Fibromyalgia is characterized by long-term muscle pain and stiffness. According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million Americans, 85 to 90 percent of whom are women. It affects about 2 percent of the general population and 20 percent of people with arthritic disease.

It used to be called fibrositis, which implies an inflammation of fibrous and connective tissues such as muscles, tendons, fascia, and ligaments. Myofascial pain syndrome is similar, but is characterized by just a few painful and achy places, most often in the jaw, that are tender when trigger points are touched.

Fibromyalgia is characterized by generalized aching, pain, and tenderness throughout the body. People complain of neck, shoulder, lower back, and hip pain that seems to move around from place to place. People often report fatigue and changes in sleep patterns. They often wake up during the night with a feeling of achiness or stiffness.

About 40 to 70 percent of people with fibromyalgia also report irritable bowel symptoms: abdominal pain, constipation, diarrhea, gas, or bloating. Other symptoms that occur with frequency include headaches, jaw pain or temporomandibular joint (TMJ) problems, and depression.

Symptoms that occur less often are heightened sensitivity to chemicals; intolerance to cold, heat, or bright lights; bladder problems; Raynaud’s phenomenon; difficulty concentrating; mood changes; dry eyes, skin, and mouth; painful menstruation; chest or pelvic pain; dizziness; nasal congestion; teeth grinding; or numbness or swelling in hands and/or feet.

People with fibromyalgia often report a traumatic event that triggered initial symptoms: emotional or physical stress, an accident, or a severe infectious illness. Though common, this doesn’t occur in everyone. Fibromyalgia shares many symptoms with chronic fatigue syndrome, though it is classified as its own disease.

People with fibromyalgia, unlike those with chronic fatigue syndrome, usually do not have low acetylcarnitine levels or have a viral infection as a trigger. Recent studies indicate that myofascial pain, fibromyalgia, and CFIDS are on a continuum of the same disease path, with myofascial pain being the mildest, fibromyalgia moderate, and CFIDS the most severe.

It’s important to be checked for vitamin D status. About half of all people with fibromyalgia are deficient in this nutrient. We make vitamin D from sunlight, but in northern climates or if people aren’t outdoors, they don’t make nearly enough. Best food source is cold-water fish such as salmon, sardines, mackerel, and herring.

Vitamin D also helps facilitate magnesium absorption. An increased need for magnesium is found in most people with fibromyalgia. People with fibromyalgia are generally put on anti-inflammatory drugs and antidepressants. One study showed that 90 percent of people treated with anti-inflammatory drugs were still symptomatic after three years.

Conventional medical therapies for fibromyalgia usually are unsuccessful. They fail to address possible underlying causes of the illness. Food and environmental sensitivities, candida, or parasites can be causal factors in fibromyalgia. A stool test may be useful in diagnosing the cause of fibromyalgia.

When the underlying problem has been identified and treated, fibromyalgia resolves. A very small but promising study was done with thirty-two people who had fibromyalgia for five to ten years. There were twenty-five active participants and seven controls.

The participants were tested for food and environmental sensitivities with the Elisa/Act test and given dietary restrictions. They were put on a detoxification program and personalized nutritional therapies to meet their needs and stimulate repair of cells and tissues.

The final component was stress management, with recommendations for relaxation training, exercise, and biofeedback. In six to twelve weeks, these people showed a reduction of 80 to 90 percent in their symptoms. They also showed a significant reduction in the number of foods and environmental sensitivities in repeated testing.

More research needs to be done in this area. Nutritional therapies have been successful in the reduction of symptoms. Fifty people with either CFIDS or fibromyalgia were given products made by Mannatech, a multilevel supplement company, including freeze-dried aloe, plant-derived saccharides with freeze-dried fruits and vegetables, and a wild yam product with multivitamins and minerals.

Although all subjects in the study had previous unsuccessful medical treatment, a remarkable reduction in symptoms was noted, with continued improvement over the nine-month test period. Although this was a small, preliminary study, it shows promise for the nutritional approach to fibromyalgia and CFIDS.

One approach to fibromyalgia is the use of guaifenesin, a gout medication. Endocrinologist R. Paul St. Amand, M.D., believes that people with fibromyalgia have calcium phosphate deposits on muscles, tendons, and ligaments. St. Amand developed his theory after observing a high level of dental calculus (calcium phosphate deposits) among his fibromyalgia patients.

His therapy (which includes a healing crisis, or a period of worsening of symptoms before improvement) begins with a dose of 300 milligrams of guaifenesin per day. He reports this working in 20 percent of his patients, but if no healing crisis occurs after two weeks, St. Amand increases the dose to 600 milligrams daily.

At this level, another 50 percent of his patients improve, while the remaining 30 percent seem to require higher doses. In two months of treatment, one year of fibromyalgia can be reversed; however, the longer you’ve had the disease, the longer you need to stay on the medication.

While doing this therapy, avoid all salicylates, because they negate the treatment. This would include aspirin; herbs such as willow bark and aloe; and some common products that may contain salicylates, such as topical pain-relieving cream, some mouthwashes, eyeliner, and some herbal hair sprays.

As guaifenesin is a weak anti-gout medication with few side effects, the therapy certainly seems worth trying. Use of a single supplement may bring some relief, but a total program is necessary to bring dramatic relief and true healing.

Taking coenzyme Q10; vitamins B1, B6, and arginine; 5-HTP; SAMe; essential fatty acids; antioxidants; niacin; and magnesium malate (magnesium plus malic acid), in addition to a hypoallergenic diet has been shown to have positive effects. Acupuncture has been proven useful in treating fibromyalgia. Chiropractic or osteopathic adjustments and massage treatments may also be of help.

Healing Options

• Take vitamin D. Vitamin D deficiency is often diagnosed as fibromyalgia. About half of people with fibromyalgia have low serum vitamin D levels. We make vitamin D in our skin from exposure to sunlight. So, get outdoors more.

Fatty, cold-water fish is your best dietary source of vitamin D, and includes salmon, tuna, herring, sardines, and mackerel. Milk, some orange juices, and some cereals are fortified with synthetic vitamin D.

A trial of 1,000 IU daily for three to four weeks may be a great starting point. Check vitamin D levels with your physician to prevent vitamin D toxicity over time.

• Try an alkalizing diet. Balancing cellular metabolism by eating an alkalizing diet may be of great help in fibromyalgia. Use pH testing to determine the best diet for you. Include fresh fruits and vegetables, vegetable juices, and sea vegetables. Use baking soda and Epsom salt baths.

• Try metabolic cleansing. Metabolic cleansing involves going on a hypoallergenic food plan and taking a nutrient-rich protein powder designed to help restore your liver’s detoxification capacities. Use this protocol for one to three weeks.

• Investigate food and environmental sensitivities. Eliminate all foods and chemicals that you are sensitive to for four to six months. Get tested to find the specifics. Work with a health professional who can help you find your way through the details.

• Try ascorbigen and broccoli powder. A study on twelve patients with fibromyalgia was done with ascorbigen and broccoli powder. Ascorbigen is the most common indole found in cooked cabbage, broccoli, brussels sprouts, and other cabbage family foods.

In one month, symptoms improved by nearly 20 percent. After the supplements were discontinued, symptoms returned to usual levels within two weeks. Take 100 milligrams ascorbigen plus 400 milligrams broccoli powder daily.

• Take a multivitamin with minerals. A high-quality, hypoallergic nutritional supplement is necessary. Although products that contain herbs, bee pollen, spirulina, and other additional food factors are good for many people, it’s best to buy supplements that are herb- and food-free.

Look for the following levels of specific nutrients: 50 to 100 milligrams vitamin B1, 50 to 100 milligrams vitamin B6, 200 to 400 IU vitamin E, 10,000 IU vitamin A, 10,000 to 25,000 IU carotenes, 200 micrograms selenium, 200 micrograms chromium, 5 to 10 milligrams manganese, glutathione, cysteine, or N-acetyl cysteine (NAC), plus additional nutrients.

Antioxidant nutrients—carotenes, vitamins C and E, selenium, glutathione, CoQ10, cysteine, and NAC—have been shown to be needed in larger quantities in people with fibromyalgia.

• Take vitamin B1 (thiamin). People with fibromyalgia have lower levels of red blood cell transketolase, which is a functional test for vitamin B (thiamin) status. Researchers found that supplemental thiamin pyrophosphate worked better than other forms.

This suggests a metabolic defect rather than a true deficiency. This may also reflect a magnesium deficiency because thiamin-dependent enzymes require magnesium. Take 25 to 100 milligrams daily.

• Take vitamin C. Vitamin C boosts immune function, helps detoxification pathways, and has antiviral effects. Take 3,000 milligrams daily. Once a week, do a vitamin C flush.

• Take magnesium. It is very common for people with fibromyalgia to be deficient in magnesium. Serum magnesium levels are often normal, but if more sophisticated tests like red blood cell magnesium are done, magnesium levels are often low.

Supplemental magnesium can improve energy levels and emotional states while decreasing pain. Most people improve by using oral magnesium supplements, but some need an intravenous injection of 1,000 milligrams magnesium sulfate by a physician

Choline citrate can greatly enhance oral magnesium utilization (available from Perque, listed in Resources). Take 500 to 1,000 milligrams magnesium citrate or magnesium/glycinate.

• Try arginine. People with fibromyalgia have been shown to have lower levels of arginine than other people. Take 500 to 1,000 milligrams or a mixed free amino acid supplement.

• Try 5-hydroxytryptophan (5-HTP). People with fibromyalgia have lower tryptophan levels than controls. Studies have shown 5-HTP to be of benefit in fibromyalgia. Tryptophan is a precursor to serotonin, a neurotransmitter that helps us sleep and prevents depression.

Tryptophan itself is only available by prescription at a few pharmacies nationwide because of a contaminated batch a decade ago. Fortunately, 5-HTP, the intermediary metabolite between tryptophan and serotonin, is available as a supplement.

Passionflower, an herb with high levels of tryptophan, has been used historically for depression, anxiety, and insomnia, all of which are symptoms of fibromyalgia. Tryptophan is also found in cashews, cheddar cheese, eggs, halibut, peanuts, salmon, sardines, shrimp, turkey, and tuna.

Our body produces it when we eat starchy foods. Take 200 to 600 milligrams daily of 5-HTP, or 500 to 2,000 milligrams daily of tryptophan. Doses can be divided between morning and bedtime.

• Try capsaicin (cayenne pepper cream). The prescription drug capsaicin was used in a study of forty-five people with fibromyalgia. It was found to improve grip strength and reduce pain over a twoweek period. Capsaicin cream burns temporarily, but this diminishes over time.

• Try S-adenosylmethionine (SAMe). A recent study of forty-seven people with fibromyalgia showed that injections and oral supplementation of SAMe significantly reduced muscle tenderness and the number of tender points, lowered pain severity, and benefited depression and anxiety.

SAMe is produced in our bodies from methionine. It is the active methylating agent for many enzyme reactions throughout the body, especially in the brain. It is probably the sulfur that is needed. People with fibromyalgia can probably make this conversion, so oral methionine may be useful clinically (1,000 to 2,000 milligrams).

Other sulfur-containing supplements are dimethylsulfoxide (DMSO), taurine, glucosamine or chondroitin sulfate, and reduced glutathione. In the study, dosages of SAMe were 200 milligrams given daily as intramuscular injection, plus 400 milligrams taken orally twice daily.

• Try Meyer’s cocktail. IV nutrients, given by a physician, can quickly help revitalize your nutrient status. Nutrients can be absorbed and used at higher concentrations. Meyer’s cocktail is a combination of magnesium, calcium, vitamins B12 and B6, pantothenic acid, and vitamin C. It has been used successfully in people with a variety of ailments.

• Try electroacupuncture. In a study of electroacupuncture with people with fibromyalgia, half the people received acupuncture on four points; the other half received acupuncture 20 millimeters away from the actual point. Seven out of eight symptom parameters improved in the four-point electroacupuncture treated group.

None changed in the placebo group. In the electroacupuncture group, a quarter had no improvement, half improved satisfactorily, and a quarter had their symptoms disappear completely. Although this study was done with electroacupuncture, similar results would occur with classical acupuncture.

• Try malic acid. Malic acid found in apples is important in energy production at a cellular level. Several physicians have found malic acid supplementation reduces fatigue and the pain of fibromyalgia. It also helps alkalize. Take 6 to 12 tablets of 300 milligrams malic acid/magnesium hydroxide daily, decreasing dosage over time.

Take quercetin. Quercetin is the most effective bioflavonoid in its anti-inflammatory effects and can be used to reduce pain and inflammatory responses and control allergies. Take 500 to 1,000 milligrams three to four times daily.

• Take glucosamine sulfate. Glucosamine sulfate is used therapeutically to help repair cartilage, reduce swelling and inflammation, and restore joint function, with no reported side effects. Take 500 milligrams two to four times daily.

• Try digestive enzymes. Pancreatic or vegetable enzymes supply the enzymes your body needs to digest fats, proteins, and carbohydrates. Some products contain lactase, the milk-digesting enzyme, others have additional hydrochloric acid to assist the stomach, and some contain ox bile to help with emulsification and digestion of fats. Take 1 to 2 tablets or capsules with meals.

• Supplement with acidophilus and bifidobacteria. Use of supplemental beneficial bacteria can help reestablish the normal microbial balance in your intestinal tract. The supplement you purchase may have additional microbes as well. Take 1 to 2 capsules two to three times daily or ¼ to 1½ teaspoons powder two to three times daily. Mix powdered supplement with a cool beverage.

• Try coenzyme Q10 (CoQ10). CoQ10 is necessary for energy production, immune function, repair and maintenance of tissues, and enhanced cell function. Take 60 to 100 milligrams daily.

• Try glutamine. Glutamine, the most abundant amino acid in our bodies, is used in the digestive tract as a fuel source and for healing stomach ulcers, irritable bowel syndrome, ulcerative bowel diseases, and leaky gut syndrome. Begin with 8 grams daily for four weeks.