Play It, Sam(e)!

S-adenosylmethionine is of fundamental importance in a number of biochemical reactions and has been trialled previously in the treatment of FM. It is quite a mouthful, isn’t it? The abbreviation SAMe (pronounced samm-ee) is much easier to say. Its chemical structure and name are derived from two materials you may (or may not) have heard about already: methionine, a sulfur-containing amino acid; and adenosine triphosphate (ATP), the body’s main energy molecule.

Depression

The evidence for SAMe for the treatment of depression is provocative but far from definitive. Several double-blind, placebo-controlled studies have found it effective in relieving depression, but most were small and poorly reported, and many used an injected form of the supplement.

Fibromyalgia

Four double-blind trials have studied the use of SAMe for FM, three of them finding it to be helpful. Unfortunately, most of these studies used SAMe given either intravenously or as an injection into the muscles, sometimes in combination with oral doses. The effects, when taken in this manner, can be quite different from when you take it orally. For that reason, these studies are of questionable relevance to most of us.

Nonetheless, the one double-blind study that used only oral SAMe did find positive results. In this trial, 44 people with FM took 800 mg of SAMe or placebo for 6 weeks. Compared to the group taking placebo, those taking SAMe had improvements in disease activity, pain at rest, fatigue, and morning stiffness, and in one measurement of mood. In other respects, such as the amount of tenderness in their tender points, the group taking SAMe did no better than those taking the placebo.

However, it isn’t clear whether SAMe is helping FM through its antidepressant effects, or by some other mechanism.

The body makes all the SAMe it needs, so there is no dietary requirement. However, deficiencies in methionine, folate, or vitamin B12 can reduce SAMe levels. SAMe is not found in appreciable quantities in foods, so it must be taken as a supplement.

It has been suggested that the supplement trimethylglycine (TMG) might indirectly increase SAMe levels; however, this is yet to be proven.

sam eA typical full dosage of SAMe is 400 mg taken 3 to 4 times per day (which can be quite expensive). If this dosage works for you, take it for a few weeks and then try reducing the dosage. As little as 200 mg twice daily may suffice to keep you feeling better once the full dosage has “broken through” the symptoms.

However, some people develop mild stomach distress (just what people who suffer with IBS want to hear!) if they start full dosages of SAMe at once. To get around this, you may need to start low and work up to the full dosage gradually.

samE sideSome labelling suggests a dosage of 200 mg twice daily. This dosage makes SAMe appear more affordable (if you’re only taking 400 mg per day, you’ll spend only about a third or a fourth of what you’d pay for the proper dosage), but it is unlikely that SAMe will actually work when taken at such a low dosage.

Safety Issues

  • SAMe appears to be quite safe, according to both human and animal studies. The most common side effect is mild digestive distress. However, SAMe does not actually damage the stomach.
  • Like other substances with antidepressant activity, SAMe might trigger a manic episode in those with bipolar disease (manic-depressive illness).
  • Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
  • SAMe might interfere with the action of the Parkinson’s drug levodopa. In addition, there may also be risks involved in combining SAMe with standard antidepressants. For this reason, you shouldn’t try either combination except under physician supervision.

 

If you’d like to see iHerb’s selection of SAM-e products, 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.

Int Fibro

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.

Whatever…Nothing!

Yesterday, I (with my Mommy) was running late for my pain specialist. I hate running late. It stresses me out. I think it is incredibly rude. But, yesterday, when my Mommy was apologising for making us late, I was just ‘whatever.’

Then I thought about it and I’ve been ‘whatever’ for quite a while. It’s not such a bad feeling – it’s stress-less, very laid back and unemotional. But it’s very nothing.

I also noticed that I haven’t been writing anything personal on this blog – it’s been all about research and studies. It’s because there is nothing.

I think I’m on too many drugs…

When I was first diagnosed, (other than a quick dose of steroids) I was immediately put on Lyrica. Anytime I felt more pain, the doctors increased my dosage…my current Lyrica dosage is 225mg both morning and night.

I also take 150mg of Sertraline for depression – it used to 100 mg but during this ‘whatever, nothing’ stage, I felt that I needed something extra. My GP was happy to increase the dose. There’s also 1100ʮg per week of Thyroxine for my under-active thyroid; the Pill (I went off it (because who’s having any sex?) but my periods were unbearable!); and, of course, there’s all the supplements that we’re supposed to take: vitamin D, Red Krill Oil, D-Ribose, Sam-E, CoQ10, and a multi-vitamin.

Anyway, my point is that no-one tried anything except the Lyrica…why not?

So, having visited the pain specialist yesterday, we’re trying something else: I’m running out of all the supplements at the moment, so I’m just going to stop them as the bottles empty; and I’m going to wean off the Lyrica:

doses

Because this ‘whatever, nothing’ just isn’t good enough. I want more. I NEED more!

Spreading Your Eggs…

The most consistent treatment advice that all the experts in FM try to promote is a multi-faceted comprehensive treatment approach. do_not_put_all_your_eggs_in_one_basketThose who have followed this blog for a while know that I have always promoted this advice: this means NOT putting all your eggs in one basket…

Over time, you can validate what works best to alleviate your pain. A number of lifestyle changes and other treatment methods can have a cumulative positive effect on the pain you experience.

Here is a list of some commonly used treatment options:

  1. Conventional medicines — Your doctor will work with you to discover what prescription medicines may work best for you. Options are many including pain and antidepressant medicines.
  2. Nutrition and diet — Some researchers believe that the foods you eat can affect FM symptoms.
  3. Dietary Supplements — Vitamins and minerals play important roles in health and maintenance of the body.
  4. Exercise — Exercise helps relieve joint stiffness and can help alleviate some of the pain as well. Short workouts have been proven to help many of us. Pain may initially increase, but then gradually decreases. Hydrotherapytai-chi and yoga are excellent forms of exercise. These forms of exercise incorporate relaxation and meditation techniques. Deep breathing and slow movement will reduce your stress level and increase your fitness.
  5. Physiotherapy — A physiotherapist can help you with stretching and good posture. Stretching will reduce joint and muscle stiffness. This therapist can also  help you with relaxation techniques, another powerful FM treatment option.
  6. Relaxation therapy — Stress aggravates FM. Reducing stress will provide you with a more restful sleep, improving symptoms.
  7. Massage therapy — This is another great relaxation technique.
  8. 270. aspirinOver-the-counter drugs — You will need to work with your doctor. Always talk to your doctor about any over-the-counter medications you plan to take.
  9. Herbal remedies — Many herbs have medicinal healing powers. Again, you must talk to your doctor when using herbal remedies
  10. Chinese medicine — Consider exploring Chinese medicine which places great emphasis on herbal remedies and incorporates life energy healing techniques.
  11. Homeopathy — Visit a homeopathic specialist. They specialize in natural remedies to illnesses.
  12. Acupuncture — Modern adherents of acupuncture believe that it affects blood flow and the way the brain processes pain signals. Studies have shown this may be effective for FM.
  13. Chiropractic care—Chiropractors specialize in spinal problems, which can be a major source of pain for some people.

Your odds of gaining a significant reduction in symptoms, and improving your quality of life through a combination of many different treatment options, is pretty good…if you get the right combination.

There are thousands of different options and combinations of options. What works best?

Somehow you have to record all the treatments you are trying, how you feel on a particular, what happens when you add a new modal. It’s not easy…I can’t even keep track and that’s part of the reason I started this blog…you forget that you took that extra pain-killer because your head was killing you on Wednesday, or that you missed your hydrotherapy session because your stomach was acting up.

That really is the great challenge with fighting Fibro – the BEST combination of treatments will be different for each individual. (Isn’t that the bit that sucks the most? Hearing that everyone is different?)

We need to remember that we (YOU) are the centre point of treatment, by focusing on treatments that match our own lifestyles, abilities, symptoms and resources. The problem is that a personalized treatment approach to FM relief cannot be developed without a firm understanding of the symptoms and co-morbid conditions that require treatment (and I’ve been trying to research it all for over a year…and I keep finding new symptoms!).

We must also establish a trustworthy support team to assist us in pursuing not only all the different treatment options, but the execution of the treatments chosen. Effective teams typically include the patient’s primary care physician, various specialists (e.g., rheumatologists, neurologists, dietitians, psychologists), as well as friends, family, and even members of fibromyalgia support groups.

And finally (if all of that was not enough), specific and achievable goals must be set in order to measure the effects of EVERYTHING!

Weighing-up-the-benefits-with-the-risks-of-virtualisation

It is vitally important to constantly and consistently observe and evaluate the treatment methods being used. Through this whole process, we get frustrated over and over again! Our reality is an ongoing trial-and-error approach to treatment. AAARGGGGHHHH!

However, it is crucial to treatment success and must be embraced as a necessary evil.

When trying to determine a personalized course of treatment, we need to forget the agendas of physicians, pharmaceutical companies, and other external entities. Our decisions need to be driven by both symptoms and causal factors. Examples of important questions to ask during this process include:

  • What symptom do I want to address?
  • How will this particular treatment impact that symptom?
  • What are the potential side effects of this treatment?
  • Does this treatment have the potential to interact with other treatments I am using?
  • What will this treatment cost?
  • What are my expected results and in what time frame should I anticipate to note results?

Throughout this process, it is important to remember that successful relief is highly individualized (again!) and will vary between patients. What appears to be a miraculous treatment for me may fail to provide any benefit to you.

This whole process takes more time (yes! most of us have had to wait years for a diagnosis and now we have to take more time!).

A trial and error evaluation process is most effective when employed in a scientific manner meaning that different treatment elements should often be tested in isolation. I know that when I read about CoQ10 and D-Ribose and Sam-E, I started taking them all at the same time. I am now no longer able to tell which supplement or combination of supplements is actually driving the results they may experience. It is impossible to accurately measure specific results to associate with any individual option, so I need to start again…again!

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.

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