Metabolic Harmony: Navigating Fibromyalgia and Chronic Fatigue
Fibromyalgia and Chronic Fatigue Syndrome (CFS) are complex, often debilitating chronic conditions that affect millions of women and men worldwide. While the exact causes remain elusive, the conditions are thought to arise out of a toxicity (usually heavy metals), previous viral infection (e.g., Epstein Barr Virus and Lyme Disease), and gut dysbiosis.
Pre-eminent doctors in the field of Fibromyalgia and CFS have long identified a link between mitochondria and the onset of these conditions, pointing to a metabolic dysregulation. Now, emerging research also suggests the crucial association mitochondria have on the progression and severity of symptoms.
What is Fibromyalgia and CFS?
Fibromyalgia and Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), are both chronic health conditions that have the potential to severely reduce a person's quality of life. They’re often confused, based on their confounding nature to diagnose and the fact they share many overlapping symptoms. Very often, people present with both conditions, as the suspected causes tend to be the same for both conditions.
To clarify, below is a description of both conditions.
Fibromyalgia:
Alternative Names:
Fibromyalgia Syndrome (FMS)
Fibromyositis
Chronic Widespread Pain
FM
Fibromyalgia is a complex chronic pain disorder. It’s characterised by widespread musculoskeletal pain and tenderness, along with general systems of fatigue, sleep disturbance, headaches and more.
Fibromyalgia symptoms:
Chronic Widespread Pain: Pain and tenderness are experienced throughout the body, often described as a ache or stiffness that lasts more than 3 months.
Fatigue or “Fibro Fog”: Profound and unrelenting fatigue is a common symptom, often described as "fibro fog." It can lead to cognitive difficulties, memory problems, and difficulty concentrating.
Sleep Disturbances: Sleep disorders, such as insomnia or restless leg syndrome. Sleep quality is often poor, contributing to fatigue and overall failure to relax the muscles.
Tender Points: The presence of tender points or trigger points in specific areas of the body, such as the neck, shoulders, chest, hips, and knees is a diagnostic feature of fibromyalgia. However, most patients who experience fibromyalgia will say that the “pain is everywhere” without pinpointing a specific area.
General Symptoms: Headaches, irritable bowel syndrome (IBS), gastric problems and nausea, depression, anxiety, and heightened sensitivity to noise, light, and temperature changes are all common features
Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME):
Alternative Names:
Systemic Exertion Intolerance Disease (SEID)
Post-Viral Fatigue Syndrome (PVFS)
Chronic Fatigue Syndrome, also known as Myalgic Encephalomyelitis (ME), is a complex disorder characterized by profound and unexplained fatigue that doesn't improve with rest and is often worsened by physical and or mental exertion.
Key symptoms of CFS/ME include:
Severe Fatigue: The hallmark symptom is debilitating fatigue that lasts for at least six months and is not alleviated by rest. It significantly impairs daily functioning.
Post-Exertional Malaise (PEM): After physical or mental activity, individuals with CFS/ME often experience a worsening of symptoms, which can include muscle pain, cognitive difficulties, and flu-like symptoms.
Unrefreshing Sleep: Despite getting adequate sleep, individuals with CFS/ME frequently wake up feeling unrefreshed and tired. They often have difficulty remaining asleep.
Cognitive Dysfunction or “Brain Fog”: Cognitive symptoms, often referred to as "brain fog," include difficulty with concentration, memory problems, and mental clarity. Some people experience mood disturbance with their brain fog.
Pain and Muscle Aches: Muscle and joint pain, as well as headaches are common symptoms in CFS/ME.
Other Symptoms: Many individuals with CFS/ME often, sometimes daily, experience additional symptoms, such as sore throat, swollen lymph nodes, and gastrointestinal problems.
Severity of symptoms in both conditions varies from person to person. Diagnosis can be challenging, with the majority of people suffering without diagnosis. There is no cure, but the median recovery rate for CFS is thought to be 5%, with as many as 31%* recovering fully from the condition.
Naturopathic and alternative treatment focuses on dealing with the suspected causes by eliminating toxins, boosting immune function, and enhancing detoxification pathways. With the awareness and strong association with metabolic dysregulation - diet, exercise and supplementation of critical nutrients are all promising treatment options that can result in remission.
Metabolic Dysregulation in Fibromyalgia/CFS
Metabolism is the intricate web of chemical processes in our bodies responsible not only for converting food into energy, but also driving every cells’ critical function. The heart holds the most mitochondria in the body; not surprising as the energy requirements to keep 60-80 beats per minute, every minute, of every day is quite labour intensive.
So when this metabolic machinery goes awry, it can contribute to the development and exacerbation of conditions that contribute to pain and low energy. In fibromyalgia and CFS, there is evidence of impaired mitochondrial function, leading to reduced energy production and increased fatigue. It also leads to metabolic imbalances than can increase oxidative stress, which damages cells and exacerbates pain and fatigue.
It’s well known that metabolic disturbances can trigger chronic inflammation, which is a hallmark of both conditions. Persistent inflammation causes pain, particularly in the joints and muscles. It also leads to tiredness and fatigue.
It’s also thought, particularly in fibromyalgia, that the neurotransmitters, serotonin and dopamine are dysregulated, contributing to the heightened sensitivity to pain. This would also lead to the mood disturbances and cognitive issues found in both diseases.
Nutritional and Lifestyle Strategies for Relief
Given the strong evidence toward metabolic dysregulation, nutritional and lifestyle changes can best help alleviate symptoms, improve overall well-being, and contribute to putting the conditions in remission:
Nourishing diet and supplements: This is the first step for recovery from any chronic illness. Opt for a well-balanced diet rich in whole foods, including fruits, vegetables, lean proteins, and fats. In Fibromyalgia and CFS, your body requires a total elimination of processed foods, sugar and alcohol. Also, incorporate anti-inflammatory foods like fatty fish (rich in omega-3s), turmeric, ginger, and green tea into your diet. Under the guidance of a qualified complementary health or healthcare practitioner, consider B vitamins, D-ribose, or probiotics that may support general health and immune assistance in these conditions. It’s important you approach high street / drugstore brands with caution as they may not be dosed correctly, in its active form, and may tend to have additives that add to the toxic load.
Mitochondrial Support: Under the guidance of a qualified complementary health practitioner, consider CoQ10, L-carnitine, and magnesium, which may help improve mitochondrial function and energy production. It’s important you approach high street / drug store brands with caution for the reasons above.
Movement: Walking, swimming, casual biking, gentle dance, Tai Chi or yoga. Gradually increase activity levels to avoid post-exertional malaise.
Reduce stressors: Chronic stress can worsen symptoms. Practice stress-reduction techniques such as meditation, deep breathing, or mindfulness. Even tiny spikes in cortisol can have a devastating impact on symptoms.
Hydration: Hydration is important for detoxification and to reduce the risk of headaches.
Supportive Community: Seek out likeminded people, coaching or other therapy to discuss the frustrations and challenges of these conditions. Emotional support is hugely healing, and it banishes the isolation that often accompanies chronic illness.
Conclusion
Fibromyalgia and Chronic Fatigue Syndrome are challenging conditions that can significantly impact your quality of life.
While the metabolic roots of these conditions remain complex, adopting a holistic approach that includes nutritional and lifestyle changes will help reduce pain and fatigue, improving your well-being overall, as well as giving you a sense of hope.
Remember that managing these conditions is an ongoing process, and it can take months, if not years to reach a state where the symptoms are not interfering with your life at all. Yet, remain positive With dedication and the right strategies, you will begin to feel better. It is possible to find relief and regain control over your health.
References:
*Devendorf AR, Jackson CT, Sunnquist M, Jason LA. Approaching recovery from myalgic encephalomyelitis and chronic fatigue syndrome: Challenges to consider in research and practice. J Health Psychol. 2019 Sep;24(10):1412-1424. doi: 10.1177/1359105317742195. Epub 2017 Nov 28. PMID: 29182007; PMCID: PMC5930162.
