Health Conditions : Fibromyalgia

Whilst fibromyalgia syndrome is generally characterised by systemic unexplained pain, it can also be accompanied by various psychological symptoms that include depression, anxiety and fatigue.

Research on different parameters in fibromyalgia indicates that there are a multitude of factors involved in the functional changes that lead to the syndrome.
These include genetic factors, abnormalities in pain mediators such as substance P, neurotransmitters such as serotonin and changes in the complex system known as the hypothalamic pituitary adrenal axis (HPA) involved in regulating how we respond to stress.

Dysregulation of the HPA-axis results in the production of products called cytokines, proteins produced during inflammation that can themselves trigger, or exacerbate existing, inflammation.

The fibromyalgia patient is subjected to a complex interaction of chemicals, hormones and proteins, all of which can contribute to their many symptoms. Not surprisingly, there are no specific biomarkers that can lead to a diagnosis of fibromyalgia.

Another area gaining increasing interest is the role of oxidative stress in the initiation and progression of fibromyalgia and its related symptoms.

Oxidative stress is a complex condition that is characterised by the release of highly unstable products called free radicals. Free radicals are considered unstable because they are missing an electron; this gives them the ability to disrupt normal cellular function.

Oxidative stress is a constantly occurring process within the body, but our bodies have evolved to limit the levels of these ‘reactive oxidants’ and the damage they inflict. Specific enzymes such as superoxide dismutase and glutathione peroxidase act directly to inactivate these potentially harmful products. However the consumption of dietary antioxidants also provides an effective defence mechanism by donating an electron to the free radical, rendering it harmless and thus removing it from the circulation.

1. Firstly by increasing consumption of fruit and vegetables, it is possible to modify the intake of key vitamins that are known to act as powerful antioxidants. We are all probably aware of ’superfoods’ which have earned their illustrious title by way of their high antioxidant content. Such foods include açai berries, blueberries and pomegranates, but more simple foods, highly available and cost effective, such as citrus fruits, avocado, broccoli, onions, peppers, spinach, and sprouts (to name but a few!) are also ‘superfoods’ in their own right.

2. Increasing levels of superoxide dismutase and glutathione peroxidase within the body can significantly help defend against the damaging effects of oxidative stress. Asparagus contains more glutathione than any other common food item, but generally it is difficult to increase levels of superoxide dismutase and glutathione peroxidase by direct consumption. Glutathione is a small protein composed of three amino acids, cysteine, glutamic acid, and glycine; the amount of cysteine in the body can determine how much glutathione the body can make. Consuming foods with a high cysteine content can therefore help as an indirect way of ensuring glutathione levels are maintained. Cysteine is found in a variety of foods including pork, poultry, yoghurt, egg yolks, red peppers, garlic, onions and broccoli.

3. Finally, it is possible to protect the body from the harmful by-products derived from lipid peroxidation by modifying dietary fat intake and reducing arachidonic acid (AA)levels. AA, gamma-linolenic acid (GLA) and linoleic acid (LA) are three forms of omega-6 fatty acids, all with differing actions. LA is converted to GLA in the body. Technically, GLA is considered to be an anti-inflammatory omega-6; however, if levels of omega-3 in the diet are low, this releases adequate amounts of enzymes that are then available to further convert GLA into inflammatory AA. Omega-6 fatty acid in the form of AA can be found mainly in non-organic meats (organs in particular), and other animal-based food items. Our high intake of grains and oils rich in LA, coupled with our low intake of omega-3 fatty acids, has led to an overall increase of AA within our cell membranes. Because the AA pathway constitutes one of the main mechanisms for the production of pain and inflammation, reducing levels can have a major effect on reducing long-term pain.

4. Increasing levels of omega-3 and in particular eicosapentaenoic acid (EPA) results in competition with AA for incorporation into cell membranes whilst also inhibiting the final conversion of GLA to AA, allowing GLA to convert to a family of anti-inflammatory products.Consuming EPA therefore reduces the AA content of cell membranes, indirectly reducing the conversion of inflammatory products from AA and directly increasing the production of omega-3 anti-inflammatory by-products and the production of omega-3 anti-inflammatory by-products.


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