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Nutrition 2 (Semester II) > 17c. MSK - Fibromyalgia > Flashcards

17c. MSK - Fibromyalgia Flashcards

1
Q

What is fibromyalgia (FM)?

A

Condition of chronic widespread pain
Abnormal pain-processing mechanisms

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2
Q

Signs/symptoms of FM?

A

Fatigue
Sleep disturbance
Stiffness
Headaches
Bowel disturbances
Anxiety
Depression

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3
Q

Causes and risk factors for FM

A

Trauma
Hypothyroidism
Intestinal dysbiosis
Infections
Nutritional deficiencies
Gluten reactivity
Genetics
Heavy metals

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4
Q

Why is hypothyroidism a risk factor for FM?

A

Thyroid hormones usually inhibit the synthesis and secretion of substance P

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5
Q

What areas of intestinal dysbiosis are common risk factors for FM?

A

SIBO
Altered composition of SCFA-metabolising bacteria

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6
Q

Which SCFA-metabolising bacteria are lower in FM patients?

A

Faecalibacterium prausnitzii
Bacteroides

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7
Q

Why is gut bacteria important in FM?

A

Gut bacteria could modulate nociception (pain) at multiple levels in the CNS

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8
Q

Which infection is implicated as a cause of FM?

A

EBV

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9
Q

Which nutrients are commonly deficient in FM?

A

D
B12
Mg

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10
Q

Which genetic SNPs are common in FM?

A

MTHFR
COMT
GSTM1

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11
Q

Why are heavy metals a risk factor for FM?

A

Reduces glutathione
Disturb GABA-glutamate balance
Disturb methylation
Increase pro-inflammatory cytokines

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12
Q

Natural approach to supporting FM

A

Support stress
Support mitochondrial dysfunction
Gluten free diet
Low FODMAP diet
Support thyroid/adrenals/GIT as needed
Reduce glutamate levels
Support methylation
Optimise detoxification and elimination
Sleep
Regular aerobic exercise
Stress support

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13
Q

How can glutamate levels be reduced to support FM?

A

Increase GAD co-factors - Mg, B6, Zn, C, taurine
(GAD reduces glutamate by converting it to GABA)

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14
Q

Nutrients to support FM

A

Mg
D
B6
CoQ10
5-HTP

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15
Q

Why is Mg good for FM?

A

Blocks NMDA receptor channels

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16
Q

Why is vit D good for FM?

A

Modulates central pain processing

17
Q

Why is B6 good for FM?

A

Co-factor for GAD
Needed for conversion of glutamate to GABA

18
Q

Dosage of B6 to support FM

A

50-100mg/day

19
Q

Why is CoQ10 good for FM?

A

Deficiency common in FM
AO
Key in ETC

20
Q

Dosage of CoQ10 to support FM

A

300mg/day

21
Q

Why is 5-HTP good for FM?

A

Improve low levels of serotonin and L-tryptophan
Serotonin plays role in descending pain regulation
Supports melatonin synthesis

22
Q

Dosage of 5-HTP to support FM

A

100-300mg/day

23
Q

How can detoxification/elimination be supported for FM?

A

Reduce toxic load
Optimise levels of metallothionein (binds to heavy metals)
Improve AO status
Improve status of chain-breaking AO
Optimise glutathione levels
Saunas
Hydrotherapy

24
Q

Which nutrients can be used to optimise metallothionein levels?

A

Cysteine
Zn
Cu
Se

25
Q

Examples of chain-breaking AOs

A

C
E
Flavonoids
Carotenoids

26
Q

Nutrients to optimise glutathione levels

A

NAC
Silymarin
Resveratrol

27
Q

Nutrients to support methylation for FM

A

B2
B6
B9
B12
Betaine
Zn
Choline

28
Q

Why is sleep support important in FM?

A

FM patients don’t go into a deep, restorative sleep

29
Q

Herbs to support FM

A

Ashwagandha
St John’s Wort
Devil’s Claw

30
Q

Why is ashwagandha good for FM?

A

Supports the HPA axis
Restorative sleep through influence on GABA

31
Q

Dosage of ashwagandha to support FM

A

300-600mg/day

32
Q

Why is St John’s Wort good for FM?

A

Increases serotonin
Increases dopamine

33
Q

Dosage of St John’s Wort for FM

A

600-1200mg/day in 3 divided doses

34
Q

Why is Devil’s Claw good for FM?

A

Anti-inflammatory

35
Q

Dosage of Devil’s Claw for FM

A

3-6g/day

36
Q

Why is capsaicin good for FM?

A

Desensitises C fibre sensory neurons responsible for the release of substance P

Nutrition 2 (Semester II) (55 decks)

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