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Fibromyalgia Syndrome: A Metabolic Approach Grounded in Biochemistry for the Remission of Symptoms.

Discussion in 'Other Health News and Research' started by Murph, Dec 19, 2017.

  1. Murph

    Murph :)

    Front Med (Lausanne). 2017 Nov 13;4:198. doi: 10.3389/fmed.2017.00198. eCollection 2017.
    Fibromyalgia Syndrome: A Metabolic Approach Grounded in Biochemistry for the Remission of Symptoms.
    Lattanzio SM1.
    Author information

    Fibromyalgia syndrome (FMS) is a chronic, complex, and heterogeneous disorder of still poorly understood etiopathophysiology associated with important musculoskeletal widespread pain, fatigue, non-restorative sleep, and mood disturbances. It is estimated to afflict 2-3% of the worldwide population, with clean prevalence among women. The objective of this paper is to propose a novel treatment for symptomatic remission of FMS, grounded in biochemistry and consisting in the withdrawal from the diet of molecules that can indirectly trigger the symptoms. The hypothesis develops from the evidence that low serotonin levels are involved in FMS. Serotonin is synthesized starting from the essential amino acid tryptophan. The presence of non-absorbed molecules in the gut, primarily fructose, reduces tryptophan absorption. Low tryptophan absorption leads to low serotonin synthesis that triggers FMS symptoms. Moreover not-absorbed sugars could also produce a microbiota deterioration activating a positive feedback loop: the increasing microbiota deterioration reduces the functionality of absorption both of fructose and tryptophan in the gut, entering a vicious circle. The therapeutic idea is to sustain serotonin synthesis allowing the proper tryptophan absorption. The core of the cure treatment is the exclusion from the diet of some carbohydrates and the marked reduction of some others. The main target is the limitation of total dietary fructose as marked as possible. It could be an effective strategy to get the remission of symptoms acting on the impaired biochemical pathways. The straying from the treatment is expected to cause the reappear of the symptoms.

  2. Murph

    Murph :)

    I've given up a lot of fructose, and I feel better these day. who knows, perhaps there's something to this hypothesis!
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  3. ChrisD

    ChrisD Senior Member

    East Sussex
    I also gave up fruit completely several months ago and all my FM symptoms lifted, pain free now! just ME and energy production levels low.

    To add, my Genetic reports show predisposition to NAFLD which I think is quite a common SNP issue amongst us and that reports a dysfunction with fructose metabolism.
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  4. *GG*

    *GG* senior member

    Concord, NH
    Can you break up the abstract, lots of people have lots of trouble reading such a huge block of text :(

  5. kangaSue

    kangaSue Senior Member

    Brisbane, Australia
    Or one could have a nerve biopsy done to see if there is an underlying condition treatable by other measures too.


    Proposed classifications by Caro and Winter:
    FM Patients with Normal Nerve Fiber Densities
    They believe that FM patients with normal nerve densities often have another, hidden disease such as rheumatoid arthritis or osteoarthritis. They pointed to the case of a 21 year old college student with FM whose pain responded to Cymbalta but not to Neurontin or Lyrica. (The lack of response to Neurontin/Lyrica was apparently something of a clue that SFN may not have been present.)

    The normal nerve fiber levels in her skin biopsy prompted them to look for a pain generator other than SFN. Tests indicated she had elevated C-reactive protein levels (but normal sedimentation rate, rheumatoid factor, CCP-IgG, and antinuclear antibodies). With her history of early morning stiffness and small joint pain they diagnosed her as having early “seronegative rheumatoid arthritis.”

    She was successfully treated using a tapered regimen of steroids, hydroxychloroquine, and an immune modulating biologic drug called Orencia (abatacep).

    FM Patients With Very Low Densities (< 3.0 fibers per ml) of Nerve Fibers
    The belief is that FM patients with very low (< 3.0 fibers per ml) small nerve fiber densities in their skin have another condition known to produce SFN. These conditions include diabetes mellitus, untreated Vitamin B-12 deficiency, an autoimmune/connective tissue disorder (Sjogren’s, lupus, scleroderma, etc.), infection, metabolic disorder (hypothyroidism) toxins and others. The treatment protocol for these patients is to identify the undiagnosed disorder and treat it.

    FM Patients With Low Densities of Nerve Fibers (< 7.0 per ml) Who Do Not Have Another Condition
    Absent the identification of another disease, Caro and Winter propose that the immune system is largely driving the small and large fiber neuropathy seen in FM. Since the immune system is often implicated in tissue injuries it makes sense, they assert, to assume that it probably plays a role in the small nerve problems found as well. They report that a substantial number of their FM patients respond to immune therapies such as IVIG.

    Caro and Winter end their review by asking if in some people FM presages inflammatory disorders such as rheumatoid arthritis or if it exists in a kind of limbo between better defined disorders. They suggest that the gastrointestinal microbiome would be the most likely place to look for the source of the inflammatory activities they believe may be causing FM.
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  6. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

    From the article:
    See also:
    Learner1 and pattismith like this.

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