NJ Nutrition

Fibromyalgia Wholistic Care

stk62884corFibromyalgia (FM) is a very challenging condition to both diagnose and treat since there are different clinical signs and symptoms that make each patient with FM unique. Therefore, we usually make the diagnosis by excluding other possibilities. To make matters even more challenging, there are “primary” and “secondary” types of FM, or those who develop FM for no know reason (primary) vs. those whose FM arises from a known condition (secondary). Because of these challenges, there is no single treatment program to apply to all struggling FM patients. Rather, studies often suggest that a multidisciplinary “team” of health care providers be utilized in the management of patients with FM. It is recommended that EACH FM patient have their needs be uniquely treated. This month, we will look a “multimodal” approach to treating FM that incorporates a “team” approach.

For those less familiar with FM, many patients with this condition have symptoms that include fatigue, “all over” body pain, sleep problems, mood symptoms, and chronic pain. They may also have conditions including irritable bowel syndrome, palpitations, thyroid dysfunction, adrenal dysfunction, gastroenterological symptoms, chronic headaches, and MANY others. Dealing with these and other FM symptoms can have a tremendous negative impact on one’s quality of life and activities of daily living.

So as previously stated, the treatment of FM requires a comprehensive approach where the patient’s individual symptoms are targeted, as there is no “cookie cutter/one size fits all” management approach. Effective management approaches include chiropractic, allopathic, acupuncture, soft tissue therapy, sleep hygiene counseling, nutritional counseling, mind-body therapy, and dietary counciling including nutritional supplementation that target specific deficiencies determined by lab/blood tests and/or are based on the clinical history.

Treatment is centered on the human body’s deficiencies with the most important being the removal of any and all “trigger(s)” that causes inflammation in the body. Use of an anti-inflammatory herb such as ginger, turmeric, boswellia, (and others) can help until the causes are identified. A gluten-free diet is often very successful in reducing the autoimmune reaction that occurs with gluten sensitivity, which is estimated to be as high as 80% of the general population. This is NOT to be confused with gluten intolerance or celiac disease (they affect 7-10% of the general population). Once inflammation is controlled, weaning away of the anti-inflammatory supplements can be done successfully.

The hormonal levels of the body must also be in balance, especially the thyroid, adrenal, and sex hormone levels. Lab tests should include a complete thyroid panel (TSH, T3, T4, T7/free thyroxin), a salivary cortisol test (for adrenal function), and sex hormone levels (DHEA, pregnenolone, progesterone, estradiol, and, free and total testosterone). Assess and eliminate food sensitivities/allergies (gluten and dairy are most common). Nutritional supplementation should include vitamins (a multiple, omega 3 fatty acids, Vitamin D3, and Co-enzyme Q-10; minerals (calcium, potassium, magnesium), amino acids and sometimes others (case dependant). These keep our organs functioning well, like a finely tuned machine! Care must also be taken not to over-dose as well, so let us guide you in this process – consider chiropractic your “coach” in this team-based approach!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Fibromyalgia Diagnosis: A Breakthrough!

stk62884corFibromyalgia (FM) is truly a challenging condition to manage, as anyone with this condition will attest to! In the past, we’ve discussed many management strategies, including dietary suggestions. Although much of the nutritional information available about FM management is not supported by a lot of “scientific study,” the National Institute of Health through the NCCAM (National Center for Complementary and Alternative Medicine — formed by Congress to evaluate and appraise alternative treatments) provides information on dietary recommendations and supplements. They also provide dietary guidelines and define the benefits and effectiveness for FM patients and us doctors to follow. This month, we will dive deeper into nutritional considerations as this can REALLY make a huge difference for the FM patient!

Since fatigue, sleep quality, and muscle pain are three VERY common FM complaints, the FM patient can track their response to different dietary approaches as they add, modify, or delete various foods and/or supplements from their diet. We recommend “grading” these three symptoms daily on a 0-10 scale (0=good and 10=bad) as this can REALLY help the FM sufferer keep track of various changes that are made in the diet and is extremely useful for future reference.

FOODS: Since many FM sufferers have “sensitivities” to certain foods (reported to be as high as 42% of all FM patients), eliminating these foods makes GREAT sense.

First, it is REALLY IMPORTANT that you KEEP A FOOD JOURNAL for future reference (using the 0-10 scale) as it is impossible to remember all the reactions or responses to various foods even a day or two later, but especially a week or month later! Some common food offenders include MSG (commonly found in Chinese food – simply ask for the MSG to be NOT included when you place your order), certain preservatives, eggs, gluten (grains like wheat, oats, barley and rye), dairy, as well as other common allergens (such as chocolate, nuts, shellfish, and others). Common symptoms may include headaches, indigestion (irritable bowel syndrome), fatigue, and sleep interruptions. When using an “elimination diet,” it is important to make sure you’re getting the essential nutrients in your diet, in which supplementation can help.

Secondly, make it easier to eat in a healthful way! Have fruits and vegetables cut up and ready to eat so when you’re hungry, you can QUICKLY satisfy that urge. Lean meats or proteins are also VERY important! Remember, a well balanced diet gives you the “ammo” needed to fight fatigue, hurt less, help you sleep more deeply, and give you energy. By doing so, you will be able to stay more active and productive. Accept the fact that unless you pre-prepare the foods, you will instinctively reach for pre-packaged, no prep time, “fast food” options that most likely have poor nutritional content. Look for healthy foods that do not require a lot of preparation such as buying pre-washed, pre-cut vegetables. Some deli sections have pre-prepared foods like beet salad or quinoa that can be purchased in small quantities to add variety to your diet.

Third, plan for WHEN you eat. It is well known that eating small meals frequently during the day helps increase energy levels, such as at 9-10am and 2-3pm, especially if you’re feeling tired. Make sure the word “SMALL” is understood or else you’ll gain weight and not be hungry for the next meal! ALSO, DON’T SKIP BREAKFAST, AND DON’T EAT LATE AT NIGHT!!! Our metabolic rate (which regulates how efficiently we digest and breakdown our food) is highest in the morning and slowest at night. Try to include some protein and whole grains with your breakfast such as a boiled egg and oatmeal as this keeps the blood sugar from spiking and provides energy that lasts longer. Next month, we will look at supplementation including vitamins, minerals, and herbs that GREATLY help as well.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Fibromyalgia (FM) Facts

What is Fibromyalgia Anyway?
Fibromyalgia (FM) is a disabling condition of the myofascia, or the fibrous connective tissues that surround muscles, that can include widespread musculoskeletal pain along with fatigue, sleep disturbance, memory changes, mood changes and more. Fibromyalgia is an epidemic diagnosis and continues to grow. The most affected group is women from the age of 30 to 50.

Studies show that FM amplifies or increases painful sensations by changing the way the brain processes pain signals. FM is NOT a psychological disorder that only people with a troubled past or present acquire. Nor is it due to being inactive or lazy.

What are the Symptoms of Fibromyalgia?

  • Chronic muscle and joint pain, muscle stiffness, leg cramps
  • Painful trigger points – small penny-sized tender spots scattered over the body in 18 specific target areas
  • Unrefreshing sleep, insomnia, depression, anxiety
  • Fatigue, sometimes overwhelming
  • Increased sensitivity to drugs, chemicals, foods, light and/or sound, changes in temperature
  • Dizziness
  • Difficulty concentrating
  • Numbness or tingling of arms, legs or feet
  • Irritable bowel, irritable bladder

What Causes Fibromyalgia?
Most researchers believe fibromyalgia is caused by a combination of factors, which may include genetic predisposition, stress, trauma, and chemical or hormonal imbalances. A deficiency of the neurotransmitter serotonin, responsible for its calming, anti-anxiety properties, has been highly implicated, especially since women have lower serotonin levels than men, and patients given SSRI medication (selective serotonin reuptake inhibitors) such as Zoloft, Cymbalta or Lyrica, have shown improvements in Fibromyalgia symptoms.

In 1990, the American College of Rheumatology established 2 criteria for diagnosing FM. The first is widespread pain lasting at least 3 months, and the second is the presence of at least 11 out of 18 positive tender points. Since then, less emphasis has been placed on the exact number of tender points, while ruling out other possible underlying conditions that might be causing the pain is now utilized. Treatment is best approached by a “team effort” combining the skills from multiple disciplines including a primary care doctor who “believes in FM” and is willing to work with chiropractors, and others. Exercising, pacing yourself, accepting your limitations, yoga, psychological counseling, nutritional counseling, and having strong family/friend support are all important in the management of FM.

What Treatments are Available for Fibromyalgia?
In addition to numerous drugs on the market, many people find relief using physical modalities to treat their symptoms. Traditional therapies like chiropractic manipulations, physical therapy and massage therapy have produced high levels of lasting success for many. In addition, new research is proving the benefits of acupuncture. Finally, new technology like class IV deep tissue laser therapy to treat the pain points can also be very effective.

Reprinted with permission from Think Teachers Magazine.