Holistic Fibromyalgia Treatment

Resilience Medicine is a Holistic and Integrative Approach to medicine. In this article you will learn about the Resilience Medicine treatment approach to fibromyalgia.

Holistic Fibromyalgia Treatment Overview

Intro To Holistic Fibromyalgia Treatment

Fibromyalgia is a complex chronic disease that is often poorly treated and poorly understood.  It can be extremely debilitating and requires a holistic approach to get well again, since there is no single effective drug for all of the symptoms and underlying factors. 

Often people have tried many treatments without much effect.   Often it’s needed to do multiple things at the right time to create the optimal long term healing outcome and these things can be different between 2 people both with a diagnosis of fibromyalgia.  Unfortunately this is not the way standard medical care works and why treatment often fails patients.

Chronic Illness & Fibromyalgia

It is often known as an ‘invisible’ illness because in between flares, many people cannot see the disabling symptoms and may think that you are well and havea  hard time understanding the illness experience and its often devistating effects on quality of life and doing ‘normal’ every day things. 

Many people with Fibro have other diagnoses too, such as depression, sleep issues, chronic fatigue and anxiety, problems with their digestive system, bladder and women’s health conditions like endometriosis. Without treating these symptoms and underlying factors together holistically, it is very difficult to get control over any of them because they all affect each other, pain levels and share some underlying mechanisms in the brain, gut and immune system

All of the symptoms can be confusing to tease apart, especially since standard specialists only treat symptoms in their area and rarely consider cross-field research.  This often leads to multiple ineffective or high side effect drugs to treat each symptom and fragmented care. 

Many people with fibro experience a frustrating deterioration in their overall quality of life and ability to do ‘normal’ things from going for walks to seeing friends and going to work, due to a vicious cycle of physically debilitating pain on top of cognitive brain symptoms like brain fog, unpredictable depression and mental fatigue.  

A Holistic Treatment approach helps to break this cycle to improve your quality of life and daily functioning.

The Integrative Medicine Understanding of What Causes Fibromyalgia

The exact mechanisms are multifactorial and likely slightly different for each person.  These involves multiple genetic factors and epigenetic changes after some kind of brain or immune system trigger, inflammation, hormonal mechanisms and environmental factors. The cause of the pain is in part due to something called ‘central sensitization’ where the brain and nerve networks involved in pain-sensing and processing become jumbled and ‘smudged’ so that pain spreads through large regions.  Inflammation may also play a key role, but is rarely seen on blood tests so standard medical care discounts this.

The ECS & Fibromyalgia

It also likely involves endocannabinoid system dysfunction (ECS), an overarching neuroregulatory system in the brain and body that helps to regulate pain signals, mood, fatigue and response to stress- all the things fibro affects. The ECS involvement may explain why medical cannabis helps with so many ‘treatment-resistant’ fibro symptoms. 

Common Conditions Linked To Fibromyalgia

People who suffer from fibromyalgia are also more likely to have other pain conditions such as headache disorders, trouble with their jaw (TMJ) joint, IBS and anxiety and depression as well as a condition called POTs. Many of these conditions share similar underlying mechanisms in the brain, nervous system and gut-brain axis function. There is also a link with ADHD that is increasingly recognised which may be related to the way the brain processes pain signals.

The Resilience Medicine Toolkit for Fibromyalgia

The Resilience Medicine Holistic approach to treating fibromyalgia includes considering cannabinoid (cannabis-based) medicines, mindbody approaches, diet and microbiome, prescribed combinations of supplements, nutraceuticals & medications, and creating a resilience environment.  These things when stacked together results in a synergistic effect, where the overall result is bigger than the the sum of each part

In the clinic, we also use functional medicine tests and approaches to further personalise treatment based on biomarkers, gut markers and genomics in some cases.  These categories were chosen based on Dr Dani’s 15 years of experience using this holistic treatment framework with her patients.  

It’s also worth remembering that even if you have tried some of these things before on your own, it is often getting the right combination of things done at the right time that makes the biggest difference.

It can be very overwhelming and confusing trying to navigate all of the pieces of a holistic treatment plan on your own.  Having expert guidance and a system to measure your progress helps remove this confusion and overwhelm and makes sure you are on the best treatment path, since fibro is a group of illnesses and is not the same for everyone.

This is a new way of thinking about medicine that goes beyond a ‘disease management’ system but aims to enhance quality of life, energy, mood and reduce the total brain and body stress burden to stay well.

Medical Cannabis for Fibromyalgia

Medical cannabis is a legal medicine in the UK, now available on private prescription from a specialist doctor.  Medical cannabis are whole plant medicines which contain over 100 active cannabinoid compounds, which are thought to work together to deliver the medicinal effects although the main cannabinoids used for dosage currently are CBD and THC.  

The different strains or chemovars, can produce different therapeutic effects for fibromyalgia, making it a highly personalised medicine.Unlike many other medications used in fibro, medical cannabis is usually well-tolerated and can effectively treat clusters of symptoms with a single medicine. 

Medical Cannabis can help patients with fibromyalgia who have failed other approaches to get a quick win in terms of pain and associated symptom relief and starting off a positive neurological ‘cascade’ in the nervous system. 

Most patients see a significant improvement within the first month of therapy across multiple symptom clusters including pain, mood, fatigue, stress, sleep and global functioning. One reason medical cannabis may be effective in treating Fibromyalgia is that it works on endocannabinoid system (ECS) dysregulation, as well as our serotonin system and inflammation pathways.  Cannabinoids have neuroprotective properties and prescription preparations containing even a ‘microdose’ of THC can work as an effective chronic pain reliever, even when other drugs have not worked or been tolerated . 

Additionally, some experts and researchers believe that Fibromyalgia may be a type of “endocannabinoid deficiency syndrome,” which means that using plant cannabinoids in the right doses and ratio may help restore balance in this system.

Dr. Gordon is the most experienced cannabinoid medicine physician in the UK, has trained the first UK specialist physicians in the prescribing of medical cannabis for fibromyalgia and has treated thousands of patients with medical cannabis first in Canada and in the past few years in the UK since it has become legal. She uses a more holistic individualised approach to cannabinoid therapy, due to her expertise in Integrative & botanical medicine in addition to her conventional medical training as a physician.

Hemp CBD oil wellness supplement products available over the counter at health shops are not the same as medical cannabis. Hemp CBD oil non-medical products do not contain any measurable THC and are not made as medicines. 

For most people with Fibromyalgia, CBD hemp supplements on their own are not effective because they lack this THC which works on the pain signalling pathways in Fibromyalgia.

Altered States and Psychedelics for Fibromyalgia

Ketamine therapy is another currently available therapy via a specialist doctor for severe chronic pain, although not available on the NHS. 

Depression, which is often comorbid in fibromyalgia, often responds well to ketamine therapy even when other treatments have failed.

Currently, there are clinical trials and studies ongoing investigating the potential of psilocybin and other compounds for the treatment of chronic pain including fibromyalgia but no big studies have had results yet.  However, many anecdotal case studies exist of benefit so this remains a promising area for more research.

Mindbody Medicine for Fibromyalgia

Mindbody practices help to actually change the brain structure and function in multiple ways, turn down the volume on stress, anxiety and pain signals and help our brains become more resilient. Utilising the bi-directional brain-body communication link can be very effective at reducing pain signalling.

For example, specific Mindfulness for pain practices has been shown to be highly effective for improving quality of life, pain and coping in patients who suffer from chronic painful conditions. This is because chronic pain becomes ‘wired’ into the brain and nervous system, not just in the place you feel the pain, like a shoulder. This starts a cycle of brain amplification of pain signalling and chemical messengers involving the limbic system, which mindfulness practices can help to regulate.

Techniques to activate the Relaxation Response, based on Dr. Gordon’s experience studying these techniques at Harvard University, as well as other targeted techniques, have been shown to have great benefits for Fibro patients. 

Neuromodulation home devices including and other noninvasive techniques are often incorporated into the mindbody approach and monitored with the doctor over time to track progress.

Creating a tailored mindbody practice to suit you best at each stage of the healing journey and making it easy and unburden-some to stick to is important to making mind-body medicine parts of your treatment most effective, since many patients may have tried some of these things previously and not noticed an improvement.

Diet and Microbiome for Fibromyalgia

Although Fibro is not a nutritional illness as the core cause, certain types of diets can influence and improve symptoms such as fatigue, pain, inflammation and mood.  

Therapeutic diets work via multiple mechanisms such as:

  • Influencing multiple inflammation and pain pathways
  • Affecting  neuro-immune modulation
  • Affecting gut-brain axis function
  • Shifting microbiome health 

 

For example, a modified ketogenic diet may improve symptoms for some people, which may work better for men as a generalisation.   

Other people may respond better to a different therapeutic diet including one of 3 different types of plant-based diets. 

Changes in the microbiome and gut biomarkers can be seen via dietary change and can affect neurotransmitter function and pain signalling via the brain-gut axis.   This is rarely considered as part of ‘standard’ medical care for fibromyalgia despite the large and growing body of evidence for this area.

Choosing the best diet approach is based on things like symptom cluster profile, gut and blood biomarkers and other individual factors which are assessed & taken into account.

Medications for Fibromyalgia

There are different medications that may be tried for the different symptoms of fibromyalgia including antidepressants, painkillers, muscle relaxants and sleeping pills, but everyone responds differently and there is no single medication that works well for everyone.  Many people cannot tolerate these medications due to the medication sensitivity common in fibromyalgia so other more holistic options may work best in these cases.  Medical cannabis is usually well tolerated even in cases where other medications were not, which makes it a bit unique.

Supplements for Fibromyalgia

Supplements and Nutraceuticals including botanical extracts, medicinal fungi, adaptogens and amino acids and minerals can all be helpful for different aspects of fibromyalgia.  It’s important to get the dosage and combination right and personalised to you.  For example, most drug store supplements have ineffective dosages or single ingredients that lack the synergistic effect and are usually ineffective.  Each person will likely have a slightly different ‘stack’ of supplements based on their specific case and won’t need all of these, but may include:

  • Magnesium Glycinate
  • Cordyceps, Reishi and Lions mane Mushrooms
  • Gut support including specific probiotics, enzymes and short chain fatty acids depending on the patient
  • Alpha lipoic acid
  • Mitochondrial support nutraceuticals including lipid membrane support (NT factor lipids,alpha-keto glutaric acid, etc)
  • phosphatidylcholine
  • NAC
  • Acetyl L Carnitine
  • PEA
  • Thiamine
  • Specific B vitamins
  • Liposomal curcumin
  • Boswellia
  • Highly purified krill or high EPA fish oil in cases of high inflammatory markers
  • sleep support botanicals which may include passionflower, hops, valerian and skullcap

Resilience Environment for Fibromyalgia

Our environment also interacts with our genes to influence how we respond to our external environment.   For example, if you have the genotype for certain enzymes not working as strongly as they could, you may be more sensitive to the effects of pollutants in the environment, which can influence a wide variety of health symptoms and triggers.

We have the most control over our home environment, so this is a good place to start optimising if you suffer with chronic pain.  Simple steps you can take at home for chronic pain include ergonomic seating and changing sleeping equipment eg.  mattresses, wedge pillows etc for comfort since muscle stiffness overnight is a big factor in fibro.

Infrared saunas and cold water immersion therapy may also be helpful for some patients to alter the pain response and inflammation pathways, but should be done gradually after discussing with a doctor or health practitioner to make sure it’s right for you.

Functional Testing for Fibromyalgia

We can use functional medicine testing to look at factors such as genetic stress tolerance, gut microbiome and gut-brain axis function, inflammatory biomarkers, circadian rhythm dysfunction, and more, based on specific clinical assessments. They can help further customise your treatment based on your biochemistry, since no two people with fibro are exactly alike. We also know now that fibromyalgia involves changes in the gut brain axis, autonomic nervous system and stress control and the immune system including inflammation pathways so addressing these at root cause level can be very beneficial for many people.

Fibromyalgia Patient Case Study

Patient: Sarah, 39 years old. Diagnosed with fibromyalgia 5 years ago

Goal: get control of her pain and stiffness which kept her at home and in bed part of the day as well as associated symptoms like fatigue and brain fog so she could do the job she loved again.

History: After failing multiple medications including different painkillers, antidepressants, sleeping pills and physiotherapy, Sarah felt like she had tried everything. She had been told by multiple doctors there was ‘nothing more’ they could do for her and that she would have to learn to live with her symptoms they way they were.

The plan: after a thorough integrative assessment, Sarah underwent functional medicine testing and started on a specific medical cannabis plan to help with her daytime symptoms and also help regulate her sleep at night. Based on the results of her tests, she was started on a specific nutraceutical and dietary protocol, brain-gut axis support based on some inflammatory and gut markers and given a short progressive muscular relaxation practice to help relax the muscles alongside her evening medical cannabis dose.

Outcome: 6 months later, she had returned to work, started going to yoga classes again and was able to go out socially and live a ‘normal’ life again. Her pain had gone from 8/10 most days to 1/10 most days and she felt more clear-headed and had more energy.  She also slept more deeply.

Measuring Quality of Life in Fibromyalgia

One of the challenges of doing multiple things together is how to know what is working and how to keep track of everything without becoming overwhelmed.  This is where a system for measuring and tracking is so important. 

We use a simple resilience and quality of life score metric that you can track in a simple app, including measurements of pain, stress, mood, energy levels and mental clarity.  This helps you track the different aspects of how you are feeling as you go on your healing journey.

Validated rating scales for pain and fatigue, such as the FSS and sleep assessments can also be useful.  

We track these metrics over time and put you in charge of your data with easy to read metrics so both you and your medical team can see what’s working and tweak the plan over time.

Next step

Fibro can be really difficult and exhausting to navigate on your own but you can start feeling better and stay well.

Dr. Dani has helped thousands of patients with difficult to treat fibromyalgia over the past 15 years using this approach, first in North America where it is more developed and now in the UK. 

Using a specific, personalised holistic approach to the pain and related symptoms can dramatically improve your quality of life even if you have failed multiple treatments in the past. 

To take the next step in your journey, book an initial consultation with our expert physicians.