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Q&As
What We Know About Fibromyalgia
The text below is
an updated adaptation from
a recent article written by Dr. John C. Lowe. The title of the
article is "Facilitating the decrease in fibromyalgic pain during metabolic
rehabilitation: an essential role for soft tissue therapies." The article was
published in the Journal of Bodywork and Movement Therapies, 2(4):208-217, 1998.
(The journal is published in England by Churchill-Livingston and is edited by Dr. Leon Chaitow.)
Scientific studies, logical
analyses, and years of related
clinical experience have led me to several conclusions about the cause
of fibromyalgia syndrome and its proper treatment.
Most Common
Cause of Fibromyalgia.The
main
cause of fibromyalgia has been determined. As I
recently
announced in France, in most cases, fibromyalgia is caused by inadequate thyroid hormone regulation of cell function. The inadequate regulation results
from thyroid hormone deficiency and/or partial cellular
resistance to thyroid hormone. Rigorous logical analyses of the available
scientific evidence make it clear that this is the most plausible
explanation of the cause of fibromyalgia. In The
Metabolic Treatment of Fibromyalgia, I demonstrated that
other proposed explanations of the cause of fibromyalgia (such as the
serotonin deficiency hypothesis) are false. (See
my recent summary of
evidence supporting inadequate thyroid hormone regulation as the major
underlying factor in fibromyalgia.)
Other Underlying
Mechanisms. Other metabolism-impairing factors may also
induce and sustain symptoms that lead to a diagnosis of fibromyalgia. All that is necessary is that these other factors
impede the metabolism of the tissues from which fibromyalgia symptoms and signs arise.
Such factors include a diet that contributes to impaired carbohydrate
metabolism, B complex vitamin deficiencies, the use of beta-blocking
drugs, and physical deconditioning. One such factor may not be enough to induce
fibromyalgia symptoms. However, combinations of the factors may be sufficient.
The fibromyalgia symptoms of most patients who come under our care are caused by a
combination of such factors combined with inadequate thyroid hormone
regulation of their tissues.
Basic Requirement
for Effective Treatment. The metabolism-impeding factors responsible
for fibromyalgia must be controlled or eliminated before a patient can
significantly improve. When fibromyalgia results from inadequate thyroid hormone
regulation, the proper form of thyroid hormone is indispensable if the patient is to
improve or recover. The use of T4 alone (such as Synthroid) is seldom
effective. Most
patients require treatment with desiccated thyroid (such as Armour Thyroid),
a synthetic T4/T3 combination (with 4 parts T4 to one part T3, such as
Thyrolar), or T3
alone. Treatment is seldom effective when the clinician adjusts the patient's dosage
according to blood TSH levels. Treatment results are likely to be no better
when the patient's dosage is adjusted according to the
free
T3 level. Most patients improve or recover
only when their thyroid hormone dosage is adjusted according to the responses of their tissues to
thyroid
hormone.
Nutritional
Supplements. For most patients, nutritional supplements are
also essential. The nutrients synergistically interact with thyroid hormone to cause a
sustained increase in metabolism. As thyroid hormone accelerates metabolism, the
bodys requirement for nutrientsespecially B complex vitaminsincreases.
Not taking nutritional supplements may result in nutritional deficiencies and an abnormality of
heart muscle (cardiomyopathy). Taking nutritional supplements can avert such adverse
effects and can aid thyroid hormone in normalizing metabolism.
Exercise to
Tolerance. For all patients, exercise to tolerance is
essential. Exercise enables patients to capitalize on the increased metabolic capacity
provided by the combination of thyroid hormone and nutritional supplements. Resistance
exercises contribute to the increase in metabolism by increasing muscle mass. Muscle has a
higher metabolic rate than fat, so increasing muscle mass by resistance exercises
increases the metabolic rate. Aerobic exercise also contributes to the increased the
metabolic rate.
Physical Treatment. For most patients, some physical treatment is
necessary during metabolic rehabilitation. For most patients, the most important forms of
physical treatment are trigger point therapy and spinal manipulation. Physical treatment
is essential for some patients' pain scores to continue to decline. With effective
physical treatment, most patients eventually no longer meet the pain criteria for
fibromyalgia.
We provide educational consulting to both patients and clinicians.
Phone us at 603-391-6061, or preferably, write to us at
Tammy@drlowe.com. Our fax number
is
303-496-6200. —Tammy Lowe