Case Studies: Herbs for Fibromyalgia

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Photo by Christopher Hobbs
California poppy helps relieve anxiety.

Fibromyalgia (a syndrome characterized by chronic pain and fatigue) often is associated with chronic fatigue syndrome. The precise causes of each remain a mystery, though immune suppression seems to be a factor.

Jody’s Case

Jody was a 32-year-old student working hard to finish her bachelor’s degree in fine arts. She came into the office for the same reason as many patients dealing with chronic fatigue or fibromyalgia: Her doctor had run out of ideas. The doctor had prescribed many of the usual drugs, including the tricyclic antidepressant amitriptyline; the muscle relaxant cyclobenzaprine; the SSRI antidepressant Celexa; the sleeping aid Ambien; the anticonvulsant clonazepam; the antidepressant trazodone; and the opioid pain medication Ultram.

Celexa had worked for a few months, but Jody developed anxiety and her sleep became even worse than usual. Ultram helped with the pain for about a year, but again, she eventually developed severe anxiety and had to stop. “I buy Tylenol by the case, but have to switch off with other pain medications I buy without a prescription,” she said. “They work for a few hours sometimes, especially after a hot bath.”

As we discussed her health history, Jody mentioned several factors strongly associated with immune suppression–10 years on antibiotics for acne during her childhood and several infections during her late teens and early 20s, including a severe bout of mononucleosis, associated with the common Epstein-Barr virus. It is perhaps the most common viral agent associated with fibromyalgia and chronic fatigue.

Internal Imbalances

A look at Jody’s tongue revealed a number of imbalances in her Spleen system, according to Traditional Chinese Medicine (TCM). The Spleen system encompasses most notably the digestive organs and immune function. A working diagnosis for her general condition was “Spleen qi deficiency,” and secondarily, “Kidney qi deficiency” and  “Heart fire.” Her tongue was so swollen it had formed around her teeth, creating indentations, and the tip was bright red. Her tongue was shaking, another sign of qi deficiency.

Not every fibromyalgia patient I’ve seen has had a Spleen imbalance, but from what I’ve seen and the research I’ve done, this is by far the most common underlying pattern. If digestive symptoms occur along with fatigue and myalgia, brain fog and some of the other common symptoms, this is a reliable sign of Spleen qi deficiency with immune suppression.

In Jody’s case, the Kidney system imbalance and Heart (associated with the nervous system in TCM) imbalance seemed to relate to a strong history of overwork, stress and her past use of stimulants like coffee, tea and soft drinks. The caffeine from these beverages eventually wears the body down, and it may take years to reverse the pattern. Not everybody with fibromyalgia has such a history, but at least one major stressor usually has been present. Jody’s problems were not uncommon, but they appeared to be severe and long-standing.

The Dietary Approach

For Spleen deficiency, it helps to avoid raw fruits and vegetables, except during the hottest months. Jody’s diet plan included baked squashes, light stir-fries with green vegetables and always included some protein–fish, chicken, tofu or tempeh. A varied whole-foods diet, low in sugar and moderate in processed foods, is best.

A Personalized Herbal Program

Herbal Spleen qi tonics are an important foundation that are best taken in tea form, using dried teas (powdered extracts) in capsules and tablets. Tinctures are not as effective for long-term tonic effects.

Make sure to buy extracts, not simple powders. Take 2 to 4 grams of the extract, either single mushrooms, or a blend of two to three mushrooms at most.

Jody’s Herbal Formulas

Spleen qi tonic formula with immune support

• Burdock root (gobo)–available fresh from many markets, or dried;
• Ginseng root (for energy)–red is more warming, white more neutral;
• Eleuthero (for counteracting stress) –tincture taken separately as needed;
• Orange peel (organic)–used to harmonize the herbs;
• Licorice (about 1/10 of the formula by weight)–if desired, for flavor.

Pain formula

• California poppy–helps with insomnia, anxiety, some analgesic effects;
• Corydalis–the main pain herb I use, but has some toxicity at high doses; best to consult with your health-care provider before starting;
• White willow bark–contains natural salicylates; new studies show good pain-relieving effects for arthritis.

Jody’s Response

After four weeks of a fairly intensive regimen, Jody began to respond. Over the long run, we both saw the effort was worthwhile. Jody still has her ups and downs, but has learned new ways to adjust and support her health when she needs to.

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