Fibromyalgia is a mysteriously debilitating pain syndrome that often gets lumped into or associated with chronic fatigue and myofascial pain syndromes. No one knows the cause but it may be triggered by injuries emotional trauma hormone deficiency states or viral infections. Traditional approaches typically offer limited success and focus on symptom management.

Functional medicine approaches offer hope for many of these patients. Most physicians are trained to look only in specific places for the answers using the same familiar labs or diagnostic tests. Yet many causes of chronic illness cannot be found in these places. There are several tests that can take snapshots of one's health to investigate the underlying cause of dysfunction. Traditional doctors use a CBC and metabolic panel for their general screening which has its merits. However this can be taken a step further especially for mitochondrial disorders as seen in fibromyalgia patients. We can measure products of metabolism organic acids which identify nutrient deficiencies and are essential in proper cellular functions such as those occurring in the mitochondria. Also this lets us assess serotonin which is of particular interest due to its association in adjusting pain levels and promoting restful sleep. Lower serotonin levels have been noted in some patients with fibromyalgia. In addition organic acids measure catecholamines produced by the adrenal medulla so the adrenals can be supported properly.

Many experts believe that fibromyalgia is not a disease but rather a dysfunctional disorder caused by biologic responses to stress. Studies have shown many hormonal and metabolic abnormalities of fibromyalgia patients. It's important to measure salivary hormones to see the circadian rhythm. In addition this would help address sleep disturbances that may be a precipitating factor in fibromyalgia pain. Disturbed sleep appears to trigger factors in the immune system that cause inflammation and pain.

Fibromyalgia is often associated with irritable bowel syndrome. Since the gastrointestinal tract is 80% of the immune system it is important do a comprehensive digestive stool analysis. Food antibody testing can identify triggers that can cause systemic inflammation and pain.

It is also important to assess environmental toxins. Exposure to toxins such as heavy metals (cadmium mercury or lead) can cause fatigue chronic pain and other symptoms of fibromyalgia.

Often many patients with generalized systemic pain and fatigue get labeled with fibromyalgia. We can't get hung up on labels. Multiple factors can mimic fibromyalgia pain and a successful treatment approach must include investigation into these factors.

A therapeutic approach

There are several supplements to consider for fibromyalgia. Coenzyme Q10 is great for antioxidant support and its role in energy production since mitochondrial disorders limit energy production. L-carnitine deficiency is common with mitochondrial disorders and fibromyalgia. Supplementing with D-ribose is important with its role in energy recovery in fibromyalgia since depletion of cellular energy pools leads to muscle pain soreness and stiffness. Magnesium plays a key role in muscle relaxation and in more than 350 enzyme reactions in the body. It is involved in virtually every metabolic process occurring in the body and many patients are deficient in this mineral. I prefer magnesium malate chelate which is chelated to the Krebs cycle intermediate malic acid to support cellular metabolism. Malic acid helps to make energy as its role in producing ATP. Research shows that malic acid combined with magnesium may relieve symptoms of fibromyalgia.  Since stress plays a big role in fibromyalgia it's important to use adaptogenic herbs to support healthy cortisol levels and optimal adrenal gland health.  Also a high-quality fish oil product is essential in helping to decrease inflammation and support overall health.

by Michael Jurgelewicz DC DACBN DCBCN

30+ experts discussing why the misdiagnosis and improper treatment of fibromyalgia is rampant. Get the facts and learn about recovery today!

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References:

Goldenberg DL et al. High Frequency of Fibromyalgia in Patients with Chronic Fatique Seen in a Primary Care Practice. Arthritis Rheum 1990;33:381-387

http://umm.edu/health/medical/reports/articles/fibromyalgia

Abraham G Flechas J. Management of fibromyalgia: rationale for the use of magnesium and malic acid. J Nutr Med 1992;3:49-59. 

Lord R Bralley J. Alexander. Laboratory Evaluations for Integrative and Functional Medicine. 2nd Edition. Chapter 2: Vitamins. p.48.