Micronutrients – Step Three

Chlorella pyrenoidosa.  A wonder food?  It sounds very nummy: “a unicellular green algae that contains high concentration of chlorophyll, cell walls, b-carotene, vitamins and minerals, as well as dietary fibre, nucleic acids, amino-acids, enzymes and other substances.”  The cell walls sells it for me.

Another option is Cellfood – an “antioxidant nutritional supplement containing 78 ionic/colloidal trace elements and minerals combined with 34 enzymes and 17 amino acids, all suspended in a solution of deuterium sulphate…”

There is of course ubiquinone (Coenzyme Q10), which is important in mitochondrial bioenergetics (remember mitochondrial dysfunction?) as a “mitochondrial energiser.” Another antioxidant booster.

And creatinine for improved “intramuscular phosphorylcreatine,” or better muscle function.

Melatonin, vitamin D, magnesium, Gingko biloba…. essentially stand in the middle of a GNC store and buy one of everything and then maybe everything will be boosted and balanced and fibro symptoms will be better.  I also think everything I read about micronutrients is not really fibro driven.  Everyone would benefit from boosting and balancing their diets, wouldn’t they?

Still, undoubtedly, micronutrients are step three in planning a fibro diet.  People with fibro are low in almost everything; however, my question goes back to the broken record question.  Do people with fibromyalgia simply not utilize these micronutrients well enough or are their diets that imbalanced?  Do they need more to have normal reactions or levels?

See Rossi et al in the library….

 

Antioxidants – Step Two

One of the few things that a lot of physicians/researchers agree on is that people with fibromyalgia have a bit of a problem with oxidative stress.  And now we’re approaching the realm of chemistry, on which I have only a very tenuous grasp.  Oxidation is essentially a chemical reaction in which molecules lose electrons to other molecules.  That’s apparently a bad thing.  And it’s complicated, but I’ll try:

  1. Cytokines (cell signaling molecules) are involved in inflammatory pain and are activated by superoxide radicals.
  2. There are increased malondialdehyde levels.  A new favorite word.  Simply, these are markers of oxidative stress (I think).
  3. There are decreased superoxide dismutase and glutathione peroxidase.  These are antioxide defense system enzymes.  In other words, they prevent oxidative stress by inactivating reactive oxygen species (which cause oxidation).
  4. Lowering antioxidant enzyme levels creates oxidative stress, which causes the oxidation of DNA and proteins, which causes fibromyalgia symptoms.
  5. Reactive oxygen species which facilitate oxidation causes mitochondrial dysfunction and reduced ATP (adenosine triphosphate, which is a molecule involved in cellular metabolism and which carries energy throughout the body.  When that is disrupted, fibro symptoms appear.

All of this lends itself to say that the cause of fibromyalgia is oxidative stress.  However, researchers say that it’s not clear if it’s a cause or consequence.  What is clear, however, is an imbalance between oxidants and antioxidants perpetuates or triggers fibromyalgia symptoms.  Therefore, a diet for fibromyalgia has to include a way to achieve this balance. Again, I’m not sure that elimination is the way to do this.  Enhancement of antioxidants may be the right way to go.

Two steps down – excitotoxicity and oxidative stress…

Analgesic Tolerance

No, I haven’t strayed from looking at optimal diet for fibromyalgia, but I did stub my toe on the blood-brain barrier and how it can become more permeable and all that.  So I’ve been reading, and an article (Kobori et al) that has nothing to do with fibromyalgia has got me thinking.

The article is “Involvement of Moesin in the Development of Morphine Analgesic Tolerance through P-glycoprotein at the Blood-Brain Barrier.”  The blood-brain barrier first caught my eye, but then “morphine analgesic tolerance” gave me a double-take.  The article talks about how certain proteins (moesin, radixin, ezrin) regulate the plasma membrane.  I don’t understand most of it, but essentially, the protein moesin, if over-“expressed” can make P-glycoprotein over-“express” which then leads to the “development of morphine analgesic tolerance.”  In other words, your body won’t get pain relief from morphine anymore.  They talk about this in terms of taking regular doses of morphine, which then loses its effectiveness and you need more to get the same effect.  At least that’s how I’m reading it.

How does this connect with fibromyalgia?  It doesn’t, not really, but it reminds me of fibromyalgia and some of my own reactions to foods and medicines.  I don’t know if I ever had morphine, so setting that aside.  Maybe a list will be easier….

  1. Food intolerances build up over time.  They’re not instant, allergic reactions.
  2. Medicine intolerances have built up over time.  It wasn’t until I was in my early 20s that I couldn’t take penicillin anymore.
  3. I’m wondering if building up a TOLERANCE to natural pain killers that our bodies release to fight regular pain works the same way.  If our bodies build up tolerances to things like morphine and other illegal substances so that we have to take more and more to have the same effect, is it possible for the same to happen to our own natural pain killers?  Thus sort of “causing” fibromyalgia by no longer fighting pain?
  4. If so, can it be related to autoimmunity, the body turning on itself and blocking or killing off good things because it doesn’t recognize them as good?

As always, I dunno what the heck I’m talking about, but curiosity just keeps rearing its ugly head.

The Blood-Brain Barrier

In a brazen act of lazy research, I have read the Wikipedia article on the blood-brain barrier.  I promise to look further because this is actually pretty interesting.

The blood-brain barrier is what separates circulating blood from the fluid in the brain that comes from the central nervous system.  Basically, it keeps the bad things out of brain fluid and lets in the good things.  Mildly ironically, the good things include glucose and amino acids.  The bad things are bacteria and viruses, which is a good thing because the blood-brain barrier also keeps out drugs that would fight any infection that gets through.

The most pertinent to fibromyalgia is that the blood-brain barrier is weakened during inflammation.  In addition, oxidative stress (something that constantly comes up in reading about fibro), apparently also plays a role in weakening the blood-brain barrier.  I don’t think that necessarily means that people with fibromyalgia (inflammatory fibromyalgia, if there is indeed two different types of fibromyalgia) are susceptible to brain infections or diseases as such. However, it does raise a question about sensitivity to glutamate.

Ingesting glutamate in food is not really a problem in terms of the blood-brain barrier, but weakening the blood-brain barrier with chronic inflammation could cause increases in glutamate levels which then works against magnesium as a block for NMDA (N-methyl-D-aspartate [remember asparate?]).  I wonder if, when the barrier is weakened, a sensitivity to ingested glutamate is then created because it can more easily cross that barrier – this then leads to excitotoxicity.  As always, I don’t know what I’m talking about, but it seems like that lays the groundwork for chronic pain/fibromyalgia.

I have found an article from 2014 discussing the the connection between blood-brain barrier permeability and fibromyalgia (Dos Santos et al, see library later) which talks about the cascading effect starting with inflammatory pain causing blood-brain barrier weakening, so this possible connection is not completely out in left field, so I need to keep looking at it.

Avoidance

Looking at some of the more popular posts on diets for fibromyalgia, I’m seeing many more foods that I shouldn’t eat rather than foods I should.  No NutraSweet, no food additives (especially MSG), no form of sugar, fructose, or simple carbohydrates, no caffeine, no yeast or gluten, no dairy, no nightshades (tomatoes, chili/bell peppers, potatoes, eggplants).  This is from MedicineNet.com.

Of course, according to another site (sorry, didn’t write it down), I can eat all the seafood I want.  Anyone who knows me well knows that I just turned pale and gagged a little.  I hate seafood.

The problem is the little bit that I’m learning about how nutrients actually work says that they need each other to balance out.  It’s like good and evil.  One can’t exist without the other, and if neither exist, you have no existence at all.  While avoiding certain foods may be beneficial in the short term, I’m not convinced it’s the way to go in the long term, for two reasons:

First, it’s all about balance, and the more I learn about fibromyalgia, the more I’m convinced it’s a balance disorder.  Things are just a bit out of whack, which causes other things to get out of balance, and there’s a vortex of imbalance. If a diet is too restrictive, then it seems to me that imbalance would get further out of whack.  I have to study more to explain better.  It’s a very loose thought in my head right now, and I could simply be rebelling against cutting tomatoes out of my diet.

Second, there’s a psychological aspect that diets have to address to be successful.  I don’t think I’m the only one that would get flat out belligerent and crave all the foods I can’t have.  A too limited diet is a binge waiting to happen, and that’s worse than an occasional pint or two of ice cream.

Of course, there is something to be said for cold turkey.  And since turkey has tryptophan and tryptophan is a source of melatonin and serotonin… no wait, I also read that a vegetarian diet is necessary for managing fibromyalgia.  Twists and turns…

Updates and Pages

I know you’re all on the edge of your seat to know that I WILL be going to Nanos tonight.  No, I haven’t been going regularly because of my lower back.  I either have to start exercising again or go to the doctor and see if they’ve perfected that spine transplant I’ve been asking about for several years now.  So far, it’s been a no go, with a slightly puzzled look like “Should I be taking this person seriously? Does she really think that’s a possibility?” I do find it’s best to keep them guessing.

So there are a couple new things on the main website.  They’re more like place markers so far, but next week they should be up and running.  In the Captain’s Log of Tuesdays, I’ve separated the pain/symptom log into “The Relentlessness Chronicle.”  I know that’s a fascinating read for everyone.  I’ve added “The Dietary Diary,” which is the place marker to track diet, and I’ll probably start with my normal weekly diet until I come up with a fibro-conscious diet.  I’ve also added “The Annals of Nanos,” which will track exercise, both in the Silver Nanos Crossfit group and at work or at home.  Since I don’t take any meds for fibro (just a very low-dose antidepressant for depression), I’ll simply track supplements in the Dietary Diet.  That will cover exercise, diet, and meds, and it will cross over in the pain/symptom log to see if there are any correlations.

I know I’m excited.

Excitotoxicity – Step 1

Another wonderful word – excitotoxicity – and a possible key to relief of fibromyalgia symptoms through diet.  Everything, according to Holton et al (see library) may hinge on glutamate and aspartate, but they are just the beginning of a twisting and interconnecting puzzle of nutrients, amino acids, and lots of initials.  I’m not sure if I’ll be able to make sense of this for you, but here we go…

Glutamate and aspartate are non-essential amino acids found in a large variety of foods. While some studies indicate that reducing foods that have these amino acids in them helps with fibromyalgia symptoms, others say pretty unequivocally no.  Looking at how glutamate and aspartate interrelate with other nutrients and the body, however, makes the conclusion a bit equivocal.

  1. Noxious stimuli (pain) causes the release of glutamate into the system – glutamate that has NOT been ingested.
  2. Prolonged pain (activation of nociceptors) causes the continuous release of glutamate into the system (again not through eating)
  3. Magnesium is a natural block of NMDA (N-methyl-D-aspartate) receptors – all I’m sure about is NMDA helps cause chronic pain, and NMDA antagonists help relieve chronic pain.
  4. Continuous release of glutamate breaks down the magnesium block.
  5. Add to that Substance P (a very mysterious substance related to chronic pain), the combination is the perfect storm for fibromyalgia.
  6. In addition, high levels of glutamate overexcites postsynaptic neurons which then die.  This is “excitotoxicity.”

High levels of glutamate and Substance P also increases the permeability of the blood-brain barrier (great image with that one…).  I don’t know exactly what that means yet, but when permeability increases, then DIETARY glutamate (stuff you eat) can enter the brain easier.  It would seem like this is the point that the spiral of fibro symptoms may start, and changing diet may help break the circuit.

At the same time, vitamin B6 assists development of an enzyme (glutamate decarboxylase) which converts glutamate into GABA (gamma-aminobutyric acid), which is an inhibitory neurotransmitter and blocks the negative effects of glutamate.

Therefore, it seems like eliminating foods is not necessarily the way to go, but making sure a proper balance of nutrients is in place is key to diet helping to relieve symptoms.  One thing to keep in mind (for me) is the idea of people having different “normals.”  One person’s B6 levels may need to be higher or lower than the next person’s.  Coming up with a diet is going to require some experimentation.

 

Food: A Girl’s Best Friend…or Not

When looking at managing fibromyalgia (as opposed to curing it, which is a faraway, faraway daydream), there is a basic formula to follow:

  1. Exercise
  2. Diet
  3. Medication

I’ve talked a lot about exercise and am still a little confounded by it.  I’ve looked at medications, and the ones that are most often mentioned are ones I can’t take; in addition, there is strong evidence that they are barely effective even as a palliative for fibromyalgia.  I’ve avoided diet.  I’d still like to avoid diet, but I can’t if I want this to be a complete exploration of fibromyalgia.  My problems with food are multitude:

  1. I hate to cook.  And I’m very bad at it, although I’m trying to appreciate the “art” of cooking more lately.
  2. There are a multitude of foods I’m sensitive to, but not allergic to.  In short, I get reactions from immediate tummy aches to eventual arthritis-type symptoms from different foods.
  3. The longer term reactions are very difficult to manage.
  4. The shorter term reactions are very difficult to guess.
  5. My diet becomes very limited, and after awhile food just doesn’t interest me.

Peanuts and raw onions are a definite no-no and easy to avoid first because they are easy to see and not ingest, second because tummy aches/cramps are instant.  Sugar gives a long term reaction with arthritis-like symptoms.  Sugar is very difficult to avoid first because it is not always apparent, second because it’s an addictive substance.  I don’t care if that sounds silly, it’s true.  The body craves sugar; the taste buds crave sugar; the mind obsesses over sugar.  Chocolate is the worst and a gateway drug.  Caffeine is disastrous.

I find the best way to manage diet is to 1) make it easy; 2) make it repetitive; 3) no sugar, no caffeine, no peanuts, no raw onions.  Breads will give me a bit of a rash after eating it regularly over a couple weeks, so I avoid bread.  I think it’s the yeast rather than the wheat, however, because I don’t seem to react to tortillas or pasta.  There’s no distinction between cane sugar, brown sugar, high fructose corn syrup, beet sugar, or just natural fruits.

Obviously supplementing my diet is important, so I take vitamins C and D and a B complex, fish oil, and a calcium supplement.  I don’t take a multivitamin supplement because they usually include vitamin K, which I overreact to and is a clotting risk.

That’s all well and good, but in absolute honesty, it’s not reality.  It’s easy to have a bit of sugar now and then because the reaction isn’t immediate.  I like bananas and pasta.  I eat too many carbohydrates, which turn into sugar in the system.  I love ice cream, especially year round.  I find eating at work very difficult, so I tend to have a breakfast, but only snack at lunch and have a large meal after work.  Not good – I should be ingesting calories and nutrients throughout the day instead of letting my blood sugar raise and lower.

So, here’s the deal.  I’m going to face my food disorder.  First I’ll do a little research to see what is recommended in terms of fibromyalgia, then I’ll create a diet (it has to be sustainable, so not too restrictive), and then I’ll give it a go and look at symptoms to see what relief there is.  Since I know myself well enough to say, yep I’ll be cheating or not giving it a fair chance, I’ll start yet another Captain’s log where I’ll post my daily diet for all the world to see.  How incredibly embarrassing.  I’ll only commit to honesty and will let you know when I start the log.

Automatic Immunity?

Unfortunately the word “autoimmunity” doesn’t translate out to “automatic immunity,” not even diplomatic immunity.  It actually means that the body turns on itself and perceives healthy cells as unhealthy and does away with them.  Autoimmune thyroiditis is one form of an autoimmune disorder, so in essence, the body perceives of the thyroid hormone as being a bad substance and obliterates it.  While the body is producing enough thyroid, it’s destroying it as fast as it’s making it.  The body then produces symptoms of having low thyroid levels.  There are about 80 autoimmune disorders – I found a list yesterday, and on that list was fibromyalgia, which is not an autoimmune disorder.  The reason the author gave for putting it on the list was that people with fibromyalgia usually have an accompanying autoimmune disorder.  I haven’t had a chance to check into that statement, but it got me thinking.

Many of the autoimmune disorders have similar symptoms to fibromyalgia, and I have read more than once that autoimmune disorders can come on slowly with flare-ups and remission times, so they behave like fibromyalgia too.  What if fibro IS an autoimmune disorder, one that has not been detected?  Or what if fibro is really a misdiagnosed autoimmune disorder, possibly not the same misdiagnosed disorder for each patient?  In other words, 80 people diagnosed with fibromyalgia may actually have one of 80 autoimmune disorders.  Not likely, I know – some are fairly rare.  However, since fibromyalgia spirals into a multitude of symptoms, it is possible that the key symptoms of autoimmune disorders are covered by the spiraling symptoms.  Isn’t it?  I have no idea what I’m talking about right now, but I think I want to look into this possibility.

I’ve been tested for lupus more than once because my symptoms initially lined up with lupus symptoms.  Right now I seem to line up very well with Sjogren’s syndrome – in particular having to cauterize my tear ducts to get relief from dry eyes.  But I remember being tested for that as well.  However, since onset is slow, testing should be done more than once – I’ve read that a few places too.  What if fibro is a cycle of autoimmune disorders?  What if they come and go?

The description of autoimmune disorders really is what makes my ears perk up.  I’ve said for years that I felt like my body was attacking itself.  Almost like the opposite of a superhero.  Instead of being a Wolverine and regenerating itself regularly, my body is Anti-Wolverine and constantly finds ways to tear itself down.  When I find something that makes me feel better, it’s never a permanent solution.  My body figures out how to nullify the benefits, and I have to look elsewhere.  I know I’m not a superhero, anti or otherwise.  But if I were, my body would be the supervillain.

Leaning to the Left

No, this is not a political post, although, yes I have a lot to say in this election year….  This is literal.  Taking my lunch walk today I kept leaning leftward and having to pull myself back to the right side of the walkway.  I didn’t run into anything, and maybe the whole building is actually askew – you know, like a Funhouse.  I tripped on the floor a half a dozen times too, so I suspect it was me.  Nothing like doing an impromptu pirouette in the middle of an office building… several times… Anyway, I’m sure I covered it just fine, and since I wasn’t wearing my glasses, I have no idea if anyone even noticed.

This wasn’t an episode of dizziness or lightheadedness.  This was strictly askew-ness, and very mild, but very persistent.  It’s not the first time it has happened.  Once I tried to knock a hand deodorizer off the wall when the building suddenly shifted left.  Again, it wasn’t a dizzy episode, and I’m not lightheaded when it happens.  There is no perceptible blood pressure or heart rate increase.  The only thing I can say for certain is that these leftward leanings are connected to fatigue and usually mid back pain.  Tripping on the floor is also connected to fatigue and simply not lifting my feet up, although a lot of times it also feels like my feet are wooden stumps clumping along.  I can feel them and control them, but they don’t feel right.  They drag a little and the floor jumps up and bites me.  Again, fatigue is the common denominator in all these things.

When fatigue takes over, I have a tendency to tip or outright fall.  Leftward leaning and tripping on reputedly flat surfaces are signals to slow down, rest, catch up a little on sleep.  I decided after my sixth pirouette in the hallway that I’m not going to Nano-it tonight.  I have to weigh the benefits out again.  So many good things for fibro, so many not-so-good things for back/hips.  Difficult decision to make, but right now, rest is imperative.  So I’ll rest.  After work.