Fibromyalgia – Pain By Another Name


HelpingHand I know a lot of people who suffer from some form of chronic pain and alongside that there are often many symptoms which get treated as if they are separate and unrelated.

“Fibromyalgia…is a chronic pain syndrome accompanied by other symptoms such as depression, anxiety, fatigue or sleep disturbances...it has…a greater presence in women than in men…Despite its high prevalence, its etiology is still unknown and there are no effective treatments.

Chronic pain has a number of possible causes but I believe that an underlying hypometabolic state can usually be found. People with ongoing pain issues are sometimes told they have fibromyalgia and then given very little useful help or advice. Sadly, they often end up believing there really is ‘no effective treatment’.

““Fibromyalgia syndrome” (FMS) is the diagnosis clinicians most often give patients who have chronic widespread pain and abnormal tenderness. Most FMS researchers state that the etiology of the disorder is unknown. In doing so, they fail to account for a substantial line of evidence showing that the main mechanism of FMS is inadequate thyroid hormone regulation.”

Women suffer from FMS (as well as thyroid issues) more commonly than men and this is most likely due to lower body temperature, slower liver function and higher estrogen levels.

“…women with FMS had significantly lower resting metabolic rates and basal body temperatures…consistent with too little thyroid hormone regulation of cell function…”

People diagnosed with hypothyroidism are almost always treated with T4 (thyroxine) for hormone replacement. Tests sometimes show a buildup of T4 in the blood of hypothyroid women. This can be because estrogen (as well as low thyroid and body temperature) interferes with the ability of the liver to convert T4 into active thyroid hormone, T3.

Over time this can suppress – rather than improve – metabolic function, eventually worsening the chronic nature and progression of FMS type symptoms.

Recognizing the relationship between thyroid function and chronic pain is very helpful, however many are led to believe that their thyroid has been examined and is now being treated effectively, when this is usually far from accurate.

Unfortunately a culture has also been promoted which erroneously assumes that thyroid issues have been properly ruled out as a factor in many cases of FMS. Widely used modern diagnostic methods lack genuine meaning and accuracy when it comes to assessing sub-optimal thyroid function.

“…a small percentage of hypothyroid FMS patients recover with T4 alone…For most patients to fully recover, however, they must use either combined T4/T3 therapy (with a 4:1 ratio of T4-to-T3) or T3 alone.”

Popular dietary advice given to those already suffering from symptoms of stress and hypometabolism often exacerbate the progression of illness and limit the effectiveness of what might otherwise be a reasonable approach to thyroid hormone replacement.

Polyunsaturated fats are included as a ‘healthy’ alternative to animal fats in many dietary protocols, regardless of the fact that they have been shown to be highly inflammatory and metabolically suppressive.

FMS is an inflammatory condition associated with increased oxidative stress and this is demonstrated in part by higher levels of breakdown products of the polyunsaturated fats (lipid peroxidation) throughout the body.

“…lipid peroxidation, one of the main consequences of oxidative stress, can interfere in the etiology of pain perception, either by induction of central or peripheral hyperalgesia…oxidative damage can cause a local reduction of nociceptors and thereby reduce the pain threshold.”

The consumption of hard to digest grains, seeds, nuts, beans and legumes as well as under cooked starchy and fibrous vegetables (and certain fruits) can promote an overgrowth of bacteria, particularly when digestion and liver function are already sluggish.

More bacteria generally means an increase in endotoxin and serotonin release in the intestines, which can then lead to greater stress on the liver and eventually cause estrogen levels circulating throughout the body to rise. This is likely to worsen inflammation and promote further interference with thyroid function and metabolism.

Tissue injury and inflammation cause more serotonin to be released and rising levels of serotonin have been directly implicated in the progression of chronic pain and many of the other issues which often go along with it.

“Peripheral tissue and nerve injury can lead to hyperalgesia, a state in which painful stimuli are perceived as more painful than normal. One major contributor to hyperalgesia is augmented sensitivity of primary nociceptive neurons, a phenomenon called peripheral sensitization…our results reveal a novel pain mechanism in which…5-HT [serotonin]…maintains central terminal sensitization by activation of presynaptic 5-HT3A receptors…”

Many different things which help to lower serotonin or limit its impact have successfully reduced pain and a variety of related symptoms in fibromyalgia.

“…a novel antidepressant…mirtazapine was used…characterized by selective blockade of 5-HT2 and 5-HT3 [serotonin] receptors…for fibromyalgia…Intensity of pain, sleep disturbances, fatigue and other symptoms were measured…the majority…experienced…improvement…of > or = 40% reduced intensity of fibromyalgia symptoms as well as reduced severity of depression….suggests a common pathophysiology of depression and symptoms of fibromyalgia.”

A hypometabolic state and digestive distress go hand in hand for a number of reasons, and they can probably all fall under the general blanket of metabolic stress. It’s unlikely to be a coincidence that inflammatory bowel issues such as IBS and SIBO have been shown to be involved in the progression of thyroid dysfunction and FMS.

“Up to 32% of patients with fibromyalgia are labelled as having IBS, and 81% report irregular bowel habits…a common finding in both fibromyalgia and IBS is…the presence of bacterial overgrowth…it is likely that endotoxin produces hyperalgesia…”

The substances which rise under stress and which are promoted by excess bacteria and endotoxin release – including serotonin, estrogen and nitric oxide – have been directly implicated in all of these conditions.

“Serotonin (5-HT) precursors such as tryptophan (5-HTP), drugs that release 5-HT…stimulate the HPA axis, indicating a stimulatory effect of serotonergic input on HPA axis function. Hyperfunction of the HPA axis could also reflect an elevated serotonergic tonus in…FMS patients.”

“…NO [nitric oxide] can actively participate in the hyper sensitization in FM…the use of [nitric oxide] inhibitors can be a very plausible alternative for the treatment of painful symptoms such as those presented in FM syndrome.”

Methylene Blue (MB) has been shown to provide protection from bacterial endotoxin, serotonin, estrogen and nitric oxide, as well as directly promoting mitochondrial energy system (metabolic) function. MB has also been shown to inhibit prolactin (which is known to rise alongside increasing estrogen levels) and which has been demonstrated to be high in another chronic pain related condition, polymyalgia rheumatica (PMR).

“…chronic administration of MB has analgesic effects on acute nociception as well as on the orofacial inflammatory pain.”

Under circumstances where sugar is being avoided, levels of stress hormones such as adrenalin and cortisol generally increase, helping to move things in a direction which is more likely to become increasingly hypometabolic.

Sugar restriction promotes the release of polyunsaturated fats out of storage as free fatty acids, aggravating inflammatory issues and causing oxidative stress. The polyunsaturated fats damage the liver, intensify problems associated with endotoxin, estrogen and serotonin and interfere with thyroid hormone conversion into the active form, T3.

This can eventually lead to a vicious circle in which the responsiveness of tissues to T3 is also significantly suppressed, metabolic function is being driven by stress rather than proper energy system performance, and pain is gradually increasing.

There are many different ways to approach the issue of chronic pain and yet they are all interrelated. Biology cannot ever be anything other than holistic. In this sense fibromyalgia is as much a brain issue as it is an hormonal or nervous system problem.

A great example of this is the way that pain dysfunction is now being shown to be able to be treated with the use of ‘brain based’ therapies such as those which look at vestibular and ocular function in relation to improving nervous system performance. Such methods can be said to tap directly into the brain and nervous system, but this is not separate from all else.

“Medical records of 124 patients (78 women, 46 men) were reviewed. Vestibular deficits were detected in 83 patients (66.9%)…Patients being treated with medications for chronic, noncancer pain or other underlying neurologic disorders may have a higher-than-average incidence of vestibular dysfunction.”

Exposure to chronic stress can lead to many different ‘disease’ outcomes with interrelated and overlapping physiological conditions and symptomology. Fibromyalgia and chronic fatigue are sometimes considered to be expressions of the same underlying problems. High levels of nitric oxide, endotoxin, serotonin and estrogen, as well as hypometabolism can all be implicated.

“…chronic fatigue syndrome (CFS), fibromyalgia (FM), multiple chemical sensitivity (MCS) and posttraumatic stress disorder (PTSD)…share common symptoms…Many patients meet the criteria for diagnosis for two or more of these disorders and each disorder appears to be often induced by…stress…followed by a chronic pathology…”

In combination with the treatments that have had success, a diet avoiding the polyunsaturated fats and limiting difficult to digest fibrous and starchy foods, including regular intake of milk, cheese and gelatin, sweet ripe fruits, fruit juice, white sugar and honey, has the potential to help deal with hypometabolism and its many symptoms including chronic pain issues.

Measuring and tracking temperature and pulse can shine a light on thyroid function and metabolism, enabling greater understanding of the impact of diet and other therapeutic approaches being used and providing information which can help improve chances of healing and recovery.

“…likely that too little thyroid hormone regulation of cell function is the main cause of most patients’ FMS...to ignore the evidence…is…not respectable scientific conduct.”

Some other safe things which have had success in treating pain related conditions include thiamine (B1), red light therapy (also in combination with MB), aspirin, activated charcoal, cyproheptadine, low dose naltrexone, progesterone, magnesium and certain antibiotics.

Popular anti-depressants such as the SSRI’s and many current and commonly prescribed pain medications have at the very least, been unsuccessful.

See more here

Inadequate Thyroid Hormone Regulation as the Main Mechanism of Fibromyalgia: A Review of the Evidence

Central terminal sensitization of TRPV1 by descending serotonergic facilitation modulates chronic pain

The complex role of serotonin and 5-HT receptors in chronic pain.

Serotonin in pain and analgesia

Morphine paradoxically prolongs neuropathic pain in rats by amplifying spinal NLRP3 inflammasome activation

Prostaglandin-mediated inhibition of serotonin signaling controls the affective component of inflammatory pain

Reinstatement of long-term memory following erasure of its behavioral and synaptic expression in Aplysia

Repeated methylene blue administration produces analgesia in experimental pain

In polymyalgia rheumatica serum prolactin is positively correlated with the number of typical symptoms but not with typical inflammatory markers

Low-level laser therapy as a treatment for chronic pain

The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain

The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis

Inaccurate Saccades and Enhanced Vestibulo-Ocular Reflex Suppression during Combined Eye–Head Movements in Patients with Chronic Neck Pain: Possible Implications for Cervical Vertigo

Vestibular Dysfunction in Patients With Chronic Pain or Underlying Neurologic Disorders

Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome.

High-dose thiamine improves the symptoms of fibromyalgia

Abnormal overexpression of mastocytes in skin biopsies of fibromyalgia patients.

Effects of antidepressant mirtazapine on fibromyalgia symptoms.

Aspirin attenuates pulmonary arterial hypertension in rats by reducing plasma 5-hydroxytryptamine levels.

Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study.

Metabolic features of chronic fatigue syndrome

Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome

Levels of lipid peroxidation, nitric oxide, and antioxidant vitamins in plasma of patients with fibromyalgia.

Common etiology of posttraumatic stress disorder, fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity via elevated nitric oxide/peroxynitrite.

Involvement of Oxidative Stress and Nitric Oxide in Fibromyalgia Pathophysiology: A Relationship to be Elucidated

Clinical Symptoms in Fibromyalgia Are Better Associated to Lipid Peroxidation Levels in Blood Mononuclear Cells Rather than in Plasma

The role of sleep in pain and fibromyalgia

Oxidative Stress in Fibromyalgia: Pathophysiology and Clinical Implications

Oxidative Stress and Antioxidant Parameters in Patients With Major Depressive Disorder Compared to Healthy Controls Before and After Antidepressant Treatment: Results From a Meta-Analysis

Vestibular evoked myogenic potentials in patients with fibromyalgia syndrome.

Modulation of NMDA Receptor Activity in Fibromyalgia

A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing

Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy

Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes.

Small intestinal bacterial overgrowth syndrome

Management of functional abdominal pain and irritable bowel syndrome in children and adolescents

Cyproheptadine for the treatment of functional abdominal pain in childhood: a double-blinded randomized placebo-controlled trial.

Cyproheptadine: A Potentially Effective Treatment for Functional Gastrointestinal Disorders in Children

Anterior pituitary weight, cAMP, cGMP and prolactin levels after combined treatment with estradiol and methylene blue.

Oral activated charcoal adsorbent (AST-120) ameliorates CKD-induced intestinal epithelial barrier disruption

The Physiologic Effects of Pain on the Endocrine System

Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.

Low Dose Naltrexone in the Treatment of Fibromyalgia.

Selective serotonin reuptake inhibitors for fibromyalgia syndrome.

Indigenous Bacteria from the Gut Microbiota Regulate Host Serotonin Biosynthesis

#thyroidafterall
#pufaispoison
#sugarfeedsthyroid
#zhealth
#raypeat

Image: Jagran Junction: Aapki Awaaz, Aapka Blog: “Social Issues Blog”
Artist: Unknown

You may also like...

x
Please "like" us:Already liked? You can close this