It is parasitic on birch and other trees. The sterile conk is irregularly formed and has the appearance of burnt charcoal. It is not the fruiting body of the fungus, but a mass of mycelium, mostly black due to the presence of massive amounts of melanin. The fertile fruiting body can be found very rarely as a resupinate (crustose) fungus on or near the clinker, usually appearing after the host tree is dead.
Geographically this fungus is mostly found in very cold habitats. It grows very slowly, suggesting it is not a reliable source of bioactive compounds in the long run. Attempts at cultivating this fungus all resulted in a reduced and markedly different production of bioactive metabolites.Secondary metabolites were either absent or present in very different ratios, and in general showed significantly less potency in cultivated Chaga. Cultivated Chaga furthermore results in a reduced diversity of phytosterols, particularly lanosterol, an intermediate in the synthesis of ergosterol and lanostane-type triterpenes. This effect was partially reversed by the addition of silver ion, an inhibitor of ergosterol biosynthesis.
Additionally, the bioactive triterpene betulinic acid is completely absent in cultivated Chaga. In nature Chaga grows pre-dominantly on birches, and birch bark contains up to 22% of betulin. Betulin is poorly absorbed by humans, even when taken intravenously; its bioavailability is very limited. However, the Chaga mushroom converts betulin into betulinic acid, and many internet sources state Chaga’s betulinic acid is bioavailable, even when taken orally. Unfortunately there is no research that confirms this claims.
Chaga mushrooms, or cinder conks, have been a staple of traditional medicine for centuries among the peoples of the boreal forests in Siberia, Asia and North America. They are used as a tonic and blood purifier. They belong to the Polypores, a group of mushrooms that grow on wood and may be the ancestors of most gilled mushrooms. Chaga and the similar reishi mushroom both have a reputation as tonics for longevity and health which are born out by recent scientific studies. These mushrooms show great promise for their anti-viral activities, immune response stimulation and anti-tumor effects that inhibit the spread of cancer cells.
In China, Japan and South Korea, extracts of chaga and other mushrooms from the family Hymenochaetaceae are being produced, sold and exported as anticancer medicinal supplements. The main bioactive ingredient in these extracts are usually (1>3)(1>6) Beta-D-glucans, a type of water-soluble polysaccharide. The biologic properties of crude preparations of these specific Beta-D-glucans have been subject of research since the 1960s.
Although these macro-molecules exhibit a wide range of biologic functions, including antitumor activity, their ability to prevent a range of infectious diseases (by triggering and supporting the immune function) has been studied in the greatest detail. Recent scientific research in Japan and China has been focused more on the anticancer potential and showed the effects of these specific beta-glucans to be comparable to chemotherapy and radiation, but without the side effects. Further research indicated these polysaccharides have strong anti-inflammatory and immune balancing properties, stimulating the body to produce natural killer (NK) cells to battle infections and tumor growth, instead of showing a direct toxicity against pathogens. This property makes well-prepared medicinal mushroom extracts stand out from standard pharmaceuticals – no side effects will occur or develop; the body is healing itself, triggered into action by the BRM effect of the chaga extract. Herbalist David Winston maintains it is the strongest anticancer medicinal mushroom. Russian literature Nobel Prize laureate Alexandr Solzhenitsyn wrote two pages on the medicinal use and value of chaga in his autobiographical novel, based on his experiences in a hospital in Tashkent, Cancer Ward (1968).
Since the 16th century, chaga mushrooms were recorded as being used in folk medicine and the botanical medicine of the Eastern European countries as a remedy for cancer, gastritis, ulcers, and tuberculosis of the bones. A review from 2010 stated, “As early as in the 16th century, chaga was used as an effective folk medicine in Russia and Northern Europe to treat several human malicious tumors and other diseases in the absence of any unacceptable toxic side effects.”
Chemical analysis shows that I. obliquus produces during its development and growth a range of secondary metabolites, including phenolic compounds such as melanins, and lanostane-type triterpenes, which include a small percentage of betulinic acid. Among these metabolites are biologically active components which have been researched and tested for their potential antioxidant, antitumoral, and antiviral activities. Both betulin and betulinic acid are being studied for use as chemotherapeutic agents and are already used as anti-HIV agents ). In an animal study, researchers found betulin from birch bark lowered cholesterol, obesity and improved insulin resistance.
In 1958, scientific studies in Finland and Russia found chaga provided an epochal effect in breast cancer, liver cancer, uterine cancer, and gastric cancer, as well as in hypertension and diabetes.
A 1998 study in Poland demonstrated chaga’s inhibiting effects on tumor growth. Noda and colleagues found betulin seems to work highly selectively on tumor cells because the interior pH of tumor tissues is generally lower than that of normal tissues, and betulinic acid is only active at those lower levels. Fulda et al. found, in 1997, once inside the cells, betulinic acid induces apoptosis (programmed cell death) in the tumors. In 2005, I. obliquus was evaluated for its potential for protecting against oxidative damage to DNA in a human keratinocyte cell line. The study found the polyphenolic extract protected these cells against hydrogen peroxide-induced oxidative stress. Another study that year found the endopolysaccharide of chaga produced indirect anticancer effects via immunostimulation. The mycelial endopolysaccharide of I. obliquus was identified as a candidate for use as an immune response modifier and indicated the anticancer effect of endopolysaccharide is not directly tumoricidal, but rather is immunostimulation. It also has anti-inflammatory properties. Saitoh Akiko published on the antimutagenic effects of chaga in 1996. Mizuno et al. published on the antitumor and hypoglycemic activities of the polysaccharides from the sclerotia and mycelia of chaga. Due to the serum glucose-lowering activity of polysaccharides, caution should be taken by those with hypoglycemia
Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider
Water makes up around 75 per cent of the human body. It’s important for digestion, joint function, healthy skin and removal of waste products. CLICK & SEE
Dehydration occurs when more fluid is lost from the body than is taken in. This causes an imbalance in important minerals, such as sodium and potassium, which are required for muscle and nerve function.
If there is a one per cent or greater loss in body weight because of fluid loss, dehydration occurs. This may be mild, moderate or severe, depending on the amount lost.
Infants and children are more susceptible to dehydration than adults because of their smaller body weights and higher turnover of water and electrolytes. The elderly and those with illnesses are also at higher risk.
Dehydration is classified as mild, moderate, or severe based on how much of the body’s fluid is lost or not replenished. When severe, dehydration is a life-threatening emergency.
Who are at Risk? Anyone’s at risk of dehydration, but some people are more at risk than others.
•Babies and young children have relatively low body weights, making them more vulnerable to the effects of fluid loss. •Older adults tend to eat less and may forget to eat and drink during the day. With increasing age, the body’s ability to conserve water decreases and a person’s sense of thirst becomes less acute. Illness and disability are also more common, which may make it harder to eat and drink enough. •People with long-term medical conditions, such as kidney disease and alcoholism, are more at risk of dehydration. •Short-term, acute health problems, such as viral infections, can result in dehydration because fever and increased sweating mean more fluid is lost from the body. Such illnesses may also make you feel less inclined to eat and drink. •People living or working in hot climates or those who take part in sports or other strenuous physical activities are at greater risk of dehydration.
The body’s initial responses to dehydration are thirst to increase water intake along with decreased urine output to try to conserve water. The urine will become concentrated and more yellow in color.
As the level of water loss increases, more symptoms can become apparent. The following are further signs and symptoms of dehydration:
•the eyes stop making tears,
•sweating may stop,
•nausea and vomiting,
•heart palpitations, and
•lightheadedness (especially when standing).
The body tries to maintain cardiac output (the amount of blood that is pumped by the heart to the body); and if the amount of fluid in the intravascular space is decreased, the body tries to compensate for this decrease by increasing the heart rate and making blood vessels constrict to try to maintain blood pressure and blood flow to the vital organs of the body. This coping mechanism begins to fail as the level of dehydration increases.
With severe dehydration, confusion and weakness will occur as the brain and other body organs receive less blood. Finally, coma and organ failure, and death eventually will occur if the dehydration remains untreated.
Around two-thirds of the water we need comes from drinks. Up to one-third comes from food (tomatoes, cucumber, fish and poultry are good sources). Some is also provided as a result of chemical reactions within the body. CLICK & SEE
The average adult loses around 2.5 litres of water every day through the normal processes of breathing, sweating and waste removal. If we lose more fluid than usual this tips the balance towards dehydration.
Your body may lose too much fluids from:
•Vomiting or diarrhea
•Excessive urine output, such as with uncontrolled diabetes or diuretic use
•Excessive sweating (for example, from exercise)
You might not drink enough fluids because of:
•Loss of appetite due to illness
•Sore throat or mouth sores
Dehydration in sick children is often a combination of both — refusing to eat or drink anything while also losing fluid from vomiting, diarrhea, or fever.
Lifestyle factors such as drinking too much alcohol, exercise, being in a hot environment or being too busy to drink liquid can also lead to dehydration.
Dehydration is often a clinical diagnosis. Aside from diagnosing the reason for dehydration, the health care practitioner’s examination of the patient will assess the level of dehydration. Initial evaluations may include:
•Mental status tests to evaluate whether the patient is awake, alert, and oriented. Infants and children may appear listless and have whiny cries and decreased muscle tone.
•Vital signs may include postural readings (blood pressure and pulse rate are taken lying down and standing). With dehydration, the pulse rate may increase and the blood pressure may drop because the intravascular space is depleted of fluid. People taking beta blocker medications for high blood pressure, heart disease, or other indications, occasionally lose the ability to increase their heart rate as a compensation mechanism since these medications block the adrenaline receptors in the body.
•Temperature may be measured to assess fever.
•Skin may be checked to see if sweat is present and to assess the degree of elasticity (turgor). As dehydration progresses, the skin loses its water content and becomes less elastic.
•Infants may have additional evaluations performed, including checking for a soft spot on the skull (sunken fontanelle), assessing the suck mechanism, muscle tone, or loss of sweat in the armpits and groin. All are signs of potential significant dehydration.
•Pediatric patients are often weighed during routine child visits, thus a body weight measurement may be helpful in assessing how much water has been lost with the acute illness.
The purpose of blood tests is to assess potential electrolyte abnormalities (especially sodium levels) associated with the dehydration. Tests may or may not be done on the patient depending upon the underlying cause of dehydration, the severity of illness, and the health care practitioner’s assessment of their needs.
Urinalysis may be done to determine urine concentration – the more concentrated the urine, the more dehydrated the patient.
As is often the case in medicine, prevention is the important first step in the treatment of dehydration. (Please see the home treatment and prevention sections.)
Fluid replacement is the treatment for dehydration. This may be attempted by replacing fluid by mouth, but if this fails, intravenous fluid (IV) may be required. Should oral rehydration be attempted, frequent small amounts of clear fluids should be used.
Clear fluids include:
•other replacement fluids that may contain electrolytes (Pedialyte, Gatorade, Powerade, etc.)
Decisions about the use of intravenous fluids depend upon the health care practitioner’s assessment of the extent of dehydration and the ability for the patient to recover from the underlying cause.
The success of the rehydration therapy can be monitored by urine output. When the body is dry, the kidneys try to hold on to as much fluid as possible, urine output is decreased, and the urine itself is concentrated. As treatment occurs, the kidneys sense the increased amount of fluid, and urine output increases.
Medications may be used to treat underlying illnesses and to control fever, vomiting, or diarrhea.
Home Treatment: Dehydration occurs over time. If it can be recognized in its earliest stages, and if its cause can be addressed, home treatment may be beneficial and adequate.
Steps a person can take at home to prevent severe dehydration include:–
•Individuals with vomiting and diarrhea can try to alter their diet and use medications to control symptoms to minimize water loss. Clear fluids often recommended as the diet of choice for the first 24 hours, with gradual progression to a BRAT diet (bananas, rice, apples, toast) and then adding more foods as tolerated.
•Loperamide (Imodium) may be considered to control diarrhea.
•Acetaminophen or ibuprofen may be used to control fever.
•Fluid replacements may be attempted by small, frequent amounts of clear fluids (see clear fluids information in previous section). The amount of fluid required to maintain hydration depends upon the individual’s weight. The average adult needs between 2 and 3 liters of fluid per day.
If the person becomes confused or lethargic; if there is persistent, uncontrolled fever, vomiting, or diarrhea; or if there are any other specific concerns, then medical care should be accessed.
Prevention:- •Environment: Dehydration due to the weather is a preventable condition. If possible, activities should not be scheduled in the heat of the day. If they are, adequate fluids should be available, and cooler, shaded areas should be used if possible. Of course, people should be monitored to make certain they are safe. Those working in hot environments need to take care to rehydrate often. •Exercise: People exercising in a hot environment need to drink adequate amounts of water. •Age: The young and elderly are most at risk. During heat waves, attempts should be made to check on the elderly in their homes. During the Chicago heat wave of 1995, more than 600 people died in their homes from heat exposure. •Heat related conditions: Know the signs and symptoms of heat cramps, heat rash, heat exhaustion, and heat stroke. Preventing dehydration is one step to avoid these conditions.
Carefully monitor someone who is ill, especially an infant, child, or older adult. If you believe that dehydration is developing, consult a doctor before the person becomes moderately or severely dehydrated. Begin fluid replacement as soon as vomiting and diarrhea start — DO NOT wait for signs of dehydration.
Always encourage the person to drink during an illness, and remember that a person’s fluid needs are greater when that person has fever, vomiting, or diarrhea. The easiest signs to monitor are urine output (there should be frequent wet diapers or trips to the bathroom), saliva in the mouth, and tears when crying.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Cytomegalovirus (say: si-toe-meg-ah-low-vi-russ), or CMV, is a very common virus. It is a viral genus of the viral group known as Herpesviridae or herpesviruses. It is typically abbreviated as CMV: The species that infects humans it is commonly known as human CMV (HCMV) or human herpesvirus-5 (HHV-5), and is the best studied of all cytomegoloviruses. Within Herpesviridae, CMV belongs to the Betaherpesvirinae subfamily, which also includes the genera Muromegalovirus and Roseolovirus. It is related to other herpesviruses within the subfamilies of Alphaherpesvirinae that includes herpes simplex viruses (HSV)-1 and -2 and varicella-zoster virus (VZV), and the Gammaherpesvirinae subfamily that includes Epstein-Barr virus. All herpesviruses share a characteristic ability to remain latent within the body over long periods. Although they may be found throughout the body, CMV infections are frequently associated with the salivary glands in humans and other mammals. Other CMV viruses are found in several mammal species, but species isolated from animals differ from HCMV in terms of genomic structure, and have not been reported to cause human disease.
People are usually infected by the time they are 2 years old or during their teenage years and carry the virus for life (usually in a dormant or inactive state). The majority of adults carry the virus by the time they are 40 years of age.
Many people are infected with CMV and don’t even know it because the virus rarely causes symptoms and usually does not cause long-term problems.
However, CMV can cause problems in people who have weak immune systems and in a newborn if the mother gets the infection during pregnancy.
CMV gets into body fluids, such as saliva, blood, urine, semen and breast milk. A person is able to transmit (or “shed”) the virus to others only when it is active in his or her system (not dormant). It can be spread from one person to another through sexual contact and contact with blood and other body fluids. CMV can rarely be transmitted by blood transfusion or organ transplantation. In developed countries, blood supplies are screened for CMV when they’re to be used for those at greatest risk from the infection.
People who have weakened immune systems due to conditions like human immunodeficiency virus (HIV) or because they received an organ transplant and are taking immunosuppressant medicines may have severe symptoms. (Immunosuppressant medicines are medicines that lower or suppress the immune system.) Symptoms of severe CMV include:
•Bleeding ulcers in the esophagus (windpipe) or intestines
•Inflammation of the brain (encephalitis)
If a pregnant woman transmits CMV to her unborn baby, miscarriage, stillbirth or death of the newborn may occur. Newborns who survive are at an increased risk for hearing loss and mental retardation. However, only 1% of newborns who are infected with CMV during pregnancy experience problems from the virus. Most are born healthy, or with only mild CMV symptoms.
In most cases, CMV is harmless, but for some people infection can have disastrous consequences.
People with weakened immune systems (because of HIV, for example) can suffer serious illness. They may experience high fever for two or three weeks, accompanied by hepatitis and jaundice.
Other serious complications include pneumonia, inflammation of the brain (encephalitis) and blindness as a result of inflammation of the retina at the back of the eye.
CMV remains in the body for life. For those with strong immune systems, it remains inactive. If the immune system is weakened through illness or medical treatments, CMV may be reactivated, causing further medical problems and distress.
If a pregnant woman becomes infected with CMV for the first time, the virus may pass through the placenta and infect her unborn baby. If this happens early in pregnancy, the risk of miscarriage increases, as does the chance of the baby being born with malformations. For example, CMV infection in the womb is the leading cause of congenital deafness.
If the infection is contracted later in pregnancy, stillbirth and premature labour are more likely. A newborn baby may suffer severe illness shortly after birth – jaundice, enlargement of the liver and blood disorders.
CMV is more likey to cause vision problems in people who have weakened immune systems, so if you have conditions such as HIV or AIDS, your doctor may recommend that you visit an eye doctor to find out whether the virus has infected your eyes. Be sure to let your doctor know if you are having any painless blurring of your vision, “floaters” only in one eye, light flashes or areas of blindness. You should also let your doctor(s) know if you are experiencing frequent shortness of breath with flu-like symptoms, or if you are having problems hearing.
For otherwise healthy people, CMV usually doesn’t require treatment. If your immune system is weakened, your doctor may use one of several different medicines to treat CMV infection. However, because CMV is a virus, regular antibiotics won’t work against it. Antiviral drugs are usually prescribed, which slows the virus down (but cannot cure CMV).
If you are pregnant, your doctor may want to test you for CMV to determine if there is a risk for your unborn baby. If you do carry the virus, your doctor may suggest a test called amniocentesis, which collects a sample of the amniotic fluid for testing. It can help determine whether your unborn baby has CMV.
If you are pregnant and your baby has CMV, you doctor will likely check your baby once he or she is born for any problems or birth defects so they can be treated early. Treatable symptoms in newborns include pneumonia, hearing loss and inflammation of the eye.
In child care centers, as many as 70% of children ages 1 to 3 can shed the virus. Careful, frequent hand washing with soap and water may help prevent the spread of CMV.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Honey has long been regarded as one of the best natural wound healers and infection ?ghters. When a researcher treated patients with Acyclovir for one herpes outbreak and honey for another, overall healing time with honey was 43 percent better than with Acyclovir for sores on the lips and 59 percent better for genital sores.
According to Nutrition and Healing:
“None of the volunteers experienced any side effects with repeated applications of honey, although three patients developed local itching with the Acyclovir.”
Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on body where slight pressure causes pain. Fibromyalgia is more common in women than in men. Previously, fibromyalgia was known by other names such as fibrositis, chronic muscle pain syndrome, psychogenic rheumatism and tension myalgias.
It is a disorder classified by the presence of chronic widespread pain and tactile allodynia. While the criteria for such an entity have not yet been thoroughly developed, the recognition that fibromyalgia involves more than just pain has led to the frequent use of the term “fibromyalgia syndrome”. It is not contagious, and recent studies suggest that people with fibromyalgia may be genetically predisposed. The disorder is not directly life-threatening. The degree of symptoms may vary greatly from day to day with periods of flares (severe worsening of symptoms) or remission; however, the disorder is generally perceived as non-progressive.
Although the intensity of symptoms may vary, they’ll probably never disappear completely. It may be reassuring to know, however, that fibromyalgia isn’t progressive or life-threatening. Treatments and self-care steps can improve fibromyalgia symptoms and general health.
Incidence: It affects more females than males, with a ratio of 9:1 by American College of Rheumatology (ACR) criteria. Fibromyalgia is seen in about 2% of the general population. It is most commonly diagnosed in individuals between the ages of 20 and 50, though onset can occur in childhood.
Signs and symptoms:-
The defining symptoms of fibromyalgia are chronic, widespread pain and tenderness to light touch. There is also typically moderate to severe fatigue. Those affected may also experience heightened sensitivity of the skin (also called allodynia), tingling of the skin (often needle-like), achiness in the muscle tissues, prolonged muscle spasms, weakness in the limbs, and nerve pain. Chronic sleep disturbances are also characteristic of fibromyalgia. Indeed, studies suggest that sleep disturbances are related to a phenomenon called alpha-delta sleep, a condition in which deep sleep (associated with delta EEG waves) is frequently interrupted by bursts of brain activity similar to wakefulness (i.e. alpha waves). Deeper stages of sleep (stages 3 & 4) are often dramatically reduced.
click & see Eighteen sites (nine pairs) or tender points seen in patients with fybromyalgia
.Signs and symptoms of fibromyalgia can vary, depending on the weather, stress, physical activity or even the time of day. Common signs and symptoms include:
* Widespread pain. Fibromyalgia is characterized by pain in specific areas of your body when pressure is applied, including the back of your head, upper back and neck, upper chest, elbows, hips and knees. The pain generally persists for months at a time and is often accompanied by stiffness.
* Fatigue and sleep disturbances. People with fibromyalgia often wake up tired and unrefreshed even though they seem to get plenty of sleep. Some studies suggest that this sleep problem is the result of a sleep disorder called alpha wave interrupted sleep pattern, a condition in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness. So people with fibromyalgia miss the deep restorative stage of sleep. Nighttime muscle spasms in your legs and restless legs syndrome also may be associated with fibromyalgia.
* Irritable bowel syndrome (IBS). The constipation, diarrhea, abdominal pain and bloating associated with IBS are common in people with fibromyalgia.
* Headaches and facial pain. Many people who have fibromyalgia also have headaches and facial pain that may be related to tenderness or stiffness in their neck and shoulders. Temporomandibular joint (TMJ) dysfunction, which affects the jaw joints and surrounding muscles, also is common in people with fibromyalgia.
* Heightened sensitivity. It’s common for people with fibromyalgia to report being sensitive to odors, noises, bright lights and touch.
* Numbness or tingling sensations in the hands and feet (paresthesia)
* Difficulty concentrating
* Mood changes
* Chest pain
* Dry eyes, skin and mouth
* Painful menstrual periods
The cause of fibromyalgia is unknown. Fibromyalgia can, but does not always, start as a result of some trauma such as a traffic accident, major surgery, or disease. Some evidence shows that Lyme Disease may be a trigger of fibromyalgia symptoms. Another study suggests that more than one clinical entity may be involved, ranging from a mild, idiopathic inflammatory process to clinical depression Genetics
By using self-reported “Chronic Widespread Pain” (CWP) as a surrogate marker for fibromyalgia, the Swedish Twin Registry found that a modest genetic contribution may exist:
* Monozygotic twins with CWP have a 15% chance that their twin sibling has CWP
* Dizygotic twins with CWP have a 7% chance that their twin sibling has CWP
Studies have shown that stress is a significant precipitating factor in the development of fibromyalgia, and that PTSD is linked with fibromyalgia.The Amital study found that 49% of PTSD patients fulfilled the criteria for FMS, compared with none of the controls.
A non-mainstream hypothesis that fibromyalgia may be a psychosomatic illness has been described by John E. Sarno’s “tension myositis syndrome”. He believes many cases of chronic pain result from changes in the body caused by the mind’s subconscious strategy of distracting painful or dangerous emotions. Education, attitude change, and, in some cases, psychotherapy are treatments proposed to stop the brain from using that strategy. Dopamine abnormality
Dopamine is a catecholamine neurotransmitter perhaps best known for its role in the pathology of schizophrenia, Parkinson’s disease and addiction. There is also strong evidence for a role of dopamine in restless leg syndrome , which is a common co-morbid condition in patients with fibromyalgia. In addition, dopamine plays a critical role in pain perception and natural analgesia. Accordingly, musculoskeletal pain complaints are common among patients with Parkinson’s disease , which is characterized by drastic reductions in dopamine owing to neurodegeneration of dopamine-producing neurons, while patients with schizophrenia, which is thought to be due (in part) to hyperactivity of dopamine-producing neurons, have been shown to be relatively insensitive to pain. Interestingly, patients with restless legs syndrome have also been demonstrated to have hyperalgesia to static mechanical stimulation.
Fibromyalgia has been commonly referred to as a “stress-related disorder” due to its frequent onset and worsening of symptoms in the context of stressful events. It was therefore proposed that fibromyalgia may represent a condition characterized by low levels of central dopamine that likely results from a combination of genetic factors and exposure to environmental stressors, including psychosocial distress, physical trauma, systemic viral infections or inflammatory disorders (e.g. rheumatoid arthritis, systemic lupus erythematosus). This conclusion was based on three key observations: (1) fibromyalgia is associated with stress; (2) chronic exposure to stress results in a disruption of dopamine-related neurotransmission; and (3) dopamine plays a critical role in modulating pain perception and central analgesia in such areas as the basal ganglia including the nucleus accumbens, insular cortex, anterior cingulate cortex, thalamus, periaqueductal gray, and spinal cord.
In support of the ‘dopamine hypothesis of fibromyalgia’, a reduction in dopamine synthesis has been reported by a study that used positron emission tomography (PET) and demonstrated a reduction in dopamine synthesis among fibromyalgia patients in several brain regions in which dopamine plays a role in inhibiting pain perception, including the mesencephalon, thalamus, insular cortex and anterior cingulate cortex.A subsequent PET study demonstrated that, whereas healthy individuals release dopamine into the caudate nucleus and putamen during a tonic experimental pain stimulus (i.e. hypertonic saline infusion into a muscle bed), fibromyalgia patients fail to release dopamine in response to pain and, in some cases, actually have a reduction in dopamine levels during painful stimulation. Moreover, a substantial subset of fibromyalgia patients respond well in controlled trials to pramipexole, a dopamine agonist that selectively stimulates dopamine D2/D3 receptors and is used to treat both Parkinson’s disease and restless legs syndrome. Trials of other dopamine agonists are currently ongoing. Serotonin
Serotonin is a neurotransmitter that is known to play a role in regulating sleep patterns, mood, feelings of well-being, concentration and descending inhibition of pain. Accordingly, it has been hypothesized that the pathophysiology underlying the symptoms of fibromyalgia may be a dysregulation of serotonin metabolism, which may explain (in part) many of the symptoms associated with the disorder. This hypothesis is derived in part by the observation of decreased serotonin metabolites in patient plasma and cerebrospinal fluid. However, selective serotonin reuptake inhibitors (SSRIs) have met with limited success in alleviating the symptoms of the disorder, while drugs with activity as mixed serotonin-norepinephrine reuptake inhibitors (SNRIs) have been more successful. Accordingly, duloxetine (Cymbalta), a SNRI originally used to treat depression and painful diabetic neuropathy, has been demonstrated by controlled trials to relieve symptoms of some patients. Eli Lilly and Company, the manufacturer of duloxetine has submitted a supplementary new drug application (sNDA) to the FDA for approval of it use in the treatment of FM. The relevance of dysregulated serotonin metabolism to the pathophysiology is a matter of debate. Ironically, one of the more effective types of medication for the treatment of the disorder (i.e. serotonin 5-HT3 antagonists) actually block some of the effects of serotonin.
Electroencephalography studies have shown that people with fibromyalgia lack slow-wave sleep and circumstances that interfere with stage four sleep (pain, depression, serotonin deficiency, certain medications or anxiety) may cause or worsen the condition. According to the sleep disturbance hypothesis, an event such as a trauma or illness causes sleep disturbance and possibly initial chronic pain that may initiate the disorder. The hypothesis supposes that stage 4 sleep is critical to the function of the nervous system, as it is during that stage that certain neurochemical processes in the body ‘reset’. In particular, pain causes the release of the neuropeptide substance P in the spinal cord which has the effect of amplifying pain and causing nerves near the initiating ones to become more sensitive to pain. Under normal circumstances, areas around a wound to become more sensitive to pain but if pain becomes chronic and body-wide this process can run out of control. The sleep disturbance hypothesis holds that deep sleep is critical to reset the substance P mechanism and prevent this out-of-control effect.
The sleep disturbance/substance P hypothesis could explain “tender points” that are characteristic of fibromyalgia but which are otherwise enigmatic, since their positions don’t correspond to any particular set of nerve junctions or other obvious body structures. The hypothesis proposes that these locations are more sensitive because the sensory nerves that serve them are positioned in the spinal cord to be most strongly affected by substance P. This hypothesis could also explain some of more general neurological features of fibromyalgia, since substance P is active in many other areas of the nervous system. The sleep disturbance hypothesis could also provide a possible connection between fibromyalgia, chronic fatigue syndrome (CFS) and post-polio syndrome through damage to the ascending reticular activating system of the reticular formation. This area of the brain, in addition to apparently controlling the sensation of fatigue, is known to control sleep behaviors and is also believed to produce some neuropeptides, and thus injury or imbalance in this area could cause both CFS and sleep-related fibromyalgia.
Critics of the hypothesis argue that it does not explain slow-onset fibromyalgia, fibromyalgia present without tender points, or patients without heightened pain symptoms, and a number of the non-pain symptoms present in the disorder.
Human growth hormone
An alternate hypothesis suggests that stress-induced problems in the hypothalamus may lead to reduced sleep and reduced production of human growth hormone (HGH) during slow-wave sleep. People with fibromyalgia tend to produce inadequate levels of HGH. Most patients with FM with low IGF-I levels failed to secrete HGH after stimulation with clonidine and l-dopa.
This view is supported by the fact that those hormones under the direct or indirect control of HGH, including IGF-1, cortisol, leptin and neuropeptide Y are abnormal in people with fibromyalgia, In addition, treatment with exogenous HGH or growth hormone secretagogue reduces fibromyalgia related pain and restores slow wave sleep though there is disagreement about the proposition. Deposition disease
The ‘deposition hypothesis of fibromyaglia’ posits fibromyalgia is due to intracellular phosphate and calcium accumulations that eventually reaches levels sufficient to impede the ATP process, possibly caused by a kidney defect or missing enzyme that prevents the removal of excess phosphates from the blood stream. Accordingly, proponents of this hypothesis suggest that fibromyalgia may be an inherited disorder, and that phosphate build-up in cells is gradual but can be accelerated by trauma or illness. Calcium is required for the excess phosphate to enter the cells.The additional phosphate slows down the ATP process; however the excess calcium prods the cell to continue producing ATP.
Diagnosis is made with a specialized technique called mapping, a gentle palpitation of the muscles to detect lumps and areas of spasm thought to be caused by an excess of calcium in the cytosol of the cells. The mapping technique is notably different from the manual tenderpoint examination upon which a diagnosis of fibromyalgia depends and is purportedly different from the detection of trigger points that characterize the myofascial pain syndrome.
While this hypothesis does not identify the causative mechanism in the kidneys, it proposes a treatment known as guaifenesin therapy. This treatment involves administering the drug guaifenesin to a patient’s individual dosage, avoiding salicylic acid in medications or on the skin. Often products for salicylate sensitivity are very helpful. If the patient is also hypoglycemic, a diet is designed to keep insulin levels low.
The phosphate build-up hypothesis explains many of the symptoms present in fibromyalgia and proposes an underlying cause. The guaifenesin treatment, based on this hypothesis, has received mixed reviews, with some practitioners claiming many near-universal successes and others reporting no success. Of note, guaifenesin is also a central acting muscle relaxant used in veterinary anaesthesia that is structurally related to methocarbamol, a property that might explain its utility in some fibromyalgia patients. A controlled trial of guaifenesin for the treatment of fibromyalgia demonstrated no evidence for efficacy of this medication. However, this study has been criticized by the chief proponent of the deposition hypothesis for not limiting salicylic acid exposure in patients, and for studying the effectiveness of only guaifenesin, not the entire treatment method.As of 2005, further studies to test the protocol’s effectiveness are in the planning stages, with funding for independent studies largely collected from groups which advocate the hypothesis. It should be noted that nothing in the scientific literature supports the proposition that fibromyalgia patients have excessive levels of phosphate in their tissues.
Other hypotheses have been proposed related to various toxins from the patient’s environment, viral causes such as the Epstein-Barr Virus, growth hormone deficiencies possibly related to an underlying (maybe autoimmune) disease affecting the hypothalamus gland, an aberrant immune response to intestinal bacteria, neurotransmitter disruptions in the central nervous system, and erosion of the protective chemical coating around sensory nerves. A 2001 study suggested an increase in fibromyalgia among women with extracapsular silicone gel leakage, compared to women whose implants were not broken or leaking outside the capsule. This association has not repeated in a number of related studies, and the US-FDA concluded “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.” Due to the multi-systemic nature of illnesses such as fibromyalgia and chronic fatigue syndrome (CFS/ME), an emerging branch of medical science called psychoneuroimmunology (PNI) is looking into how the various hypotheses fit together.
Another hypothesis on the cause of symptoms in fibromyalgia states that patients suffer from vasomotor dysregulation causing improper vascularflow and hypoperfusion (decreased blood flow to a given tissue or organ).
Always a comorbid disease?
Cutting across several of the above hypotheses is the proposition that fibromyalgia is almost always a comorbid disorder, occurring in combination with some other disorder that likely served to “trigger” the fibromyalgia in the first place. Two possible triggers are gluten sensitivity and/or irritable bowel. Irritable bowel is found at high frequency in fibromyalgia, and a large coeliac support group survey of adult celiacs revealed that 7% had fibromyalgia and also has a co-occurrence with chronic fatique.
According to this hypothesis, some other disorder (or trauma) occurs first, and fibromyalgia follows as a result. In some cases, the original disorder abates on its own or is separately treated and cured, but the fibromyalgia remains. This is especially apparent when fibromyalgia seems triggered by major surgery. In other cases the two disorders coexist.
Risk factors for fibromyalgia include:
* Your sex. Fibromyalgia occurs more often in women than in men.
* Age. Fibromyalgia tends to develop during early and middle adulthood. But it can also occur in children and older adults.
* Disturbed sleep patterns. It’s unclear whether sleeping difficulties are a cause or a result of fibromyalgia — but people with sleep disorders, such as nighttime muscle spasms in the legs, restless legs syndrome or sleep apnea, can also develop fibromyalgia.
* Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.
* Rheumatic disease. If you have a rheumatic disease, such as rheumatoid arthritis, lupus or ankylosing spondylitis, you may be more likely to have fibromyalgia.
As with many other syndromes, there is no universally accepted cure for fibromyalgia, though some physicians claim to have found cures.However, a steady interest in the disorder on the part of academic researchers as well as pharmaceutical interests has led to improvements in its treatment, which ranges from symptomatic prescription medication to alternative and complementary medicine.
The European League Against Rheumatism (EULAR) issued the first guidelines for the treatment of fibromyalgia syndrome (FMS) and published them in the September 17th On-line First issue of the Annals of the Rheumatic Diseases.
Many medications are used to treat specific symptoms of fibromyalgia, such as muscle pain and insomnia.
A number of pain relievers have been prescribed for fibromyalgia. This includes NSAID medications over the counter, COX-2 inhibitors, and tramadol in prescription form for more advanced cases. Recently, pregabalin (marketed as Lyrica) has been given FDA approval for the treatment of diagnosed Fibromyalgia.
Muscle relaxants, such as cyclobenzaprine (Flexeril) or tizanidine (Zanaflex), may be used to treat the muscle pain associated with the disorder.
Tricyclic antidepressants (TCAs)
Traditionally, low doses of sedating antidepressants (e.g. amitriptyline and trazodone) have been used to reduce the sleep disturbances that are associated with fibromyalgia and are believed by some practitioners to alleviate the symptoms of the disorder. Because depression often accompanies chronic illness, these antidepressants may provide additional benefits to patients suffering from depression. Amitriptyline is often favoured as it can also have the effect of providing relief from neuralgenic or neuropathic pain. It is to be noted that Fibromyalgia is not considered a depressive disorder; antidepressants are used for their sedating effect to aid in sleep.
Selective serotonin reuptake inhibitors (SSRIs)
Research data consistently contradict the utility of agents with specificity as serotonin reuptake inhibitors for the treatment of core symptoms of fibromyalgia. Moreover, SSRIs are known to aggravate many of the comorbidities that commonly affect patients with fibromyalgia including restless legs syndrome and sleep bruxism.
Anti-seizure drugs are also sometimes used, such as gabapentin and pregabalin (Lyrica). Pregabalin, originally used for the nerve pain suffered by diabetics, has been approved by the American Food and Drug Administration for treatment of fibromyalgia. A randomized controlled trial of pregabalin 450 mg/day found that a number needed to treat of 6 patients for one patient to have 50% reduction in pain.
Dopamine agonists (e.g. pramipexole (Mirapex) and ropinirole(ReQuip)) have been studied for use in the treatment of fibromyalgia with good results. A trial of transdermal rotigotine is currently on going .
A controlled clinical trial of amitriptyline and fluoxetine demonstrated utility when used in combination.
Central Nervous System (CNS) Stimulants
Cognitive dysfunction in fibromyalgia, often referred to as “brain fog,” may be treated with low doses of central nervous system (CNS) stimulants such as Modafinil, Adderall, Provigil, Methylphenidate (Ritalin, Ritalin SR, Methylin, Methylin ER.) These non-amphetamine stimulants are also used to treat the chronic fatigue that is characteristic of fibromyalgia.
Stimulants may be habit forming and can have other serious side effects, so it is important to note that other treatments may be effective. Care should be taken with any prescription, as people with fibromyalgia are known to be sensitive to medications.
Cannabis and cannabinoids
Fibromyalgia patients frequently self-report using cannabis therapeutically to treat symptoms of the disorder. Writing in the July 2006 issue of the journal Current Medical Research and Opinion, investigators at Germany’s University of Heidelberg evaluated the analgesic effects of oral THC (?9-tetrahydrocannabinol) in nine patients with fibromyalgia over a 3-month period. Subjects in the trial were administered daily doses of 2.5 to 15 mg of THC, but received no other pain medication during the trial. Among those participants who completed the trial, all reported a significant reduction in daily recorded pain and electronically induced pain.Previous clinical and preclinical trials have shown that both naturally occurring and endogenous cannabinoids hold analgesic qualities,particularly in the treatment of cancer pain and neuropathic pain, both of which are poorly treated by conventional opioids. As a result, some experts have suggested that cannabinoid agonists would be applicable for the treatment of chronic pain conditions unresponsive to opioid analgesics such as fibromyalgia, and they propose that the disorder may be associated with an underlying clinical deficiency of the endocannabinoid system.
Users of Epsom Salts in the gel form (Magnesium Sulfate), have reported significant and lasting relief from pain associated with fibromyalgia. Epsom Salts have long been touted for their ability to reduce pain and swelling.
Studies have found exercise improves fitness and sleep and may reduce pain and fatigue in some people with fibromyalgia. Many patients find temporary relief by applying heat to painful areas. Those with access to physical therapy, massage, or acupuncture may find them beneficial. Most patients find exercise, even low intensity exercise to be extremely helpful. Osteopathic manipulative therapy can also temporarily relieve pain due to fibromyalgia.
A holistic approach—including managing diet, sleep, stress, activity, and pain—is used by many patients. Dietary supplements, massage, chiropractic care, managing blood sugar levels, and avoiding known triggers when possible means living as well as it is in the patient’s power to do.
As the nature of fibromyalgia is not well understood, some physicians believe that it may be psychosomatic or psychogenic.Although there is no universally accepted cure, some doctors have claimed to have successfully treated fibromyalgia when a psychological cause is accepted.
Cognitive behavioral therapy has been shown to improve quality of life and coping in fibromyalgia patients and other sufferers of chronic pain. Neurofeedback has also shown to provide temporary and long-term relief.
Biofeedback and self-management techniques such as pacing and stress management may be helpful for some patients. The use of medication to improve sleep helps some patients, as does supplementation with folic acid and ginkgo biloba.
In a 2001 review of four case studies, symptom alleviation was found by minimizing consumption of monosodium glutamate.
Milnacipran, a serotonin-norepinephrine reuptake inhibitor (SNRI), is available in parts of Europe where it has been safely prescribed for other disorders. On May 22nd, 2007, a Phase III study demonstrated statistically significant therapeutic effects of Milnacipran as a treatment of fibromyalgia syndrome. At this time, only initial top-line results are available and further analyses will be completed in the coming weeks. If ultimately approved by the FDA, Milnacipran could be distributed in the United States as early as summer, 2008.
Among the more controversial therapies involves the use of guaifenesin; called St. Amand’s protocol or the guaifenesin protocol the efficacy of guaifenesin in treating fibromyalgia has not been proven in properly designed research studies. Indeed, a controlled study conducted by researchers at Oregon Health Science University in Portland failed to demonstrate any benefits from this treatment, and the lead researcher has suggested that the annecdotaly reported benefits where due to placebo suggestion. The results of the study have since been contested by Dr St. Amand, who was a co-author or the original research report.
Dextromethorphan is an over-the-counter cough medicine with activity as an NMDA receptor antagonist. It has been used in the research setting to investigate the nature of fibromyalgia pain; however, there are no controlled trials of safety or efficacy in clinical use.
Living with fibromyalgia:-
Fibromyalgia can affect every aspect of a person’s life. While neither degenerative nor fatal, the chronic pain associated with fibromyalgia is pervasive and persistent. FMS can severely curtail social activity and recreation, and as many as 30% of those diagnosed with fibromyalgia are unable to maintain full-time employment. Like others with disabilities, individuals with FMS often need accommodations to fully participate in their education or remain active in their careers.
In the United States, those who are unable to maintain a full-time job due to the condition may apply for Social Security Disability benefits. Although fibromyalgia has been recognized as a genuine, severe medical condition by the government, applicants are often denied benefits, since there are no formal diagnostic criteria or medically provable symptoms. Because of this, if an applicant does have a medically verifiable condition that would justify disability benefits in addition to fibromyalgia, it is recommended that they not list fibromyalgia in their claim. However, most are awarded benefits at the judicial level; the entire process often takes two to four years.
In the United Kingdom, the Department for Work and Pensions recognizes fibromyalgia as a condition for the purpose of claiming benefits and assistanc.
Fibromyalgia is often referred to as an “invisible” illness or disability due to the fact that generally there are no outward indications of the illness or its resulting disabilities. The invisible nature of the illness, as well as its relative rarity and the lack of understanding about its pathology, often has psychosocial complications for those that have the disorder. Individuals suffering from invisible illnesses in general often face disbelief or accusations of malingering or laziness from others that are unfamiliar with the disorder.
There are a variety of support groups on the Web that cater to fibromyalgia sufferers.
The validity of fibromyalgia as a unique clinical entity is a matter of some contention among researchers in the field. For example, it has been proposed that the pathophysiology responsible for the symptoms that are collectively classified as representing “fibromyalgia” is poorly understood, thereby suggesting that the fibromyalgia phenotype which is the difference between an individual’s heredity and what that heredity produces, may result from several different disease processes that have global hyperalgesia – an increased sensitivity to pain – and allodynia in common, an observation that has led to the proposition that current diagnostic criteria are insufficient to differentiate patient groups from each other. Alternatively, there is evidence for the existence of differing pathophysiological – which is the study of the disturbance of normal mechanical, physical, and biochemical functions of the body – within the greater fibromyalgia construct[, which may be interpreted to represent evidence for the existence of biologically distinct “sub-types” of the disorder akin to conditions such as epilepsy, schizophrenia and major depressive disorder. In a January 14, 2008 article in the New York Times, the controversy of the reality of the disease and its proposed cures are discussed, while citing that the American College of Rheumatology, the Food and Drug Administration and insurers recognize fibromyalgia as a diagnosable disease. Drug companies are aggressively pursuing fibromyalgia treatments, seeing the potential for a major new market.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose