Overview
Fibromyalgia is a diagnosis of exclusion, which means all other diagnoses causing similar symptoms need to be ruled out. Patients with fibromyalgia experience generalized aches, throbbing, burning or stiffness at three different anatomical sites for at least three months. On exam, they have multiple reproducible tender points. They can also experience generalized fatigue, sleep disturbance, neurological or psychological complaints such as mood disorders, numbness or tingling of extremities, joint swelling, chronic headaches, jaw or facial pain, bladder pain, irritable bowel syndrome, and a variation of symptoms with changes in activity, weather, or stress.
There is no single cause of fibromyalgia. It is thought to be due to a change in pain perception, known as “central sensitization.” Certain people may be genetically predisposed to this change in pain perception, and it may be triggered by various stressors, such as physical or emotional trauma, infections, poor sleep habits, hormone dysregulation, and years of eating the Standard American Diet. This low-nutrient diet causes damage to the gut lining resulting in increased intestinal permeability and small intestine bacteria overgrowth which contributes to the hypersensitivity experienced by patients. With a Nutritarian diet, patients improve and most resolve their symptoms.
Action Plan
Diet
- A Nutritarian diet, with its high micronutrient density, includes a broad variety of vitamins, minerals, and phytochemicals to help heal the gut, regulate hormones, and boost the immune system. This diet-style has helped numerous patients resolve their fibromyalgia symptoms entirely. The addition of green juicing and/or green smoothies may aid resolution of the condition by enhancing tissue isothiocyanates and other phytochemicals that enhance cellular detox and repair.
- Food sensitivities may play a role in producing symptoms. An elimination of gluten and dairy, the two most common allergenic foods, may be beneficial for a time period of 2-4 months.
- Supplement appropriately following my general guidelines to assure sufficiency of Vitamin D, zinc, DHA, iodine, and B12. Probiotics can also be helpful for many with fibromyalgia and should be added for the initial period until improvements are noted.
Exercise
Exercise regularly as appropriate to individual tolerance. Tai chi for example, has demonstrated benefits in patients with chronic pain syndromes through its adaptive exercise, mind-body interaction, and meditation.2Sleep
- Aim for 7-8 hours of sleep per night, making sure to go to bed at the same time each night in a completely dark room. Expose yourself to bright light early in morning soon upon awakening.
- Avoid stimulants like caffeine or nicotine, and do not eat 2-3 hours prior to bedtime.
- Keep a consistent relaxing bedtime routine avoiding any stressful, stimulating activity. Use the bed only for sleeping, not for reading or watching TV.
- Avoid naps during the day which will disrupt the sleep-wake cycle.
◇ References:
- Chakrabarty S, Zoorob R. Fibromyalgia. Am Fam Physician 2007, 76:247-254.
- Peng PW. Tai chi and chronic pain. Reg Anesth Pain Med 2012, 37:372-382.
