More on this book
Community
Kindle Notes & Highlights
Read between
May 23 - May 25, 2020
preparing to drop out of school completely. Then I read Claire Musickant’s Fibromyalgia: My Journey to Wellness.
naturopath.
John F. Barnes’ Myofascial Release Approach, which
Based on my own relief with myofascial release I was convinced that the fascia was the source of fibromyalgia pain, and my research has focused on it ever since.
Frida Center for Fibromyalgia, in Lake Oswego, Oregon.
you will learn, I do feel that there is a specific cause for fibromyalgia and thus refer to it as a disease or illness throughout this book.
The eighteen tender points used to diagnose fibromyalgia.
Instead, a patient must describe widespread pain in specific areas of the body
and moderate to severe symptoms of fatigue, waking unrefreshed from sleep, and cognitive dysfunction. These newer criteria are still being refined and have not been officially adopted by the American College of Rheumatology as of the writing of this book, but many specialists have already started using them in addition to a
2014 researchers at Virginia Commonwealth University discovered a specific pattern of inflammatory chemicals in the blood of fibromyalgia subjects (Sturgill 2014). Other researchers found that certain types of white blood cells do not respond normally to chemical stimulation in patients with fibromyalgia. The results were so striking, in fact, that it was developed into a test for consumers, called FM/a, which they are calling “the first objective diagnostic test” for fibromyalgia
(Behm 2012).
is this overactive immune response, not a viral infection, that leads to fatigue, low-grade fevers, sore throat, and swollen lymph nodes. Fibromyalgia, on the other hand, usually has a gradual onset, and is not associated with fevers, sore throats, or lymph node swelling. For patients with both fibromyalgia and chronic fatigue syndrome, I find that they still need my complete four R’s regimen, but also benefit from addressing any immune system problems directly.
The crux of the debate is that the available blood tests for Lyme disease are not very accurate. Generally, the best way to test for infection is to take a blood or fluid sample and see what bacteria
in the lab, so instead we look for
positive on both tiers to be officially diagnosed with Lyme. The International Lyme and Associated Diseases Society estimates that these antibody tests are wrong about 40 percent of the time. Instead of relying exclusively on those results, the society emphasizes the importance of a doctor’s clinical judgment. If you are concerned that you may have chronic Lyme disease, I highly recommend you find a knowledgeable practitioner, a “Lyme-literate doctor.” In my region this is usually a naturopath, but it will vary
hyperactive stress
Growth hormone is essential for muscle and nerve health, and it’s found to be low in fibromyalgia patients, most noticeably
The secretion of cortisol, the stress hormone, is also affected (Mahdi
When the muscles and their surrounding connective tissue, called the fascia, are chronically tightened, as in fibromyalgia, they become inflamed and painful (Spaeth
Even at rest, fibromyalgia muscles show the level of lactic acid you would expect in someone who has run a 5K race (Gerdle 2010). Nonstop muscle tension is equivalent
Thus, to reduce inflammation we must improve deep sleep and treat it at the source: hidden infections and food sensitivities.
Chemicals secreted by the fight-or-flight nerves irritate pain-sensing nerves (the nociceptors) into sending louder signals, and in fibromyalgia they become exceptionally
This results in hypersensitivity to pain, also called central sensitization (because the central nervous system has become more sensitive to pain). Studies have shown three times more
substance P, a chemical that is important in the transmission of pain signals, in the spinal fluid of fibromyalgia patients compared
printable version is available
When scientists have analyzed the levels of magnesium inside red blood cells in fibromyalgia patients, they are consistently low (Eisinger 1994). Hair testing analysis has also confirmed
Oral magnesium supplements help support healthy adrenal function and boost energy production (see chapters 13 and 15 for more information), but to trigger a relaxation response, you need to get the high doses that can only be attained by letting your skin and muscles soak it up.
We absorb magnesium better through our skin than through our intestines, so a transdermal application is an effective way to trigger relaxation. You may bathe in Epsom salt or rub magnesium oil or lotion on your feet and legs before bed, which guides the body into deeper sleep and acts as natural relaxant to tight muscles. Be
In fibromyalgia, normal sleep patterns are disrupted and sleep is of very poor quality: light, choppy, and lacking the normal periods of “delta wave” or deep sleep (Moldofsky 2008). Studies consistently show that patients with fibromyalgia don’t spend much time in deep sleep, and the deep sleep they do get is interrupted by fast “wakeful” brain waves (alpha waves) that are normally only seen in the awake brain, a phenomenon called “alpha-wave intrusion”
Most sleep studies ordered by doctors attempt only to diagnose sleep apnea and thus don’t report the number of alpha intrusions, which must be done by hand and is labor intensive. There is also no consistent way to document the frequency of alpha waves. But exciting new research done by Dr. Victor Rosenfeld, a sleep physician, may change that. He has developed a specialized computer program to quickly analyze a sleep study by counting the alpha waves (awake) compared to delta (deep sleep) waves, which gives a delta-alpha ratio. He has found that a low delta-alpha score (a disproportionate
...more
The cause of alpha intrusion seems to be the stress response system, which in a healthy person is quiet at night, but in fibromyalgia remains continually active (Kooh 2003). The brain won’t allow itself to fully sink into deep sleep because it’s trying to remain awake in order to fight off a threat by “sleeping with one eye open.”
fibromyalgia sleep, proposed back in 1975 that it should be considered a “non-restorative sleep syndrome.” He was able to induce fibromyalgia
RLS is related to low levels of the brain chemical dopamine. Iron is required for production of dopamine, so people with iron deficiency anemia often have restless legs. Because of this iron-dopamine connection, if you have RLS it is important to monitor your iron levels and replace any deficiency. Testing includes a complete blood count and measuring the levels of iron and ferritin (the best way to gauge the amount of iron in your bloodstream). In the case of RLS, however, it is not just the level of iron in your bloodstream but the amount in your brain that matters. People
temazepam (Restoril)
Eliminate nighttime benzodiazepines and opiates.
Avoid caffeine after 2 p.m.
Some of these medications have good research behind them, with studies showing that they increase deep sleep or are otherwise helpful for sleep in fibromyalgia. In those cases I have
deep sleep, with a few exceptions. Trazodone is an antidepressant that is very sedating and has a long history helping people fall asleep; it also slightly
most commonly prescribed sedatives for insomnia are known as the “Z-drugs”: zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata). Z-drugs are distant cousins of benzodiazepines (like the antianxiety medications clonazepam or lorazepam). They bind to the same brain receptors as benzodiazepines, but they do so in a very different way. This is an important distinction, because benzodiazepines have a negative impact on sleep (and some other side effects too; see FAQ), while Z-drugs have a neutral or even positive effect on sleep quality in fibromyalgia. For example, eszopiclone
...more
Another sedative that is not a Z-drug is now on the market in the United States, and it works in a very different way to induce sleep. Suvorexant (Belsomra) blocks the actions of orexin, one of the wakeful chemicals in the brain. By blocking orexin, it changes the brain from wake to sleep mode. So far, in my limited experience, it seems to work well and have few side effects, but as a newer medication it is very expensive.
boost digestive power, you can take enzyme supplements with meals. The most effective are those that contain stomach acid, usually in the form of betaine hydrochloric acid, along with pancreatic enzymes. Keep in mind that it is not safe to take acid-containing digestive supplements if you have stomach ulcers; it can make them worse. Both steroid medications and nonsteroidal anti-inflammatories (NSAIDs) increase the risk of developing stomach ulcers, so if you take either of those medications regularly it is best to avoid acid-containing digestive enzymes. Instead, take digestive enzymes
...more
often recommend that patients stop or lower their dosage as part of strengthening digestion, but make sure to talk to your HCP first, as people with certain medical conditions, such as severe GERD or stomach ulcers, do need them. Interestingly, the symptoms of low stomach acid often mimic those of excess stomach acid. Naturopathic doctors believe that the underlying cause of GERD is not an overproduction of acid, but actually an underproduction. The theory is that low stomach acid levels cause the sphincter muscle on top of the stomach to relax, allowing what little stomach acid there is to
...more
esomeprazole (Nexium)
People with fibromyalgia on average allow nearly twice as many large particles through their small intestinal wall as control subjects (Goebel 2008). The immune system mistakenly recognizes them as foreign attackers, so they are more likely to bring about symptoms of inflammation such as fatigue and pain.
Reducing Leaky Gut • Minimize use of NSAIDs. • Take probiotics. • Take L-glutamine 500 mg three times a day.
alternative prescription anti-inflammatories. You
glutamine, an amino acid that is the primary fuel for the cells of the small intestine, has been shown to reduce gut leakiness (Quan
About 70 percent of patients with fibromyalgia also have irritable bowel syndrome (IBS) (Veale 1991), so the final step in repairing digestion is to reduce its symptoms: abdominal pain, bloating, constipation, diarrhea, and nausea. Alternating bouts of constipation and diarrhea are common.
also recommend a daily probiotic supplement to restore a healthy balance of bacteria in the intestine. One study found that four weeks of probiotics (Bifidobacterium lactis, Lactobacillus rhamnosus, and Streptococcus thermophilus) lessened IBS symptoms in 68 percent of patients (Yoon 2014). To keep up a diverse balance of intestinal bacteria I recommend changing brands every few months to
ones with different species. Avoiding foods that
