Pain relief is critically important to the eight to 12 million Americans who suffer from fibromyalgia, a condition characterized by muscle pain and multiple spots on the body that are tender when touched. The pain wears down these patients...and they also must cope with insomnia and severe fatigue. Other symptoms include anxiety...depression...morning stiffness...headaches...abdominal pain...bloating and constipation.
In the past, many in the medical community dismissed this condition as "all in their patients heads"-and didn't believe that it was a real medical condition. I never agreed with that. Fibromyalgia is as real as the pain and discomfort it causes. A few years ago, the FDA approved a drug-pregabalin (Lyrica)—to specifically treat the condition. Studies show that this drug is not very effective. I believe that treating fibromyalgia with pharmaceutical drugs, such as Lyrica, or with antidepressants, which also are commonly prescribed, is not the best way for patients to get relief. These drugs have many side effects, including dizziness and coordination problems. I find that many fibromyalgia patients regain their health with natural remedies.
Finding The Cause
The exact cause of fibromyalgia is unknown. Many patients receive a diagnosis of fibromyalgia from their rheumatologists before coming to see me. Those most at risk are women...people who are 40 to 50 years old.. and those with an autoimmune disease, such as lupus or rheumatoid arthritis. I always first test my female patients for hormone deficiencies or imbalances. The results often show low levels of thyroid activity...low progesterone...and not enough of the stress hormone cortisol. With men, I typically first look at thyroid and cortisol levels. Of ten, once the patient's underlying condition is treated, symptoms disappear completely or are greatly reduced.
Several natural substances can relieve the symptoms of fibromyalgia and reverse the disease's progression. I have used supplements to treat several hundred patients with fibromyalgia. Most of them show signs of improvement within two to four weeks of treatment. After several months, they feel much better. Once they improve, some reduce their doses or no longer need supplements at all. My fibromyalgia patients take most Gif not all) of the remedies recommended below. These supplements help in the following ways…
- D-ribose. This naturally occurring sugar found in all cells is essential for cellular energy production. A study in The Journal of Alternative and Complementary Medicine found that patients with fibromyalgia who took d-ribose had less pain and improved energy, sleep, mental clarity and overall well-being. Side effects are rare. Although it is a type of sugar, it is safe for people with type 2 diabetes.
Dose: Take 5 grams twice daily in powder form (mixed with water or juice). If taking d-ribose makes you feel light-headed, take it with meals.
- Coenzyme Q10 (CoQ10). The antioxidant can increase energy production in cells. CoQ10 is a mild blood thinner, so if you are on blood-thinning medication, consult your physician before taking it.
Dose: Take 200 milligrams (mg) to 300 mg daily with meals.
- Acetyl-L-carnitine (ALC). This nutrient can increase cellular energy production. A study published in Clinical and Experimental Rheumatology found that ALC was effective in treating fibromyalgia patients.
Dose: Take 500 mg daily on an empty stomach. Cut back on the dosage if it causes digestive upset.
- 5-hydroxytryptophan (5-HTP). This form of the amino acid L-tryptopban helps to produce serotonin. A study reported in The Journal of International Medical Research of 50 patients with fibromyalgia found that 5-HTP can improve pain, morning stiffness, insomnia, anxiety and fatigue.
Caution: 5-HTP should not be taken with any psychiatric medications, nor should it be taken by women who are pregnant or breastfeeding. Side effects are rare.
Dose: Take 100 mg three times daily-30 minutes or more apart from eating any food.
- S-adenosylmethionine (SAMe). Clinical studies show that SAMe can help adjust neurotransmitter balance, which in turn reduces the body's release of pain signals.
Caution: SAMe should not be taken if you are on any psychiatric medications. Take either 5-HTP or SAMe. 5-HTP is less expensive, so try it first.
Dose: Take 400 mg twice daily on an empty stomach.
- Melatonin. This naturally occurring hormone, derived from serotonin, helps ensure a good night's sleep, which is critical for fibromyalgia patients.
Dose: Start by taking 1 mg 30 minutes before bedtime. If that amount doesn't help you sleep, gradually increase to 3 mg.
- Magnesium. Take 400 mg to 500 mg daily in two divided doses, with or without food. You can get this total amount from all of your supplement sources added together, including a multivitamin
- Vitamin D. Studies show that people with low levels of vitamin D are at greater risk for fibromyalgia. Taking vitamin D can help relax tight muscles. Your doctor can administer a blood test to check your vitamin D level and to determine the exact dose you need. Most people take 1,000 international units (IU) to 2,000 IU daily.
Eating To Reduce Pain
I recommend that fibromyalgia patients eat an anti-inflammatory diet because this type of diet also will reduce pain. It includes plenty of coldwater fish, such as salmon and sardines...lots of green, leafy and brightly colored vegetables... fruits (berries and apples and generous amounts of spices with anti-inflammatory properties, such as turmeric, garlic, onions and ginger.
Exercise can help fibromyalgia patients fight fatigue and pain. In early treatment stages, most people are physically unable to do much exercise because they are in a lot of pain. After that, I advise patients to start walking or using a stationary bike for 10 minutes daily.
If patients don't exercise, I urge them to find other ways to relax. Stress management is important for all my fibromyalgia patients. Some turn to meditation...prayer...or listening to soft music,
Finally, Pain Relief Without Side Effects
As a naturopathic physician, I find there is nothing more satisfying than helping patients alleviate pain with natural pain relievers—especially since these have few of the adverse effects of pharmaceutical medications.
More than 30 million Americans take conventional painkillers daily for a variety of ailments, including arthritis, headaches, sore muscles and back or neck pain. While these drugs are good at temporarily relieving pain, they all have unhealthful side effects, particularly when used over time for chronic conditions. They can irritate the stomach, cause stomach and intestinal ulcers and increase heart disease risk.
Fortunately, there are natural pain relievers that work as well as, or better than, these drugs, and they are much gentler on your body. I prescribe the herbs described here for patients with a variety of ailments. I believe that they can help you, too.
Caution: Women who are pregnant or breast-feeding should not take these remedies, because they have not been studied in these populations.
Strategy: For chronic pain involving any of the conditions in the table that follows, take the first painkiller listed for that condition for four weeks. If you notice an improvement, stay with it. If not, try the next one if there is one).
Try the following herbs-which are all available at health food stores or online-for the conditions listed…
Devil's claw (Harpagophytum procumbens), a shrub found in southern Africa, works similarly to many pharmaceutical pain relievers-by blocking the action of pain-promoting compounds in the body—but without damaging the digestive tract. In studies involving people with chronic low-back pain, devil's claw extract proved as effective as prescription pain relievers.
Dose: Devil's claw extract is available in capsules. Look for 1.5% to 2.0% harpagoside, one of the active ingredients. Take 1,000 milligrams (mg) three times daily of a standardized extract.
Recommended brand: Nature's Way Standardized Devil's Claw Extract (800-962-8873, http://naturesway.com). The only significant potential side effect is diarrhea.
Curcumin (diferuloylmethane), a constituent of turmeric, is the pigment compound that gives the spice its distinctive yellow coloring. In one study of rheumatoid arthritis patients, 1,200 mg daily of curcumin extract improved morning stiffness and joint swelling.
Dose: Take 500 mg of standardized turmeric extract (containing 90% to 95% curcumin three times daily.
Recommended brands: New Chapter Tur mericforce (800-543-7279, www.newchapter. com) and Life Extension Super Curcumin (888771-3905, www.lifeextensionvitamins.com). It has blood-thinning properties, so do not take curcumin if you take blood-thinning drugs, such as warfarin, unless you are being monitored by a physician.
Avoid this: If you have gallstones, because curcumin can cause gallstones to block bile ducts.
White Willow Bark
This pain reliever has anti-inflammatory and blood-thinning benefits similar to those of aspirin, but unlike aspirin, it doesn't appear to damage the stomach lining. For centuries, the bark of the white willow (Salix alba), a tree found in Europe and Asia, was noted for its pain-relieving qualities. Its active ingredient is salicin, which the body converts to salicylic acid, a close cousin to aspirin (acetylsalicylic acid).
Dose: Take 120 mg daily of white willow bark extract capsules. If this amount does not reduce pain, try 240 mg.
Recommended brand: Solaray White Willow Bark (For information: 800-579-4665).
Avoid this: If you have an aspirin allergy and for one week before undergoing surgery. White willow bark is a blood thinner, so take it only while being monitored by a physician if you take blood-thinning medication.
Part of India's Ayurvedic healing tradition, boswellia (Boswellia serrata) comes from a tree found in India, Northern Africa and the Middle East. The tree yields a milky resin containing boswellic acids, substances that inhibit the body's synthesis of inflammatory leukotrienes. A study of patients with kneearthritis found that boswellia extract relieved pain and stiffness as well as daily doses of the prescription drug valdecoxib (Bextra). And boswellia's benefits persisted for one month longer than those of Bextra.
Dose: Take 750 mg of a standardized extract containing 60% to 65% boswellic acid two to three times daily for as long as symptoms last.
Recommended brand: Solgar Boswellia Resin Extract (877-765-4274, www.solgar.com). While generally safe, boswellia has been known to cause occasional mild digestive upset.
Natural Pain Relievers
Condition-Pain relievers to try*
Headache (tension or migraine)-White willow bark
Inflammatory-Boswellia, curcumin bowel disease
Low-back pain-Devil's claw, white willow bark, curcumin
Muscle aches and pain-White willow bark, curcumin
Menstrual pain Boswellia, white willow bark, devil's claw
Osteoarthritis, rheumatoid arthritis-Boswellia, curcumin, devil's claw Tendonitis-Devil's claw, curcumin, white willow bark
*Take the first painkiller listed for your condition for four weeks. If it doesn't work, try the next one (if there is one).