The human body is
miraculous. Although we have accumulated an enormous encyclopedia of
information about the human body, its function remains far too
complex for human understanding. Nonetheless, it still manages to
operate quite well on its own. Despite the marvelous achievements of
Western Medicine, the holistic healing wisdom of nature continues to
command a clear element of reverence from all experienced health
care practitioners.
This article will
explore our current understanding of fibromyalgia (FM) from both
conventional and alternative perspectives, and will offer management
options that will substantially improve its lost energy and
vitality.
FM is characterized
by varying combinations of profound fatigue, muscle weakness, flu
like symptoms, non restorative sleep, muscle and joint pains,
abnormal bowel function, and a variety of mental symptoms that range
from difficulty in concentration to outright depression. (1,2,3) Its
natural course is typically characterized by years of incapacitation
that necessitates challenging lifestyle changes. Social and economic
factors often create profound hardships on both patients and their
families that can be catastrophically disruptive. It is no wonder
that depression is such a frequent finding in FM! However, medical
research has clearly documented that this depression is the result
of FM, and is not the cause of it. Nonetheless, the frustration
experienced by most health care practitioners in managing FM has led
to many patients being labeled as “neurotics.”
Understanding FM is
a tall order because there are so many possible causes for it, and
because it can involve so many systems of the body. There is a
dysfunction in the regulation of the central nervous, immunologic,
and endocrine systems that is superimposed upon the malfunction of
many organs. To make a long story short, however, conventional
medicine does not understand either the etiology or the
pathophysiology of this disease well enough to cure, or even manage
it satisfactorily. (4) Consequently, physicians and patients alike
have experienced continuing frustration resulting from the typically
poor treatment outcomes, as well as from the enormous economic
burden incurred by ongoing medical costs and lost income. Even the
insurance industry has been severely challenged by the mighty costs
generated by this disease.
This predicament
has created the need to conceptualize a new approach that can
provide a better management of the mal homeostasis (the body's
physiologic adjustment to metabolic abnormalities) that results from
FM, and causes its associated symptoms. This has been done! A new
paradigm of natural healing has emerged that is based on supporting
the innate healing capacity of the body, and relies on nutrition and
natural therapies as its major tools. Unfortunately, conventional
medicine has not yet acknowledged this paradigm. Why?
Conventional
medicine is built on a premise of fighting and conquering disease
with drugs and surgery. However, because of an inadequate
understanding of the cause of FM, there is no clear target to direct
it’s mighty technology and, therefore, effective therapies have not
followed.
This new “natural
healing” paradigm is based on what is called a “process oriented
approach” (POA) to managing disease. The objective of the POA is to
create a healthier homeostasis by identifying and correcting
metabolic imbalances, and in responding to the specific increased
metabolic needs created by the disease process. No attempt is made
to intervene with the disease process itself to effect a cure, or to
suppress the symptoms of the disease. The innate wisdom of the body
to heal itself is respected and is allowed to restore a more
functional homeostasis, which can then manifest the healing process.
Much of the basis
for this concept is developed from the premise that if all your
cells are healthy and functioning perfectly, how can you be sick?
Each individual human cell is analogous to a microscopic industrial
plant. Without an adequate supply of appropriate raw materials, it
cannot be expected to manufacture all of its products properly.
Similarly, if it is supplied with the wrong raw materials, it will
be unable to produce a product that is perfect. Put simply, we must
consume all the nutrients (food) that our cells require, and avoid
those that are not needed (and potentially toxic), if our cells are
to manufacture everything required for perfect function.
As a culture, we do
not appreciate the widespread nature of the nutritional deficiencies
in the standard American diet (SAD). (5) As we migrated from the
country, where we consumed whole, unprocessed, and unrefined foods,
to the city, where there was an incredible increase in population to
be fed, we became faced with new problems that made it difficult to
easily provide this kind of sustenance. Storage became a new and
important challenge, and we responded by developing a sophisticated
technology for refining and processing our food. As this technology
improved, we began creating “foods” that were so deficient in
nutrients that many of them weren’t food at all. Nonetheless they
stored well, tasted good, and above all, sold.
These unnatural
foods are generally high in calories and low in nutrient density,
thereby setting the stage for a pandemic of both obesity and
malnutrition. In this era of “fat phobia,” it is ironic that we are
significantly malnourished in the omega 3 and 6 fats that are
absolutely essential for good health, and are overdosed with
saturated and trans fats that are not only making us fat, but are
also killing us. It is interesting that these imbalances in fat
metabolism have been found to be particularly common in patients
with FM, and that normalization through supplementation usually
leads to clinical improvement. (6)
It is tragic that
nutrition is not valued as critically important therapy for patients
with any disease, let alone FM. Metabolic demands are dramatically
increased in FM, further highlighting the vital importance of
nutrition. Woefully, conventional medicine has persisted in its
frantic search for the magic bullet that might cure FM. As this
approach has failed, the search has shifted to seek out unnatural,
synthetic pharmaceuticals that might at least suppress its symptoms.
Making matters
worse, like all of us, patients with FM are continually exposed to
the estimated one hundred thousand synthetic chemicals that have
been synthesized within the past 100 years. These chemicals
frequently interfere with an already stressed out metabolism, as the
thousands of years that are probably required to evolve and enable
our bodies to render these chemicals nontoxic, have not yet lapsed.
These ubiquitous chemicals have saturated the food, water, and air
that sustain and poison us on a daily basis. While most healthy
people have the necessary metabolic capacity to compensate for many
of these insults, sick people very often do not. This is the reason
why people with FM are called “chemically sensitive,” and why they
decompensate from what seems trivial to the rest of us.
Typically,
traditional laboratory testing is normal in patients with FM.
However, a myriad of abnormal findings are discovered when the POA
tests are performed. These tests are designed to measure how well we
are nourishing our bodies, how much toxic activity is occurring in
it, and how effectively our defense systems are operating to sustain
normal homeostasis.
The
gastrointestinal tract provides a great window through which we can
assess our body’s capacity to nourish itself and to defend itself
against toxic exposures. (7) Three tests are particularly
informative in this regard. First, a comprehensive digestive stool
analysis provides information about gastrointestinal digestive and
absorptive capacities, and offers important clues about the gut’s
ability to keep toxic chemicals out of the body. It assesses the
ecological balance of the intestinal microflora, the adequacy of
digestive enzyme and acid production and of digestion itself, the
capacity of the gut’s immune system to defend itself, and screens
for parasitic infections. It is easy to appreciate that cell
metabolism can significantly improve when abnormalities found in
these tests are corrected.
Second, permeability across the intestinal surface is very often
increased in FM, creating the so-called “leaky gut syndrome.”
Intestinal permeability is very simple to measure, is economical,
and provides information that is vital in terms of assessing the
potential extent to which the body is challenged to cope with toxic
and allergy provoking chemicals that can gain entry into the
internal body. Third, by means of a liver detoxification profile
test, it is possible to assess the liver’s capacity to detoxify what
does get across the intestinal lining. This information allows us to
devise a nutritional protocol that will support liver detoxification
in such a way that fewer toxins are allowed access into the general
circulation.
The immune system
in FM is in a state of sustained hyperactivity. (8) This continual
strain results in diminished resistance to candida and viral
infections, which are frequently seen in FM. The POA approach to
this is to simply reduce this stimulation to the immune system, and
give it a chance to “catch its breath.” Correcting the leaky gut
syndrome can be of tremendous value in this regard by decreasing the
influx of abnormal, immune stimulating chemicals into the internal
body. Another approach that can also be of value in this regard,
involves specialized allergy testing for specific foods and
chemicals (Elisa/Act test), and then eliminating further exposure to
the offending substances. This can also be accomplished through the
use of hypoallergenic diets. Other measurements of immune
parameters, such as natural killer cell activity (involved in
defense against cancer and viral infections) can also be assessed
and modified.
Recent discoveries
in mitochondrial (the small energy producing factories within our
cells) biochemistry have revealed exciting new possibilities for
managing the chronic fatigue that is characteristic of FM.
Supporting defects in energy production with supplements such as
magnesium, acetyl carnitine, and coenzyme Q10 can be very effective
in many patients. (9) Clinical trials with these OTC supplements can
be tried empirically, although laboratory confirmation of
deficiencies can be verified if desired.
It is important in
this setting to assess endocrine function, and screen for
hypothyroidism, adrenal insufficiency, and hypoglycemia. These
endocrine disorders can masquerade as FM and should be
differentiated, as they are often easily treated. Studies of the
levels and balance of the adrenal hormone, cortisol, and its
counterpart, DHEA, may also provide information that can be helpful
in both the diagnosis and management of FM.
FM is associated
with high levels of oxidative stress. This is a technical way of
saying that the body is producing large quantities of powerful toxic
chemicals called “free radicals,” that cause severe inflammation and
destruction in its tissues. Fortunately, these free radicals can be
neutralized by means of a diet that is rich in whole, fresh foods,
and through supplementation with appropriate antioxidants such as
vitamin C, E, beta carotene, picnogenol, coenzyme Q 10, glutathione,
and lipoic acid. It is now realistic to measure the amount of free
radical activity and of antioxidant levels in serum, and to create
healing nutritional protocols based on this data.
The reductionistic
approach of Western Medicine is designed to primarily focus on the
body as the major malfunctioning factor that “needs fixing.” The
inseparability of body, mind and spirit is acknowledged, but not
revered. No healing therapy would be complete without honoring this
holism. It is not surprising that there is scientific evidence
supporting the value of other disciplinary approaches such as Tai
Chi (10), Qi Gong, Ayurveda, Chinese Medicine, and a multitude of
others, where attention is paid to “balance and movement” as
reflected by breathwork, physical exercise, and “mobilization of the
life force.” It is especially important to work in collaboration
with other disciplines when requested by our patients, especially
when what we are doing isn’t working very well.
In a patient
centered approach, it is imperative that we not view our patients as
“a set of symptoms that should be managed with our bag of tools.”
Operating from an attitude of “being with,” rather than “doing to”
our patients, carries with it a message of personal responsibility
and empowerment. This inspires participation in the decision making
process, and also provides hope that it is possible to recover from
any disease process. These important attitudes have profound effects
on our belief system and act as very potent healing agents.
Healing from any
disease is best accomplished by using an integrative approach that
is holistic and patient centered. This is the medicine that will
launch America’s health care system into the third millennium. It is
called “Health Medicine.” |
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