Fibromyalgia and
Chronic Fatigue Syndrome
No longer a mystery
Imagine being so tired that you can’t function. I’m not talking about being pooped at the end
of a long day at work or exhausted after a big hike. I mean the kind of tired that prevents working
a normal job or the kind of tired that only allows doing a few hours of chores
before having to go back to bed from being so wiped out. Normally exercise gives one a bit of energy
but not this type of tired – if not careful exercise just makes it worse.
Now consider having this type of fatigue all the time, for
months to years on end without relief, and even rest won’t help. To make matters worse insomnia is usually
present as well, so although one may be “dog-tired” they can’t even get a sound
night’s sleep. This is the definition of
“chronic fatigue syndrome” (CFS) and it is called a syndrome because there is
not one simple cause for the fatigue.
As if this fatigue was not bad enough now let’s add
pain. A deep aching kind of pain that
moves throughout the body, in the tissues and bones and joints, as well as
isolating to 18 specific points about the body.
These tender points, called “trigger points”, are like epicenters of
pain and touching them with just enough pressure to blanch your fingernail
produces severe pain. The pain syndrome
that centers on the tender trigger points is called “fibromyalgia”.
About half of people with fibromyalgia also have CFS and visa-versa. Fibromyalgia affects an estimated 10 million
people in the U.S. and an estimated 3% to 6% of the population worldwide,
according to National Fibromyalgia Association. For some reason about 80-90% of fibromyalgia
sufferers are women. The good news is
that effective treatment is possible for most of these patients.
What is Fibromyalgia?
Dysfunction in a few key systems seems to be the common
denominator with fibromyalgia. Areas
involved include the cellular energy producing mitochondria, the “all
controlling” part of the brain called the hypothalamus, and the immune system.
Defects in the mitochondria powerhouses lead to the lack of
energy, fatigue, muscle shortening and pain. Abnormal control signals from the hypothalamus
leads to disrupted sleep, which then causes a lack of important healing
hormones, physical rest and tissue repair.
Further changes in the autonomic nervous system are related to the abnormal
pain signaling. The immune system
changes lead to altered balance of immune pathways that result in excess
inflammatory chemicals called cytokines.
We are finding that these dysfunctional systems are caused
by a combination of conditions from genetic defects in metabolic and
detoxification pathways, to external stressors such as infections, toxic
chemicals, or heavy metal accumulation in the body. Poor nutrition and stress are two very
important lifestyle issues that play a role.
Diagnosis
The first step for most patients is getting a proper
diagnosis. Many physicians still doubt
the diagnosis of fibromyalgia even exists and rather simply point to depression,
pain or insomnia as the main issue.
Fortunately, this is changing and along with it more and more patients
are getting the correct diagnosis, followed by successful treatment that is
rooted in integrative and functional medicine.
That is, there are many different body systems to investigate and
treatment modalities to integrate into a plan that gets to the root cause of
this tricky syndrome.
First of all, fibromyalgia is a purely clinical
diagnosis. There is not a specific lab
test or imaging study that makes the diagnosis.
Many of us practitioners familiar with treating fibromyalgia and CFS have
quit making such a big deal out of needing the recommended 11 out of 18 tender
trigger points to make the diagnosis. At
the end of the day, having widespread persistent pain, above and below the
waist, on both sides of the body and along the midline of the body, meets the
definition of fibromyalgia.
Other symptoms that are often present with fibromyalgia
include severe fatigue for more 4-5 months, fatigue that is worse after
exercise, insomnia, depression or brain fog, bowel issues, recurrent or
frequent infections, and multiple chemical or medication sensitivities.
Treatment
Our general treatment goals are to “rest, fortify and
restore”. We restore function with
natural supplements, nutrition, sleep control, nervous system balance and
hormone supplementation. It is critical
to eliminate energy drains such as stress, allergies, intestinal disorders,
infections and heavy metal accumulations.
Restoring cellular energy involves using numerous supplements
that help heal and “tune-up” the energy producing mitochondria. Specific brain neurotransmitter levels can be
obtained through a simple urine test and imbalances may be treated with
amino-acid precursors and natural compounds that increase or decrease
production of certain neurotransmitters.
As patients improve most of the supplements for energy and brain
chemistry support are usually discontinued.
Treatment for hormone imbalances or deficiencies is
frequently a cornerstone of treatment. A
disturbed adrenal stress hormone system leads to alterations in cortisol
regulation. Undetected low thyroid or
thyroid resistance disorders are common.
Imbalances in sex hormones such as estrogen dominance or menopause are triggers
for fibromyalgia.
The most important role of the immune system is to defend the body from invaders. The cytokines that are made help maintain a
balance in the immune system.
Cytokines influence mood, sleep,
energy, cognitive function and many other important aspects of
health. Physical triggers
(infection s, toxins, allergens) and psychological
events (emotional trauma, mental stress) lead to the increased
production of cytokines. If these triggers
are not resolved, cytokine levels will remain high, resulting in chronic systemic inflammation, which may
cause symptoms that are not immediately recognized as inflammatory in nature.
Fibromyalgia is often started after an infection and is
often associated with persistent, chronic infections. These infections can be yeast/fungal, parasitic, bacterial, or viral.
Most infections involve the respiratory tract including bronchitis or sinusitis, bowel infections, and chronic prostatitis. If the infections don’t resolve with general
treatment then direct treatment is advised.
The exposure to heavy metals such as lead, mercury, arsenic, or cadmium will lead to deposits
in the body that are not detected in blood work (unless it is an acute
exposure).
Heavy metal accumulation is well known to disturb the neurologic, endocrine and immune
systems. Chelation is a process of giving a substance that will bind to
metals and pull the metals out of storage so they can then be eliminated in the
urine.
Working with nutrition, eliminating delayed food allergies, and
healing the inflamed or leaky gut is absolutely critical. Lifestyle issues include removing stressors
and aggravating factors – this might include situations, people, or
toxins.
Sleep, pain, and mood management can all addressed with
combinations of natural supplements and prescription medications. We encourage time for relaxation, time out,
laughter and modest exercise.
Psychological counseling and support of friends and family is key just
like with other chronic health issues.
With fibromyalgia becoming less of a mystery treatments
based on integrative functional medicine are emerging to “lift the veil” of
suffering for many with this perplexing syndrome.
Free
seminars
Fibromyalgia
and Chronic Fatigue Syndrome
Monday,
October 1st at 6pm, at the IMC
The Acne
Cure: Functional Medicine &
Aesthetic Skin Care
Monday,
October 15th at 6pm, at the IMC
Bio
Scott Rollins, MD, is Board Certified with the American Board
of Family Practice and the American Board of Anti-Aging and Regenerative
Medicine. He specializes in Bioidentical Hormone Replacement, thyroid and
adrenal disorders, fibromyalgia, weight loss and other complex medical
conditions. He is founder and medical
director of the Integrative Medicine Center of Western Colorado and Integrative
Weight Solutions. Call 245-6911 for an
appointment or more information.
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