A very interesting paper which suggests that diet could be key to fibromyalgia in at least some sufferers.
I appreciated many aspects of the paper - such their understanding of the patient demonstrated in this sentence:
The growing severity of symptoms highly motivated the patient to strictly follow the diet guidelines.
And what looks to me a somewhat wry observation:
This result opens new perspectives in the treatment of FMS solving the substantial functional limitations experienced by patients, virtually requiring no costs for the treatment itself.
Well worth reading the full paper even if you don't have fibromyalgia. It is, quite simply, interesting, and might in some ways hold a key to other issues so often reported here.
A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.
I'm going to print that to wave at several people at my local Pain Club that I've been trying to convince how important diet is to FM, RA, & general wellbeing. THs, drugs, & all the supplements available won't substitute for poor nutritional intake!
It is very restricted but has the saving grace that it seems only to take a few days to get results. We so often see people trying a change of diet (whether gluten-free, dairy-free, autoimmune protocol, or most others) and having to persevere for weeks or months.
You could try this for a week and discard the plan if no improvement. On the other hand, if it works, then you have the challenge of keeping to it full time.
Interesting article. My immediate thought was that she was probably malnourished (BMI 18) and eating well restored her nutrient levels. However, would we expect her to recover in three days?
I did some research on FMS some time ago and can relate it to a combination of magnesium deficiency (which modulates chronic pain and smooth muscle contraction) and poor aerobic fitness. These combine to cause the 'alpha delta sleep anomaly' which FMS patients suffer from. It's thought the poor aerobic fitness leads to oxygen shortness in the brain and poor sleep quality. FMS patients have reduced 'stage 4' sleep. This is important because we produce 70% to 80% of our growth hormone (GH) during stage 4 sleep and GH is needed to repair micro-trauma to tissues that occurs daily.
Interestingly hypothyroidism leads to loss of intracellular magnesium (which can't be determined by a blood test). Hypothyroidism and FMS often occur together and John Lowe in particular treated FMS by addrssing hypothyroidism, regardless of blood tests. It's quite possible that her depression (legitimately arising from awful pain and other symptoms) had an effect on her thyroid axis. Possibly restoring serotonin levels resolved her mood and depression and corrected her HPT axis. I believe serotonin does have a role in the HPT axis.
None of this ties in with recovery after three days. Certainly the physical trauma associated with FMS would take much longer to recover. I wonder if she noticed minor improvement after three days but it took a lot longer to really recover. I remember when I was very ill I would notice small changes, maybe 5% improvement.
Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months.
Which carries two messages - someone could expect to see some improvement very quickly, yet it could take two months or longer for the full effect to come about.
Also found this fragment of a paper:
The Influence of Endocrine Glands on Carbohydrate Metabolism III.—The Effect of Thyroid Hormone on Utilization of Fructose
L. Macho
Pages 713-719 | Published online: 27 Sep 2008 (Original paper from 1960)
A very interesting paper, thanks for posting helvella. lets hope further testing and research leads to improvement in treatment of FM. Of course the big flaw is that no Pharmas are involved and no expensive treatment - can't possibly work then, "she says tongue in cheek"!!!
Helvella, just wondering if you know anything about Polymyalgia Ruematica, I was diagnosed with it Oct.17 and have been on Prednisilone reducing the dose about every 4-6 weeks depending on monthly blood results. I am now on 10mg per day but still getting a lot of pain in the mornings. I am type 1 diabetic and under active thyroid for around 30 yrs.
I am also very depressed, have a little tingling in my finger tips, constipation. Have put a stone on with the steroids.I thought this condition would be a lot better by now, perhaps I am being impatient.
If you could shed any light on this I would value your opinion.
Sorry, Kathy21, I'd be happy to tell you anything I know. Unfortunately, that is precisely nothing.
I do not even know anything about the forum here on HealthUnlocked - but it is likely a reasonable place to expect more knowledge and experience. The PMRGCAuk does have 6,638 members and 10,234 posts.
Just like with doctors, we have forums for specific issues and sometimes understanding how they relate is difficult. Please feel free to post a brand new post here asking. I suggest any test results in your post.
Tingling in your fingers could be LOW B12. Do you know your level ?
Do you have Hashimotos ? - and is your thyroid optimally treated ?
I was diagnosed with PMR by GP and prescribed steroids. I refused. Private consultation downgraded PMR to Fibro without treatment. In 2005 I was diagnosed with Hashimotos and so the learning began ... 😊
Being depressed and suffering with constipation suggests undertreatment of your thyroid.
Before I was diagnosed with PMR I had stopped taking B12 because I was well above range but I am now wondering with PMR and Steroids etc; if it has dropped, I am going to GP tomorrow to ask if I can get a blood test, and also talk about how I am feeling. I have been on quite a journey the last few months, the steroids played havoc with my didiabetes making me resistant to insulin. Because I put on a stone in weight I did increase my thyroxin by 25 every other day and now on 150 per day, did myself as have used to useing my initiative where my health is concerned. I also take Magnisium, VitD, turmeric, blueberry.
Sadly testing B12 whilst supplementing will skew results. The B12 showing up in a test is not the amount that reaches your cells where it is needed. Docs really do not have a clue - even though this point is laid down in Guidelines they should be following. I would always suggest a maintenance dose of B12 along with a GOOD B Complex - B9 and B12 work together in the body in a very important way.
How much VitD are you taking ? - and were you tested beforehand ?
Do you have any results for your thyroid you could share with members ? You could ask for them when you go to the surgery tomorrow. If the GP will not test the Thyroid correctly - ie TSH - FT4 - FT3 and Anti-TPO & Tg - then Private Testing is available through Thyroid UK .... see link below.
You have to get to the very end of the paper to read the rational for the diet. I didn't read closely, but I think it's entirely about restricting fructose.
Feels like only a few years ago that fructose was described as a healthier form of sugar, but its really getting slammed lately!
I don't know much about it, but I wonder how similar this is to a low FODMAP diet, which is also restricting specific forms of sugar/carbohydrate chains.
I read in one of the big Autoimmune Paleo Diet books that FODMAP was something to try if you'd been on AIP for a while and hadn't had much improvement. So maybe they get tied together in the end.
Thank you Silver Avocado, the last few days I am trying carb free hopeing it will help my PMG and my Diabetes. Following it properly from Diabetic type 1 foram.
I was diagnosed with 'fibromyalgia'. While I think it's a legit diagnosis I also think it's given too quickly when there could be underlying reasons. I was told that the pain I was experiencing was psychological and even given breathing exercises to try and 'think away the pain'.
I found that eliminating gluten and dairy drastically reduced my joint and muscle pain.
I've also found out recently that I've been suffering with Rheumatic Fever since childhood, which no doubt damaged my nerves and caused chronic joint and muscle pain.
I was also diagnosed as having fibromyalgia alongside Ehlers Danlos Syndrome.
I was told by a rheumatologist that the pain in my neck was fibromyalgia and she wanted to prescribe me anti-depressants. I paid for a private upright MRI that shows a partial subluxtion in my neck, and a physiotherapist examined me and said my neck muscles are in a permanent spasm and I have about 50% movement in my neck. I felt very validated that there was a physical cause for my pain. And I feel I was given the diagnosis of fibromyalgia before exploring other causes of the pain.
I was also low on B12 and have had thyroid and hormonal issues. I just think fibromyalgia should be a diagnosis of elimination.
As the improvement was noticeable in only 3-4 days of avoiding fructose keeping a food journal does makes sense. Should you feel more aches & pains, referring back over these days in a food journal may reveal patterns in fructose overindulgence.
A lot of research has been done on collagen supplementation and reduced pain in fibromyalgia and I’ve bern taking it for a few months plus follow a paleo diet and addressing other digestive issues and I’m able to not need painkillers and can deal with the daily discomfort.. I still take panadol from time to time as well but no longer as often . It will be interesting to see how winter goes but definitely diet plays a part . How big a part I’m not sure
Since the patient encountered more FMS problems in autumn (“worst episodes appear to correlate to decreasing temperatures of autumn”), I wonder if this is the FMS equivalent of a Seasonal Affective Disorder i.e. Fructose Affective Disorder(?)
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