Please enable JavaScript.
Coggle requires JavaScript to display documents.
Fibromyalgia & Nutrition Research Compilation (Treatment (Only…
Fibromyalgia & Nutrition Research Compilation
Definition
chronic muscle pain and tenderness throughout the body
Prevalence
2% in the general population
3 women :1 men
3.9% ages 20–40
5.8% ages 40–60
8.0% ages 55–64
The prevalence and characteristics of fibromyalgia in the general population. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L Arthritis Rheum. 1995 Jan; 38(1):19-28.
The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. White KP, Speechley M, Harth M, Ostbye T J Rheumatol. 1999 Jul; 26(7):1570-6.
Etiology?
Genetic predisposition
May have genetic factors (DQ2 (DQA1
05—DQB1
02) or DQ8 (DQA1
0301–DQB1
0302) heterodimers)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209093/
Stress
Physical trauma
Repetitive injuries
Illness
https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780
Risk factors
Gender (80-90 percent women)
Presence of certain rheumatic diseases
osteoarthritis, rheumatoid arthritis or lupus
Family history
Age
can affect all ages but more likely during middle age and older
Obesity
Diagnosis Overview
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394355/
Symptoms
(All feed into one another!!)
unrestorative sleep
chronic pain
Morning stiffness
paresthesias
tender points
Headaches/migraines
fatigue
inactivity
depression
anxiety
IBS/irritable bladder syndrome
Research
Raw/Vegetarian diet
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC57816/
Weaknesses: Small sample size, not all subjects met diagnostic criteria for FMS, limited control of diet, self-reported diet and pain, no placebo (unblinded observational study)
carrot juice, dehydrated barley grass juice, flax seed oil, fresh f&v. animal products once weekly to none. Soft drink intake in n=11
Higher intake of Intakes of fats, protein, fiber, several vitamins, including the antioxidants vitamin C, vitamin E, and beta-carotene, and minerals (especially magnesium, potassium, and zinc) than the general population)
19 out of 30 responded with improved markers (10-pt improvement in FIQ score:
FIQ (quality of life, greatest impact in active recreation, health, socializing, and participation in organizations)
physical performance (range of motion, strength, endurance)
SF-36 improvement in all areas of health except for bodily pain
Followed for 7 months; 3 lost, 26 turned in 2 months, 20 f/u at month 0, 2, 4, 7
Vegan diet
https://www.ncbi.nlm.nih.gov/pubmed/11093597
open, non-randomized controlled study
3 month
n=15, n=15 control (differed by pain and urine sodium)
intervention: strict, low-salt, uncooked vegan diet rich in lactobacteria
vegan diet => reduced BMI, lower Chol, drop urine sodium
Conclusion: vegan diet benefit at least in short run
Gluten sensitivity
Part of a larger study:
n=246 FMS + gluten-sensitivity + strict GF diet
n=90 clinical response observed
n=20 described (why??)
All female
Median 46 years (range 25–73)
comorbilities included GI disorder, depression/migraine/hypohyroidism/undifferentiated spondyloarthritis)
Clinical response = remission of FM pain criteria, return to work, return to normal life as judged by the patient, or opioid discontinuation.
non-celiac gluten sensitivity = presence of Intraepithelial lymphocytosis without villous atrophy and without specific celiac antibodies
Follow-up period for GF diet: 16.4 months (range 5–31)
Time needed before improvement observed varied btwn pts
Strict GF diet + iron, vitamin D, and multivitamins supplements with oligoelements.
lactose-free if lactose intolerant
Results: FM improved for some pts (n=20)
For all, widespread chronic pain improved + other symptoms (fatigue, GI, migraine, depression)
n=15 chronic pain no longer present
n=3 stopped opiates
Conclusion: remarkable clinical improvement can be achieved with a gluten-free diet in patients with FM, even if CD has been ruled out, suggesting that non-celiac gluten sensitivity may be an underlying treatable cause of FM syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209093/
FODMAPS
FM associated with IBS
Weight loss (OW is aggravating factor)
improved IBS symptoms
https://www.ncbi.nlm.nih.gov/pubmed/28627205
n=38, 4 week repeated assessments
Results:
decr BMI, waist circ.
No signif. effect on body composition
"all symtoms" declined significantly
INCLUDING somatic pain
no signif. dif in intake of essential nutrients
Physical Activity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165132/
aerobic: small effect, better at physical function
Strength training: large effect but limited data across all factors except fatigue
Mixed training: large effect on pain, physical function
aquatic exercise: medium effect on pain and global health, large effect on physical function and depression (limited evidence)
taichi, toga, breathing exercises, pilates
holistic; mind-body integrative approach may be beneficial for people with FM
Lifestyle Physical Activity
pedometer incr of 54% reported improved symptoms and lower pain levels than control.
benefits not maintained, but greater perceived improvement
Treatment
(Only symptomatic)
Medication
amitriptyline and fluoxetine most common (antidepressants)
https://www.webmd.com/fibromyalgia/guide/medicines-to-treat-fibromyalgia#2
https://www.fda.gov/consumers/consumer-updates/living-fibromyalgia-drugs-approved-manage-pain
NSAIDS - pain does not usually respond (find source)
Acetaminophen eases pain/stiffness (find source)
analgesics, dopamine agonist, growth hormone
nutritional supplements
malic acid
https://www.ncbi.nlm.nih.gov/pubmed/8587088
https://www.ncbi.nlm.nih.gov/pubmed/8587088
s-adenosyl methionine
https://www.verywellhealth.com/sam-e-for-fibromyalgia-and-chronic-fatigue-syndrome-715796
(Evidence is dated and anecdotal)
https://www.ncbi.nlm.nih.gov/pubmed/1925418
https://clinicaltrials.gov/ct2/show/NCT00528710
https://www.verywellhealth.com/same-what-should-i-know-about-it-90004
https://rhochistj.org/RhoChiPost/is-sam-e-an-effective-treatment-for-fibromyalgia/
5-hydroxytryptophan
https://www.webmd.com/fibromyalgia/guide/fibromyalgia-herbs-and-supplements#1-3
building block of serotonin.
Evidence is mixed, but applement is usually well tolerated
https://journals.sagepub.com/doi/pdf/10.1177/030006059202000210
https://journals.sagepub.com/doi/pdf/10.1177/030006059202000210
physical activity
cardiovascular training
(endurance/conditioning)
strengthening (build strong muscles/tendons)
stretching/range of motion
electroacupuncture?
https://www.webmd.com/fibromyalgia/guide/fibromyalgia-and-exercise#3
**
Find a different source
@@
Too little = no benefit?
@@
Too much = exacerbate pain?
Start low, go slow
alternative therapies
(Acupuncture, etc.)
Not much research
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC57816/#B12
Balanced
Diet
Weight management
https://link.springer.com/article/10.1007%2Fs10067-012-2053-x
adequate Mg, Zn
low intakes associated with increased pain -> prevent
Omega-3 fatty acids
https://www.ncbi.nlm.nih.gov/pubmed/10919346
Environmental Nutrition article
Excitotoxins
Avoid glutamate/aspartate
linked to increased pain
Avoid MSG (monosodium glutamate), NutraSweet (contains aspartame)
oxidative properties
http://americannutritionassociation.org/newsletter/review-excitotoxins-taste-kills
https://www.futuremedicine.com/doi/pdf/10.2217/pmt-2016-0019
https://onlinelibrary.wiley.com/doi/pdf/10.1111/jabr.12137
https://pubs.acs.org/doi/pdfplus/10.1021/acs.jmedchem.7b00956
FOOD DIARY
Gluten sensitivity???
Fibromyalgia and nutrition: what news?
https://www.ncbi.nlm.nih.gov/pubmed/25786053/
Vegan/Vegetarian/Raw/Low sodium???
high in antioxidants
vitC/E, resveratrol (grapes), polyphenols (tea)
FODMAPS
Adequate B6
stress management / CBT
Nutrition
Nutritional Supplements
Fatigue
Inactivity
Diet
Behavioral
Health
Restless
Sleep
Depression
Anxiety
Talk Therapy
CBT
Medication
(Antidepressants)
Physical Activity
Pain
Paresthesias
Morning Stiffness
Headache/Migraine
IBS
Irritable bladder syndrome
Tender points
Weight management