Treatment Of FibromyalgiaUntil the advent of alternative medicine methods
(from the anti-aging medicine branch) the standard multidisciplinary treatment
protocol described below had a success rate of about 40 to 50%. When a thorough
assessment of the hormone status is done and the missing items are replaced, as
described under "alternative medicine treatment of fibromyalgia" below,
the treatment success rate can be as high as 85 to 90%. It is important to be
aware that there are various degrees of severity of fibromyalgia, which correlate
to various degrees of hormone and nutritional deficiencies (at the level of brain
hormones and of the hormone glands of the body). Whatever is missing has to be
supplemented in natural form (bioidentical hormones and nutraceuticals). I will
deal with both treatment approaches under separate headings, but they can be combined.
Standard Treatment of Fibromyalgia:Treatment of fibromyalgia consists
of a comprehensive program, where the various factors that are observed in the
patient are addressed. The sleeping disturbance, if present, is treated with cyclobenzaprine
(brand name: Flexeril, Flexitec) at bedtime. This medication, which is an tricyclic
antidepressant, is used mainly as a muscle relaxant, but has been found in fibromyalgia
patients to restore abnormal sleep patterns. Another medication that can be
used for this is the antidepressant trazodone ( brand name: Desyrel, Trazorel),
which when taken at bedtime seems to help not only to normalize the sleeping pattern,
but also lift the mood (antidepressant effect) and thus help with some of the
myalgias (painful muscles).
| Multidisciplinary treatment
approach for fibromyalgia | | Target
symptom: | Treatment modality: |
| muscle deconditioning | swimming,
aquatherapy, walking, and mild stretching exercises (better tolerated with IceWave
patches from Lifewave in place) |
| muscle spasm and tender spots | 1)
Local heat treatments, massage therapy, chiropractic adjustments and physiotherapy,
aquatherapy | | 2) trigger
point injections by the physician | | sleep
disorder | cyclobenzaprine (brand name: Flexeril, Flexitec)
or trazodone (brand name: Desyrel, Trazorel), however see remarks on the use of
conventional drugs under "Alternative Medicine Treatment" below |
| mild to moderate depression | SSRI
antidepressant medication (but see remarks on the use of conventional drugs under
"Alternative Medicine Treatment" below) |
| anxiety | yoga, meditation,
self-hypnosis, prayer, cognitive and behavior therapy, psychological counseling;
bioidentical hormone replacement will often also treat anxiety naturally (see
Ref.8) | Many of the SSRI
antidepressants have a similar effect as trazodone. They also help
to lift depression, which is another symptom complex that the physician will treat.
Physical activities in the form of swimming, aquatherapy, walking, and mild stretching
exercises are instituted. Often it might be best to do this as part of a local
fibromyalgia support group, as motivation could otherwise be a problem. Local
heat treatments, massage therapy, minor chiropractic adjustments for spinal malalignments
are all useful modalities as is physiotherapy for flare-ups of the muscle aches
and pains. Trigger point injections by the physician with 1% Xylocaine (occasionally
with a small amount of cortisone mixed in) may be very useful for more painful
muscles. Meditation, self-hypnosis,yoga, cognitive and behavior modification
therapy are all useful adjunctive methods to help with the associated anxiety
and depression along the medications mentioned above. These latter methods help
with coping strategies in the treatment of fibromyalgia (Ref. 4).Alternative
Medicine Treatment of Fibromyalgia: According to the interviews with
a number of anti-aging doctors contained in Suzanne Somers' book "Breakthrough"
(Ref.8) fibromyalgia is often associated with hypothyroidism and may include other
hormone weaknesses (weak adrenal glands, low human growth hormone levels) and
also often low steroid hormones (testosterone, estradiol, progesterone). This
can be determined with appropriate blood tests (T3, T4, 24 hour urine for cortisol,
DHEA, IGF-1), which your regular physician may not be comfortable ordering. However,
any of the anti-aging physicians listed in the back of Ref.8 would have no problems
ordering and treating this.
Here are the major treatment steps using an anti-aging
type approach for the treatment of fibromyalgia:
1. This new approach
to treat fibromyalgia puts emphasis on detoxifying the body, starting a low
glycemic well balanced diet, exercising
regularly and keeping you away from as many conventional drugs
as possible including antidepressants (including trazodone mentioned above). The
reason for this is that all of the hormones including the brain hormone serotonin
need to be balanced to treat fibromyalgia successfully.
2. Insomnia
is treated with a combination of melatonin capsules in the dosage range of 3 mg
to 15 mg at bedtime. Dr. Lichten (Ref. 9) treats insomnia with a combination of
L-Tryptophan 500 mg to 1000 mg combined with 125-250 mg of sublingual GABA at
bedtime. This can also be combined with melatonin as indicated. Dr. Lichten treats
with GABA only for 5 to 6 nights per week as tolerance can quickly develop through
saturation of GABA receptors in the brain. But by taking a GABA rest for 1 to
2 days in a week the receptors reset themselves.
3. Another important
point to note is that magnesium deficiency leads to increased anxiety and restless
leg syndrome. Chronic insomnia also depletes the cells' magnesium content (Ref.9).
Dr. Lichten recommends taking 1000 mg of magnesium supplements daily. Alternatively
a couple of teaspoons of milk of magnesia will also provide the body with the
equivalent of magnesium and keep the bowels regulated at the same time.
4.
Vitamin D sublingual drops at a dose of 1000 mg to 5000 mg have a very beneficial
effect on getting a good night's sleep. However, we do know from the more recent
literature that higher doses of vitamin D help prevent diabetes, cancer, and treat
chronic muscle aches and pains, particularly of the fibromyalgia type (Ref. 9).
Dr. Lichten recommends that your doctor should order a 25-hydroxyvitamin D level
initially and bring this up to and above 50-6- ng/mL with vitamin D drop supplementation.
5. Fibromyalgia patients are not all the same when saliva hormone tests
and blood screening tests are analyzed. However, the physician will find that
invariably there are some deficiencies in some of the anabolic type hormones (testosterone,
human growth hormone and DHEA). Whatever hormone is weak, needs to be replaced
by bio-identical hormone replacement (Ref. 10 and 11). Postmenopausal women need
extra hormonal replacements as described under menopause,
males need replacements as described under male
menopause. If IGF-1 tests below 80 ng/mL, this indicates a growth
hormone deficiency. In such cases somatotropin (brand name: Saizen) is given with
a low dose of 1 international unit per day subcutaneously for 5 to 7 days per
week (Ref. 9). Dr. Lichten describes several cases of astounding recoveries from
fibromyalgia using low dose human growth hormone injections in this reference.
6. Nutraceuticals (high dose vitamins and minerals as described under
vitamins,
minerals and supplements) are also required to stimulate the mitochondria
to supply the body's cells with adequate energy. As often the digestive tract
is slow pancreatic enzymes as supplements can improve the absorption of food,
vitamins and supplements (Ref. 9).
7. Exercise is now possible when
the muscle aches are under control and this should consist of a regular walking
program, swimming, ballroom dancing etc. This is important as endorphins that
are released in the brain by exercise will help to control the muscle aches and
pains as well. Yoga exercises, meditation, prayer and self-hypnosis treatments
will help to overcome anger and resentments that would otherwise feed into the
adrenalin release/muscle tension cycle. Patience is required to await the full
benefit of all of these treatment factors. It often takes 6 to 12 months for a
good response to all of these factors (Ref. 9, 10, 11).
8. Detoxification
of the body from lead, mercury and other heavy metals by intravenous treatments
(Glutathione 750 mg to 1250 mg, mixed with 10,000 mg of vitamin C in Ringer's
lactate) and given in intervals twice per week up to 20 to 30 treatments in total
will help the patient to regain a lot of the lost energy. This intravenous treatment
can also been augmented by adding a number of minerals (called "Myer's
cocktail"), which help to balance the cell metabolism. This
latter treatment possibility is particularly important in those cases where fibromyalgia
presents together with irritable bowel syndrome. In these cases there can be malabsorption
of minerals and nutrients and Myer's cocktail can lead to remarkable improvements.
All of these points should be done in combination and should be co-ordinated
with the items mentioned in the "multidisciplinary treatment approach for
fibromyalgia" table above to get the best possible treatment success.
Another link
re. fibromyalgia treatment. |
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