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Fibromyalgia: pain, depression, stress

 
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Fibromyalgia (FM) is a common syndrome characterised by extensive, long-term pain and tenderness in muscles, joints, tendons and other soft tissues. Other features include non-restorative sleep, fatigue and psychological distress. Some patients report that their fatigue is more upsetting than their pain. 

While the cause is not fully understood, current research points to several underlying factors including abnormalities in the neuroendocrine and autonomic nervous systems, genetic factors, psychosocial variables and environmental stressors.

In recent years, the hypothesis that FM can be attributed to central sensitisation of nociception has also proved worthy of serious consideration. This widely researched theory demonstrates that FM is a condition caused by alterations in pain neuropeptides, especially substance P. There is increasing evidence suggesting that the use of specific nutritional supplements, such as S-adensylmethionine (SAMe), magnesium, coenzyme Q10 and activated vitamin B6, may prove useful in managing this multifactorial condition.

In this infographic we pay special attention to those key nutrients and provide a framework for their incorporation into a wider nutrient-based solution.

REFERENCES

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  2. Arnold, L, Clauw, D, McCarberg, B. Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 2011;86(5):457-464. [Full text]
     
  3. Arnold L, Hudson J, Hess E, et al. Family study of fibromyalgia. Arthritis Rheum 2004;50(3):944-952. [PDF]
     
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  6. White KP, Nielson WR, Harth M, et al. Does the label “fibromyalgia” alter health status, function, and health service utilization? A prospective, within-group comparison in a community cohort of adults with chronic widespread pain. Arthritis Rheum 2002;47(3):260-265. [Full text]
     
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  8. Boomershine C. Fibromyalgia. Medscape 2014. Viewed 17 Oct 2014, emedicine.medscape.com/article/329838-overview
     
  9. Now we know: why opioids don’t work against fibromyalgia pain. Recent study reveals reduced opioid receptor availability in the brain; but a new FDA-approved drug brings relief. Duke Med Health News 2008;14(1):3.
     
  10. MRI scans reveal hypersensitivity in the brains of people with fibromyalgia. Nurs Stand 2014;15;29(7):17. [Abstract]
     
  11. Russel IJ, Orr MD, Littman B, et al. Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome. Arthritis Rheum 1994;37:1593-1601. [Abstract]
     
  12. Sarchielli P, Mancini ML, Floridi A, et al. Increased levels of neurotrophins are not specific for chronic migraine: evidence from primary fibromyalgia syndrome. J Pain 2007;8:737-745. [Abstract]
     
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  15. Carpenter DJ. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev 2011;16(1):17-39. [PDF]
     
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  18. Takase B, Akima T, Uehata A, et al. Effect of chronic stress and sleep deprivation on both flow-mediated dilation in the brachial artery and the intracellular magnesium level in humans. Clin Cardiol 2004;27(4):223-227. [Full text]
     
  19. Nutrition and inflammation. Micronutrient information center, Linus Pauling Institute 2010. Viewed 26 Feb 2014, http://lpi.oregonstate. edu/infocenter/inflammation.html
     
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  21. Vitamin B6. Micronutrient information center, Linus Pauling Institute 2010. Viewed 26 Feb 2014, http://lpi.oregonstate.edu/infocenter/ vitamins/vitaminB6/

 

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Melissa Lee
Melissa is a designer turned nutritionist, who has combined the two modalities to create purposeful designs for various health publications and websites. Having initially studied Multimedia Systems Design, she then went on to complete a BHSc in Nutritional Medicine which led to her involvement in the integrative medicine industry and eventually to FX Medicine.