Friday, June 8, 2012

Fibromyalgia: A Proposed Diet for Relief

This post is for a friend of mine who is suffering so badly from fibromyalgia that she's unable to work. Comments, suggestions and corrections are welcome. I care more about helping her than being right.

What is fibromyalgia (FM)? Literally, the word means fiber (fibro) and muscle (my) pain (algia). The American Fibromyalgia Syndrome Association lists symptoms that include pain, fatigue, memory and concentration problems, sleep disorders, exercise difficulties, irritable bowel syndrome, chronic headaches and jaw pain. Sufferers have tender points on the neck, back, hips, shoulders, arms and legs. Thyroid disorders are common, but they're not necessarily a cause or effect. Stress and accidents or injuries can set off painful episodes. The vast majority of sufferers are women. Nobody is sure what causes it, but different people suspect nutritional deficiencies, autoimmune disorders or infection. Since it's a syndrome, different things might cause be the cause in different cases.

What's helped? Dr. Michael Holick writes in The Vitamin D Solution,

The "fibromyalgia epidemic" that some doctors refer to may actually be a massive increase in vitamin D deficiency-related osteomalacia...I've estimated that 40 to 60 percent of patients who have been diagnosed with fibromyalgia or chronic fatigue syndrome have a vitamin D deficiency and suffer from osteomalacia.(1)

While fibromyalgia is associated vitamin D deficiency, it seems unlikely that's the cause of the illness. According to the Vitamin D Council's website, "There is no evidence that risk or symptoms of fibromyalgia are related to sunlight exposure."(2) Doing a search on Google Scholar, I couldn't find any link between fibromyalgia and latitude, as there is with certain other illnesses. However, if an infection is involved, vitamin D might help because of its antiviral and antibacterial properties. D is also an anti-inflammatory, but Dr. Seignalet says that there is no muscle inflammation in FM.(3)

I did find a few studies showing raw or mostly raw vegan diets alleviated FM symptoms. (4),(5). The Hallelujah Diet is explained here; it allows a small amount of grains.

Dr. Jean Seignalet, a French physician, reported a 97% success rate with a raw paleo diet. (6) What's going on?

The first thing I thought of when I saw the list of FM symptoms was magnesium deficiency. From The MedlinePlus Medical Encyclopediaa lack of magnesium can cause confusion, fatigue, insomnia, muscle twitching, poor memory, reduced ability to learn, continued muscle contraction, delirium, numbness and tingling, among other problems. Stress can crank up adrenaline, which burns through magnesium, says Dr. Carolyn Dean in The Magnesium Miracle (7). Dr. Dean says, "[I]n my experience, a person with fibromyalgia can diminish her or her symptoms by 50 percent by taking the right amount of magnesium. In order to get sufficient magnesium into the tissues of the body that may mean taking IV magnesium, or more conveniently, applying magnesium oil or gel on the body."(8)

What does magnesium have to do with raw vegan diets, vitamin D and raw paleo diets? Severe magnesium deficiency badly impairs vitamin D's ability to work. (9). But raw vegan and raw paleo diets should be high-magnesium diets. Dr. Loren Cordain calculated the nutritional values of certain food groups and ranked them in his book The Paleo Answer. Magnesium is most plentiful in nuts, seafood and leafy green vegetables. (10) (It's also in coffee and chocolate.) Thiamine (vitamin B1) and calcium (in the right proportion to magnesium) are important cofactors of magnesium(11) and vegetables rank #1 on Dr. Cordain's list for vitamin B1 and #2 for calcium.  Raw vegetables are staples of a raw vegan diet and Dr. Seignalet's raw paleo program (12).

But if "up to 80 percent of the U.S. population is suffering from a magnesium deficiency," as it states at nutritionalmagnesium.org, is magnesium deficiency really the cause of FM, or just a symptom? And if the root of FM is magnesium deficiency, why does the raw paleo program work so much better than supplementing? The raw paleo and vegan programs include cofactors of magnesium and mostly or entirely eliminate grains and beans--two foods that can cause leaky gut and, without special preparation, bind to magnesium (and other minerals) keep you from absorbing them. "Increasingly," says Dr. Cordain, "scientific evidence shows that [eliminating gluten] may work for many...autoimmune diseases." (13) He lists several other leaky gut triggers, most of which can't be eaten raw (the major exceptions are tomatoes and peppers). Dr. Seignalet believed that FM was an autoimmune disease that started in the gut and ended up "fouling" muscle cells, if I'm reading the Google translation of his book correctly. I don't have enough of a biology background to know how plausible this is, but it seems to me that nutrients aren't getting to the cells.

How could you make the raw paleo program even better? Nutritionist and RN Julianne Taylor doesn't think the program has to be raw.(14) If you are taking antacids, get off them: they impair absorption of magnesium and many other nutrients. Likewise, low stomach acid might be a problem: nutrients don't necessarily dissolve in weak stomach acid. Look into HCl pills if that might be the case. Avoid alcohol and stress as much as possible--they're magnesium burners. And take the magnesium supplements and a multivitamin: if you have a leaky gut, it's going to take awhile to heal and absorb nutrients. UPDATE 6/27/2012: Avoid an additive called carrageenan. It's used to create inflammation in laboratory animals, and it can damage the gut--exactly the thing this diet seeks to avoid.

Further Recommended Reading:
Fibromyalgia Relief Diet: How to DIY
The Role of Magnesium in Fibromyalgia: An investigatory paper by Mark London
The Truths and Myths of the use of Guaifenesin for Fibromyalgia or Guaifenesin:  One Medicine, Several Effects by Mark London
Magnesium Deficiency and Fibromyalgia by Emily Deans

Sources:
1. The Vitamin D Solution by Dr. Michael Holick, Kindle location 424. Penguin Group, New York. 2010
2. http://www.vitamindcouncil.org/health-conditions/musculoskeletal/fibromyalgia/.
3. L'ALIMENTATION ou la Troisième Médecine by Dr. Jean Seignalet. 2004. Google translation of the fibromyalgia section here.
4. "Vegan diet alleviates fibromyalgia symptoms," Scandinavian Journal of Rheumatology 2000, Vol. 29, No. 5, Pages 308-313.
5. "Fibromyalgia syndrome improved using a mostly raw vegetarian diet: An observational study," BMC Complementary and Alternative Medicine 2001, 1:7 doi:10.1186/1472-6882-1-7
6. Seignalet.
7. The Magnesium Miracle by Dr. Carolyn Dean, Random House, New York. 2007, p. 47-49
8. Ibid p. 179.
9. http://www.vitamindcouncil.org/news-archive/2009/magnesium-and-vitamin-ds-co-factors
10. The Paleo Answer by Dr. Loren Cordain, Kindle location 2409, John Wiley & Sons, 2012
11. Dean, p. 37-38.
12. http://seignaletdiet.wordpress.com/diet-basis/ 
13. Cordain, location 3565.
14. Dr. Jean Seignalet, ancestral diet and auto-immune disease trials by Julianne Taylor. April 1, 2011.







5 comments:

tess said...

here are a couple of articles you may find interesting:

http://www.totalityofbeing.com/FramelessPages/Articles/FibroDepression.htm

http://www.totalityofbeing.com/FramelessPages/Articles/FibroRealArt.htm

http://www.totalityofbeing.com/FramelessPages/Articles/WhatAreSystemicEnzymes.htm

i'm a fan of systemic enzymes (preferred brand is Exclzyme)....

Lori Miller said...

When you consider that over 300 of the body's enzymes require magnesium to work, it makes sense that enzyme supplements might help if Mg were deficient.

Someone also gave me a link to a video of a doctor saying he'd had success in treating FM patients with iodine. I don't know what the FM-iodine-thyroid connection is, if any, but Cordain says a paleo diet provides sufficient iodine.

tess said...

:-) depends on, if you think the RDA for iodine is enough (which i don't). i use iodoral ... plus extra selenium to balance, of course.

i can imagine why fibrosis might contribute to thyroid problems, but how iodine could alleviate the former is a mystery to me....

Lori Miller said...

He was referring to preventing health problems. I don't know what the level should be--I could write what I know about iodine and thyroid on a postage stamp.

I agree with Cordain that it's possible to go overboard on vitamin supplements, But I don't agree with his assertion that on a paleo diet, most supplements aren't needed. Not true in my case, and the practitioners I'm familiar with recommend supplements. Between leaky guts, missing cofactors, antinutrients, medications, altered gut bacteria, low stomach acid, and farming practices that are the equivalent of strip mining, the nutrients that are there on paper don't necessarily find their way to the cells.

tess said...

so true! in an "unbroken" young person eating whole, home-grown foods, i'm sure Cordain is right -- but I certainly don't fit that profile....