When The Pain Takes Overhand …
The fibromyalgia syndrome is characterized by chronic pains, which are felt especially in the area of the muscles and the tendon attachments. The fibromyalgia syndrome is not a disease of the muscles and joints and neither a rheumatic-inflammatory disease. The syndrome includes rapid fatigability, fatigue, mental disorders, sleep disorders, decreased stress tolerance, stiffness or swelling of the hands and feet and much more. The disease is more common in women than in men and increases with age.
The causes of fibromyalgia are still unclear. Most likely, several factors play a role. Scientists from Mexico dealt in a professional article with a variety of pathological mechanisms involved in the development of the fibromyalgia syndrome. This includes oxidative stress. Nerve cells only have low stock of antioxidant enzymes but a high level of poly-unsaturated fatty acids, which are particularly susceptible to oxidative damage. An improvement in the antioxidant capacity is therefore a useful measure in the treatment of fibromyalgia syndrome.
Nitrostress (a special form of oxidative stress) may also play a role in the development of fibromyalgia. There was also evidence of mitochondrial dysfunction and a reduction of mitochondrial mass in fibromyalgia patients. In addition, a dysregulation of autophagy was found. Autophagy refers to a cellular purification process, a kind of recycling of the cells, where diseased or disintegrated cell components are degraded and otherwise utilized. Autophagy plays an important role in the degradation of damaged mitochondria. The latter are an important source of free radicals.
In the following, various aspects of micronutrient supply in fibromyalgia patients are presented, taking into account recent study results:
A scientist from Italy was dealing in a scientific article with a strategy to improve serotonin synthesis. Low serotonin levels would trigger fibromyalgia symptoms. Important is the waiver of certain carbohydrates, especially on fructose. Fructose can react with tryptophan in the intestine and thereby impair tryptophan uptake.
Scientists from Turkey investigated the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome in pregnant women. Serotonin levels were lower in women with fibromyalgia than in the control group. In general, serotonin levels decreased as the pregnancy progressed. The onset of depression significantly increased the likelihood of developing fibromyalgia. Impairment of serotonin availability also increased the likelihood of developing a fibromyalgia syndrome, but without statistical significance.
In 2017, scientists from Australia published a systematic review of a possible role for glutamate in the pathophysiology of the fibromyalgia syndrome. Seven out of eight studies showed a relationship between brain glutamate concentration and the severity of fibromyalgia.
From a nutritional point of view, abstinence from sodium glutamate and aspartame should be considered in fibromyalgia patients. Glutamate and aspartate act as excitatory neurotransmitters.
It is known that glutamate can promote the onset of pain. Smaller case studies have shown that abstinence from sodium glutamate and aspartame had a beneficial effect on fibromyalgia.
In 23 women with fibromyalgia and in 20 healthy controls, the concentrations of free amino acids were determined. The fibromyalgia patients had significantly higher concentrations of aspartate, cysteine, glutamate, glycine, isoleucine, leucine, methionine, ornithine, phenylalanine, serine, taurine, tyrosine and valine compared to controls. Patients with more severe fibromyalgia symptoms showed elevated levels of alanine, glutamine, isoleucine, leucine, phenylalanine, proline, and valine. Thus, in fibromyalgia patients, amino acid imbalances were present.
Several studies have shown an association between vitamin D levels and fibromyalgia symptoms. A meta-analysis by Iranian scientists published in 2017 revealed that serum vitamin D levels were significantly lower in patients with fibromyalgia than in controls. In general, musculoskeletal pain is very often associated with vitamin D deficiency.
In 2013, scientists from Italy reported that high-dose vitamin B1 therapy significantly improved fibromyalgia in three female patients.
Vitamin B6 is important for glutamatergic neurotransmission. It is an important cofactor for the enzyme glutamate decarboxylase, which converts glutamate to GABA. Thus, vitamin B6 deficiency can lead to increased levels of glutamate and promote decreased levels of GABA and thereby excitotoxicity of the central nervous system.
The excitotoxicity (harm of neurotransmitters) also increases the need for antioxidants because it is associated with increased oxidative stress. In patients with fibromyalgia syndrome, multiple levels of lipid peroxides and other parameters of oxidative stress have been demonstrated. Important is therefore a good supply of antioxidant micronutrients.
Scientists from Turkey found reduced levels of zinc and magnesium in fibromyalgia patients. The zinc concentration in the serum also showed an association with the number of tender points (painful trigger points in fibromyalgia patients).
In 2010, scientists from Turkey published the results of a study on 46 fibromyalgia patients. They found in fibromyalgia patients compared to the healthy control subjects reduced ferritin concentrations. US scientists have been able to improve the severity of fibromyalgia by iron infusions.
Acetyl-L-carnitine was found in a study to be as effective as Duloxetine and improved depressive symptoms, pains and the quality of life in fibromyalgia patients.
Researchers from Spain were able to achieve clinical improvement in fibromyalgia patients by supplementing with 300 mg coenzyme Q10. Decreased levels of coenzyme Q10 were also detected in fibromyalgia patients. Coenzyme Q10 is central to mitochondrial function.