Fibromyalgia or Something Else?
Is it fibromyalgia or another chronic pain syndrome? It may take falling into a web of confusion before that question can be answered. David Brady, ND, who has dedicated much of his career to understanding fibromyalgia clears away much of that confusion in his book, The Fibro Fix.
How physicians and patients view fibromyalgia at this time is all over the map. The diagnostic criteria are changing as more is known, but many physicians have not caught up. Most are familiar with the scoring system that qualifies a person as having fibromyalgia when there are at least eleven out of eighteen tender points and pain above and below the waist on both sides of the body. Brady informs us that these were criteria established for use in research, not diagnostic purposes. The problem with using this as a diagnostic tool is that it fails to eliminate any other pain disorders and does not truly pinpoint the classic fibromyalgia diagnosis. This may account for the statistic that only 34% of fibromyalgia diagnoses are accurate.
There was some improvement when the American College of Rheumatology revised the diagnostic criteria in 2011. Patients' responses on questionnaires about pain and other symptoms now guide the diagnosis. But pain can be a result of many other conditions, and Brady advocates thorough hands-on exams to rule them out. Without such examination, the patient stands a good chance of being misdiagnosed and fibromyalgia over-diagnosed. Brady advises a thorough history, comprehensive physical exam, and both standard and functional lab tests before diagnosis. Without the thorough exam, one might miss other conditions that can mimic fibromyalgia such as hypothyroidism, autoimmune diseases, and anemia, to name a few. Fibromyalgia is different in that it is a dysfunction of the central nervous system and the way it processes pain.
By the end of the first chapter, the author directs the reader to his Fibro-Fix Foundational Plan no matter what pain syndrome may be present--there is no need to wait for the thorough diagnosis. Brady has devised a three-week plan that includes an anti-inflammatory diet, a toxin-lowering lifestyle, and movement and relaxation. Brady is selling a detox shake and packets of supplements for the diet but purchasing them is not necessary. He includes a list of the ingredients for the shakes and names the supplements.
Other dietary instructions call for elimination of sugar, gluten, alcohol, and dairy for the duration of the diet. High-quality proteins from fish and chicken are essential for the detox process. We learn that toxins bind to other chemical compounds, or conjugators, to be carried out of the body. The most effective of these are sulfur-containing amino acids, which come from proteins. Red and green foods are also included to act as antioxidants for the initial breakdown of the toxins.
Recommendations for the toxin-lowering lifestyle are a bit short in the avoidance category but included are ideas to assist the body in detoxing, such as Epsom salt baths and filtered water. It is too bad, though, that Brady did not include more information about the many toxic exposures inside and outside the home that could be avoided or eliminated. There is a list of these in a later chapter which is concerned with functional issues in a discussion of multiple chemical sensitivities.
The movement and relaxation part of the plan takes into account the fact that patients are in pain. The exercises are gentle and are intended to increase blood flow. This in turn allows for better results with muscle relaxation exercises that are needed to relieve the muscle tension that occurs when someone is in pain. Guided imagery instructions are included with the goal of reconnecting with inner calm, or one's well self.
This book will assist the reader in identifying whether it is classic fibromyalgia they are suffering from or a condition found in three other categories: musculoskeletal issues; functional/metabolic problems; or conventional medical diseases. The author refers to these as "buckets." He includes questionnaires, descriptions, and tests to help the reader determine if they may indeed be suffering with a problem that falls into one of the bucket categories. If that is the case, there are recommendations for testing and illustrative patient case studies.
The chapter for functional disorders addresses the symptoms that many physicians find confounding. A doctor trained in functional medicine will be able to parse out the vague symptoms such as fatigue, difficulty concentrating, food sensitivities, intestinal distress, and more, with an eye toward suboptimal functioning of a metabolic process or other system. Here we find discussions of subtle thyroid problems, mitochondrial dysfunction, and more. Left untreated the suboptimal in time can become disease.
The cause of fibromyalgia is not known, but Brady offers his best estimate of cause. He attributes early childhood abuse or trauma as the root cause. The developing nervous system in a child may react to such stresses by over responding to stimuli, which can cause nerve signals to spill over onto other neurons therefore widening the receptive fields of pain. Once set up for hypersensitivity, a trigger later in life will then misinterpret stimuli as pain. He discusses the role of serotonin, which is found to be low in fibromyalgia patients, and the neuromodulator substance P, which is elevated. It is not clear in the book if the childhood trauma explanation he describes is the result of consensus though.
As someone who has not had to face the maze one must go through with a suspected diagnosis of fibromyalgia, I found this book eye opening. There is so much information to help those with fibromyalgia and other conditions as well. It would certainly be a helpful tool for physicians who are trying to help their patients.
review by Katherine Duff
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|Title Annotation:||Fibro Fix: Get to the Root of Your Fibromyalgia and Start Reversing Your Chronic Pain and Fatigue in 21 Days|
|Article Type:||Book review|
|Date:||Nov 1, 2018|
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