Herbs and Supplements for Fibromyalgia

Managing the symptoms of FM or related ailments is not easy. So, many patients turn to alternative therapies for relief of pain and sleep problems. They may use Chinese herbs or over-the-counter supplements such as 5-HTPmelatonin, and SAM-e.

200px-US-NIH-NCCAM-Logo.svgBecause so many people — not just those with FM — are using alternative therapies, Congress has formed the National Center for Complementary and Alternative Medicine (NCCAM). It is part of the National Institutes of Health (NIH), and it helps appraise alternative treatments, including supplements, and define their effectiveness. This organization is now creating safe guidelines to help people choose appropriate alternative therapies that may help their symptoms without making them ill.

Are Herbs and Supplements for FM Safe and Effective?

Some preliminary studies indicate that some medicinal herbs and natural supplements may help treat symptoms of FM. Other studies of herbs and natural supplements, though, are less positive. If you want to take a natural approach to treating FM, it’s important to learn as much as you can about the therapies you consider. The herbs and natural supplements described here are just some of the alternative therapies that may have an impact on FM.

How Does 5-HTP Help FM Pain?

5-HTP (5-Hydroxytryptophan) is a building block of serotonin. Serotonin is a powerful brain chemical, and serotonin levels play a significant role in FM pain. Serotonin levels are also associated with depression and sleep.

For those with FM, 5-HTP may help to increase deep sleep and reduce pain. In one study published in the Alternative Medicine Review, researchers reported that supplementation with 5-HTP may improve symptoms of depression, anxietyinsomnia, and FM pains. However, there are some contradictory studies that show no benefit with 5-HTP.

5-HTP is usually well tolerated. But in the late 1980s, the supplement was associated with a serious condition called eosinophilia-myalgia syndrome. It’s thought that a contaminant in 5-HTP led to the condition, which causes flu-like symptoms, severe muscle pain, and burning rashes.

141. sleep deprivationCan Melatonin Help Relieve Sleep Problems Associated With FM?

Melatonin is a natural hormone that’s available as an over-the-counter supplement. It is sometimes used to induce drowsiness and improve sleep patterns. Some preliminary findings show that melatonin may be effective in treating FM pain. Most patients with FM have sleep problems and fatigue, and it’s thought that melatonin may help relieve these symptoms.

Melatonin is generally regarded as safe with few to no side effects. Due to the risk of daytime sleepiness, though, anyone taking melatonin should use caution when driving until they know how it affects them.

Is St. John’s Wort a Helpful FM Herb?

There’s no specific evidence that St. John’s wort is helpful in treating FM. However, this herb is often used in treating depression, and depression is commonly associated with FM.

There are several studies that show St. John’s wort is more effective than placebo and as effective as older antidepressants called tricyclics in the short-term treatment of mild or moderate depression. Other studies show St. John’s wort is as effective as selective SSRI antidepressants such as Prozac or Zoloft in treating depression.

St John’s wort is usually well tolerated. The most common side effects are stomach upset, skin reactions, and fatigue. St. John’s wort should not be mixed with antidepressants and can cause interactions with many types of drugs. If you’re on medication, check with your doctor before taking St. John’s wort or any supplement. In addition, be careful about taking St. John’s wort with other drugs, including antidepressants, as it could make you ill.

How Can SAM-e Help FM Pain and Depression?

289. pain in meIt’s not known exactly how SAM-e works in the body. Some feel this natural supplement increases levels of serotonin and dopamine, two brain neurotransmitters. Although some researchers believe that SAM-e may alter mood and increase restful sleep, current studies do not appear to show any benefit of SAM-e over placebo in reducing the number of tender points or in alleviating depression with FM. Additional study is needed to confirm these findings.

Can L-carnitine Help Improve FM Symptoms?

The studies are limited, but it’s thought that L-carnitine may give some pain relief and treat other symptoms in people with FM. In one study, researchers evaluated the effectiveness of L-carnitine in 102 patients with FM. Results showed significantly greater symptom improvements in the group that took L-carnitine than in the group that took a placebo. The researchers concluded that while more studies are warranted, L-carnitine may provide pain relief and improvement in the general and mental health of patients with FM.

What About the Effect of Probiotics on Digestive Problems Associated With FM?

poo-2Probiotics are dietary supplements that contain potentially beneficial bacteria or yeasts. They may assist with the breakdown and proper absorption of food and help improve digestive problems such as irritable bowel syndrome — a common symptom of FM. Some of the ways probiotics are used include:

  • treating diarrhea
  • preventing and treating infections of the urinary tract or female genital tract
  • treating irritable bowel syndrome

Side effects of taking probiotics are usually mild and include gas or bloating.

There are other herbs and natural supplements that people say have helped manage FM symptoms. They include echinacea, black cohosh, cayenne, lavender, milk thistle, and B vitamins. Nevertheless, there are no definitive studies on the efficacy of these natural therapies.

Fuzzy shot of pharmacy supplements shelf.How Can I Know Which Herb or Natural Supplement Will Help my FM?

***Before taking any herb or supplement for FM, talk to your doctor or pharmacist about possible side effects or herb/drug interactions. Herbal therapies are not recommended for pregnant women, children, the elderly, or those with weakened immune systems. In addition, some herbs have sedative or blood-thinning qualities, which may dangerously interact with anti-inflammatory painkillers or other pain medications. Others may cause stomach upset if taken in large doses.

If you’d like to see iHerb’s selection of supplements, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

Trans-POO-sions

I haven’t spoken about poo in a while, have I? So, here’s a new use for poo…

WHAT? you say – there is only one use for poo and that’s to go down a toilet. WRONG!

798035-fecal-transplants

Faecal Microbiota transplantation has been viewed by many doctors as the crack-pot end of medicine but a recent study has suggested it might have a use.

What I’m talking about is a healthy person, with no nasty infections, donating their poo to have it mushed up with saline and then inserted via a tube into the intestine of the recipient. The idea is that medications like antibiotics kill off the natural bacteria in our bowels and that the usual probiotics containing lactobacillus may not replace the full range of natural organisms we need for health.

To explain the process simply, stool is put in a blender with saline (salt water), and poured into a syringe. The sick patient is then given the freshly homogenised human stool via a colonoscopy, which is done through the rectum.

The transplants are currently used to treat gut bacterial conditions such as colitis, Irritable Bowel Syndrome and Clostridium difficile, or C. diff – an infection which causes diarrhoea so severe that it kills thousands of people every year.

Tests are also being done in Europe to look at what else FMT can be used for – it is thought to be effective in treating metabolic issues, obesity, type 2 diabetes, and neurological conditions including Multiple Sclerosis and Parkinsons.

“Contrary to popular belief, stool has no waste in it – it’s a mass of good bacteria,” says Professor Borody, director of the Centre for Digestive Diseases , who does one to six transplants a week in his Five Dock clinic.

“The incoming bacteria are capable of killing bad bacteria and recolonising your gut, restoring your body’s balance and leading to a resolution of your symptoms.”

While it might sound gross, the results speak for themselves. Prof Borody has had people flying in from as far afield as Paris to undergo stool transplants in his surgery.

Many of his patients are C. diff sufferers who have been plagued with recurrent diarrhoea for years, but are cured within days.

So if FMT is so successful, why isn’t it more widely available?

“Some people just can’t get past the ick factor,” says Prof Borody. “It’s similar to any new theory or practice when it’s introduced – is very hard to get old dogs to learn new tricks. Little interest has been shown within the pharmaceutical industry. Young doctors are very much on board with FMT, it’s the old farts who are holding us back.”

Some enterprising individuals have taken up doing the job of doing it on their own by recruiting stool from their spouse or family. Some have had surprisingly good results as far as combating Crohn’s or Irritable Bowel Syndrome symptoms (but all the links I found in regards to this had been deleted – so, perhaps you might not want to try this one alone.)

Lab Rats Wanted

Are you willing to put your body on the line? Or might you be at the end of your tether and willing to try anything?

As it is beyond me to list EVERY research study on FM, here are all the studies that are currently recruiting in the top 6 countries where my blog is being read:

*** If you live in another country, visit ClinicalTrials.gov, then enter your country and ‘fibromyalgia’ in the search box…you never know what you might find ***

Australia

NIL

Canada

A Phase 3b Multicenter Study of Pregabalin in Fibromyalgia Subjects Who Have Comorbid Depression

Conditions: Fibromyalgia

Interventions: Drug: Pregabalin; Drug: placebo

The Impact of Omega-3 Fatty Acid Supplements on Fibromyalgia Symptoms

Conditions: Fibromyalgia

Interventions: Dietary Supplement: Omega-3 (oil); Dietary Supplement: Fatty Acids (placebo)

Online Acceptance-based Behavioural Treatment for Fibromyalgia

Conditions: Fibromyalgia

Interventions: Behavioural: Acceptance-based behavioural therapy;   Other: Will vary per participant

India

Adolescent Fibromyalgia Study

Conditions: Fibromyalgia

Interventions: Drug: placebo; Drug: pregabalin (Lyrica)

A Study of Duloxetine in Adolescents With Juvenile Primary Fibromyalgia Syndrome

Conditions: Fibromyalgia

Interventions: Drug: Duloxetine; Drug: Placebo

Pregabalin In Adolescent Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: pregabalin

Israel

Prevalence of Fibromyalgia in Israel

Conditions: Fibromyalgia

Interventions:

Effect of Milnacipran in Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: Minalcipran; Drug: Placebo

Peripheral Arterial Tonometry (PAT) Evaluation of Sleep in Fibromyalgia

Conditions: Fibromyalgia

Interventions:

Study Assessing the Efficacy of Etoricoxib in Female Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: etoricoxib

Cognitive Dysfunction in Fibromyalgia Patients

Conditions: Fibromyalgia

Interventions:

United Kingdom

NIL

United States of America

Observational Study of Control Participants for the MAPP Research Network

Conditions: Fibromyalgia; Irritable Bowel Syndrome; Chronic Fatigue Syndrome,

Interventions:

Pain and Stress Management for Fibromyalgia

Conditions: Fibromyalgia

Interventions: Behavioural: Stress and Emotions; Behavioural: Thoughts and Behaviours; Behavioural: Brain and Body

Adolescent Fibromyalgia Study

Conditions: Fibromyalgia

Interventions: Drug: placebo; Drug: pregabalin (Lyrica)

A Phase 3b Multicenter Study of Pregabalin in Fibromyalgia Subjects Who Have Comorbid Depression

Conditions: Fibromyalgia

Interventions: Drug: Pregabalin; Drug: placebo

A Study of Duloxetine in Adolescents With Juvenile Primary Fibromyalgia Syndrome

Conditions: Fibromyalgia

Interventions: Drug: Duloxetine; Drug: Placebo

Pregabalin In Adolescent Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: Pregabalin

Combined Behavioural and Analgesic Trial for Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: Tramadol; Drug: Placebo; Behavioural: Cognitive Behaviour Therapy for FM; Behavioural: Health Education

Quetiapine Compared With Placebo in the Management of Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: quetiapine; Drug: Placebo

Cyclobenzaprine Extended Release (ER) for Fibromyalgia

Conditions: Fibromyalgia; Pain; Sleep; Fatigue

Interventions: Drug: cyclobenzaprine ER (AMRIX); Drug: placebo

Tai Chi and Aerobic Exercise for Fibromyalgia (FMEx)

Conditions: Fibromyalgia

Interventions: Behavioural: Lower frequency, shorter period of Tai Chi; Behavioural: Higher frequency, shorter period of Tai Chi; Behavioural: Shorter frequency, longer period of Tai Chi; Behavioural: Higher frequency, longer period of Tai Chi; Behavioural: Aerobic Exercise Training

Effects of Direct Transcranial Current Stimulation on Central Neural Pain Processing in Fibromyalgia

Conditions: Fibromyalgia

Interventions: Procedure: Transcranial Direct Current Stimulation (tDCS)

Lifestyle Physical Activity to Reduce Pain and Fatigue in Adults With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Behavioural: Lifestyle physical activity (LPA); Behavioural: Fibromyalgia education

Neurotropin to Treat Fibromyalgia

Conditions: Fibromyalgia

Interventions: Neurotropin

Effect of Milnacipran on Pain in Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: Neurotropin

Investigation of Avacen Thermal Exchange System for Fibromyalgia Pain

Conditions: Fibromyalgia

Interventions: Device: AVACEN Thermal Exchange System

Phase 2 Study of TD-9855 to Treat Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: TD-9855 Group 1; Drug: TD-9855 Group 2; Drug: Placebo

Cymbalta for Fibromyalgia Pain

Conditions: Fibromyalgia

Interventions: Drug: Duloxetine

Effects of Milnacipran on Widespread Mechanical and Thermal Hyperalgesia of Fibromyalgia Patients

Conditions: Fibromyalgia

Interventions: Drug: Milnacipran

Qigong Exercise May Benefit Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Behavioural: Intervention Group; Behavioural: Placebo Comparator: Control Group

Effect of Temperature on Pain and Brown Adipose Activity in Fibromyalgia

Conditions: Fibromyalgia, Pain

Interventions:

Effect of Milnacipran in Patients With Fibromyalgia

Conditions: Fibromyalgia

Interventions: Drug: Minalcipran; Drug: Placebo

The Pathogenesis of Idiopathic Dry Eyes

Conditions: Dry Eye, Fibromyalgia

Interventions:

Evaluation and Diagnosis of People With Pain and Fatigue Syndromes

Conditions: Fatigue; Fibromyalgia; Pain; Complex Regional Pain Syndrome; Reflex Sympathetic Dystrophy

Interventions:

The Functional Neuroanatomy of Catastrophizing: an fMRI Study

Conditions: Fibromyalgia

Interventions: Behavioural: Cognitive Behavioural Therapy; Behavioural: Education

A Placebo-Controlled Trial of Pregabalin (Lyrica) for Irritable Bowel Syndrome

Conditions: Irritable Bowel Syndrome

Interventions: Drug: Pregabalin (Lyrica); Drug: Placebo

 

 

Poo! Poo! to That!

2010-09-29-beetleAm I the only one who talks about poo?

One of our favourite (NOT!) symptoms of FM is Irritable Bowel Syndrome (IBS). New research has shown that IBS may be tied to abnormal brainstem function. UCLA researchers used functional MRI to monitor women’s brainstems while using a balloon-type device to cause rectal distention. Before distention, they’d give the women a visual cue.

The women in the control group had a significant drop in brain activity after the visual cue, which the researchers say is a “down-regulation of pain-signalling systems.” You know how you prepare yourself for an injection – this is how your body prepares itself for pain it knows is coming and also knows isn’t dangerous.

However, the brains of women with IBS didn’t have the same activity drop-off, which researchers say shows they can’t stave off expected pain like most people can. The IBS group also had stronger brain reactions during distention.

It was concluded that the brains of some pain patients react differently to pain than ‘normal’ people, though (once again) they say more research needs to be done. “If we can identify receptors and genes associated with these abnormal brain responses, we should improve both identification of predisposed patients and development of effective remedies,” says Emeran A. Mayer, M.D., who worked on the study.

Researchers say their findings could also help uncover underlying causes and possible treatments for fibromyalgia and other chronic pain conditions.

 

Umm…What Exactly are Tender Points?

Tender points are one of the major characteristics of FM (along with all those others like widespread deep muscle pain, fatigue, and depression).

Tender points are pain points or localized areas of tenderness around joints, but not the joints themselves. These tender points hurt when pressed with a finger. Tender points are often not deep areas of pain. Instead, they are superficial areas seemingly under the surface of the skin, such as the area over the elbow or shoulder.

The actual size of the point of most tenderness is usually very small, about the size of the tip of your thumb. These areas are much more sensitive than other nearby areas. In fact, pressure on one of the tender points with a finger will cause pain that makes the person flinch or pull back. Tender points are scattered over the neck, back, chest, elbows, hips, buttocks, and knees.

The cause of these pressure points is not known. Even though it feels like these areas are inflamed, researchers have not found particular signs of inflammation when examining the tissue. What is known is that the locations of tender points are not random. They occur in predictable places on the body. That means many people with FM experience similar symptoms with tender points.

There are 18 tender points important for the diagnosis of FM (see illustration below).

These tender points are located at various places on your body. To get a medical diagnosis of FM, 11 of 18 tender point sites must be painful when pressed. In addition, the symptom of widespread pain must have been present for three months.

19. tender pointsYour doctor can test the painful tender points during an examination. Yet even with tender points, you need to tell your doctor about the exact pain you feel in those areas. You also need to tell the doctor about your other symptoms, such as deep muscle pain, fatiguesleep problemsdepression, irritable bowel syndrome, and more. It is often best you maintain a symptom diary/log and take it with you to your doctor (see Improving Patient-Doctor Communication)

If you don’t explain all your symptoms fully to your doctor, the doctor will not be able to effectively(?) treat the FM. As a result, you won’t get any relief from the chronic pain and other symptoms.

When a doctor tests tender points for pain, he or she will also check “control” points or other non-tender points on your body to make sure you don’t react to these as well. Some physicians use a special instrument called a ‘doximeter’ or ‘dolorimeter’ to apply just the right amount of pressure on tender points.

Pain management for tender points with FM involves a multifaceted treatment program that employs both conventional and alternative therapies. While the reason is not entirely clear, FM pain and fatigue sometimes respond to low doses of antidepressants. However, the treatment for FM and tender points involves medications, daily stress management, exercise, hydrotherapy using heat and ice, and rest. Other remedies for symptoms may also be used.

 

Obsessed with Poo!

poo 1After another uncomfortable visit to the toilet, I decided to Google ‘Focal Nodular Hyperplasia’ and ‘IBS.’ I found absolutely nothing that linked the two but I did find another study that shows that nearly all patients with Irritable Bowel Syndrome and Diarrhea (IBS-D) actually have a different condition!

It was found that patients thought to have IBS-D – a condition which affects up to 15 per cent of the US population (35 million Americans (US study so US statistics – I’m sure the figures apply to other countries, too)) – may in fact have a different condition altogether.

This was the largest study to date and indicates that doctors may use IBS-D as a blanket diagnosis, rather than cite a collection of separate medical conditions.

According to the study, 98 per cent of participants were found to have a diagnosis different from the initial presentation of IBS-D. This study refutes the existence of IBS-D as a single medical entity and implies that this diagnosis is simply a catch-all diagnosis. The findings also revealed that 68 per cent of the participants actually had conditions related to treatable (that means that 68 per cent of us could actually feel better!) bile acid induced diarrhea as a result of gallbladder dysfunction.

A dysfunctional gallbladder that produces an abnormal amount of bile causing chronic diarrhea can be very treatable, as opposed to IBS, for which physicians and patients often search for treatment to alleviate the discomfort, often to no avail.

bird_pooAccording to the study, once patients were accurately diagnosed, 98 per cent experienced a favourable response (that is, the elimination of urgency and incontinence for at least three months). Wouldn’t that be nice? The end of a lifetime of discomfort, unease and frustration!

“The results of this study demonstrate quite convincingly that many patients may needlessly be going through the physical and emotional pain of IBS and functional diarrhea when, in reality, they may be afflicted with something else that is easily treatable,” said Saad F. Habba, M.D., gastroenterologist at Overlook Hospital and the study author.

Test results

  • 41 per cent were found to have Habba Syndrome (a relatively new entity relating dysfunctional gallbladder with chronic diarrhea , which is successfully treated with bile acid binding agents);
  • 23 per cent of the study subjects were diagnosed with post cholecystectomy diarrhea;
  • 8 per cent had lactose intolerance; and
  • 7 per cent had microscopic colitis.

Doesn’t quite add up to the 98 per cent – but it still shows that there is some hope!

 

And It All Comes Back to the Poo!

***This is NOT dinnertime reading! Do NOT read if you are easily offended, nauseous, or just don’t like to talk about bowel movements***

Isn’t it funny, we all go to the toilet, but we don’t like to talk about it, particularly number twos.

Today, I had a ‘normal’ bowel movement – but what is considered to be a ‘normal’ bowel movement?

A bowel movement should be soft and easy to pass, though some people may have harder or softer stools than others. In general, stool should be brown or golden brown, be formed, have a texture similar to peanut butter, and have a size and shape similar to a sausage. In many cases, a stool that varies a bit from this description is no cause for alarm, especially if it is an isolated incident.

It seems that most of us, especially those with IBS issues, never have a ‘normal’ bowel movement. In fact, our ‘normal’ is more likely to be those ‘really difficult to push out rabbit droppings type,’ or the ‘rush to the closest toilet explosion,’ or even the ‘my ass is dribbling type.’

Most of us who live with FM also have IBS. FM and IBS are co-diagnosed in up to 70% of FM patients. IBS (also known as irritable colon, spastic colon, mucous colitis, or spastic colitis) is a disorder of the bowel, or large intestine. It is characterized by severe abdominal pain and cramping, changes in bowel movements, and a variety of other symptoms.

It has been estimated that as many as two-thirds of all IBS patients have FM, and as many as 70% of FM patients may also have IBS. These statistics differ greatly from the corresponding rates in the general population, where only 10%-15% of individuals are estimated to have IBS. It is unknown if the two conditions are related symptomatically or causally, or if their frequent co-occurrence is merely a coincidence.

Adding pain killers to the mix can be frustrating and painful.

Now, the ‘really difficult to push out rabbit droppings type’ tends to be a constipation. Constipation means different things to different people. For many people, it simply means infrequent stools. For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement. This is called fecal impaction, a condition in which stool hardens in the rectum and prevents the passage of any stool.  According to reports in the Journal of Psychosomatic Research, constipation or infrequent stools occur in 30% of FM sufferers.

Constipation also can alternate with diarrhoea. Diarrhoea is an increase in the frequency of bowel movements, an increase in the looseness of stool or both. It is caused by increased secretion of fluid into the intestine, reduced absorption of fluid from the intestine or rapid passage of stool through the intestine. This is the other two types of (what I refer to as) our ‘normal.’

My point to all this crap (Ha! Ha! Lol!) is that I get used to the IBS stuff: I have cramps, I take Buscopan; I have diarrhoea for too long, I take Immodium; and, if I’m constipated, greasy fish and chips seems to do the trick. But when I have a ‘normal’ poo, it feels like it is dragging all my insides out with it. It’s tiring and it’s physically draining. It leaves my body feeling empty (but not in a good way!).

So, is this what ‘normal’ feels like?

Further Reading: 

 

Intestinal Fortitude

 

My stomach is NOT my friend! I am lucky enough to swing from constipation to diarrhoea in less than the blink of an eye.

Research findings from the Walton Centre in the UK report that the small bowel in FM sufferers (and when it comes to IBS, we are definitely sufferers!) shows overgrowth of abnormal bacteria. The study demonstrated an increased intestinal permeability that produces increased hyperactivity of the intestines. Intestinal permeability means abnormal substances gain access to the body and alter its immune function.

Constipation

According to reports in the Journal of Psychosomatic Research, constipation or infrequent stools occur in 30% of FM sufferers. Constipation is defined as having a bowel movement less than three times a week. Some individuals complain of abdominal pain and straining to move the bowels in conjunction with the constipation.

Diarrhoea

Clinical Nurse Specialist describes diarrhoea occurring in up to 90% of FM sufferers. Individuals describe a pressing urge to move the bowels as well as passage of unformed stool. Diarrhoea occurs along with high levels of anxiety. Reports in the Journal of Nutrition indicate ingestion of probiotics decreases the symptoms of diarrhoea.

Fecal Incontinence

The Journal of Psychosomatic Research reports 2% to 7% of individuals with FM report uncontrolled passage of stool. This fecal incontinence transpires frequently in concurrence with diarrhoea and creates major problems in daily life. If it has ever happened to you, you never want to leave the house again (or, at least, without knowing where the closest toilet is!)

gastroesophageal Reflux Disease

According to the Journal of Psychosomatic Research, gastroesophageal reflux disease describes the condition where food travels backward from the stomach into the oesophagus. The oesophagus is the tube connecting the mouth to the stomach. Characteristic symptoms of gastroesophageal reflux disease include epigastric pain, a sensation of fullness, and heartburn. gastroesophageal reflux disease and other intestinal problems occur in 50% of FM sufferers.

I have tried some (very expensive) probiotics without any improvement. Basically, I make sure that I have a constant supply of Imodium, Buscopan and Durolax on hand, at all times.

Has anyone found something that works (not just on symptoms)?

 

Sore Pink Bits?

One in four women suffer from chronic vulvar pain at some point in their lifetime, according to the National Volvodynia Association.

AND women with chronic vulvar pain, or vulvodynia, are at a substantially increased risk for other chronic pain conditions, according to a University of Michigan Health System study published in Obstetrics & Gynecology (just in case sore pink bits weren’t enough!)

The new research reveals that women suffering from this painful vaginal condition have between a two and three times more likelihood of having other chronic pain conditions, including FM.

Vulvodynia is chronic vulvar pain that consists of burning, stinging, soreness, or rawness in the area at the opening of the vagina. To date, it has no identified cause, although a genetic component or nerve injury may be the culprit. The pain can be so severe that it makes exercise, intercourse and even sitting unbearable. The condition may occur for months, but can last for years.

“Chronic pain conditions like these can seriously hamper quality of life and it’s imperative that we understand the commonality among them,” says lead author Barbara D. Reed, a professor of family medicine at the U-M Medical School. “Chronic pain is starting to get a lot more attention, with more research being done on all of these disorders, as well as combinations of these disorders. I think the identification and treatment of these conditions will continue to improve.” (Yippee! – but there are huge numbers of these conditions; we need to get FM out ‘there’ so we can be first on the list!)

“Women who have these disorders often see physicians but are not given a diagnosis or are given an erroneous diagnosis and continue to suffer without being treated properly,” Reed says. “Until their symptoms have a name, it can be really discouraging because patients begin thinking it’s all in their head.

Millions of people have chronic pain. This report stresses the need to further study relationships between these types of disorders to help understand common patterns and shared features.

Found It! Just When You Thought One was Enough…

There was quite a bit of discussion after the Take A Breath post. One of the questions that arose was about what other conditions did FM sufferers have to endure?

So, I remembered that during my previous research, I had come across some of this information – so, off I went to sift through all my downloads and page histories. And I found it!

There are specific conditions which are frequently comorbid (occurring simultaneously) with FM, including osteoarthritis, autoimmune disease, lupus, myalgic encephalomyelitis/chronic fatigue syndrome, migraines, irritable bowel syndrome, sleep problems, mood disturbances, nueroendocrine disorders, and hypothyroidism.1 Patients with FM were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis.2

A 2007 survey showed the following prevalence of comorbid disorders:3

Upon examination, no structural changes or muscular inflammation is detectable despite a widespread decreased pain threshold and peripheral sensitization indicative of changes in pain pathways.

Another site I found merely listed comorbid conditions and symptoms, without any statistics or references but, for the sake of completeness, here they are:

Scary looking lists, aren’t they? The conditions/symptoms in purple are mine. What’s everyone else got? (but if you name it, you have to explain the condition – another opportunity to learn!)

There are several conditions which mimic FM and should be ruled out and/or treated.4 They include hypothyroidism, polymyalgia rheumatica, autoimmune disorders, hepatitis C, sleep apnea, chiari malformation, and celiac disease.

  1. Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol. 2003;17:685-701; and McBeth J, Silman AJ, Gupta A, Chiu YH, Ray D, Morriss R, Dickens C, King Y, Macfarlane GJ.  Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain: findings of a population-based prospective cohort study.  Arthritis Rheum. 2007 Jan;56(1):360-71.
  2. Weir P, Harlan GA, Nkoy FL, Jones SS, Hegmann KT, Gren LH, Lyon JL. The Incidence of Fibromyalgia and Its Associated Comorbidities: A Population-Based Retrospective Cohort Study Based on International Classification of Diseases, 9th Revision Codes. JCR: Journal of Clinical Rheum. 2006 June; 12 (3): 124-28.
  3. Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L.  An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007 Mar 9;8:27; and Kato K, Sullivan PF, Evengard B, Pedersen NL. Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med. 2006;166:1649-1654.
  4. Clauw DJ. Fibromyalgia. In: Loeser JD, Butler SH, Chapman CR, Turk DC, eds. Bonica’s Management of Pain, 4th edition. Philadelphia, Pa: Lippincott Williams and Wilkins. 2008.