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May 23 - May 25, 2020
adrenals as a car, it can be running very low on gas but still be drivable. In adrenal insufficiency the gas tank is empty and the car won’t move.
Based on what I had learned in med school, I was initially quite skeptical that adrenal burnout even existed, but I became a convert once I saw so many of my patients benefit from treatment with naturopathic providers. If you are concerned that you may have adrenal burnout, I encourage you to talk to your HCP about getting salivary cortisol testing for an accurate diagnosis. Since many Western providers aren’t trained in the concept, you may have more success working with a naturopath or holistic HCP for testing and treatment.
see it more often in patients who in addition to fibromyalgia also have hypothyroidism or chronic fatigue syndrome, or are on long-term high-dose opiates.
Daily Recommended Thyroid Support Nutrients Selenium 200–400 mcg Zinc 15–30 mg Vitamin D 2,000 IU Vitamin A 2,000 IU Iodine 150 mcg Iron supplementation to achieve a ferritin of 50–100
Finally, iron deficiency impairs thyroid hormone production, so it is important to get checked if you have hypothyroidism. The most sensitive marker for iron stores in the body is ferritin, and although a low ferritin is considered to be 10 or below, the range for optimal thyroid function is 50–100. Vitamins A and D also support healthy
High levels of inflammation also interfere with the body’s ability to utilize thyroid hormones, and one of the most common hidden culprits is sensitivity to foods, especially gluten.
you are concerned about undiagnosed or undertreated hypothyroidism, consider seeing a naturopath or holistic HCP.
For men with fibromyalgia, low testosterone levels will exacerbate their symptoms (Traish 2009).
complicating factor is that many men with fibromyalgia are on opiate pain medication, which suppresses testosterone—one study found that 74 percent of men on high-dose opioids had low levels of the hormone (Smith 2012; Daniell
Symptoms of Low Testosterone • Lack of energy
Lethargy • Sadness/grumpiness • Diminished muscle mass and weakness • Decreased strength and endurance • Erection weakness • Decreased libido
Some studies show that testosterone replacement increases a man’s risk of heart attack and stroke, while others report that it is protective and reduces the risk of heart attack and stroke (Vigen 2013; Xu 2013; Malkin 2010; Schwarz 2011). It may also increase the risk of prostate cancer, although several large studies showed no danger (Roddam 2008;
you do go on testosterone, you should screen for prostate cancer before and during treatment.
Conversion of folic acid. Another option is the supplement 5-hydroxytryptophan (5-HTP), which your body converts into serotonin. When combined with other serotonin-increasing medications like antidepressants, it can cause serotonin excess, which can be toxic and lead to serotonin
If you currently take antidepressants, talk with your HCP before trying 5-HTP.
be skeptical if I hadn’t experienced stunning results myself. At my first visit with an energy healer we talked briefly
Energy work or myofascial release might not be right for you, but please pursue whatever path feels right to heal from the emotional and spiritual damage that trauma can inflict.
ecthealth.com. • Ask about risks before taking 5-HTP, especially if you are already on prescription antidepressants.
Unfortunately, many of the medications used to treat fibromyalgia pain have side effects of sedation and sleepiness. The most sedating medications are pregabalin (Lyrica), gabapentin (Neurontin), and the muscle relaxants. To
pregabalin (Lyrica)
noon and in long-acting or extended-release forms. The newer stimulants modafinil
obstructive sleep apnea. Several
reports have shown that modafinil and armodafinil can improve fatigue in fibromyalgia,
Certain amino acids (protein building blocks) called branched-chain amino acids can also mitigate fatigue (Greer 2011). They work by blocking the absorption of tryptophan, one of the main chemicals that causes the brain to sense fatigue (and briefly acknowledged every Thanksgiving). These amino acids include leucine, isoleucine, and valine and can be supplemented at 1,200–3,000 mg per day, in divided doses, between meals. This kind of amino acid also reduces muscle damage during exercise, so can relieve fibromyalgia muscles that are working hard even while at rest (Greer 2007).
Fibromyalgia patients demonstrate decreased blood flow in areas of the brain important for cognition and increased blood flow in pain-processing areas (Glass 2011).
production, which have the added benefit of improving brain function. These powerhouse nutrients include alpha-lipoic acid, acetyl-L-carnitine, and CoQ10. They act as protectors of nerve cells and can improve memory and brain power (Packer 1997; Liu 2008; Kobayashi 2010; Orsucci 2011). Other nutrients that support nerves include activated B vitamins and omega-3 fatty acids (Suchy 2009). The good news is that these supplements can help both fibrofog and pain, but it can take time for the full benefits to become clear, so take them for at least three months before judging their effectiveness.
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known as central sensitization (because the central nervous system has become more sensitive to pain) (Lee 2011; Murphy 2012; Cagnie 2014).
have our old friend, the fight-or-flight nervous system, to thank. Constant fight-or-flight signaling acts as an irritant to the pain-sensing nerves and flares up hypersensitivity
The
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other trigger is excessive pain signals from the muscles and other tissues that overwhelm the volume control syst...
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most common are the beta-blockers, usually used as treatment for high blood pressure, which inhibit the action of signaling chemicals used by the fight-or-flight nerves. Some beta-blocker medications, including atenolol and metoprolol, primarily work on the heart, whereas others block fight-or-flight nerves in both the heart and in muscles; those are the ones we use in fibromyalgia. Pindolol and propranolol can both reduce fibromyalgia pain (Wood 2005; Light 2009). Linda, my patient with Lyme disease and fibromyalgia, had a significant abatement in pain once she started pindolol. Beta-blockers
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If you are on another medication for high blood pressure, talk to your doctor about trying pindolol or propranolol instead.
a compounded pain cream for fibromyalgia that includes clonidine, and I have found it very effective for local pain relief (Campbell 2012). (See the compounded medication section below and on the following page for more details.) Muscle: Reducing Inflammation
NSAIDs show up at a concentration four to seven times greater in muscular tissue after topical versus oral administration (Tegeder 1999; Dominkus 1996).
Prescription Topical NSAIDs
