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:
Now before I lose part of my audience, here are some definitions for my non-medical readers:
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.
How can we make this knowledge work for us?
Did you know that cortisol hormone levels can have a significant impact on your health and wellbeing by influencing both the way your other hormones e.g. oestrogen, progesterone and testosterone, are produced and metabolised?
Cortisol levels are generally driven by our brain’s stress response as a part of the Hypothalamic/Pituitary/Adrenal (HPA) axis.
Originally designed to be of short duration to give us a quick burst of adrenaline to escape from danger (lions and tigers and bears – oh my!), these days our stress response is often in a constant state of overload from work, family and lifestyle commitments.
This puts our HPA axis into overdrive and we find it harder to maintain quality sleep, get grumpy and tired, find that it gets harder to lose weight, are injured more easily when exercising or playing sports and find it harder to fight off or recover from illnesses and strenuous exercise. As time moves on the body can struggle to make enough cortisol hormones through its normal pathways, so it starts diverting the progesterone and testosterone precursor hormone to try and make cortisol in what is called the “pregnenolone steal”. This can be tragic for people trying to become pregnant as it can lead to fertility issues for both men and women. It can also lead to oestrogen dominance in women since there is a reduced amount of progesterone to balance out oestrogen putting us at risk of PMS, fibroids and oestrogen driven cancers. The extra hormonal complication for women is what makes it harder for us to lose weight.
And even the blokes can’t escape from this one! Cortisol mobilises fat stores in the body to become belly fat in both women and men. Constant stress also puts us at risk of systemic inflammation which increases the risk of heart disease, diabetes and cancers. We have all heard of people burning out and many will have heard of adrenal fatigue syndrome that occurs as a result of too much stress.
Stress does not even need to be real to have an impact – just imagining or anticipating a situation is enough to elicit a stress response.
Here are some simple things that you can do about it before you get to the point that you cannot raise enough energy to even get out of bed:
It’s been a busy week at the clinic with not just people receiving help and healing. Tim the Chiropractor regularly has dogs come in for treatment but we had a change of focus this week when it was discovered that a mama cat and her four kittens had moved in under the building.
Last Sunday Tim and his family caught mama and one of her kittens, who came to stay with me, and then over the next few days they caught two more of the kittens – one now staying with me and one re homed with Tim’s family. Where the fourth kitten went was a mystery until we found out that a neighbour near the clinic had taken it in and given it a home. Yay!
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.
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.