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
- Guymer E, Littlejohn G. Fibromyalgia. Australian Family Physician 2013;42(10):690-694. [Full text]
- Arnold, L, Clauw, D, McCarberg, B. Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 2011;86(5):457-464. [Full text]
- Arnold L, Hudson J, Hess E, et al. Family study of fibromyalgia. Arthritis Rheum 2004;50(3):944-952. [PDF]
- Fibromyalgia. Mayo Clinic 2014. Viewed 22 Oct 2014, www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/definition/co...
- Clauw DJ, Arnold LM, McCarberg BH. The science of fibromyalgia. Mayo Clin Proc 2011;86:907-911. [Full text]
- 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]
- Arnold LM, Clauw DJ, McCarberg BH, et al. Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 2011;86(5):457-464. [Full text]
- Boomershine C. Fibromyalgia. Medscape 2014. Viewed 17 Oct 2014, emedicine.medscape.com/article/329838-overview
- 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.
- MRI scans reveal hypersensitivity in the brains of people with fibromyalgia. Nurs Stand 2014;15;29(7):17. [Abstract]
- 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]
- 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]
- Maletic V, Raison CL. Neurobiology of depression, fibromyalgia and neuropathic pain. Front Biosci (Landmark Ed) 2009;14:5291-338. [Full text]
- Harris RE, Clauw DJ, Scott DJ, et al. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci 2007;27:1000-1006. [Full text]
- 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]
- Braun L, Cohen M. Herbs and natural supplements: an evidence-based guide, 3rd ed. Sydney: Churchill Livingstone Elsevier, 2010.
- Jacobsen S, Danneskiold-Samsøe B, Andersen RB. Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation. Scand J Rheumatol 1991;20(4):294-302. [Abstract]
- 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]
- Nutrition and inflammation. Micronutrient information center, Linus Pauling Institute 2010. Viewed 26 Feb 2014, http://lpi.oregonstate. edu/infocenter/inflammation.html
- Cox IM, Campbell MJ, Dowson D. Red blood cell magnesium and chronic fatigue syndrome. Lancet 1991;337(8744):757-760. [Abstract]
- Vitamin B6. Micronutrient information center, Linus Pauling Institute 2010. Viewed 26 Feb 2014, http://lpi.oregonstate.edu/infocenter/ vitamins/vitaminB6/
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