Just before Christmas a friend of mine shared a Facebook post from a news website that discussed some newly published research about Fibromyalgia syndrome (FMS). Initially I intended to just share this directly to my own Facebook page, but I wanted to see if I could find the published study first to check what I was sharing. As anyone who reads medical journal articles knows, getting more than just the abstract for free for a recent article is about a rare as hen’s teeth, so when I found that Elsevier had made it available in full, I was over the moon. I printed it out and sat down with my yellow highlighter and started to go through the article.

It would be fair to say that my first reaction was an emotional one. Here, in front of me, was more evidence that fibromyalgia syndrome had a physical manifestation that could actually be measured and was the possible reason for the symptoms experienced. For years people diagnosed with FMS have had to rely on whether or not their physicians “believed” in FMS – and let me tell you from experience, many didn’t. So, it has taken me a little while to get over the “wow, no way!” reaction and get to writing the blog post 😊!

The journal article is titled “Brain glial activation in fibromyalgia – A multi-site positron emission tomography investigation” Albrecht, D., Forsberg, A., Sandstrom, A., et al (2018). I know that sounds like a load of medical jargon. In plain English it means that a type of brain scan using positron emission tomography (PET) found that cells called glial cells are more active in people with fibromyalgia.

Although this is a relatively small study with 31 participants with FMS and 27 healthy participants, there are two things that I like about it:

1. It is on living humans (in vivo), not mice or rats and not on cells in a lab (in vitro).
2. The Massachusetts General Hospital, USA and the Karolinska Institute, Sweden collaborated on the study with groups of people from both countries.

The study focused on levels of a translocator protein (TSPO) which has been found in to be upregulated in the glial cells of people who experience chronic pain.

Now before I lose part of my audience, here are some definitions for my non-medical readers:

• Glial cells are a group of cell types found in association with nerve cells, but are not nerve cells and do not make synaptic connections. They provide support to the nervous system. The studies discussed here refer to microglia – which are part of the body’s clean-up crew, aka macrophages. They are attracted to and remove debris created by injuries, inflammation or general cell renewal.
• Translocator Protein (TSPO) – is a protein that is found on the membrane of the mitochondria inside your cells. It is involved in a number of processes that I won’t go into here, and is also expressed/activated when inflammation is present, so is a good indicator of an inflammatory process going on in areas of the body where it is active in high densities. TSPO activity is also implicated in heart disease and, most importantly for FMS people, the production of neuroactive and reproductive steroid hormones which impact on mood, pain and cognition – starting to sound familiar anyone? It can also be easily scanned in PET imaging, as was done in these studies.
• Serotonin Transporter 5-HTT – aka SERT is a protein that regulates the amount of serotonin that is available for nerve cells to use by releasing it into the gap between cells (synaptic cleft) and then recycling (reuptaking) it. The way this functions is related to the genetic polymorphism, or variant, of the gene that codes for 5-HTT that you carry.

 
An equally interesting and earlier study by Kosek, K., Martinsen, S., Gerdle, B., et al (2016), also from the Karolinska Institute and on 126 real live people, found a link between some of the polymorphisms, of the gene that codes for TSPO, and the level of pain experienced by people with FMS. It found that people with FMS who had a genotype for high affinity binding TSPO reported greater severity of symptoms, including pain, than those with mixed and low affinity TSPO binding. They also looked at serotonin transporter 5-HTT polymorphisms and found that people who had high levels of TSPO expression AND had high levels of 5-HTT expression (leading to higher levels of serotonin) reported the highest levels of pain.

In a “things that make you go hmmm” kind of way I wonder if the reason that the popular supplement 5-HTP is helpful for some people with fibromyalgia and also anxiety, but causes increased levels of anxiety in others, is related to the 5-HTT polymorphism that people carry.

There was also a comment that TSPO upregulation has an association with higher levels of another inflammation indicator interleukin 8 (IL-8), which has also been recorded as elevated in cerebral spinal fluid in FMS people.

As usual, more research is required, but this is great to know and means that there is tangible evidence to start working with.

Whether you mark the arrival of spring by the calendar date of 1st or September or last weekend’s Vernal Equinox, this year the season seems to have burst forth with flowers and new growth all over the place. The local ducks are walking around with their baby ducklings and the tui and grey warblers have returned to our local forest.

One of the variety of flowers that have taken my notice this year are on the kūmarahou, kūmerahou or pāpapa  (Pomaderris kumerahou) plant, which is native to the top half of the North Island of New Zealand. At this time of year, the plant has masses of pretty, little, creamy yellow flowers and is said to traditionally mark the coming of kūmara (sweet potato) planting season.

So often plants make themselves known just at the time of year that we need them. In spring, even though the days are getting longer, the weather is often at it’s wildest and spring colds seem to do the rounds. Kūmarahou has a long traditional use as a Rongoā and herbal medicine plant for the treatment of respiratory complaints including coughs, bronchitis and as a general tonic. It is often included in NZ made cough mixtures.

Kūmarahou has been used topically for rashes and wounds. The saponins in the plant have another useful application - by rubbing the flowers between the palms of your hands with a little water you quickly create soapy bubbles to effectively clean your hands. I remember being shown this with the leaves too in my Girl Guide days and being amazed that bubbles could appear from leaves! We told the European name was “gum diggers” soap.

Kūmarahou has also been used to make a type of home brew or paikaka by both Maori and Pākehā. There is a recipe for this in “Māori Healing and Herbal – Murdoch Riley, 2010” which sounds quite interesting. If you have tried making this, let me know in the comments whether or not it is worth experimenting with 😊.

​Stay well.
 
As always, this is general information and not to be taken as direct advice. For a more personalised approach, either click the “Book Now” button to book a consultation with me or contact your local registered Naturopath or other Health and Wellness professional

References:
Phytomed Medicinal Herbs Ltd. (n.d). Herbal Monograph: Kumerahou (Kumarahou) (Pomaderris kumerahou: P.elliptica). Retrieved from Phytomed Medicinal Herbs Ltd: https://www.phytomed.co.nz/site/phytomed/Kumerahou%20monograph.pdf
Riley, M. (2010). Māori healing and herbal. Paraparaumu, New Zealand: Viking Sevenseas NZ Ltd.
 

A quick disclaimer before we begin – this is purely from my own perspective! I have mentioned some people below who have been of influence to me in some way and who I believe to be key to this story. Just because I have mentioned them does not mean I am endorsing them. I am likely to have missed some important figures out, so please forgive me if I have missed one of your favourites. Perhaps add a comment with why you think they should be included?

Many of us grew up, and had our views instilled about healthy eating during the Keysian era. The Seven Countries Study, which was started in the 1950’s and is famously attributed to Ancel Keys, proposed the Lipid Hypothesis which, put simply, attributes the cause of heart disease to high levels of lipids in the blood which was theoretically affected by the amount of saturated fats people eat.
In the 1970’s we saw the rise of the food pyramid, variations of which also demonised fats and recommended increasing the amounts of whole grains that people eat. There is plenty of information on the internet about how this came about – follow the money from lobbyists etc, but I won’t go into this here.

Suddenly many of the foods that people had eaten for generations were now considered not just bad for us but down right evil. With the iconic cover of Time Magazine in March 1984, bacon and eggs became a “heartattackonaplate”. We were advised to switch butter for table spreads and margarine, as much fat was trimmed from meat as possible and it was recommended that vegetable oils should be used to cook with – but only when necessary. This spawned the rise of the non-stick fry pan along with its non-stick utensil cousins and the breeding of heavy-breasted chickens and “trim” pork.

​Well here we are at April and the weather is sending us an early reminder that winter is fast approaching. It’s time to start looking at how you can support your immune system to help you fight off the season’s colds and flu.
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As always, the best place to start is with good nutrition. I know this may sound a bit clichéd and repetitive, but, reducing processed foods and sugars, increasing the amount of lovely colourful vegetables you eat and adding in some fruit really is a great place to start.

During winter, nature provides us with beautiful fruits that are full of vitamin C and other antioxidants that our immune system just loves. Seasonal fruits like the citrus family – oranges, mandarins, lemons, grapefruit and kiwifruit are all good sources (hold off on the grapefruit if you are taking statins for cholesterol control or other medication with a warning about grapefruit). Frozen berries are another great source of vitamin C and other antioxidants which can be easily added to smoothies or thawed and eaten with yoghurt. Take care with fruit juices as they can contain high amounts of sugar – fruit is best eaten whole. If you have a lot of stress in your life, are very physically active, or have issues with adrenal fatigue you may benefit from taking a vitamin C supplement to support your adrenal glands, which can take a hammering during any stress including illness.

Zinc is another element that is important for our immune system. Oysters are one of the best sources of zinc, however if you are not keen on these - or don’t have the budget of the rich and famous for more than an occasional indulgence - then beef, lamb, pork, whole grains, nuts and pumpkin seeds are good sources too.

Herbs are a traditional and effective method of improving our immunity, both directly and indirectly by supporting other systems. One of the most famous is Echinacea, which is found in a number of over the counter remedies. Echinacea has been shown to prevent acute infections and to stimulate the immune response. Withania is also a well-known adaptogen that helps our bodies to cope with stress and also supports the immune system. Liquorice can assist with supporting the adrenals glands during times of stress. Keeping our stress levels under control is important in reducing the risk of illness and infections. Talk to a qualified Naturopath or Herbalist to determine which herbs are right for you, as some do have contraindications.

Vitamin D – the sunshine vitamin! This is a very important component of our immune systems, central nervous systems and is important for bone health. Many Kiwis have low levels of vitamin D, which is a downside of the sun protection message to avoid skin cancer in this part of the world. Generally GPs will not test vitamin D levels as it is cheaper to prescribe a supplement than it is to do the blood test. 

Winter, with its short daylight hours, is the season when many animals hunker down and rest. We should also take the hint and make the time to rest too because our bodies do their best repair work when we are resting and sleeping. Often our modern lifestyles and the winter weather mean we are as busy as ever and so we compensate for lack of daylight with artificial lighting and rarely venture outside. Our bodies have evolved to react to natural sunshine that changes spectrum throughout the day. Early morning light helps us to wake up, sunset light tells our bodies it is time to go to sleep. At this time of year, we often miss those cues – how many times do you hear people say “I leave for work in the dark and get home in the dark”? This can mess up our circadian rhythm, leaving us tired, run down with depleted vitamin D and prone to catching the latest lurgy.  For some people it can cause Seasonal Affective Disorder. 

​“So what can I do about it?” you may ask.
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