By David Blyweiss, M.D.

Imagine waking up early after a late night of too much alcohol and no food or water. You’d undoubtedly feel stiff, achy and utterly exhausted. This is what it feels like if you have fibromyalgia. It’s almost like the body has blown a fuse.

Fibromyalgia is a mysterious condition. In fact, many conventional doctors don’t even acknowledge it as a real disease. Yet fibromyalgia is very real and it affects about two percent of Americans, most of who are between the ages of 35 and 55. It also occurs seven to 10 times more frequently in women.

And, as if the pain and fatigue weren’t enough, a constellation of other symptoms often accompany the disorder—foggy thinking, sleep disturbances, painful menstrual cramps and irritable bowel symptoms. Because of this, it can be hard to make a clear-cut diagnosis. But even though the cause of fibromyalgia continues to elude researchers, certain stresses on the body, such as intense exercise, illness or a traumatic event, appear to intensify symptoms or even bring on the condition itself.

Fibromyalgia has no single cause. It’s thought that people with the condition experience a “short circuit” that suppresses the hypothalamus. The hypothalamus controls sleep, hormonal function, temperature and autonomic functions such as blood pressure and blood flow. This tiny area of the brain uses more energy for its size than any other organ, so when there is an energy shortfall, it goes offline first. This decreases its protective function in the face of what it perceives as overwhelming stress. As a result, the muscles end up short of energy and in pain.

The larger, more inclusive tapestry of what causes fibromyalgia is often made up of environmental, lifestyle and genetic components that are triggered by stress, toxins, allergens, pathologic bacteria, viruses, fungi, or critically low nutritional status. Any or all of these can affect energy metabolism and lead to fatigue and other fibromyalgia symptoms.

To date, there is no single FDA-approved drug therapy that addresses all of the symptoms of fibromyalgia. Conventional drug therapy consists of antidepressants and pain relievers and is aimed at improving sleep, mood, and relieving pain. But these drugs can also trigger a number of side effects. Fortunately, I’ve found several safe and natural solutions for my patients suffering from fibromyalgia.

Sleep is a primary concern for anyone with fibromyalgia. Ninety percent of patients awaken multiple times a night. Even if they do make it through the night, they rarely sleep deeply enough to feel rejuvenated. Other symptoms may disrupt sleep as well, such as restless legs syndrome, irritable bladder and nocturnal myoclonus (jerky muscles). An important first step is to rule out sleep apnea. If that is not a problem, I suggest taking L-theanine, an amino acid found in green tea. L-theanine has been shown to promote sleep, reduce mental and physical stress, improve cognition and mood, and boost immune function. I recommend taking 200 mg. of L-theanine daily at bedtime. If this does not help, try taking 1 mg. of melatonin with 50 mg. of 5-HTP, also at bedtime.

Even when sleep is improved, many people with fibromyalgia still feel fatigued.  That’s not surprising, since research shows that fibromyalgia sufferers have lower levels of ATP (the body’s cellular energy molecule). But exciting new research shows that supplementing with D-ribose (often just called ribose) can help the body replenish ATP.

A natural sugar, ribose occurs in all living cells. It is the key building block for making energy. In fact, the main energy molecules in your body are made of ribose, plus B vitamins and phosphate. The body typically acquires ribose through diet, creating it from the glucose found in food. This is a slow process, however, that cannot always keep up with the energy lost in daily activities. Because of this, it may take several days to restore lost ATP—and possibly much longer for those who suffer with fibromyalgia.

Supplemental ribose can reduce muscle pain, stiffness, and exercise fatigue. People also tolerate it well and it has no side effects, even at doses up to 10 grams per day. In one promising study, fibromyalgia patients took supplemental ribose for an average of 28 days. In just 12 days, 66 percent of those taking ribose reported significant improvement in energy, sleep, mental clarity and pain intensity, with a 44 percent average increase in energy and an overall 30 percent increase in well-being.

Along with taking ribose (the usual dose I recommend is 5 grams three times a day), it is important to take a good magnesium/ malic acid combination as well as a highly absorbable COQ10 supplement like Ubiquinol-100. My patients also find that bathing in a warm Epsom salt bath can temporarily relieve pain.

Finally, I tell my patients with fibromyalgia to exercise. A gentle exercise routine is indispensable for those with fibromyalgia to increase flexibility, reduce pain and reign in stress. But since most patients can’t begin or maintain a typical exercise routine, I recommend a program that focuses on gentle stretching like yoga or tai chi.  Water exercises are also ideal since they do not put stress on the joints.

When it comes to fibromyalgia, there isn’t a one-size-fits-all treatment. What seems to work best is a combination of customized tactics that focus on ensuring quality sleep, reducing pain, increasing flexibility, improving metabolism and reducing stress. Finding a health care provider who will work with you on your journey can also ease your path to wellness. Someone who can identify and remove the likely heavy metal burden you carry, as well as understanding the nutritional support you may need is critical.

References:

Hauser W. Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Research & Therapy. 2010;12:R79.

Kimura K. L-Theanine reduces psychological and physiological stress responses. Biological Psychology. 2007;74: 39–45.

Teitelbaum JE. The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study. Journal of Alternative and Complementary Medicine. 2006;12:857-862