Tag Archives: fibromyalgia

Fibromyalgia and Nutrition.

11 Dec

Fibromyalgia (FM) is truly a challenging condition to manage, as anyone with this condition will attest to! In the past, we’ve discussed many management strategies, including dietary suggestions. Although much of the nutritional information available about FM management is not supported by a lot of “scientific study,” the National Institute of Health through the NCCAM (National Center for Complementary and Alternative Medicine — formed by Congress to evaluate and appraise alternative treatments) provides information on dietary recommendations and supplements. They also provide dietary guidelines and define the benefits and effectiveness for FM patients and us doctors to follow. This month, we will dive deeper into nutritional considerations as this can REALLY make a huge difference for the FM patient!

Since fatigue, sleep quality, and muscle pain are three VERY common FM complaints, the FM patient can track their response to different dietary approaches as they add, modify, or delete various foods and/or supplements from their diet. We recommend “grading” these three symptoms daily on a 0-10 scale (0=good and 10=bad) as this can REALLY help the FM sufferer keep track of various changes that are made in the diet and is extremely useful for future reference.

FOODS: Since many FM sufferers have “sensitivities” to certain foods (reported to be as high as 42% of all FM patients), eliminating these foods makes GREAT sense.

First, it is REALLY IMPORTANT that you KEEP A FOOD JOURNAL for future reference (using the 0-10 scale) as it is impossible to remember all the reactions or responses to various foods even a day or two later, but especially a week or month later! Some common food offenders include MSG (commonly found in Chinese food – simply ask for the MSG to be NOT included when you place your order), certain preservatives, eggs, gluten (grains like wheat, oats, barley and rye), dairy, as well as other common allergens (such as chocolate, nuts, shellfish, and others). Common symptoms may include headaches, indigestion (irritable bowel syndrome), fatigue, and sleep interruptions. When using an “elimination diet,” it is important to make sure you’re getting the essential nutrients in your diet, in which supplementation can help.

Secondly, make it easier to eat in a healthful way! Have fruits and vegetables cut up and ready to eat so when you’re hungry, you can QUICKLY satisfy that urge. Lean meats or proteins are also VERY important! Remember, a well balanced diet gives you the “ammo” needed to fight fatigue, hurt less, help you sleep more deeply, and give you energy. By doing so, you will be able to stay more active and productive. Accept the fact that unless you pre-prepare the foods, you will instinctively reach for pre-packaged, no prep time, “fast food” options that most likely have poor nutritional content. Look for healthy foods that do not require a lot of preparation such as buying pre-washed, pre-cut vegetables. Some deli sections have pre-prepared foods like beet salad or quinoa that can be purchased in small quantities to add variety to your diet.

Third, plan for WHEN you eat. It is well known that eating small meals frequently during the day helps increase energy levels, such as at 9-10am and 2-3pm, especially if you’re feeling tired. Make sure the word “SMALL” is understood or else you’ll gain weight and not be hungry for the next meal! ALSO, DON’T SKIP BREAKFAST, AND DON’T EAT LATE AT NIGHT!!! Our metabolic rate (which regulates how efficiently we digest and breakdown our food) is highest in the morning and slowest at night. Try to include some protein and whole grains with your breakfast such as a boiled egg and oatmeal as this keeps the blood sugar from spiking and provides energy that lasts longer. Next month, we will look at supplementation including vitamins, minerals, and herbs that GREATLY help as well.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

 

Fibromyalgia and Sleep Interference.

10 Dec

Fibromyalgia (FM) affects the entire body, which makes the diagnosis challenging! A VERY common issue with patients struggling with FM includes problems related to sleep. This goes beyond the number of hours one “tries to sleep” but rather the quality of sleep and feeling “restored” in the morning. That is, quality is more important than quantity! Let’s look further.

1. Common sleep problems: Insomnia, or difficulty falling asleep as well as frequent awakenings to the point of recalling being awake during the night is common with FM. Even more common are instances of waking up during the night but being unable to remember it in the morning. This interrupts “deep sleep” and poses an even more important issue. Common sleep disorders associated with FM include restless leg syndrome and sleep apnea. The goal of sleep is to feel restored when waking in the morning. Sleep deprivation can also be caused by pain, depression, and anxiety, all of which are associated with FM.

2. Restless Legs Syndrome (RLS): RLS is considered a neurologic disorder that usually occurs at night and at times during the day when the body is inactive. It is characterized by an overwhelming urge to move the legs when they are at rest.

3. Sleep Strategies: Developing better sleep “hygiene” is important in the management of FM. This can reduce pain, fatigue, the “fibro fog” and in turn, reduce anxiety and depression. Here are some effective ways to accomplish a better sleep pattern:

Though this sounds counterintuitive, sleep ONLY as much as needed to feel refreshed. Excessively long periods of time in bed relates to fragmented and shallow sleep.

Keep a diary to log how much you sleep each night, when you went to bed and woke up in the morning, when and what you last ate/drank prior to bedtime and any other “triggers” you can think of that may have interrupted your sleep. Follow the “best” pattern!

Try to go to bed at night and wake up in the morning at consistent times, once you determine the “best” pattern. This will strengthen your circadian rhythms and facilitate sleep quality.

Practice relaxation techniques such as gentle massage, deep breathing, and relaxation recordings to enhance restorative sleep. Soak in a hot bath or shower prior to going to bed.

Exercise regularly to enhance sleep quality.

Sound machines can help those accustomed to noise, as loud noises can disturb sleep, even if it’s not remembered in the mornings. Keep the room dark and/or use a sleep mask.

Avoid long daytime naps, as they can interfere with nighttime sleep.

Keep the bedroom temperature cool, as too much heat is sleep disturbing.

If you are hungry at night, a light carbohydrate rich snack may help you sleep.

Avoid nicotine, alcohol, or caffeine in the evenings as they interfere with sleep.

4. Medication and nutritional aids: First, try herbs like valerian root, hops, ginger, turmeric, boswellia, amino acids like melatonin, 5-HTP, tryptophan, magnesium, and/or Kava as NONE of these are habit forming. We can help you with this decision! If the herbal/nutritional approaches are not satisfying, we can refer you for a medical consult for prescription options.

 

Fibromyalgia Holistic Care

9 Dec

Fibromyalgia (FM) is a very challenging condition to both diagnose and treat since there are different clinical signs and symptoms that make each patient with FM unique. Therefore, we usually make the diagnosis by excluding other possibilities. To make matters even more challenging, there are “primary” and “secondary” types of FM, or those who develop FM for no know reason (primary) vs. those whose FM arises from a known condition (secondary). Because of these challenges, there is no single treatment program to apply to all struggling FM patients. Rather, studies often suggest that a multidisciplinary “team” of health care providers be utilized in the management of patients with FM. It is recommended that EACH FM patient have their needs be uniquely treated. This month, we will look a “multimodal” approach to treating FM that incorporates a “team” approach.

For those less familiar with FM, many patients with this condition have symptoms that include fatigue, “all over” body pain, sleep problems, mood symptoms, and chronic pain. They may also have conditions including irritable bowel syndrome, palpitations, thyroid dysfunction, adrenal dysfunction, gastroenterological symptoms, chronic headaches, and MANY others. Dealing with these and other FM symptoms can have a tremendous negative impact on one’s quality of life and activities of daily living.

So as previously stated, the treatment of FM requires a comprehensive approach where the patient’s individual symptoms are targeted, as there is no “cookie cutter / one size fits all” management approach. Effective management approaches include chiropractic, allopathic, acupuncture, soft tissue therapy, sleep hygiene counseling, nutritional counseling, mind-body therapy, and dietary counciling including nutritional supplementation that target specific deficiencies determined by lab/blood tests and/or are based on the clinical history.

Treatment is centered on the human body’s deficiencies with the most important being the removal of any and all “trigger(s)” that causes inflammation in the body. Use of an anti-inflammatory herb such as ginger, turmeric, boswellia, (and others) can help until the causes are identified. A gluten-free diet is often very successful in reducing the autoimmune reaction that occurs with gluten sensitivity, which is estimated to be as high as 80% of the general population. This is NOT to be confused with gluten intolerance or celiac disease (they affect 7-10% of the general population). Once inflammation is controlled, weaning away of the anti-inflammatory supplements can be done successfully.

The hormonal levels of the body must also be in balance, especially the thyroid, adrenal, and sex hormone levels. Lab tests should include a complete thyroid panel (TSH, T3, T4, T7/free thyroxin), a salivary cortisol test (for adrenal function), and sex hormone levels (DHEA, pregnenolone, progesterone, estradiol, and, free and total testosterone). Assess and eliminate food sensitivities/allergies (gluten and dairy are most common). Nutritional supplementation should include vitamins (a multiple, omega 3 fatty acids, Vitamin D3, and Co-enzyme Q-10; minerals (calcium, potassium, magnesium), amino acids and sometimes others (case dependant)). These keep our organs functioning well, like a finely tuned machine! Care must also be taken not to over-dose as well, so let us guide you in this process – consider chiropractic your “coach” in this team-based approach!