Fibromyalgia – Natural Treatment Options, Part 2

Fibromyalgia is one of the most common topics that I get asked to write blog articles about.  To be certain, Fibromyalgia affects an estimated 5.8 million Americans.  Of these millions of Americans, women are more commonly affected than men.  If you suffer from this condition, make sure to read my original article on fibromyalgia–Fibromyalgia, new treatment option. My previous article highlights some of the key features of fibromyalgia.  Unfortunately, there is a paucity or lack of research into natural treatment options for fibromyalgia.

Symptoms of Fibromyalgia Syndrome:

  1. Widespread pain
    1. Pain in specific areas where pressure is applied, “pressure points.”
      1. Diagnosis: widespread aching pain for at least three months and have a minimum of 11 locations on your body that are abnormally tender under relatively mild, firm pressure
  2. Fatigue and sleep disturbances
  3. Irritable bowel syndrome (IBS)
  4. Constipation/bloating, abdominal pain
  5. Headaches and facial pain
  6. Heightened sensitivity
  7. Depression/Anxiety

Fibromyalgia Treatment Options:

  1. Conventional analgesics

  2. Antidepressants

  3. Muscle relaxants

  4. Lyrica (pregabalin)–First FDA approved drug for Fibromyalgia

Pregabalin for Fibroymalgia:

This randomized, placebo-controlled trial of 300, 450, and 600 mg/d of pregabalin monotherapy demonstrated that all 3 doses were efficacious for up to 14 weeks for the treatment of fibromyalgia and were well tolerated by most patients. These results provide evidence that pregabalin is an important treatment option for patients with fibromyalgia. (Arnold et al, 2008).

Natural Treatment Options:

  1. Acetyl l-carnitine (2 capsules of 500 mg taken daily)
  2. ?Dietary Soy (see below)
  3. S-adenosyl methionine (Natural anti-inflammatory, analgesic, and antidepressant)
  4. Magnesium (see below)
  5. Melatonin
  6. ?Chlorella (see below)
  7. ?Omega-3 fatty acids.

Dietary Soy Supplement for Fibromyalgia:

Results of statistical analysis using the separation test and intent-to-treat analysis revealed no benefit of soy compared with placebo. (Wahner-Roedler et al, 2008)

* No current evidence to support the use of soy in patients with fibromyalgia.

S-Adenosyl Methionine for Fibromyalgia:

Some herbal and nutritional supplements (magnesium, S- adenosylmethionine) and massage therapy have the best evidence for effectiveness with FM. Other CAM therapies such as chlorella, biofeedback, relaxation have either been evaluated in only one randomized controlled trials (RCT) with positive results, in multiple RCTs with mixed results (magnet therapies) or have positive results from studies with methodological flaws (homeopathy, botanical oils, balneotherapy, anthocyanidins and dietary modifications). Another CAM therapy such as chiropractic care has neither well-designed studies nor positive results and is not currently recommended for FM treatment. (Sarac et al, 2006).

  • best evidence for magnesium and s-adenosyl methionine for fibromyalgia
  • limited evidence for chlorella

Melatonin

Preliminary evidence indicates that melatonin, a molecule that is endogenously produced and is available as an over-the-counter supplement, may be effective in treating the pain associated with this syndrome. Although melatonin is commonly known as a sleep aid (sleep/wake problems are common in FM sufferers), it has a variety of other beneficial effects that may account for its potential benefits in the treatment of FM  (Reiter et al, 2007).

  • Melatonin is potentially beneficial for people with fibromyalgia.
  • Though it is available over-the-counter in the U.S., there are potential side-effects from melatonin use.

Lifestyle Remedies

  1. Maintain a healthy lifestyle
  2. Ensure that you get adequate sleep
  3. Reduce stress
  4. Exercise regularly
  5. Support groups

My Conclusions:

  • Overall, there is limited evidence to support the use of dietary supplements for fibromyalgia.
  • There is some limited evidence to support the use of acetyl l-carnitine, magnesium, s-adeonsyl methionine, and melatonin for fibromyalgia patients.
  • The use of dietary supplements for fibromyalgia is not a heavily researched topic–additional studies are required to support the use of the above dietary supplements for these patients.

References:

  1. Arnold LM, Russell IJ, Diri EW, Duan WR, Young JP Jr, Sharma U, Martin SA, Barrett JA, Haig G. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain. 2008 Sep;9(9):792-805.
  2. Wahner-Roedler DL, Thompson JM, Luedtke CA, King SM, Cha SS, Elkin PL, Bruce BK, Townsend CO, Bergeson JR, Eickhoff AL, Loehrer LL, Sood A, Bauer BA. Dietary Soy Supplement on Fibromyalgia Symptoms: A Randomized, Double-blind, Placebo-controlled, Early Phase Trial. Evid Based Complement Alternat Med. 2008 Nov 6.
  3. Sarac AJ, Gur A. Complementary and alternative medical therapies in fibromyalgia. Curr Pharm Des. 2006;12(1):47-57.
  4. Reiter RJ, Acuna-Castroviejo D, Tan DX. Melatonin therapy in fibromyalgia. Curr Pain Headache Rep. 2007 Oct;11(5):339-42.

5 thoughts on “Fibromyalgia – Natural Treatment Options, Part 2

  1. I have been living with Fibromyalgia for 11 years. I have recently begun researching and trying out holistic and alternative means of treating my symptoms.

    I just posted on my blog about practicing Qigong to help with pain management. What are your thoughts about Chinese medicine? I am really looking to control my symptoms without the use of prescription drugs or surgery.

  2. Fibrohaven, I can imagine that suffering from Fibromyalgia symptoms must be pretty disruptive to your life. I personally think that Chinese medicine has an interesting perspective to offer in terms of helping people cope with illness.

    However, I also think that western medicine’s attempt to evaluate several forms of alternative medicine has very significant limitations.

    From my balneotherapy article:

    “One challenge with randomized clinical trials that evaluate unconventional treatment forms is that it is often difficult to create an adequate placebo. For example, with a clinical trial involving tablet type medication, you can make a placebo tablet that looks, tastes, and feels exactly the same as the medication tablet. However, whether the clinical trial is attempting to evaluate a treatment method such as tai chi, spa baths, or meditation, these types of treatment options do not fit into the conventional evaluation methods preferred by physicians.

    Just try to imagine what type of placebo comparison one would actually use for a randomized clinical trial for tai chi. A group of people engaged in fake tai chi? Well, actually no. Current comparison methods include people that are on a waiting list for a treatment who do not receive any treatment interventions. The problem with using a waiting list of patients as a comparison group is that the trial is no longer blinded. The people who are conducting the clinical trial know exactly which group received the intervention and which group did not. As well, the people that are in the trial themselves also know that they are receiving an intervention. Further, many of these types of trials have the additional problem that people who enroll in the study will simply drop out if they are not randomized to the tai chi group, for example. All of these problems as well as others create bias in evaluating these types of treatments.”

  3. I developed a natural treatment program at the request of an LMP about 2 decades ago. An MD in the area offered to monitor anyone using the protocol. Those who worked with this MD were all found to be free of FMS at then end of our monitoring process.
    The program involves herbs, supplements, massage, martial arts to meet the exercise component.

  4. great article you have there!

    It is reported that chiropractors who treat fibromyalgia with a focus on muscles, such as Morter Bio Energetic Synchronization Technique (BEST) are more likely to be helpful in FIBROMYALGIA cases than the more active adjustment methods,

  5. You mentioned melatonin…what about 5-HTP? It’s on the same pathway as melatonin. So you would think that 5-HTP could also help in fibromyalgia?

Comments are closed.