A Most Misunderstood Disease
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By David Zeiger, D.O.
“Ladies and Gentlemen of the audience, after being seen and evaluated by multiple medical specialists, poked and probed with every conceivable standard diagnostic medical test, the esteemed medical committee’s summary diagnosis for your symptoms of diffuse multiple muscle pain, joint pains, fatigue and flu-like feelings of ‘no known cause’ over these past 6 months to several years is… FIBROMYALGIA!!” “You are awarded a lifetime of symptomatic pharmaceutical treatment escalating towards multiple drug dependency!!”
Does this scene sound familiar? Have you or loved ones, coworkers experienced this scenario?
Fibromyalgia is a set of symptoms or syndrome, still in search of a cause. This is much akin to insomnia, the cause of which can range from restless legs syndrome to hyperthyroidism. It crosses all socioeconomic barriers. This disease affects about 5 million women and men a year with the ratio of women to men about 8 to 1.
The deep muscular and joint pains begin insidiously, often following a bout of the flu. The muscle aches and joint pain progresses in both intensity and oftentimes migratory pattern across the body over succeeding months. The pain can come and go with out warning affecting one side preferentially then the next then both sides. Sleep becomes erratic when even the slightest physical exertion rudely disrupts ones attempt at restful slumber. Unable to find respite from this deep internal physical torture the patient becomes more and more fatigued, irritable, moody and finally depressed.
There are key elements to many a patient with fibromyalgia. These salient features share much in common with other well described medical conditions that have often been found to have fairly clearly defined symptoms, physical signs and most importantly, medical laboratory findings. So, once other diseases are ruled out, one is then left with the orphan disease of the neuromusculoskeletal system: fibromyalgia.
In my years of studying this disease and treating patients I have found the following a few important factors in a patient’s history that gives me a very good clinical suspicion that the patient has fibromyalgia and not some other disease such as systemic lupus.
The patient is more often a female than a male in their mid 20s-late 30s. There is a history of recurrent ear, strep throat or even acne for which they have been administered several courses of antibiotics over the years from early adolescence to mid teens. Diet has favored fast foods, high carbohydrates, low protein, and there is often a time urgency pattern in their lifestyle of many years. About 75% of women have a history of physical, emotional and or sexual abuse. Finally, the abrupt onset of their fibromyalgia often follows a severe bout of flu, upper respiratory infection and or major physical or emotional life trauma.
Establishing what does and does not hurt is challenging at times. Pain can come from muscle both deep and superficial, tendon, ligament, joint capsule even bone. A thorough orthopedic and neurological exam is essential. Many times I’ve been referred a patient with what was initially presented to me as intractable fibromyalgia was later discovered to be a series of muscles acting on skeletal joints biomechanically imbalanced. In other words, some muscle groups were tighter on one side of a joint than the other pulling the joint slightly out of it’s proper biomechanical alignment thus affecting nerves, arteries, veins and other muscles associated with it. Using acupuncture, osteopathic manipulation, massage, physical therapy, Chinese herbs, homeopathic medicines and supplements will help decrease muscle pain and inflammation and restore proper musculoskeletal alignment. Overstretched ligaments also can be a source for such intractable pain.
By making the proper diagnosis, if this is the case, then ligament regeneration injection technique has been very useful. I refer readers to my August 2002 article on this subject in Conscious Choice magazine.*
Bacterial, viral, parasitical and ameba infections can create inflammation and send neurotoxins from the gut into the musculoskeletal system causing muscle spasm and pain. Anti-inflammatory treatments, either medication, ie: ibuprofen or natural substances, ie: ginger may not be effective as stand alone treatments.
Many patients with a history of recurrent antibiotic use often have weakened gastrointestinal immune system and in addition may have picked up through restaurant food, ie: sushi, microbial invaders like entameba histolytica. This parasite has been shown in certain genetically susceptible patients to activate an immune response that promotes inflammation within the connective tissue of the musculoskeletal system. By checking for salivary antibodies to these parasites as well as for other components of a healthy gastrointestinal immune system, I have been able to track and treat another element in the clinical picture of this disease process.
Probiotics like lactobacillus acidophilus and an Ayurvedic medicinal food, Chaywanprash, are part of a program used to restore the ecology of the gastrointestinal immune system.
Thyroid Adrenal Dysfunction
Time urgency — feeling that uncontrollable need that one must run ‘hither or yon’ to have self fulfillment stresses out the thyroid and adrenal gland. These master regulatory glands are interdependent on each other and need to be for proper support and balance of one’s neuroendocrine immune system. Here, I will refer the reader to my article in the October 2002 issue of Conscious Choice magazine.*
In short physical or emotional stress will release the hormone cortisol from the adrenal gland. If the stress does not let up after 10 days then more cortisol is produced and this will shift the immune system to begin producing chemicals that create inflammation and pain in the body. At the same time food fuels like carbohydrates are burned faster, thyroid hormone that tell the cell to produce energy will be decreased and even estrogen and testosterone hormone levels will fluctuate. The person will experience emotional highs and lows as well as deep internal sense of fatigue — ‘like your battery has run down.’ The most accurate testing for tissue levels of these hormones is through salivary not blood testing. Depression is often used as the key clinical diagnosis for fibromyalgia — in my clinical experience it is often found to be a ‘subclinical depressed’ thyroid–adrenal function. Mitochondria, those energy forming organelles within cells, are also damaged many times from recurrent antibiotic usage.
Treatment then is aimed at not only re-regulating these master glands but also helping to restore cellular mitochondrial function which will often relieve this cornerstone symptom. Natural as well as synthetic hormone therapy, acupuncture, homeopathic medicines and key essential nutrient supplementation programs accomplish this goal.
How an infant, child or adult is able to deal with the stresses of living is unique to the situation in which that individual finds themselves in. We are a product of our external and internal environments. What starts out as potential can be allowed to blossom or suppressed. Working with a well trained psychological counselor can be an enormous aide in helping to reestablish the ‘software programming’ that guides us in coping in a healthy way with life’s various psycho- emotional stressors. I will often refer patients to a well trained psychotherapist to work in concert with my integrative medical plan. Homeopathic and nutritional supplementation programs offer a non–pharmaceutical support for a person with such psychoemotional issues, ie: guilt, grief, anxiety during the healing process.
Combining a thorough integrative medical approach crossing many disciplines will offer the patient with fibromyalgia a life of hope, health and infinite possibilities.
To life and good health,
David Zeiger, D.O.
Dr. David Zeiger is board certified family
physician in private practice. He specializes
in Integrative Medicine treating
chronic/acute illness like IBS, Allergies,
Women’s/Men’s health issues, Thyroid-
Adrenal Syndrome, Hypertension, CFIDS/
Fibromyalgia, Asthma, Diabetes, and Neuromuscular
He uses acupuncture, functional nutritional
medicine, osteopathic manipulation, homeopathy,
Chinese herbal medicine, neural therapy
and ligament regeneration injection therapy.
Contact: David J. Zeiger, D.O., health-
Works-Integrative Medical Clinic, 2731 N. Lincoln Ave, Chicago, IL 60614;
Phone: 312-255-9444; fax: 312-255-9446
E-mail: zeigerd @ healthworksimc.com
The above is intended for educational
purposes only and is not intended to replace
proper medical diagnosis or treatment.