Fibromyalgia

Fibromyalgia syndrome is a musculoskeletal pain and fatigue disorder manifested by diffuse myalgia [muscle aches and pain], localized areas of tenderness, fatigue, lowered pain thresholds, and nonrestorative sleep.

This description comes from a paper titled: Fibromyalgia and the serotonin pathway

The paper discusses how low serotonin is often a contributing factor with fibromyalgia and how beneficial tryptophan and/or 5-HTP can be for the anxiety, depression, pain and insomnia we often see in those with classic fibromyalgia:

Evidence from multiple sources support the concept of decreased flux through the serotonin pathway in fibromyalgia patients.

Serotonin substrate supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and somatic pains in a variety of patient cohorts.

I recently blogged about the effectiveness of 5-HTP being a clinically-effective serotonin precursor and how it improves many of these same symptoms:

Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.

5-HTP improves symptoms of fibromyalgia but can also cause agitation when cortisol is high

An open 90-day study in 50 patients affected by fibromyalgia found benefits with the use of 5-HTP:

When all the clinical variables studied throughout the trial (number of tender points, anxiety, pain intensity, quality of sleep, fatigue) were compared with baseline results, they all showed a significant improvement.

It is concluded that 5-HTP is effective in improving the symptoms of primary fibromyalgia syndrome and that it maintains its efficacy throughout the 90-day period of treatment.

UPDATES March 25, 2022:

Despite the fact that 5-HTP is beneficial for many individuals there is no one-size fits all. 

I don’t recommend 5-HTP when a client has elevated cortisol levels because we know that it can raise cortisol levels in certain individuals. This can leave you feeling agitated, cranky, as well as “wired and tired” at the same time. You may be able to relate to this if you’ve ever used 5-HTP to help with anxiety and insomnia and ended up feeling more anxious and more wide-awake despite your exhaustion and need for sleep. You can read more about this here: Does 5-HTP make you “wired-tired” and affect your sleep when cortisol is high? 

A tryptophan-enriched diet and a combination tryptophan product for fibromyalgia symptoms

As you can see below, a tryptophan-enriched diet and a combination tryptophan product improved some fibromyalgia symptoms and for some individuals, but we still need to customize protocols.

In this study, Psychological and Sleep Effects of Tryptophan and Magnesium-Enriched Mediterranean Diet in Women with Fibromyalgia, “the intervention group received a Mediterranean diet enriched with high doses of tryptophan and magnesium.” Interestingly, the source of extra tryptophan (60 mg) and magnesium (60 mg) was eating walnuts at breakfast and dinner!

This study concludes that tryptophan and magnesium-enriched Mediterranean diet reduced anxiety symptoms, mood disturbance, eating disorders, and dissatisfaction with body image but did not improve sleep quality in women with fibromyalgia.

The addition of additional tryptophan as a supplement would be the next thing I’d recommend for improving sleep. This would be dosed according to each person’s unique needs and after doing a trial and adjusting as needed.

In another study, Comparison between Acupuncture and Nutraceutical Treatment with Migratens^® in Patients with Fibromyalgia Syndrome: A Prospective Randomized Clinical Trial, the treatment group used product called Migratens^®, a powdered blend of coenzyme Q10, vitamin D, alpha-lipoic acid, magnesium, tryptophan (300mg), niacin, and riboflavin.

It was used twice a day on an empty stomach and dissolved in a glass of water, spaced about 10 hours apart.

The authors report that “Migratens^® treatment shows a statistically significant reduction of pain 1 month after the start of therapy, strengthened after 3 months with maintenance of treatment.” They also noted improvement in quality of life.

Unfortunately, gastrointestinal side-effects (diarrhea, nausea, dyspepsia, constipation, and lack of appetite) were reported by 11% of participants in the treatment group. I’d suspect these side-effects were caused by the ingredients used to make the product slow release.

It’s not surprising that the authors also confirmed “the validity of acupuncture in these patients, as stated by the most recent literature.”

If we suspect low serotonin may be a factor, I have my clients do the following (whether or not they have a fibromyalgia diagnosis):

• complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms on the low serotonin section.  The rating uses scale of 1-10 with 10 being worst.
• review the Amino Acids Precautions and figure out if we can do a trial of 5-HTP or tryptophan
• do a trial of the amino acid 5-HTP or tryptophan and observe for improvements in anxiety, depression, pain, insomnia and the other low serotonin symptoms

We are all unique and some people do better on 5-HTP and some do better on tryptophan. I typically start with a tryptophan trial since I’ve seen such great benefits with this amino acid. If that’s not working, we’ll do a 5-HTP trial, always watching for high cortisol as 5-HTP can raise cortisol if it’s already high. In this instance 5-HTP may be too stimulating.

Quality is an important issue when it comes to the amino acids and this is especially the case with tryptophan. I find that the Lidtke brand is the most superior. You can see my amino acid product recommendations here.

If you suspect low levels of serotonin and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with. Blog posts like this are intended to add value to the chapter on amino acids, which contains detailed information on doses and time of the day for dosing.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

 

Do you have a diagnosis of fibromyalgia and have you found benefits with 5-HTP or tryptophan? For your pain? For your sleep? For your anxiety and/or depression?

I’d love to also hear what else has helped with your symptoms?

Feel free to ask your questions here too.