Fibromyalgia

It is needless to say a frustrating and distressful health concern.

Most patients with fibromyalgia present to the clinic with long-term muscle and joint pain inconsistent and variable in its
intensity. However most patients respond very favourably with a combined protocol of diet and nutritional supplementation.

Magnesium is always prescribed and this alone (as long as it is the right type of magnesium), often brings some immediate
relief. I always ensure that the magnesium supplement also contains malic acid.

Substance P is a neurotransmitter that triggers a pain sensation. In patients with fibromyalgia, substance P is elevated in
nerve fibres at the tender points. Magnesium helps to degrade substance P.

Another possible cause of fibromyalgia is oxygen starvation at tender muscle sites, together with a reduction in energy (ATP) production. This leads to the breakdown of muscle tissue, and consequently muscle pain. Magnesium and malic acid can reverse these effects by both being pivotal in energy production and having oxygen-sparing properties. Magnesium and malic acid also have the ability to counteract aluminium accumulation.
Supplementation with magnesium and malic acid over 8 weeks has been shown to improve symptoms by 67%.

Carnitine, an amino acid (Acetyl-L-Carnitine), also plays a crucial role in cellular energy production in muscle tissue.
Acetyl-L-Carnitine supplementation at a dose of 1000–1500 mg daily over 10 weeks has been shown to improve musculoskeletal pain and depression scores in patients with fibromyalgia.

It is also crucial to rule out vitamin deficiency. Many recent studies have suggested that patients who have been labeled with
fibromyalgia are, in fact, suffering from vitamin D inadequacy.

Vitamin D is a steroidal hormone that binds to receptor sites in
many parts of the body, including bone, muscles and nerve tissue, to stimulate a biophysical response. This means it regulates bone strength, muscle strength, and neural pain messages … all the areas that are affected by fibromyalgia. (Need to exclude osteomalacia too.) In Saudi Arabia where women are veiled or conservatively dressed, vitamin D deficiency was diagnosed in 100% of women with fibromyalgia who participated in a study. Certainly, vitamin D supplementation must be strongly considered in the treatment of all fibromyalgia patients, as it can significantly reduce pain symptoms.

Any food intolerances must also be identified, and a diet high in fresh fruit and vegetables, oily fish and adequate water is recommended. Grains, especially wheat and all refined sugars should be avoided. Massage is helpful for symptomatic relief.