QandA

FIGURING OUT FIBROMYALGIA

My sister has been diagnosed with fibromyalgia. She was wondering if there were any herbs or supplements she could take. She is on the drugs baclofen (20 mg) and clonazepam (1 mg). Could you please tell me more about fibromyalgia and what might help her?
D.G.
Raeford, North Carolina

Keville responds: Holistic practitioners always want to treat the cause of a condition, yet no one knows exactly what causes fibromyalgia or, for that matter, how to cure it. Fortunately, your sister can do several things to ease her symptoms.

Compounds derived from two Ayurvedic herbs reduce inflammation: curcumin from turmeric (Curcuma longa) and boswellia from Indian frankincense (Boswellia serrata). Both are available as capsules and tinctures, either individually or in formulas. Follow the dosage directions on the bottle.

Heat brings relief to most fibromyalgia sufferers. Toss 1/4 cup Epsom salts with five drops of lavender essential oil into a hot bath. Lavender is an anti-inflammatory that soothes the mind as well as the body.

Recommending natural remedies for someone who’s taking prescription drugs is tricky. If your sister has her doctor’s blessing, she can try switching from the sedative drugs to herbal muscle relaxants, such as chamomile (Matricaria recutita), skullcap (Scutellaria lateriflora), valerian (Valeriana officinalis) and passionflower (Passiflora incarnata). She will need professional guidance if she chooses to take the drugs and herbs together.

Sedative herbs won’t offer much direct pain relief, but they will ease the tension that contributes to pain and will help improve the balance of pain-related substances in the brain. If your sister is one of the many people with fibromyalgia who suffer from insomnia, she will sleep better, too. Sedative and anti-inflammatory herbs are good to use before bed, but she should also use small amounts during the day to fend off stiffness and pain.

The symptoms of pain and insomnia point to possible underlying nervous system and adrenal gland problems. Eleuthero (Eleutherococcus senticosus) and nettles (Urtica dioica) are tonics for these systems. St. John’s wort (Hypericum perforatum) is thought to repair an injured nervous system and also will help if she tends to get depressed — another possible symptom of fibromyalgia.

People with fibromyalgia should avoid caffeine. They also tend to have low levels of magnesium and find it helpful to eat dark green, leafy vegetables and to take daily doses of 300 to 600 mg of magnesium malate, a very absorbable form.

Khalsa responds: Fibromyalgia is one disorder where every day will be an adventure. There are so many chemical, physiological, psychological and environmental factors that symptoms can wax and wane wildly, and progress back toward health will be quite variable. But progress can, and does, happen. With a well-organized plan, unswerving discipline and consistent follow through, this disorder can be managed, and in the best outcomes, become a thing of the past.

Because it is a chronic illness and cannot be cured medically, treatment regimes are designed to manage the symptoms of fibromyalgia. This includes a good understanding of the diagnosis and that the disorder is painful and is better sometimes and worse at other times. In addition, good sleep habits, gentle aerobic conditioning and a flexibility program are essential. These can be achieved by exercise programs, physical therapy visits and medications to facilitate sleep, as well as techniques such as biofeedback, relaxation and stress management to assist in managing the tension and sleep difficulties associated with fibromyalgia.

Many natural healing practitioners agree that magnesium is the single most important therapeutic tool in managing fibromyalgia. Research shows that patients are usually very low in magnesium, which is one of the most crucial nutrients for the production of ATP, the source of energy in the muscle tissue. Good food sources of magnesium include grains, vegetables, legumes and nuts.

Magnesium is a key mineral supplement for fibromyalgia; its effect is very powerful. I have seen magnesium produce improvement in one week in cases where numerous other therapies had failed. Magnesium has a laxative effect, so use it carefully. Use the magnesium to bowel tolerance — the maximum dose that is not quite laxative. In most people, that dose is around 1,500 mg per day.

Vitamin D deficiency is occurring in epidemic proportions in the United States and other temperate climates, according to sources that include the Mayo Clinic. The occurrence of vitamin D deficiency in healthy postmenopausal women is extremely high, according to a study published in 2001 in the Journal of Bone and Mineral Research. Make sure you’re getting enough vitamin D by receiving moderate sun exposure for about 20 minutes daily, or eating fish, egg yolks and foods fortified with the vitamin, such as milk.

Restless legs can be one of the most uncomfortable and frustrating conditions associated with fibromyalgia. You want to sleep, but your legs just won’t turn off. This problem often is caused by calcium deficiency, and can respond rapidly to simple calcium supplementation.

Corydalis (Corydalis yanhusuo) is nature’s medicine for aches and anxiety. It’s the main herb used in Traditional Chinese Medicine for treating pain, and it also promotes relaxation. Corydalis is an ideal herb for fibromyalgia. Corydalis is relaxing and promotes sleep, so don’t take it while driving, and exceed the recommended dose only with caution. Increase the dose gradually until you are familiar with the pain-relieving and sedative effects. As a tea, start with 1/2 ounce (dry weight) of chopped herb, brewed, per day.

Some believe that fibromyalgia never goes away completely. Some think it can be thoroughly reversed. We do know from experience that it can be managed successfully as a chronic condition. It is possible to conquer fibromyalgia. I have seen it happen dozens of times, in motivated people who are willing to change their lifestyles and create a supportive new structure for living that creates and maintains a base of solid, balanced health.

WEIGHT-LOSS WISDOM

When I started nursing school a year ago, I was tremendously stressed out. I gained 30 pounds in one semester. Also, I developed amenorrhea. I’ve had that for more than a year. I still haven’t lost the weight — I am 5’4’’ and 190 pounds. I am taking black cohosh, evening primrose and bladderwrack for the amenorrhea. I have always had a slow metabolism, so what can I do about my weight in addition to exercise and diet?
S.Y.
Valley Stream, New York

Keville responds: You certainly are on the right track and may already be taking at least part of the correct formula for amenorrhea (lack of menstruation). The tricky part is that a number of things can cause it and it’s difficult to know the source. It is a good guess that it’s associated with your stress level, which definitely influences hormones. Although more often connected with weight loss, amenorrhea can develop in women who carry excess body weight. If you’ve been on a strict diet to drop the extra pounds, that too can contribute. For one thing, hormones rely upon an adequate amount of cholesterol in the diet. An underactive thyroid can disrupt hormones and that’s probably why you’re taking the seaweed bladderwrack (Fucus vesiculosus).

I hope you’ve been checked by a doctor to rule out some of the other causes of amenorrhea, such as polycystic ovarian syndrome, tumors and infection. Most commonly, the problem is hormonal imbalances, especially very low levels of estrogen. That’s where your use of black cohosh (Cimicifuga racemosa) fits. However, you may be taking too little of the herb or haven’t allowed enough time — three to five months — for it to work.

Or, perhaps you need a better formula. Black cohosh isn’t considered an estrogenic herb and doesn’t directly increase estrogen in the body. Try vitex (Vitex agnus-castus), one of my favorite herbs to adjust menstrual imbalances. It helps the pituitary gland regulate female hormones and is especially helpful when menstruation stops due to an excess of the hormonal substance prolactin. It also makes the action of the hormone progesterone stronger by adjusting the ratio between estrogen and progesterone. Take at least three droppersful of tincture or four capsules a day. Evening primrose oil (Oenothera biennis) can’t hurt and depending upon your situation, may indirectly help you achieve hormonal balance.

You may wish to go to an acupuncturist in addition to taking herbs. One who also practices Traditional Chinese Medicine will probably look for signs of “blood deficiency.” One important herb that builds blood and also promotes menstruation is dong quai (Angelica sinensis).

A low-calorie diet that includes protein from fish, legumes and spirulina helps regulate the menstrual cycle. Soy and many other beans contain plant hormones with estrogenic effects that help regulate periods. I am also wondering if all your studying has kept you indoors. Low levels of vitamin A reduce the menstrual flow, and this vitamin depends upon vitamin D, which is produced in the skin from sun exposure. If this is the case, take vitamin A in the form of beta-carotene. Or, better yet, eat plenty of vitamin A-rich foods, such as carrots and yellow squash, and spend some time relaxing outdoors. (Avoiding excessive sun exposure that promotes skin cancer.) Good luck with your healthful therapy and career!

Study participants who took green tea extract burned an extra 266 calories per day.

Khalsa responds: Bladderwrack is mainly a source of iodine, and was commonly used in the past to treat iodine-deficient hypothyroid conditions. If you’re using it on the theory that you have low thyroid function, with associated weight gain and amenorrhea, you are probably not going to get great results. While hypothyroidism is pervasive, it is almost never the result of iodine deficiency today. (Hypothyroidism is a serious medical condition, and should be evaluated by a qualified practitioner.)

I am concerned about you not having a period for a year. Get it checked out medically. That said, I generally reach for blue cohosh (Caulophyllum thalictroides) to stimulate reluctant menstruation. It can make you queasy, so start carefully. Start with 500 mg in capsules, or the equivalent in tincture. Each successive day, increase by 500 mg. A dose of about 6 grams usually does the job. Take it in divided doses with food.

American women often have what practitioners of Traditional Chinese Medicine (TCM) term “blood deficiency,” which is more comprehensive than simple anemia. Blood deficiency, in TCM terms, results from weak digestion, stress, poor diet and generally poor health habits. Blood-deficient women are fatigued, pale, depressed, confused and have scanty periods.

Dong quai is a superb general tonic herb and the most popular Chinese herb. Around half a billion women in China alone, as well as millions in other Asian countries, take dong quai daily to regulate the menstrual cycle. Dong quai should not be taken during pregnancy, by overly hot or febrile people or by those with diarrhea or endometriosis.

Now let’s picture a common herb that really could help overweight people shed excess fat without side effects. Some plant components — including some in green tea (Camellia sinensis) — may modulate calorie and fat burning through the sympathetic nervous system, the adrenal glands and specific nerve chemicals.

Researchers at the University of Geneva, Switzerland, studied a green tea extract’s fat-burning properties. Ten healthy men were randomly assigned to receive three daily doses of either a placebo, 50 mg caffeine or a green tea extract containing 50 mg caffeine and 90 mg epigallocatechin gallate, one of tea’s most abundant and important components. The results, published in the American Journal of Clinical Nutrition in 1999, indicate that green tea extract caused an appreciably greater increase than pure caffeine in 24-hour energy expenditure (thermogenesis) and the portion of fat calories burned.

Results indicated that 266 extra calories were burned per day while taking the green tea product. While these numbers might seem like small increases, it only takes the burning of a small amount of extra calories every day to promote serious weight loss over time.

Three cups of green tea daily provide protection against cancer, studies suggest. Extracts in pill form are now available. The usual dosage is 100 to 150 mg three times daily of a standardized green tea extract.

Kathi Keville is the director of the American Herb Association (www.AhaHerb.com) and author of 11 herb and aromatherapy books, including Herbs for Health and Healing (Rodale, 1996). She teaches seminars throughout the United States.

Karta Purkh Singh Khalsa has more than 25 years of experience with medicinal herbs. A licensed dietitian/nutritionist, massage therapist and board member of the American Herbalists Guild, he specializes in Ayurvedic, Chinese and North American healing traditions.