Liver Pain And Fibromyalgia
I recently saw a 54 year old lady who complained of widespread aches and pains in her muscles and ligaments and also had some stiffness and tenderness in many of her joints. She also complained of psoriasis affecting the skin of her knees and elbows and feet and her toe nails were pitted and discolored, which is a common feature of psoriasis. She had been thoroughly investigated by various specialists who had ordered a DEXA Bone Mineral Density test and a nuclear bone scan. Her DEXA bone density test revealed significant bone loss equivalent to osteopenia but not yet low enough to be qualified as osteoporosis. The nuclear bone scan showed up hot areas of inflammation in various tendons and some small joints of her skeleton.
This woman was unable to take steroids, anti-inflammatory drugs or pain killers, as she suffered with stomach inflammation and reflux.
Blood tests revealed the following:
- Elevated inflammatory markers including ESR and CRP, although thankfully she was not positive for rheumatoid factor or lupus
- Raised liver enzymes and her liver ultrasound scan did show a fatty liver
- Low levels of all her sex hormones, as she was post menopausal; in particular her levels of the adrenal hormone DHEA were very low
- Very low levels of vitamin D, with her level being 25nmol/L (10ng/mL), the normal range of blood vitamin D is 60 to 150nmol/L (24 to 60ng/mL) although there is considerable debate that the lower levels of normal should be revised upwards. Low vitamin D increases inflammation and greatly increases the risk of osteoporosis and vitamin D can be an excellent pain reliever as well as a potent bone builder.
Fibromyalgia is often associated with fatigue, depression and poor sleep, and is a chronic inflammatory condition affecting the connective tissues such as ligaments, joint capsules and muscles. If we are unable to use prescribed drugs to suppress the inflammation, we need to use nutritional supplements to reduce the amount of inflammatory chemicals being produced by the immune cells. The inflammatory chemicals that are produced by the immune cells contribute to depression. Improving the immune system and reducing levels of inflammation in the body are a reliable way to improve mood.
To achieve this natural anti-inflammatory effect I prescribed the following:
- Serrapeptase capsules – 2 capsules daily on an empty stomach. Serrapeptase is a natural enzyme that helps to break up and remove debris from the joints and muscles that can lead to pain and stiffness.
- Fish oil capsules – two capsules twice daily just before food; fish oil must be kept in the refrigerator.
- Magnesium Complete – 2 tablets twice daily
- Vitamin D 5000 IU daily plus increased exposure to sunshine, making sure not to get sun burnt
- DHEA capsules 25mg twice daily
- Joint-Eze capsules, one twice daily with food. Joint-Eze capsules contain the anti-inflammatory herbs: Boswellia, Yucca root, alfalfa and Devil’s claw.
To reduce the inflammation in her gut I recommended raw juicing which would reduce acidity in her body – an effective recipe for this is to juice:
- 3 Celery sticks
- ½ cucumber
- 2 carrots
- 1 green apple
- ½ inch slice ginger root
- 2 handfuls of mint and parsley
It was important for this lady to avoid gluten in her diet, because this would help to reduce inflammation. I have found that all cases of psoriasis are cured or greatly improved by avoiding gluten containing foods.
A regular exercise program to increase bone density and muscle strength is very important and can be increased gradually on a daily basis.
The program took two months to produce significant benefits and after four months she had a 70% reduction in her pain scores. Four months after commencement of her program her blood tests showed normalization of the inflammatory markers ESR and CRP and her serum vitamin D levels were well into the normal range. Her psoriasis was almost imperceptible and her toe nail bases were looking normal and healthy. Interestingly she had lost 35 pounds in weight and her digestive and reflux problems were greatly improved probably because of the gluten free diet and raw juicing.
Some patients with fibromyalgia, especially those over 50 years of age, may also need supplementation with the natural (bio-identical) forms of other sex hormones such as testosterone, pregnenolone and progesterone and this is worth trying in difficult or unresponsive cases, especially if their blood levels of these hormones are below the normal age-adjusted ranges. Natural steroid hormones (such as testosterone, progesterone and DHEA) have anti-inflammatory effects and yet they are often overlooked as part of a treatment regime in stubborn cases of fibromyalgia.
Factors that reduce levels of the natural steroid hormones in our body can include
- Smoking cigarettes
- Sleep apnea
- Auto-immune disease
- Cholesterol lowering drugs, especially large doses
- Lack of sunshine
These statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any diseases.