Fibromyalgia Syndrome – FMS Part 1

The clinical features of the pathophysiology associated with Fibromyalgia include widespread pain with tender points weakness, fatigue, stiffness, numbness and tingling, poor sleep and difficulty concentrating and thinking clearly. Stress seems to worsen these symptoms.
About 70 percent of patients diagnosed with Fibromyalgia have overlapping medical conditions such as chronic fatigue syndrome, irritable bowel syndrome, PMS and headaches.Dietary Modifications
The recommended intake for water is 8-10 glasses per day, avoid caffeinated beverages that cause more acidity in the body and eat a minimum of 5 servings of vegetables daily. Fruits and grains, protein, legumes, and oils should constitute the remaining balance of nutrients. A ratio of approximately 30 percent protein, 30 percent fat and 40 percent of carbohydrates would be ideal. Removing processed foods from the diet will reduce the risk for potential chemical sensitivities such as MSG which can irritate the gut and cause further inflammation.

Therapeutics

1. Acetyl L-Carnitine
Increases blood flow and enhances the activity of certain enzymes increasing metabolism and reducing symptoms of chronic fatigue that are associated with FMS. A study published in 2007 evaluated the therapeutic effects of Acetyl- L-carnitine in a randomized clinical trial. ACL was used due to the belief that FMS may be associated with a deficit of carnitine. Patients were randomized to placebo or active treatment for 4 to 8 weeks. The results demonstrated a statistically significant between-group difference in favor of ALC treatment for improving pain as well as the general and mental health of patients.(5)

2. 5 HTP
Increases serotonin production or availability . A double-blind study (1) and a 90-day open study (2) evaluated the therapeutic effects of patients with FMS . the results of both studies demonstrated that 5 HTP produced significant improvements in the symptoms of FMS such as anxiety, pain intensity, quality of sleep, fatigue and pain in tender points .

3. Magnesium
The benefits of magnesium are correlated to its function as a cofactor in ATP synthesis . Magnesium acts as an enzyme at the cellular level. Disordered Magnesium metabolism appears to play a role in FMS. In one study , FMS patients were found to have intracellular magnesium deficiency despite having normal serum levels of the mineral (3). In another study, abnormal intracellular concentrations of calcium and magnesium were only found among FMS in comparison to normal controls. (4)

Reference 
1. Caruso I, Sarzi Puttini P, Cazzola m, Azzolini V.Doubkle blind study of 5 HTp vrs Placebo in the treatment of Fibromyalgia Syndrome. Journal Of Internal Medicine Res. 1990;18:201-209

2. Sarzi Puttini, P Carusso I.Primary Fibromyalgia Syndrome and 5 HTP; a 90 day open study. Journal of Internal medicine Res. 1992;20:182-89

3. Moorens G, Manuel, Keenoy B, Vertommen J. et al. Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue.. Magnes Res 1997:10:329-37.

4. Magaldi M,Multoni L,Biasi G,, Marcolongo R. Changes in the intracellular calcuim and magnesuim ions in the physiopathology of the fibromyalgia syndrome. Minerva Med 2000;91:137-40

5. Wallace DJ Shapiro S, Panush RS. Update of fibromyalgia syndrome. Bulletin on the Rheumatic Diseases.

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