Lisa Nelson RD #10: Do you feel there is a link between heart disease and fibromyalgia? I have noticed many individuals diagnosed with heart disease also diagnosed with fibromyalgia. Could this be due to medications used to treat the heart conditions?
Dr. Shelby-Lane: Fibromyalgia symptoms were akin to the symptoms of several “functional” disorders (i.e., medical conditions that affect bodily function via causes that are poorly understood) including recurrent non-heart-related chest pain, heartburn, heart palpitations and irritable bowel syndrome. However, a number of studies since have detected evidence of abnormalities in the internal organs of many fibromyalgia patients, including heart valve problems, malfunction of the muscles that move food to the stomach, and weakened lung function. These studies suggest that the abnormalities likely are symptoms of a larger disease, not illnesses by themselves.
Because of weakened respiratory muscles an individual finds it hard to breathe and the supply of oxygen to heart is decreased resulting in the above symptoms. Similar is the case with neck pain, due to weakened muscles.
Fibromyalgia (FM) is a recently recognized disorder rheumatologists and practitioners see quite often, especially in women 20 to 50 years old. It is characterized by widespread, chronic musculoskeletal pain, tenderness, fatigue and stiffness affecting muscles, tendons, ligaments and connective tissues with loss of sleep, depression, and shortness of breath. It is a poorly understood condition and there appears to be no universal cause and no single treatment that is effective for every person. Diagnosis of fibromyalgia is based on the tenderness of specific anatomical sites (at least 11 of 18 points) and pain in all four quadrants of the body that has lasted for 3-6 months or longer. It mostly affects the neck, shoulders, lower back, chest and/or thighs. Fibromyalgia patients meet many of the diagnostic criteria for chronic fatigue syndrome. Three to six million people are affected by fibromyalgia.
Possible Causes or Contributing Factors of Fatigue & Fibromyalgia
The cause of fibromyalgia is not known. Patients experience pain in response to stimuli that are normally not perceived as painful. Researchers have found elevated levels of a nerve chemical signal, called substance P, and nerve growth factor in the spinal fluid of fibromyalgia patients. The brain nerve chemical serotonin is also relatively low in patients with fibromyalgia. Studies of pain in fibromyalgia have suggested that the central nervous system (brain) may be somehow supersensitive. Scientists note that there seems to be a diffuse disturbance of pain perception in patients with fibromyalgia.
Also, patients with fibromyalgia have impaired non-Rapid-Eye-Movement, or non-REM, sleep phase (which likely explains the common feature of waking up fatigued and unrefreshed in these patients). The onset of fibromyalgia has been associated with psychological distress, trauma, and infection.
Some report onset of symptoms following viral, bacterial, or parasitic infection.
Cytokine release may be responsible for many symptoms in fibromyalgia.
Emotional states: stress, anxiety or depression
Heavy metal toxicity, mainly aluminum.
Food allergy and intolerance
Altered intestinal permeability
Essential fatty acid deficiency.
Magnesium deficiency–may be a factor in the development of fibromyalgia.
Altered neurotransmitters. Significant changes occur in brain chemistry, i.e. serotonin and tryptophan.
Jay Goldstein, M.D., author of Chronic Fatigue Syndrome: The Limbic Hypothesis, believes that FM/CFS is related to disordered function of the part of the brain known as the limbic system, which is highly interconnected with the immune system, endocrine system, and emotions (Schmidt, M.A., Tired of Being Tired. Overcoming Chronic Fatigue & Low Energy, Frog, Ltd. c/o North Atlantic Books, Berkeley, Calif., 1995, p. 136)
Irritable bowel syndrome
Subjective soft tissue swelling
Dysbiosis - yeast or parasitic infection
Deposition of immune complexes in and around the joints may be responsible for continued immune responses.
Physical trauma such as an accident
Disruptive sleep patterns
Immune or endocrine abnormalities
Multiple nutritional remedies exist for the management of FM. Please review your entire health report for more information.
Recovery from Fibromyalgia
Recovery from FM/CFS requires an integrated approach involving diet and nutritional therapy, stress management, exercise, stretching, meditation, analgesics, therapy and detoxification.
The following functional tests may be helpful in analysis of fibromyalgia and CFS:
Amino acid analysis
Heavy metal analysis
IgG tests for food hypersensitivity
ELISA/ACT for delayed reaction to foods and chemicals
Nutritional therapies that help with fibromyalgia are D-ribose, L carnitine, magnesium, coenzyme Q 10, glutamine, fixated nitrogen, SAMe (optimal dosages vary for all supplements) and detoxification, but detection and correction of the underlying problem is the first course of action. This should also include hormone evaluation for adrenal and thyroid problems.
To learn more about Dr. Cynthia Shelby-Lane and the services she provides, go to www.elanantiaging.meta-ehealth.com.
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