Continued.
. . 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,
11, 12
Acupuncture
Fibromyalgia patients (25 women, four men), as defined by the American College
of Rheumatology criteria, with a mean age of 48.2 years and a mean disease
duration of 6.1 years, participated in the acupuncture study. During the therapy,
no analgesic medication was allowed. Pain levels and positive tender points
were assessed using the visual analogue scale (VAS, range 0-100).
Following therapy, the VAS scores
decreased from 64.0 mm to 34.5 mm (p< .001). The number of tender points decreased from 16.0 to 11.8
(p< .01). Serotonin levels decreased from 715.8 micrograms/1012
platelets to 352.4 micrograms/1012 platelets (p< .01). Substance
P levels in serum increased from 134.0 ng/ml to 66.9 ng/ml (p< .01).
Acupuncture
treatment of patients with fibromyalgia was associated with decreased
pain levels and fewer positive tender points as measured
by VAS. These results suggest that acupuncture therapy is associated
with changes in the concentrations of pain-modulating substances
in serum.30
Branched-Chain Amino Acid Supplementation
Patients with fibromyalgia have been
found to have significantly lower plasma concentrations of the three
branched-chain amino acids (BCAA – valine,
leucine, and isoleucine – than normal controls. It is hypothesized
that the deficiency of BCAAs may play a role in the pathophysiology of fibromyalgia,
since BCAAs supply energy to the muscle and regulate protein synthesis in
the muscles. The amino acid phenylalanine, though not a BCAA, was also deficient
in fibromyalgia patients. Supplementation with branched-chain amino acids
may benefit fibromyalgia patients.31
Melatonin Supplementation
Since disturbed sleep is one symptom of fibromyalgia patients, and since melatonin
is known to be effective in promoting sleep, a four-week study was conducted
with 21 fibromyalgia patients and 20 age- and sex-matched controls. Patients
were evaluated before and after treatment (3 mg melatonin at bedtime) for
tender point count, pain score in four predesignated areas, and pain severity
on a 10 cm visual analogue scale (VAS). At day 30, median values for the
tender point count and severity of pain at selected points and VAS for sleep
were significantly improved with melatonin treatment.32
Chlorella Supplementation
Eighteen fibromyalgia patients having a tender point index (TPI) of at least
22 were given daily dietary supplements of
both 10 g of "Sun Chlorella" tablets
and 100 ml of liquid "Wakasa Gold" for a period of two months.
The average TPI for the group, 32 at the beginning, decreased to a mean of
25 after two months. This decrease was statistically significant (p = .01),
representing a 22% decrease in pain intensity. Seven patients felt that the
dietary supplementation had improved their symptoms, while six thought they
had experienced no change. Five patients believed their symptoms had worsened
over the time period of the study. Dietary Chlorella supplementation may
help relieve the symptoms of fibromyalgia in some patients.33
Serotonin Receptor
Antagonists
Serotonin receptor antagonists are potent and highly selective inhibitors of
the serotonin receptor with negligible affinity for other receptors. They are
rapidly absorbed and penetrate the blood-brain barrier easily. Half-lives in
healthy persons vary from three-to-four hours (ondansetron, granisetron) to
seven-to-ten hours (tropisetron, hydrodolasetron). Drugs of this category diminish
serotonin-induced release of substance P and prevent unmasking of these receptors
in the presence of serotonin.34
In a study comparing the effectiveness
of ondansetron and paracetamol, a marked improvement in pain intensity
measured by VAS (p< .005),
pain score, tender points, average pain threshold (p< .01), and
a lower pain threshold was obtained with ondansetron, whereas no improvement
was seen with paracetamol. Ondansetron appears to be an effective drug
in about 50% of patients with fibromyalgia.35
Antidepressants
Three classes of antidepressants were evaluated: tricycles (nine trials), selective
serotonin reuptake inhibitors (three trials), and S-adenosylmethionine (two
trials). When the effects on individual symptoms were combined, antidepressants
improved sleep, fatigue, pain, and well-being, but not trigger points. Antidepressants
are efficacious in treating many symptoms of fibromyalgia.36
A randomized, double-blind, crossover trial of fluoxetine (FL) and
amitriptyline (AM) was conducted in the treatment of 19 fibromyalgia
patients, consisting of four six-week trials of FL (20 mg), AM (25
mg), a combination of FL and AM, or placebo. Both FL and AM were associated
with significantly improved scores on the Fibromyalgia Impact Questionnaire
(FIQ) and on the VAS for pain, global well-being, and sleep disturbances.
When combined, the two medications worked better together than either
medication alone. (a synergistic response).37
Serotonin reuptake inhibitors alone seem to be of little value. Moclobemide,
a reversible inhibitor of monoamine oxidase, seems to be inferior to
amitriptyline as an inhibitor of pain. Although only one-third of the
patients respond, amitriptyline remains the first choice in the conventional
medication treatment of fibromyalgia.38
Venlafaxine is a medication available by prescription in the U S,
both in an immediate release form as well as an extended release formulation.
Preclinical studies indicate it has the effect of potently blocking
the serotonin transporter. Venlafaxine has been approved by the FDA
for the treatment of major depressive disorders and anxiety. Suggestive
evidence also indicates efficacy in fibromyalgia.39
5-Hydroxytryptophan
5-Hydroxytryptophan (5-HTP) is the intermediate metabolite of the essential
amino acid L-tryptophan in the biosynthesis of serotonin. 5-HTP is well absorbed
from an oral dose, with about 70% absorption into the bloodstream. It easily
crosses the blood-brain barrier and effectively increases CNS synthesis of
serotonin. In the CNS, serotonin levels have been implicated in the regulation
of sleep, depression, anxiety, and pain sensation. Therapeutic administration
of 5-HTP has been shown to be effective in treating a wide variety of conditions,
including depression and fibromyalgia.40
Tropisetron
Oral treatment of fibromyalgia with
5 mg oral tropisetron, a 5-hydroxytryptamine (serotonin) receptor antagonist,
resulted in significantly decreased pain
as measured by VAS, with a mean reduction of 59.7% (p< .0001).41 In another
study, the reduction in pain score was –13.5% for 5 mg/day of tropisetron,
-13% for 10 mg/day (p< .05). The number of painful tender points was also
reduced significantly (p< .002) in the 5 mg/day group.42 Following a single
I.V. injection of 2 mg, a more rapid and profound reduction in pain was achieved
than with 5 mg/day oral tropisetron.43 See Charts 10
and 11.
Chart 10: Fibromyalgia
Therapy
- Stabilized Alkanylated Sulfur
Compound (Lowers Pain antifungal)
- Stabilized Active Oxygen Carrier
(Inactivates Virus, Bacteria)
- Aerobic Exercise
- Acupuncture
- Branched-Chain Amino
Acids (Valine, Leucine, Isoleucine, Benefit to Muscles)
- Melatonin
(Improves Sleep)
- Chlorella
- Serotonin Receptor Antagonists
(Ondansetron, Granisetron, Tropisetron, Hydrodolasetron)
- Antidepressants
(S-Adenoxylmethionine, Fluoxetine {PROZAC}, Amitriptyline, Moclobemide,
Venlafaxine, Tropisetron)
- 5-Hydroxytryptophan
(Precursor of Tryptophan, Serotonin)
Chart 11: Ingles
Integrative Hospital Antimicrobial Protocol Dosage and Administration
IV Push Benadryl 10 - 20 mg (push)- (1 - 2 cc)
Or PO (25 - 50 mg)
Infusion 1:
25 grams Vitamin C
1.42 grams Taurine (20 cc.)
42 mg. Stabilized Glycyrrhizic Acid (5 cc)
500 mg. Glutathione (5 cc.)
1 gram Magnesium Chloride (10 cc.)
200 cc. Normal Saline
INFUSION RATE: 60-80 DROPS/MIN.
Infusion 2:
15 cc. Stabilized Active Oxygen Carrier (25K-ppm)
100 cc. Normal Saline
INFUSION RATE: 80-120 DROPS/MIN.
Infusion 3:
Stabilized Alkanylated Sulfur Compound 200 cc.
(15% pre-mixed alkanylated sulfur compound infusion)
INFUSION RATE; 180-300 DROPS/MIN.
Continued. . . 1, 2, 3, 4, 5, 6, 7, 8, 9, 10,
11, 12 |