Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest to Dr. Weyrich that may be of interest to the world wide audience. Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is published here. Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of non-free access journal articles for him to review on a topic. Constructive criticism is also welcome.

Overview of Fibromyalgia

Fibromyalgia is a functional diagnosis, for which conventional medicine has identified no causative mechanism; its cause may be multifactorial, with multiple contributing factors.

Although fibromyalgia and chronic fatigue syndrome appear to share many of the same symptoms and causative factors, they appear to be distinct disorders with different treatments. Hence, careful differential diagnosis based on history, signs, and symptoms is necessary for effective treatment [Liptan2016].

It is also possible that a patient may present with diagnoses of both fibromyalgia and chronic fatigue syndrome.

Complimentary and alternative treatments for fibromyalgia that are considered below include:

  • Immune System Balancing
  • Low Dose Naltrexone
  • Neuro-Gen High Performance Neuromodulation (HPN)
  • Conventional Neuro-feedback
  • Neurotransmitter Balancing

Etiology of Fibromyalgia

The cause of fibromyalgia is unknown, but among the theories that have been advanced, post traumatic-stress reaction [Liptan2016] appears most credible. In a nutshell, psychological or physical trauma induces a self-perpetuating cycle of sympathetic nervous system arousal ('fight-or-flight') that triggers and sustains prolonged abnormal muscle contraction. This prolonged elevated muscle tone in turn depletes muscle-mitochondrial energy stores, resulting in increased levels of lactic acid being produced. Lactic acid is responsible for the characteristic "burn" an athlete normally feels after a set of strength-training exercises. But whereas in normal athletic training, the lactic acid dissipates after the workout, in the case of fibromyalgia, the muscle tension never relaxes, and the lactic acid can never dissipate. Unfortunately, the pain causes a reflex feedback cycle in which the neurological system is driven further into sympathetic arousal, and muscle tension is further increased.

In addition to driving painful muscle contractions, the elevated sympathetic nervous system arousal also disrupts the fibromyalgia-sufferer's sleep, resulting in a hypervigalence that has been characterized as "sleeping with one eye open." This state prevents the patient from achieving the deep sleep state necessary for physical and mental repair. The end result of this unrestful sleep is daytime fatigue and mental fog.

Other contributing factors may include mitochondrial dysfunction. Note that Dr. Weyrich has argued that mitochondrial dysfunction may be secondary to overgrowth with yeasts and fungi, and [Shaw2008] has pointed out that elevated urinary levels of tartaric acid and other markers of overgrowth with yeasts and fungi are associated with fibromyalgia [ORWJr: however, it is not clear that these findings are not better associated with a diagnosis of chronic fatigue syndrome].

Diagnosis of Fibromyalgia

Symptom picture:
  • Widespread muscle pain.
  • Fatigue.
  • Brain-fog.

Differential Diagnosis of Fibromyalgia

Treatment of Fibromyalgia

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed below.

Naturopathic, Complimentary and Alternative Treatments

Immune System Balancing

[McCulley2018, pp 180, 223-228] reports that fibromyalgia is not a true autoimmune disorder because there are no antibodies, but since it has other features of immune disregulation, proposes an approach to treating this disease, which should be supervised by a properly trained medical professional. Dr. Weyrich has considerable interest in this topic, but has not treated any cases of fibromyalgia with Immune System Balancing.

Please see What is Immune System Balancing? for more information.

Low Dose Naltrexone (LDN)

Clinical studies have shown that Low Dose Naltrexone benefits fibromyalgia. [Younger2009] obtained a 30% reduction in symptoms, and also noted that "baseline erythrocyte sedimentation rate predicted over 80% of the variance in drug response. Individuals with higher sedimentation rates (indicating general inflammatory processes) had the greatest reduction of symptoms in response to low-dose naltrexone." See also [Younger2013]. According to [LDN_Chopra], "A study done on treating Fibromyalgia pain with LDN showed a 30% reduction in symptoms."

Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN) and offers these protocols as a complement to other therapies; however at this time Dr. Weyrich has only treated two confirmed cases of Fibromyalgia using LDN: (1) in the first case the patient did not adequately taper completely from high doses of opiates and therefore did not tolerate the treatment. Dr. Weyrich remains optimistic that a more prolonged wash-out period would result in successful treatment. In the second case the patient reported significant improvement in symptoms and remains on the treatment (as of 08/19/2019).

Please see What is Low Dose Naltrexone? for more information.

Neuro-Gen High Performance Neuromodulation (HPN)

HPN has been reported to be useful for treating fibromyalgia [Snook]. Dr. Weyrich has been trained in the use of Neuro-Gen High Performance Neuromodulation system by it's inventor, Corey Snook. However, Dr. Weyrich has not treated any cases of fibromyalgia with this technique.

Please see What is Neuro-Gen High Performance Neuromodulation? for more information.

Conventional Neuro-feedback

Neuro-feedback may be useful for treating fibromyalgia. Dr. Weyrich has been certified in Neuro-feedback since 2008, and more recently completed an additional residency training program at ADD Clinic of Scottsdale, AZ. However, Dr. Weyrich has not treated any cases of fibromyalgia with this technique.

Please see What is Neurofeedback? for more information.

Neurotransmitter Balancing

Neuro Research [Hinz2015] reports that fibromyalgia can be benefited by balancing neurotransmitter levels in the body.

Dr. Weyrich has been trained in neurotransmitter balancing protocols, but has not treated fibromyalgia using this technique.

Please see What is Neurotransmitter Balancing? for more information.

Pathophysiology of Fibromyalgia

Elevated levels of tartaric acid (3-hydroxymalic acid or 2,3-hydroxy-succinic acid) are associated with fibromyalgia. Tartaric acid is an analog of the Krebs cycle intermediate malic acid that inhibits the Krebs cycle enzyme fumarase that converts fumaric acid to malic acid [Shaw2008], [Russell1995].

References for Fibromyalgia