action.

Inflammation – the natural answer

Research into the anti-inflammatory actions of curcumin has revealed that curcumin is a safe and effective inhibitor of COX2 and of the LOX enzyme that is responsible for the generation of the powerful inflammatory actions of leukortrines. What’s more, curcumin has also been shown to block the initial release of AA from the cell membrane. By doing this curcumin may have an effective preventative action as well as a powerful anti-inflammatory effect when used on a regular basis. To date, there have been no indication or suggestion that curcumin inhibits the endothelial COX1.

One factor that goes against curcumin is it’s poor absorption from the digestive tract. To get around this problem manufacturers have produced a highly bio-available extract; Theracurmin. This innovative ingredient uses a microscopic particle (100 times smaller than regular curcumin powder) size to enhance the curcumin absorption from the gut. Studies using Theracurmin have shown that the microscopic curcumin particles are absorbed up to and reach concentrations 300 times higher than regular powders.

How to take curcumin supplements

Theracurmin is simple and easy to use; take 1-2 capsules daily around a meal time. Because of the lack of available information, those who are pregnant or breast feeding or taking warfarin should only use curcumin based products after taking medical advise.

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Vitamin B12 – the story continues

Marcus Webb

Observations and comments by Marcus Webb

Vitamin B12 has always been associated with fighting fatigue and supporting nerve function. However, this complex vitamin with many biological functions that new research indicates extend beyond simple physical wellbeing.  

Vitamin B12 has an established key role is the normal functioning of the brain and nervous system as well as for the formation of healthy blood cells and is involved in the metabolism of every cell in the body. For such an essential nutrient it may come as a surprise that the human body is unable to produce its own B12 and is completely reliant on dietary sources. While some may quote authorities who state that our bowel bugs generate some vitamin B12 it has been shown that this tiny trickle is not absorbed from the colon and serves as no real nutritional source. We vitamin B12, albeit in small amounts, but we have to get it from our diet. Some key dietary sources are describe later on but in essence there is no reliable non-animal source of vitamin B12 making it very difficult for strict vegetarians or vegans to obtain significant amounts.

Interestingly, vitamin B12 was initially discovered due to its relationship with the condition pernicious anaemia. This is an autoimmune disease whereby the cells in the stomach responsible for secreting intrinsic factor (IF), which is crucial for the absorption of B12, are destroyed.

Taking vitamin B12

Vitamin B12 is often used to treat nerve pain. In most cases, the reported benefit of B12 is related to the injected form of B12 in people suffering from nerve pains in relation to diabetic neuropathy or shingles pain.

There have been some news stories relating to poor B12 absorption in people taking gastric acid blocking drugs. These drugs take effect on the same cells within the stomach that produce IF. In regular users, regular tablets or capsules of B12 will not help much because the absorption of B12 has become impaired as a consequence of the drug action. This is where the suckable/chewable tablets (B12 Infusion tablets from Enzymatic Therapy) come into their own. Vitamin B12 can be effectively absorbed across the delicate membranes of the mouth in sufficient amounts to readdress any deficiency without the need for injection therapy in most cases. For those with true pernicious anaemia who need regular injections of B12 every 3 months a top-up using the B12 Infusion tablets in the month leading up to the next injection can offer a great ‘lift’ for those who notice a general low energy phase before their next injection. So long as the B12 is in the biologically active form known as methylcobalamin and in a chewable/suckable form dosing up on one tablet per day for a month or so could make all the difference to fatigue or ‘brain fog’. Even if you have not been using the acid-blocking drugs, it may be worth trying a course of sublingual B12 for a month especially if you are over 50 years old or follow a strict vegetarian or vegan lifestyle.

Chronic Fatigue Syndrome, Fibromyalgia and Vitamin B12

Scientific studies into the causes of fibromyalgia (FM) and chronic fatigue syndrome (CFS) are always interesting, especially when they appear to support what we notice in the clinic. In the case of vitamin B12 many FM/CFS sufferers report improved energy and overall well-being following a course of high-dose B12 supplementation over 4-6 weeks. Lending some scientific evidence to this anecdotal observation, a study carried out in Sweden back in 1997 gave support to the use of B12 in FM/CFS cases when it was shown that the fluids surrounding the brain and spinal cord (the cerebrospinal fluid of CSF) was significantly lower in vitamin B12 than expected. Having such a low CSF B12 level was closely associated with increased levels of a metabolite known as homocysteine. This in turn was linked to profound symptoms of fatigue. The study concluded that these findings were probably contributing to the FM/CFS in their study group. Sadly, since then, little work has been performed in this area of vitamin B12 research but a team from Kings College did provide preliminary evidence of reduced functional B vitamin status in CFS patients. It’s not often practical to perform routine blood testing for B-vitamin status in cases of FM/CFS let alone sampling of the CSF, but in the holistic management of this complex spectrum of disorders, a trial of vitamin B12 or a good vitamin B complex often yields impressive results and is well worth considering.

Product link: BioActive B12 infusion 1000mcg vitamin B12 in the sublingual methylcobalamin form

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Helping to combat fatigue and body-energy crises using D-ribose.

What frustrates many people who suffer from fatigue with or without the associated muscular pain known as fibromyalgia is the fact that, on paper, they are too well to be ill. Routine blood tests are typically normal in both situations but the level of pain and fatigue are far from normal and can be life destroying.

Back in August we posted a brief note on the research behind ribose and fatigue. In this post we take it a bit further and explain more of the detail.

It is true to say that there is no known cause for fibromyalgia with all laboratory tests including muscle samples (biopsies) taken from the most tender regions appearing perfectly normal on specialist examination and analysis. This lack of medical evidence places sufferers in a dilemma; how to manage the problem? Exciting work coming out of America is throwing new light on the issue. The latest in a number of small scale studies confirms what has been observed clinically. A simple sugar-like substance, known as ProRibose (contains pure D-ribose), can be of help. The study in question involved 41 sufferers and was set up to investigate the effects of D ribose on two key end points; improvements in pain relief and easing of fatigue. The average age of the study group was 48 years old and 78% were female. This is in keeping with the typical profile of a fibromyalgia and fatigue sufferer. As with many studies, some people dropped out before the test month was finished but of the 36 who completed the trial 69% reported significant improvements in both of the symptoms being investigated and a 25% improvement in quality of life, as assessed by a special questionnaire. The mechanism behind this exciting set of results is not clear. What is known, however, is that fibromyalgia sufferers have lower levels of the energy molecule called adenosine triphosphate (ATP) and a reduced capacity to make ATP in their muscles. It is also known from previous studies that D-ribose can fuel ATP production. This may, in part, be responsible for the effects of D-ribose supplementation which appears to reduce muscle pain and enhance quality of life for those suffering with fibromyalgia and / or chronic fatigue. D-Ribose, also known simply as ribose, is a simple sugar. Technically known as a 5 carbon monosaccharide, or pentose sugar it is used by all the cells of the body and is an essential compound in energy metabolism. Ribose also provides the structural backbone of our genetic material, DNA and RNA, certain vitamins and other important cellular compounds. If the cellular energy pool is depleted by disease, overwork, or exercise it must be replaced. Supplemental ribose can be viewed as jump-starting the energy manufacturing mechanisms and accelerating the process of energy production. To date D-ribose has been shown to be a safe supplement. Only two side effects have been noted; in very large doses, in excess of 10 grams, loose stools (diarrhoea) has been reported and in similar doses a transient dip in blood sugar levels. However, when using any supplement that contains or influences the blood sugar levels or energy levels it is always recommended that a diabetic patient consults a health professional beforehand. To reduce both of these potential but rare side effects, sensitive individuals should take D-ribose with a carbohydrate meal. Taking D-ribose at the recommended intake of between 2-5 grams per dose is not normally associated with any dose effects. A great advocate of the use of D-ribose in CFS/FM is Dr Jacob Teitelbaum. He has suggested that its critical to use the proper dose for the first 3 weeks, which is 5 grams (5000 mg) three times a day, after which the intake can be dropped to twice a day. Dr Teitelbaum is keen on using D-ribose in CFS/FM patients because he has noted that when people consume D-ribose, their body recognizes that it is different from other sugars and preserves it for the vital work of actually making the energy molecule that powers our hearts, muscles, brains, and every other tissue in the body. With its established association with the energy currency of the cell (ATP) D-ribose provides the key building block of ATP, and the presence of D-ribose in the cell stimulates the metabolic pathway our bodies use to actually make this vital compound. If the cell does not have enough D-ribose, it cannot make ATP. So, when cells and tissues become energy starved, the availability of D-ribose is critical to energy recovery. In his detailed article about D-ribose (available online) Dr Teitelbaum describes how normal, healthy heart and muscle tissue has the capacity to make all the D-ribose it needs. However, when normal tissue is stressed by overexertion, several days of rest will usually allow it to fully recover. The muscle may be sore during recovery, as we frequently see for the three or four days after a hard day of gardening or similar unaccustomed work. Eventually energy levels will be restored and the soreness will disappear. But when the muscle is chronically stressed by disease or conditions that affect tissue energy metabolism, the cells and tissues simply cannot make enough D-ribose quickly enough to recover. Heart and skeletal muscles just don’t have the metabolic machinery they need to make D-ribose very efficiently. The result is chronic, persistent pain, stiffness, soreness, and overwhelming fatigue that may never go away. Given the high level or reported muscular pain in cases of CFS/FM that fit this clinical picture it would appear reasonable to consider a trial of D-ribose following the dose recommendation outlined by Dr Teitelbaum, who as a CFS/FM sufferer himself, takes D-ribose every day. Most natural agents are needed for 4-9 months to help restore deficiencies but if D-ribose works for you its safe to use on a regular basis.

Study supports D-Ribose use

In a very recent study published in the Pain Journal this year, Dr Teitelbaum and colleagues followed 203 diagnosed CFS/FM patients over a 3-weeks course of D-Ribose therapy. They discovered that improvements began in the first week of treatment, and continued to increase at the end of the 3 weeks of treatment. Their findings are summarized below;

61.3 % increase in energy

37% increase in overall well being

29.3% improvement in sleep

30% improvement in mental clarity

15.6% decrease in pain

 

At the end of the study they concluded that D-ribose resulted in markedly improved energy levels, sleep, mental clarity, pain relief, and well being in patients suffering from fibromyalgia and chronic fatigue syndrome.

Further Information

The study can be view on line (Treatment of Chronic Fatigue Syndrome and Fibromyalgia with D-Ribose– An Open-label, Multicenter Study. The Open Pain Journal, 2012, 5, 32-37).

Useful product link to ProRibose.

 

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Ribose Increases Energy an Average 61% in CFS and Fibromyalgia

Multicenter Study Shows Ribose Increases Energy an Average 61% in CFS and Fibromyalgia

Summary

Fibromyalgia represents a cellular energy crisis with many causes. Taking steps to increase energy production can often be helpful. One such method is outlined by the “SHINE Protocol” (Sleep, Hormones, Infections, Nutrition, and Exercise) which was shown to be highly effective in an earlier pilot and placebo-controlled study. A new just-published multicenter study of 257 people with CFS/FMS at 53 health clinics showed that d-ribose supplementation increased energy an average of 61% at three weeks, while also improving sleep, cognitive function, pain, and overall well-being. 

Have you been feeling like a zombie lately? You’re not alone! But new research is again showing more reason for hope.

Read the full report here.

Ribose product link here.

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Co-enzyme Q10 shows promise for fibro-headache sufferers

Headaches can be a debilitating problem for anyone especially if they become chronic and persistent. The fact that fibromyalgia (FM) sufferers are more prone to headache combined with the other chronic pain issues can make for a very complex situation. Because there are so many cause of headache knowing what to focus on first is a common dilemma for FM suffers and their health professionals. Known physical triggers such as muscular tension, neck arthritis, eye strain, jaw (TMJ) dysfunction and night teeth grinding (Bruxism) are often fairly easy to diagnose, especially when they are co-existing in a case of FM, and can be addressed. However, chronic headache can present in the absence of all physical triggers forcing one to seek a deeper understanding of the cause. As part of the diagnostic work up various inflammatory and hormonal problems need to be considered such as sinus infection/inflammation, allergy, cyclical headaches that shadow the female hormonal cycle and in some cases an adverse reaction to the birth control pill. Naturally there are a myriad of other problems that can cause chronic headache so a consultation with your doctor is always an advisable step but for many FM sufferers the cause of their headache is often never found and a long-term course of pain relief medication is the only treatment offered. Ironically, the long-term use of certain pain relief medication can actually cause headache! Drugs that contain codeine or a mixture of codeine and paracetamol are probably the worst culprits, but medication-overuse headaches can also occur on anti-inflammatory drugs and some medication used in the management of migraine such as triptans. If you feel you are taking any of these drugs for an extended period you should take a look at the web link at the end of this article and have a chat with your doctor.

As already mentioned, in many cases of FM-headache the exact cause is never discovered. This prompted a team from Spain to investigate the link that has been proposed to exist between oxidative stress and many of the symptoms associated with FM including headache. Before we take this any further, the term ‘oxidative stress’ needs some clarification. As paradoxical as it may sound, oxygen is a toxic substance when it’s not harnessed into chemical reactions needed for life or removed from the cells where, if freely available, it can cause damage through a process known as oxidation. We have all seen the effects of oxygen and oxidation on over ripe fruit or even on metal work such as the rust seen on the surface of iron exposed to the air. In a similar way, oxygen can punch holes in cell membranes and even damage the DNA found within the heart of our cells. Oxygen can be bad news to a cell and it’s this process that the term ‘oxidative stress’ owes its origins. All form of life have chemical systems that aim to reduce the oxidative stress by using special cellular enzymes but if the oxidative stress becomes too great these systems become overwhelmed. Many chronic health problems (atherosclerosis, chronic fatigue syndrome, Alzheimer’s disease, fibromyalgia and even Parkinson’s disease) have been associated with excessive oxidative stress either due to lifestyle habits (poor diet, smoking etc…) or a defective set of enzyme reactions that would normally deal with the overload of free and super-reactive oxygen (free-radicals) molecules. Returning to the Spanish study, the scientists theorised that oxidative stress may be a contributing factor for the development of chronic headache in FM suffers. They then took the work a step further using the established knowledge that FM sufferers are known to display low levels of Co-Enzyme Q10 (CoQ10), a key enzyme in the metabolic chain reaction needed to reduce oxidative stress. Those with low Co-Q10 levels were also known to have higher levels of free radicals (bad oxygen molecules) contained within special cellular structures called mitochondria. Co-Q10 is normally concentrated within these structures so the possibility existed that re-dressing the deficiency could enhance the free-radical clearance, reduce the oxidative stress and in so doing improve many of the FM symptoms (including headache) that has been attributed to excessive oxidative stress.

The team set about working with FM suffers with an established 2 to 3 year diagnosis who were free of active infections or other medical causes for their headaches; they fitted the category for headache of unknown origin! As part of the study, blood tests were performed to determine the FM sufferer’s levels of CoQ10 and markers that indicated the level of oxidative stress (lipid peroxidation) and cellular energy production (ATP). Once all the pre-treatment results were in the FM sufferers were given 100mg of CoQ10 three times a day for 3 months.

Following the 3 month treatment period all the blood tests were performed again. Interestingly, those with low CoQ10 levels also had low levels of ATP and high levels of oxidative stress. The study confirmed a significant correlation between FM headache (and pain in general) and high levels of oxidative stress. The study went on to demonstrate a marked improvement in headache symptoms that followed the correction of the high level of oxidative stress. This effect was attributed to the effects of improved Co-Q10 levels and it’s free-radical reducing actions within the mitochondria. The scientists had their work published this April in the journal, Public Library of Science which is freely available online. With the authors final comments reflecting a ‘remarkable improvement’ in the clinical symptoms of headache in FM a trial of Co-Q10 may worth consideration in cases of ‘headache of unknown origin’. However, as always, do chat to your doctor before making any changes to your treatment.

 

1. Self help information on medication-overuse headaches: http://www.patient.co.uk/health/Headache-Medication-Induced.htm

2. Oxidative Stress Correlates with Headache Symptoms in Fibromyalgia: Coenzyme Q10 Effect on Clinical Improvement available at the Public Library of Science: www.plosone.org

3. Product link: 100mg Co-Q10

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