Hormonally Challenged: What You Need To Know About Adrenal Hormones, Fatigue, and Fibromyalgia

If you have fibromyalgia and want to reduce your fatigue, this is what you need to know about the critical link between your sleep/wake cycle and adrenal hormones. Your adrenal glands play a vital role in determining your daily energy/fatigue cycle because they produce the important hormones cortisol and DHEA.

The Critical Link Between Adrenal Hormones, and Your Sleep/Wake Cycle

When I got the results of my adrenal function test, I found the explanation for my daily energy and fatigue cycle. This test measures the functioning of your adrenal glands, which are responsible for regulating the production of several critical hormones, including cortisol and DHEA. It can help you figure out your daily energy/fatigue cycle so you can modify your treatment and pacing decisions to best effect.

To be clear, I am not suggesting that the diagnosis of adrenal fatigue,  a controversial condition among medical doctors, is the same as fibromyalgia fatigue. Instead, I believe that research has demonstrated the important role hormones, like cortisol, melatonin and DHEA, play in your daily circadian rhythm (sleep/wake cycle).

Abnormality in circadian rhythm of hormonal profiles has been observed in [fibromyalgia]. Moreover, there are reports of deficiency of serotonin, melatonin, cortisol and cytokines in FMS patients, which are fully regulated by circadian rhythm (Mahdi, et al., 2011).

These hormones are often deficient in people with fibromyalgia. Since cortisol and DHEA are produced by the adrenal glands, I think it is correct to say that ‘adrenal hormones’ are part of the fibromyalgia fatigue puzzle.

What is an Adrenal Function Test?

The test involves taking saliva samples four times during one day (before breakfast, lunch and dinner and at bedtime). My naturopath gave me a kit with four test tubes to spit into, and a plastic envelope to mail the samples across the country to Rocky Mountain Analytical labs (weird, right?). They tested my saliva for the cortisol level from each sample and graphed how it fluctuated during the day. I also had my overall DHEA level tested.

What is Cortisol and Why Should You Care?

Cortisol, also known as the ‘stress hormone’s is produced by the adrenal glands (endocrine glands that sit on top of the kidneys). You may have heard of cortisol and its role in the ‘fight or flight’ response to stressful situation – when the body releases high levels of cortisol , alongside adrenaline, to initiate that heart-pounding mode, pumped up feeling you get in a crisis.

But cortisol also plays a vital role in day-to-day functioning.  Cortisol is released in the morning to help you become alert and focused. It is supposed to decline gradually during the day so that by evening you feel sleepy and ready for bed. Melatonin, the ‘sleep hormone’, rises before bedtime and reduces cortisol production by the adrenal glands. However, in women with fibromyalgia, night-time melatonin has been found to be abnormally low and night-time cortisol abnormally high, probably leading to poor sleep quality.

The green shading on the graph in Fig. 1 shows the ideal downward curve from morning to night. There is a normal range in the population, with people on the upper end going from 7.0 to 1.3 ng/mL from a.m. to p.m. and people on the low end of the range going from 1.0 to 0.2 ng/mL.

In some studies, a pattern of low daytime cortisol and high night-time cortisol is characteristic of a disordered circadian rhythm in some people with fibromyalgia.

 

Fig 1 My Cortisol levels during the day

Fig 1 My Cortisol levels during the day

My results: Mid-afternoon Slump and Energetic Evenings

You can see that my results are all off (above, the dark line connecting dots): high in the morning, low in the afternoon and back up again in the evening. I start the morning at 2.8 ng/ml, decrease to 1.4 by mid-afternoon, then increase back up to 2.6, and finally taper off at 1.0 ng/mL at bedtime. This explains my mid-afternoon slump and energetic evenings. Dr. Love also pointed out that I go from being in the bottom 50% of the normal cortisol range in the morning and afternoon, but by evening I am in the upper 50%, and trying to fall asleep with a relatively high level (l.0 ng/mL cortisol). This is probably contributing to my night time insomnia.

Yes, my results are in the normal range, but fibromyalgia involves increased central nervous system sensitization. My pattern of cortisol production is abnormal and I believe that a sensitized nervous system can interpret sub-optimal levels as intense fatigue.

How To Balance Your Cortisol Levels to Improve Energy

Be wary of many adrenal supplements that lower cortisol – if you have FMS your problem might be cortisol levels that are already too low.  I need to boost my cortisol levels in the afternoon and reduce them in the evening. You can read about my favorite adrenal boosting supplements here.  They include Vitamin C, B5, licorice and rhodiola. For night-time cortisol lowering, I like to use time-release melatonin to improve my sleep.

There are also important lifestyle changes you can make to balance your cortisol levels and improve your fibromyalgia symptoms (New Life Outlook). For example:

  • Relaxing music. Enya is still putting out the tunes, guys. Play it all day or take a break and get lost in it. At a nice low volume, of course.
  • Meditate. Grab your heating pad and a timer. Even just five minutes a day can keep major stress away.
  • Acupuncture. Once a week or once a month, for body and mind relief, I swear by those magic needles!
  • Exercise. Nothing too intense for me. I work with light weights and a slow pace.
  • Eat clean. The more you do it the better you’ll feel. Your body will thank you for not having to work so hard.
  • Consistent sleep schedule. Your body has a natural rhythm, just like Enya. Listen to it… Just like Enya (New Life Outlook).

 What is DHEA and Why Should You Care?

Fig. 2 The numbers

Fig. 2 The numbers

DHEA is produced in the adrenal glands, and is a precursor hormone for estrogens and androgens (male and female sex hormones). This hormone helps to counter the stress effects of cortisol in some tissues, such as the brain and heart, and supports a healthy immune system. It is an important factor in balancing your cortisol levels. Studies have demonstrated that DHEA supplementation can help improve mood and sexual interest in women with adrenal fatigue. It’s role in fibromyalgia is unclear:

A small study published in 2012 suggested that DHEA levels may be low in post-menopausal women with fibromyalgia and that lower levels were linked with reduced pain threshold and tolerance and several measures of illness severity. However, studies have been inconsistent as to whether FMS involves low DHEA levels (VeryWell).

My naturopath recommended 1 start with 5 mg per day (a fairly low dose). I found that my energy is more sustained, even on days where I slept poorly. Processed wild yam and maca root can also increase DHEA.

Update: because I have endometriosis, boosting my estrogen by taking DHEA was worsening my pain levels, so I don’t recommend it for women with endometriosis, fibroids or breast/ovarian cancer. 

Instead, I now take rhodiola when my fatigue is high. Rhodiola is considered to be an adaptogen, and studies demonstrate that taking this supplement improves stress tolerance by “influencing key brain chemicals, such as serotonin and norepinephrine, and natural feel-good opioids such as beta-endorphins” (Life Extension Magazine: Rhodiola).

A Word of Caution About Balancing Hormones

One final note: “In advanced stages of adrenal fatigue, when the body is already exhausted of nutritional reserves, it is inadvisable to take supplements that may stimulate the adrenal glands. Doing so, would be like stepping on the gas pedal in a car that has no gasoline in it. Not only will you not get anywhere, it can actually hurt the car” (Dr. Lam). It’s best to consult with your healthcare provider and to educate yourself about improving your energy by supporting your adrenal glands rather than pumping them up with a bunch of supplements.

I was  made aware of a great new book about Adrenal Fatigue called The Adrenal Fatigue Solution by Dr. Eric Wood and Fawne Hansen. I had previously read a book on adrenal fatigue several years ago, but a lot of research has been done since. This book presents the research in an accessible, easy to read way, along with naturopathic treatments. They also have a helpful website http://adrenalfatiguesolution.com/  with a lot of information there on adrenal insufficiency and treatments. (For full disclosure, the authors contacted me to review the book and provided me with a free copy. I genuinely feel it is a helpful resource on the topic, and have not been compensated for saying so).

Resources

Fatima, G., Das, S. K., Mahdi, A. A., Verma, N. S., Khan, F. H., Tiwari, A. M. K., … Anjum, B. (2013). Circadian Rhythm of Serum Cortisol in Female Patients with Fibromyalgia SyndromeIndian Journal of Clinical Biochemistry28(2), 181–184. http://doi.org/10.1007/s12291-012-0258-z

Life Extension (Rhodiola)

Dr. Lam (Understanding Rhodiola Health Benefits and Adrenal Fatigue Syndrome)

Life Extension (Stress Management)

Mahdi, AA., et al. (2011). Abnormality of circadian rhythm of serum melatonin and other biochemical parameters in fibromyalgia syndrome. Indian J Biochem Biophys.  Apr;48(2):82-7.

New Life Outlook (Cortisol and Fibromyalgia)

Teitelbaum, J. (2007). From Fatigued to Fantastic. Penguin Books: NY.

VeryWell (DHEA Supplementation in Fibro)

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Probiotics for Fibromyalgia: Help Your Gut Help You to Boost Immunity and Relieve Anxiety

Can probiotics help treat fibromyalgia? According to science, probiotics can strengthen the immune system, which is compromised in people with fibromyalgia. Probiotics may help relieve stress, anxiety and depression– which are common symptoms in fibromyalgia. In other words, take care of you gut, and it will take care of you!

Probiotics for Fibromyalgia: Help Your Gut Help You

Can probiotics help treat fibromyalgia? Despite all the research being done on friendly gut bacteria, there are actually no studies to date that directly answer that question. But when you dig into the science a little deeper, you can find a wealth of studies that support the use of probiotics to treat fibromyalgia symptoms. In other words, take care of your microbiome (the ecosystem of gut bacteria), and it will take care of you!

Probiotics Can Get Your Immune System into Fighting Shape

Ever since I developed fibromyalgia, I dread getting sick. Infections trigger flare-ups at best and relapses at worst. Many people with chronic illnesses report getting sick more frequently than when they were healthy, and believe that their immune systems are compromised.

This is supported by the science. In the case of fibromyalgia, researchers were able to develop a test for diagnosing the illness by examining cellular immunity. The study proved that people with fibromyalgia have disregulated immune function at the cellular scale. Participants with fibromyalgia were found to have increased chemical messengers called cytokines, which are involved in activating inflammation in the body (Sturgill, et al. 2014).

Strengthening the immune system using different means, including by taking probiotics, seems like a really good idea in the face of this kind of evidence. Up to 70% of the immune system’s activities occur in the digestive tract. There are more than 400 species of bacteria in the gut, which altogether add up to more than 100 trillion bacterial cells. So how do probiotics help keep your immune system in fighting shape?

  • Probiotics protect the lining of your intestines from harmful germs and toxins (Yan et al., 2011). They promote the health and integrity of the cells that line the barrier wall of the gut, keeping germs and toxins from being absorbed into the bloodstream. In the intestines, friendly bacteria compete with harmful bacteria, preventing them from growing out of control. Some probiotics even produce substances to kill harmful bacteria – this is a take no prisoners kind of fight!
  • Probiotics communicate with the immune system to strengthen its response to infections and enhance its repair of intestinal damage. (If the nerd in you wants to know, probiotics interact with intestinal wall cells in complicated ways, such as by releasing signalling proteins that stimulate the immune system). Friendly bacteria can act like guards calling for backup, priming the immune system to prevent and treat diseases, like allergy, eczema and viral infections.

Probiotics May Help Relieve Anxiety and Depression

As people living with fibromyalgia and know all too well, the challenge of living with chronic pain on a daily basis is very stressful and raises difficult emotions. Depression commonly occurs alongside chronic pain (Holmes, 2012). Research has demonstrated that anxiety disorders are more common in patients with chronic pain conditions like arthritis, fibromyalgia migraine and chronic back pain (Asmundson, 2009).

What does this have to do with friendly bacteria? Scientists are beginning to uncover a fascinating gut-brain connection. There is exciting preliminary research on the potential benefits of probiotics for mental health. Researchers call these types of friendly bacteria “psychobiotics.” One study looked at the effect of consuming probiotics on depression versus a placebo. After eight weeks, participants who took the probiotic had significantly lower scores a depression inventory test, as well as lower levels of inflammation (University Health News). If you’re interested in knowing which strains were used so you can pick a similar supplement for yourself –this study used 2 billion CFUs each of Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum.

How can probiotics act like “chill pills”?

  • Some probiotics are able to produce the same kind of compounds that the nervous system uses as chemical messengers. For example, gut bacteria can produce serotonin, which is a feel-good neurotransmitter released in the brain and nervous system when we are happy.
  • Probiotics can help regulate inflammation in the body. As you may know, excessive inflammation is linked to many chronic diseases, including depressive disorders.
  • Friendly gut bacteria interact with our hormones, and may help to turn off the response of the stress hormones cortisol and adrenaline.

Take Care of Your Microbiome And It Will Take Care of You

It’s important to remember that research has only studied a few strains of probiotics, among the many thousands that make up the human microbiome. It’s clear that each type of bacteria causes different effects in the body. Some of these effects are contradictory – some probiotics turn up the activity level of the immune system, while others turn it down. The sheer complexity of it all makes it difficult to draw any hard and fast conclusions. What is clear, however, is that having a diverse and replenished microbiome improves overall health.

The best way to take care of your microbiome is to regularly consume fermented foods rich in probiotics, and to take a probiotic supplement. It’s also vital to consume foods that help to “feed” the probiotics in your gut. After all, friendly bacteria need to eat too. Some foods help to nourish probiotics more than others, and these foods are called prebiotics. Some of the best prebiotics to regularly include in your diet are: dandelion greens, garlic, onions, leeks, asparagus, unripe bananas, barley, oats, apples, flax seeds, wheat bran, seaweed and cocoa. Prebiotics are often better consumed raw and cooked.

The best fermented foods to incorporate into your diet are:

yogurt: preferably a natural yogurt without the high sugar content of flavoured yogurt

  • kefir: a fermented milk product like drinkable yogurt
  • kombucha: tastes like a fruit flavoured ice tea, and is a fermented black tea and sugar drink
  • sauerkraut or kimchee: both are types of fermented cabbage
  • miso: a savoury fermented soybean product, usually used to make soup
  • tempeh: a fermented soybean product with a nutty flavour

Resources:

Asmundson, G. and Katz., J. (2009). Understanding the concurrence of chronic pain and anxiety: state-of-the-art. Depression and Anxiety (26)888-901.

Healthline (The 19 Best Prebiotic Foods You Should Eat)

Holmes, A., Christelis, N., and Arnold, C. (2012). Depression and chronic pain. MJA Open Suppl (4):17-20.

Psychology Today (Do Probiotics Help Anxiety?)

Psychology Today (The Gut-Brain Connection, Mental Illness, and Disease)

Sturgill, J. et al. (2014).Unique Cytokine Signature in the Plasma of Patients with FibromyalgiaJournal of Immunology Research.

University Health News (The Best Probiotics for Mood)

Yan, F., and D. B. Polk (2011). Probiotics and Immune Health. Current opinion in Gastroenterology 27 (6): 496-501.

 

Find other fibro blog posts on the Fibro Blogger Directory Friday Link-up

Fibromyalgia Fatigue: The Top 8 Supplements I Take to Improve My Energy

Fatigue is a disabling symptom of fibromyalgia – but I have benefited from several supplements which improve my energy. This article explains the difference between adrenal and mitochondrial energy supplements, how they work and what the research says.

This post contains affiliate links, which help support this blog. I only link to products that I use and like – my opinion has been in no way influenced by the makers of the products I recommend.

Tart Cherry

My Christmas present one year was an evil cold. I had been lucky the past several years not to encounter any viruses. After reading about the  negative experiences of other bloggers with FM or CFS who have caught a flu or a cold, I was nervous about the potential consequences. My worries were realized when, after my other cold symptoms cleared up, the extra fatigue didn’t disappear too. My fibro fog and afternoon fatigue were the worst I had ever experienced!  I spent the months after trying to figure out how to recover my energy to my baseline level.

Prior to this cold, my ‘energy envelope’ consisted of:

  •  required 10 hours of sleep
  • most energetic in the late a.m. and evening, lowest in the afternoon
  • able to do 3-4 hrs of blogging per day
  • able to spend one evening per week out

Now, even 11 hours of sleep was unrefreshing. I had to drop my classes because of afternoon crashing. The strangest symptom was visual over-stimulation – for example, difficulty making sense of store displays during an energy crash. My acupuncturist explained my post-viral fatigue as a failure of my body to turn off the sickness response. In other words, your body makes you feel tired and achey when you get sick to induce rest, so energy can be redirected to your immune system. Usually that response stops when you get better, but sometimes your body fails to ‘flip the switch’ from sick mode to healthy mode.

In the last few years I have discovered that my energy is impacted by two primary factors – adrenal function and mitochondrial function. The challenge is to figure out how to best support energy production in your body, both at the cellular level (mitochondrial) and organ system level (circadian rhythm and/or adrenal fatigue).

Adrenal Glands and Energy Production stop scrolling down

In a previous post, I wrote about the results of my adrenal function test. The adrenal gland regulates the production of several critical hormones, including cortisol and DHEA. Cortisol, also known as the ‘stress hormone’ is produced by the adrenal glands (glands that sit on top of the kidneys). Cortisol regulates many of the body’s responses to stress, including blood sugar levels, metabolism, immune responses, blood pressure, and central nervous system activation. Although high levels of cortisol are released, alongside adrenaline, to initiate the ‘fight or flight’ response to stressful situations, it also plays a role in day-to -day functioning. Cortisol is released in the morning to help you become alert and focused. It is supposed to decline gradually during the day so that by evening you feel sleepy and ready for bed. Proponents of the theory of ‘adrenal fatigue’ argue that initially, in stressful circumstances,  adrenal glands overproduce cortisol. But if a high-stress situation persists over time, the fatigued glands begin to under-produce cortisol, resulting in low daytime levels and worsening daytime fatigue (Life Extension: Stress Management).

The results from an adrenal function test show that my cortisol curve is all off. I start the morning at the low end of the normal range, but then my cortisol slumps significantly by mid-afternoon, and finally increases to the high end of the normal range by bedtime. These results explain my mid-afternoon crash and energetic evenings (not to mention insomnia). According to my naturopath, this pattern of low daytime cortisol and high nighttime cortisol is characteristic of a disordered circadian rhythm in some people with fibromyalgia.

So how can you improve your overall energy by supporting your adrenal function?

  • Vitamin C and B5 (Pantothenic Acid): Both of these vitamins help promote adrenal function. They are inexpensive and provide a good foundation for re-balancing cortisol production. Vitamin B5 is a lesser known but still important member of the B vitamin family and it is used for energy production in the body. According to Dr. Teitelbaum, “your body’s highest levels of vitamin C are found in the adrenal glands and brain tissues, and the urinary excretion of vitamin C is increased during stress” (From Fatigued to Fantastic p. 90). Vit C formulations can be more or less potent and come with or without added antioxidants. I like Natural Factors Extra C + Bioflavonoids.
  • Licorice Root Extract:  In order to try to sustain cortisol throughout the afternoon to prevent the usual crash, I added licorice tincture on really tired days. It helps slow the breakdown of cortisol in the body, so whatever you do produce stays around longer (Life Extension: Stress Management). (Licorice is not for people with high blood pressure, so please check with a health care provider to see if it is appropriate for you and do your research first). I prefer to use a liquid extracts/tincture because I can tailor the dose – I found the average capsule dose made me jittery but with a liquid I can take just a few drops. Dr. Teitelbaum recommends the equivalent of 100 to 150 mg daily.
  • Time Release Melatonin: In order to improve my circadian rhythm, I added 5mg of sustained / time release melatonin at night.  Melatonin reduces cortisol, so it helps me with my elevated night-time levels (Life Extension: Stress Management). This stuff is quite effective! I have been sleeping through the night more regularly since I added this to my night time pill regimen. (I found regular melatonin did not have this effect).
  • Rhodiola: finally, I am also taking Rhodiola to support my nerve and endocrine system functions. Rhodiola is considered to be an adaptogen, and studies demonstrate that taking this supplement improves stress tolerance by “influencing key brain chemicals, such as serotonin and norepinephrine, and natural feel-good opioids such as beta-endorphins” (Life Extension Magazine: Rhodiola).  Rhodiola helps to promote mental focus and energy – key for those of us with fibro fog!

Fibromyalgia and Mitochondrial Function: Improving Energy One Cell at a Time 

Secondly, mitochondrial function is a critical part of increasing energy in fibromyalgia. Mitochondria are the power plants of our cells.

Studies suggest the energy factories may be running a bit low in FM. Muscle biopsies have found patterns of mitochondrial dysfunction (abnormal mitochondria, mitochondrial defects and muscle fiber abnormalities) similar to those typically found in mitochondrial disorders. Some skin biopsies have shown patterns of neurogenic inflammation and oxidative stress – two factors that negatively impact the mitochondria. Peripheral blood cells have demonstrated CoQ10 deficiency, mitochondrial dysfunction, oxidative stress and mitochondrial degradation (Health Rising: Is FM a Mitohondrial Disorder?).

I’m trying to take a combination of supplements that are factors used by mitochondria in the production of energy.

  • D-ribose:  D-ribose is a sugar produced in the body and taken to alleviate fatigue and pain in fibromyalgia and chronic fatigue syndrome. Dr. Teitelbaum contends that CFS/FMS is caused by “energy crisis” in the body, leading to a cascade of different symptoms like fatigue, pain, sleep disturbance, among others. One root cause of the energy problem, he argues, is that the ability of the mitochondria in your cells to generate energy is suppressed. Mitochondria produce the energy, called ATP, used by your cells to carry out all their functions. D-ribose is essential to the production of ATP. Therefore, taking additional D-ribose should help to support mitochondrial function and improve energy output in fatigued patients.  Dr. Teitelbaum has authored a few pilot studies that have demonstrated some promising results. The most recent study was an open-label study published in 2012. Significant improvements were found; specifically a 61.3% increase in energy, 37% increase in general well-being, 29% improvement in sleep, 30% improvement in mental clarity, 15.6% decrease in pain (Teitelbaum: From Fatigued to Fantastic).
  • CoQ10, a powerful antioxidant, is the catalyst that enables mitochondria to produce 95% of all cellular energy (in the form of the compound ATP). A Spanish research team has conducted several studies that demonstrate a CoQ10 deficiency in people with fibromyalgia, leading to mitochondrial dysfunction and increased oxidative stress. These researchers have also found that supplementing with CoQ10 improves clinical symptoms of fibromyalgia like pain, depression and fatigue (Phoenix Rising: CoQ10).
  • Acetyl-L-Carnitine, is an amino acid produced in the body from l-carnitine which is used to manufacture fuel for energy via mitochondria. This nutrient is also used in bodily processes that regulate muscle movement, as well as heart and brain function. People with fibromyalgia have been found to have low levels of carnitine. Supplementing with acetyl l-carnitine has been found in a double-blind placebo-controlled study to improve pain levels, depression and quality of life among people living with fibromyalgia (Prohealth: L-Carnitine).

Since starting this combination of adrenal and mitochondrial support, my afternoon crashing has evened out. My fatigue does not bottom out in the afternoon (less brain fog and no visual over-stimulation). I finally regained my pre-viral energy envelope. I am sharing all of this in the hope it gives some direction to others finding themselves in a similar situation! Take care of yourselves, dear readers!

 

Life Extension (Rhodiola)

Life Extension (Stress Management)

Health Rising (Is FMS a Mitochondrial Disorder?)

Phoenix Rising: (CoQ10)

Prohealth (L-Carnitine: Typically low in fibromyalgia and ME/CFS; Promotes healthy mood and energy)

Teitelbaum, J. (2007). From Fatigued to Fantastic. Penguin Books: NY.

Bottoms up: Tart Cherry Juice is a Potent Natural Treatment for Chronic Pain and Insomnia

BOTTOMS UP: TART CHERRY JUICE IS A POTENT NATURAL TREATMENT FOR CHRONIC PAIN & INSOMNIA

Interested in natural treatments for fibromyalgia or chronic pain?Learn about how tart cherries, one of the top antioxidant and anti-inflammatory foods, can reduce pain and alleviate insomnia.

Many people with fibromyalgia and other chronic pain conditions are interested in effective natural treatments to relieve their pain. I am always on the lookout for promising supplements to try. Pharmaceutical drugs can absolutely provide pain relief and I don’t think there should be any stigma about taking prescription medications. I take pain killers and they improve my quality of life. However, drugs are often only partially effective and they can cause unwanted side effects. To me, it only makes sense to integrate helpful natural treatments with mainstream medical approaches. Supplements can reduce pain and often have fewer side effects than pharmaceuticals.

One promising natural treatment for relieving pain is tart cherry juice. Tart cherries are incredibly rich in in antioxidants – greater even than dark chocolate or red wine – and tart cherries can significantly reduce inflammation. Antioxidants are important for overall health, and specifically benefit people with chronic conditions associated with high rates of oxidation (damage caused to cells by oxidants). Antioxidants neutralize oxidants (also called free radicals),  preventing tissue damage and providing a host of other benefits including reduced inflammation.

Research shows that tart cherry juice is particularly effective for reducing muscle pain caused by overexertion. Tart cherry juice works to “protect muscles, lower pain, and accelerate muscle repair” (Life Extension). Not surprisingly, post-exercise pain is caused in part by oxidation and inflammation, which is where tart cherries come in. Studies on the impact of tart cherry juice on post-exercise recovery found that it accelerated muscle repair, reduced inflammation, and reduced pain compared to control groups (Life Extension). Tart cherry juice might therefore be helpful for people with illnesses that cause muscle pain like fibromyalgia and myofascial pain syndrome. I have found that it help to drink it on days that I go for longer walks or do my physical therapy strengthening exercise, to reduce the soreness and ward off a flare.

The anti-inflammatory effect of tart cherry juice has potentially widespread benefits for many chronic conditions. I get pain relief from my endometriosis symptoms and fibromyalgia symptoms using pharmaceutical anti-inflammatories like ibuprofen, but I often worry about taking too much, because of the damage non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can cause to your stomach lining. There is dispute about the extent of inflammation in fibromyalgia, but one study found inflammation of the fascia (the connective tissue sheath that covers muscles).  “In 2012, a double-blind, randomized, placebo-controlled trial found that…among those patients consuming tart cherry juice, there was a statistically significant decrease in inflammation, indicated by reduced levels of C-reactive protein (CRP)” (Life Extension). Tart cherries also inhibit the same inflammatory compounds, called COX enzymes, that NSAIDs do: “Tart cherries contain high levels of flavonoids and anthocyanins that have anti-inflammatory properties that also work through the inhibition of COX enzymes” (Runners Connect).

Amazingly, that’s not all tart cherries can do for us. Insomnia is a significant problem for people with fibromyalgia. Tart cherries contain melatonin, the hormone that tells your body it’s time to go to sleep. A randomized, double-blind, placebo-controlled trial showed that drinking tart cherry juice in the morning and before bed helps improve sleep time and overall time in bed.  Maybe tart cherry juice will help with your insomnia too!

So how much should you drink? Studies of effective tart cherry juice action had participants drink 8-12 oz (236-354 mL) of juice twice daily (remember one cup is 8 oz or 236 mL).  I’m going to head out and get me some more tart cherry juice.  Bottoms up!

Reference:

‘Report – Anti-Inflammatory Properties of Tart Cherry’ Life Extension Magazine June 2013

‘Can Tart Cherry Juice Replace NSAIDs to Relieve Pain and Reduce Inflammation for Runners?’ Runners Connect 

fIG. 1 FROM lIFEeXTENSION.cOM
Guard Against Degenerative Disease and Inflammation with Tart Cherries

Guard Against Degenerative Disease and Inflammation with Tart Cherries

  • Physical exercise can induce muscle damage that generates inflammation and with it, burning, stiffness, and pain. The effect worsens with age.
  • Standard treatment with nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil®) involves potentially deadly adverse effects, such as stroke.
  • Evidence shows that the weave of complex anthocyanins and phenols in tart cherries provides superior protection against muscle injury—by safely inhibiting the pain and inflammatory effects.
  • The potent components in tart cherries have been demonstrated to deliver high-level protection against inflammatory and degenerative diseases, including cardiovascular disease, metabolic syndrome, and neurodegenerative diseases such as Alzheimer’s.

Book Review: ‘Memory of Health’ by Edie Summers

book review_memory of health

I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company.

I was recently given the opportunity to review a new book by Edie Summers called Memory of Health. Edie Summers is both a wellness coach and chronic illness patient expert, with 20 years of experience in the alternative health field.

 

If I had to sum up Memory of Health in a sentence, I would say that it is essentially a manual of self-care for people living with chronic illness. The approach that Edie Summers takes to health and healing is truly holistic, which I think is perfectly summed up by a quote she includes: “Health, wholeness and holiness … all three share the same root word and all three share the same state of harmony or disharmony (Deepak Chopra).”

So what can you expect to find in this book? First, Summers shares her personal journey living with chronic illness, including how she recovered. She emphasizes the power of storytelling for well-being. Many of us with chronic illness can feel very alone in our experiences living with these conditions. Connecting with each other over our shared experiences is empowering. From making us feel less isolated in our experiences, to learning from each other, storytelling is very impactful. And there is much to learn from Summers’ story. One thing that really resonated with me was her relentless detective work to find what helped her to heal. The other was how Summers identified mental, physical and spiritual causes that contributed to her illness, and then made changes to effect her recovery.

Secondly, this book covers a wide range of factors that may contribute to chronic illness, and how to address each in turn, including:

  • identifying and removing environmental toxins that may exacerbate your condition
  • causes of chronic fatigue, including changes to the thyroid, anemia, microbiome, immune health, inflammation, depression, etc.
  • improving nutrition, restorative movement, relaxation, mindfulness, improving sleep etc.

In covering all these topics, Edie Summers keeps her focus on the systems that keep the body in balance. In her own words: “This is why I’m fascinated with systems biology which notices patterns, watches for the surfacing of self-organizing models, and observes healing from a holistic point of view. The thing is, nature is a dynamic system, which learns, evolves, and grows (p.120).”

In the final sections of Memory of Health, Summers provides a roadmap to self-care in order to help readers improve their well-being. The book includes detailed summaries of tips to improve physical health including diet modifications, supplements, super foods, relaxation, de-stressing, sleep support, yoga and many other important topics.

I think the most powerful section of the book is dedicated to mental, emotional and spiritual healing. Summers writes “The problem is, you cannot heal if you are not present in your body. This is your first step: get back into your body and stay there. It bears repeating: health resides in your body (p. 336).” Summers believes the road to greater presence is founded in self-love. Finally, she emphasizes connection– to loved ones, to activities that give us joy and to a sense of purpose.

Ultimately Summers sees all these different threads of wellbeing being woven together to effect synergy. She explains: “Synergy, then, is how health occurs, when the total is greater than the sum of “its” parts. A great example of synergy is the experience of listening to a symphony orchestra vs. hearing each individual instrument played on its own (p.280).”

At times I found reading this book challenging because the way it is written is very dense. Some sections interweave scientific explanations, personal observations and spiritual reflections in a way I sometimes found hard to digest all at once. I think the best way to read this book is to focus in on the sections you think are most applicable to your situation, rather than trying to read the entire thing in one go. There is a very detailed Table of Contents to help you identify the sections that you feel are most relevant to you, which is very helpful.

The other caveat is that all of these suggestions are based on Edie Summers’ personal experiences and should not be taken as medical advice. Make sure you consult with a healthcare practitioner before trying to implement any of these tips.

So, ultimately, who is this book for? I think it is ideally suited to anyone living with a chronic illness who feels like they have tried everything and nothing has worked. Memory of Health opens up many new avenues to pursue and can provide hope to people who feel stuck. It is also an inspirational read. If you are feeling in need of guidance on how to live with more purpose, joy or connection, even if you have a chronic illness, then I think this is the book for you.

Click here to see more reviews on Amazon

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Click here to visit Edie Summers’ website

Massage for Fibromyalgia: A Complete Guide to Getting the Most Out of this Healing Therapy

Massage for Fibromyalgia_A Complete Guide

If you have fibromyalgia, could massage be the effective, natural and drug-free treatment you have been looking for to treat your muscle pain?

If there is one hallmark symptom of fibromyalgia, it has to be sore, aching muscles. Chronic body-wide pain is one of the most limiting features of this chronic illness, because it reduces our ability to participate in the activities we love. Unfortunately, muscle pain is also one of the more difficult symptoms to treat. Medications for fibromyalgia offer only partial relief from pain. So with no magic bullet available, many patients consider alternative treatments. I don’t know about you, but painful muscles often lead me to think about massage. But is massage therapy an effective treatment for fibromyalgia?

For someone who doesn’t have fibromyalgia, that might seem like an odd question. The reason people with fibromyalgia are cautious about massage is because of another common symptom called ‘allodynia’ – painful sensitivity to pressure or touch on the skin. If putting on a blanket hurts you or wearing clothing feels like sandpaper on your skin, then you probably experience  allodynia. In cases where this is severe, massage is probably not the best treatment option.

However, a common misconception is that when it comes to massage, the attitude should be ‘no pain, no gain’. This is untrue. It is entirely possible to have a therapeutic massage that is also gentle. In fact, research shows that “Manual therapy, and any exercises prescribed as part of it, should … take into account the fact that our bodies react strongly to sensation. Basically, they should be gentle and appropriate to what we can handle without increased symptoms.”[i] If you can tolerate light pressure, then massage might well be the effective, natural and drug-free treatment you have been looking for to treat your muscle pain.

Personally, once I found the right therapist, massage became one of my go-to treatments for muscle pain. It’s crucial that you find a practitioner who has the right training and experience. In this article, I’m going to share the different types of massage and the essential questions you need to ask in order to get the most out of your treatment session.

Infographic on massage for fibromyalgia

What are the Different Types of Massage Therapy for Fibromyalgia?

 Swedish massage: is the most common type of massage therapy. It is based on Western medical concepts of anatomy (compared to the focus on energy therapy in Asian forms of massage). Swedish massage uses techniques like ‘effleurage’ (long smooth strokes), as well as kneading, rolling, circular and rocking motions.

Shiatsu massage: this Japanese form of massage incorporates acupressure points from traditional Chinese medicine.[ii] Essential life energy, called ‘qi’ (chee) is believed to flow along channels in the body called meridians. Acu points are mapped along meridians. Stimulating acupressure points restores the flow of qi along the meridians, improving the health of the individual.

Deep tissue massage: this type of massage focuses on knots, or adhesions,  in the deeper layers of muscles, which are associated with chronic pain or injury. Techniques include deliberate strokes or friction across the grain of the muscle. As the name implies, this form of massage uses a greater degree of pressure, so fibromyalgia patients should communicate closely with their therapist to ensure that the massage is not painful.

Myofascial release massage: focuses on muscles and fascia – the connective tissue membrane that encompasses your muscles like a sheath. When the therapist feels that myofascial tissue is tight and constricted, including finding trigger points (painful contractions of muscle tissue), they use techniques to lengthen and restore elasticity using stretching and manual pressure.[iii] In my personal experience, this kind of therapy can be intensely painful if the practitioner applies direct pressure to trigger points. However, finding a practitioner experienced in treating fibromyalgia makes all the difference – in my case, the therapist used gentler, more indirect techniques, making the massage much less painful.

What are the Benefits of Massage for Fibromyalgia?

In general, massage increases blood circulation, encourages cell oxygenation and nutrition, relieves muscle tension, and releases natural painkillers like serotonin.[iv]

Massage has been found to improve pain levels, sleep and mood in people living with fibromyalgia.[v] One study found that levels of a neurotransmitter, called substance P, which stimulates pain receptors in the body, were reduced after twice-weekly massage therapy sessions over five weeks. As a result, the “patients’ physicians assigned lower disease and pain ratings and rated fewer tender points in the massage therapy group.”[vi]

Another study investigated the effects of shiatsu massage for managing fibromyalgia symptoms. It found that participants who received a twice-weekly 40 minute shiatsu massage for eight weeks had reduced pain intensity and decreased sensitivity to pressure, as well as improved sleep, compared to a control group .[vii]

Researchers have also investigated whether myofascial release massage improves fibromyalgia symptoms. A randomized, placebo-controlled study found that the experimental group (who received massage) had improved anxiety levels, quality of sleep, pain levels and quality of life, as compared to the control group (who did not have myofascial massage). However, six months after the study concluded, only sleep quality remained significantly better for the experimental group than the control group. This suggests that massage needs to be continued on an ongoing basis to see the full benefits of the treatment.[viii]

 How Do I Find a Qualified and Experienced Massage Therapist?

Finding the right massage therapist is the key to getting the most benefit from this treatment for fibromyalgia. I have had healing, therapeutic massages and painful, flare-inducing massages. Through trial and error I learned that the primary difference was the training and experience of the massage therapist. Training matters because regulations for massage therapy vary across states in the US and provinces in Canada. Unfortunately, some massage practitioners have very little training or clinical experience and could do more harm than good if they treat you.

However, in order to increase standards and build consumer confidence, a number of professional massage therapy organizations have created certifications with a higher standard of training and clinical experience. In order to receive this certification, therapists voluntarily meet these standards. Before seeing a potential massage therapist, make sure you ask:

  • (In the US) Are you board certified by the National Certification Board for Therapeutic Massage and Bodywork?  The NCBTMB is the regulatory authority for massage therapy professionals in the USA, and responsible for ensuring that massage therapists follow best practices and uphold the codes of ethics, quality and legality. A helpful website is NCBTMB.com, where you can locate a Nationally Certified Massage Therapist in your zip code.
  • (In Canada) are you a member in good standing of your provincial massage therapy professional organization? Massage therapy Association self-regulate standards of practice in six Canadian provinces, while four have established massage therapy as a regulated health profession. You can utilize provincial massage therapy association websites to find a therapist near you.

Broadly speaking, I have found that massage therapists often focus on either relaxation, sports medicine or injury rehabilitation/chronic pain. Spas often employ a ‘masseuse’ for relaxation massage, who are typically poorly trained in therapeutic massage techniques. Sports or athletic focused massage therapists often use more aggressive techniques. This makes sense, given that athletes are anxious to get back on the field, but it is not appropriate for fibromyalgia patients who have a high sensitivity to pressure or touch and a low threshold for pain. This makes massage therapists who have experience in rehabilitation and treating chronic pain the best choice for people living with fibromyalgia. Always ask:

  • What is your experience treating clients with fibromyalgia?
  • What type of massage do you practice?
  • Inform them that you are looking for a gentle therapeutic massage, not a painful or intense massage

As we have discussed throughout this article, each individual with fibromyalgia has a different level of sensitivity to touch. It is critical that your massage therapist asks for your continual feedback to ensure that they use the right intensity and amount of pressure for you. Once you’ve selected a therapist,

  • Ask that they use light pressure during your first appointment
  • Tell them that it is important that you have an ongoing dialogue about whether the pressure or technique is comfortable for you
  • Don’t be afraid to speak up if something feels painful or uncomfortable!

References:

[i] https://www.verywell.com/fibromyalgia-chiropractors-massage-therapists-715646

[ii] http://www.prevention.com/health/health-concerns/fight-fibromyalgia-shiatsu

[iii] http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/myofascial-release/faq-20058136

[iv] http://www.prevention.com/health/health-concerns/fight-fibromyalgia-shiatsu

[v]http://journals.lww.com/jclinrheum/Fulltext/2002/04000/Fibromyalgia_Pain_and_Substance_P_Decrease_and.2.aspx

[vi] http://journals.lww.com/jclinrheum/Fulltext/2002/04000/Fibromyalgia_Pain_and_Substance_P_Decrease_and.2.aspx

[vii] https://www.massagemag.com/shiatsu-improves-fibromyalgia-symptoms-2-13210/

[viii] https://www.hindawi.com/journals/ecam/2011/561753/abs/

Beginning Again: Living with the Ups and Downs of Life with Chronic Illness

 

My new article on Prohealth is about learning to relate differently to the inevitable ups and downs of life with chronic illness, through letting go, drawing on the inner strength all spoonies cultivate, and beginning again. 

Watching my goals, plans, and self-care routines careen out of control is sometimes harder for me to accept than the symptoms that come with a flare-up. Maybe it’s because I have always been a control freak, but the sense of helplessness, frustration and self-doubt that accompanies this situation is one of the most difficult aspects of living with fibromyalgia for me. This time, as I was venting about how it felt like my daily life had come tumbling down like a house of cards, a question occurred to me: What if the problem isn’t a failure to control or manage my schedule during a flare-up, but a failure to understand that living with chronic illness inevitably involves ups and downs?

My practice of mindfulness meditation has helped me find answers to this question. Renowned mindfulness teacher Sharon Salzberg writes that, in contrast to our conditioned belief that self-blame and fear of failure help us succeed, “ease in letting go and kindness in starting over is a lot more effective.”(1)

Finish reading here…  http://www.prohealth.com/library/showarticle.cfm?libid=29692

Organic Aromas Diffuser: The New Aromatherapy Tool in my Fibromyalgia Treatment Toolbox

I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company.

The Organic Aromas nebulizing diffuser mists microdroplets of essential oil throughout a space of up to 800 ft.² The diffuser works without using heat or water, by applying Bernoulli’s principle to pressurize the essential oil into a fine mist. This means the essential oil is unaltered, thereby retaining its rich scent and therapeutic effect. The product itself is comprised of a handcrafted wooden base with the blown glass diffuser set on top. Gentle LED mood lights flicker within. The design of the product is aesthetically pleasing. You can leave it on a tabletop or windowsill and it looks decorative even while it is not in use.

The diffuser is very easy to use. You simply put 10-15 drops of essential oil into the opening at the top of the glass reservoir, and switch it on. The scent it produces is noticeable but not overwhelming, unless you sit or lie down within 1-2 ft. The full richness of the scent was more noticeable to me than produced by other aromatherapy products that I tried. It works quietly, although there is a slight hissing sound as it produces the mist. I found the lights unobtrusive especially in daylight.

Another feature that appealed to me is that it uses very little energy. The diffuser alternates between misting and rest every two minutes. The base contains a dial so you can choose the strength of diffusion you want. It automatically turns off after two hours.

You can find more information on Organic Aromas Nebulizing Diffusers here: https://organicaromas.com.

How can aromatherapy help with chronic illness? 

Many of us struggle with the side effects of medical interventions. Aromatherapy offers an enjoyable and side-effect free alternative. One critical caveat here,  if you have multiple chemical sensitivities or light/scent induced migraines, this may not be appropriate for you.

There are many essential oil that you can try for a range of purposes. I began with lavender oil in the evening for relaxation/sleep and rosemary oil during the day for mental fatigue, memory issues related to brain fog, and circulatory stimulation. You may be surprised to know that studies support the use of essential oils for medicinal purposes. For example, according to the University of Maryland Medical Center, “Scientific evidence suggests that aromatherapy with lavender may slow the activity of the nervous system, improve sleep quality, promote relaxation, and lift mood in people suffering from sleep disorders”[i].  Since sleep is a primary complaint for those living with fibromyalgia, aromatherapy with lavender oil could be a valuable tool in your treatment toolbox. According to another recent study, rosemary oil diffused throughout a room helped participants perform significantly better on a memory test than participants in a control room[ii]. This appealed to me because brain fog affects my word recall and short term memory. Essential oils are believed to work when compounds that are inhaled enter the blood stream. In the case of rosemary, some of those compounds are able to cross the blood-brain barrier, affecting brain activity[iii].

If you are interested in learning about other essential oils that may be helpful for fibromyalgia, check out the links below:

References:

[i] http://umm.edu/health/medical/altmed/herb/lavender

[ii] http://www.bbc.co.uk/news/magazine-33519453

[iii] http://www.bbc.co.uk/news/magazine-33519453