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Ask The Nutritionist: Can holistic treatments help people with fibromyalgia?

In her weekly column, Bradford West Gwillimbury licensed nutritionist, Nonie De Long, answers a difficult reader question about fibromyalgia
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Dear Nutritionist,
Hello, Ms. De Long. I have struggled with my health for decades. I have serious fibromyalgia and clean eating has never improved my fatigue or pain. I have been to see many naturopaths and a dietician and doctors and acupuncturist and had lots of tests but nothing has worked. You seem honest so I would like to know if it’s realistic to think that holistic treatments or nutrition can really help people with fibromyalgia. Have you found anything that really works? I realize you may not want to publish this but you can answer privately I don’t mind either way.
Thank you, 

Dear Gladys,
Thank you for your question and your candor. I will give you the good and the bad news pertaining to your condition straight up, as you’ve requested. Readers that aren’t affected may find my reply overly technical, but I want to do your question justice. Next week I will cover a reader question about how to manage holiday celebrations low carb. The following week I will be sharing some recipes for a grain and sugar free holiday meal. 

So let’s get to it.

The bad: Fibromyalgia is a very complex health condition and is not well understood or managed within the current medical paradigm. As you are probably well aware, for a long time those presenting with it were summarily dismissed as fabricating their symptoms for “attention,” since it affects females to males at a rate of about 9:1. And we all know how doctors have enjoyed dismissing anything specific to female suffering as hyprochrondiacal. Now that fibro is medically accepted - and if you are persistent enough to get a diagnosis - the treatment you can expect is a lot of meds to manage specific symptoms - for life. 

You will, of course, also need meds to manage the side effects of the meds you are prescribed. And later, meds to manage the side effects and health problems created by those. There may also be novel new drugs from time to time that will get your hopes up but sadly, likely not be transformative. Why? Because treating specific symptoms does nothing to address the underlying cause(s) of fibromyalgia. At most this type of treatment model will help you manage your discomfort and pain. But a return to a vibrant, fully functional life is almost impossible unless you get help to reverse the underlying pathology of the disease.

The good: These complex health issues with global symptoms are where functional nutritional therapies really shine. I will do my best herein to outline some of the considerations a good practitioner will guide you through to begin to turn your health around. Do not misconstrue this to mean that the medical model is of no use and you should fire your doctor(s). And run, don’t walk, if a practitioner tells you to do so. You are going to need integrative support where you use practitioners from both models to help you manage your immediate symptoms while working to create lasting, underlying correction. 

The bad: Fibromyalgia is complicated and treating it will be like peeling an onion. It will take time. You didn’t get this sick overnight and you aren’t going to get better overnight. You will have to address one layer of your health problems at a time, and you will need a good practitioner to guide you so you don’t become overwhelmed. 

More bad: Finding such a practitioner is hard and will not be cheap. A good practitioner will ensure those with complex or obscure health issues keep a food/ mood/ sleep/ lifestyle journal, which is shared and monitored regularly, if not daily. This data helps the practitioner detect any possible links to symptom aggravation and amelioration. Over time, patterns emerge that will help the practitioner understand how to move you in the right direction. This is overlooked when there are monthly or bi-monthly check-ins vs consistent, regular monitoring. 

In addition, the direction you receive needs to be specific to your needs, lifestyle, and preferences. All of this requires not only expertise, but time and 1:1 attention. Or 2 or 3:1, as many functional medicine practitioners hire nutrition coaches and nurse practitioners, each to handle different pieces of your case management. It’s rare to find someone who does this level of coaching alone. Either way, this equals money. You are not going to get this type of service without paying for it. 

More bad: If you didn’t get the right testing done or if it is outdated, you will need to get more done. At your expense. Supplements will also be at your expense.

And more bad: OHIP and private insurance likely won’t cover this. The exception is if you have preventative coverage, which may be applicable, but it is most certainly minimal compared to the expense of this type of treatment. 

And more bad: This type of care is going to require that you change your diet and learn new recipes and stick to that consistently. And, you are going to have to take numerous supplements at the onset. You may have to drink gross things. You may also have to change your sleep and the products you use in your home and on your body. And you may be shocked to find your doctor does not want to work with you if you decide to use holistic therapies. There are ones out there who respect functional nutritional approaches and are willing to work together, but there are still ones that will refuse to see you if you enlist this type of help. Working with various professionals who refuse to work cooperatively is always more stressful and difficult so this can be a major issue to sort out. Lastly, you will have to make the effort to keep the daily journal, as described above. All of this amounts to a lot of work you will need to undertake in your fragile state.

The good: It’s realistic to expect good results working with a skilled functional nutrition practitioner who uses these methods. You should start to see improvements within 3-6 weeks of consistent implementation. A complete amelioration of any complicated or chronic health issue takes time, but the body responds quickly when you’re on the right path. A reduction in the severity or frequency of any one symptom is a good sign. If you don’t experience this, there should be an early clause for refund and termination of contract, as I offer with all clients. 

Too often I see clients pay for holistic healthcare without expectation of results in their health condition because they think the recommendations are making them “healthier overall” and helping them lose excess weight and that’s the best they can expect. Diet doesn’t really impact your health conditions, after all. 

But nothing could be further from the truth! (Add more exclamation marks!!) A healthy body knows how to overcome disease when it’s given the nutrients to do so and any blocks to that process are removed. This is a program that comes installed in each healthy body at birth and automatically runs in the background under the right conditions. So getting “healthier overall” should ALWAYS translate into a reduction in dis-ease symptoms. A “healthy diet” should always lead to improved health! It should always make you more vibrant, more resilient, and less sickly. If it doesn’t, it’s not a healthy diet. And you need to find a new practitioner. 

Dear readers, it does not matter how good a diet sounds on paper, how many studies have been done to prove it’s wonders, how many documentaries are made to promote it, how many pandas it saves, or how many global catastrophes it promises to thwart. I am not dismissing environmental and animal rights activism; they are important work! But they are not the measure of any diet.

The measure of any diet is the outcome it produces in your health. If you don’t notice that you feel better after the initial adjustment period, you have not found an optimal diet. It’s true you may need other therapies to fully correct chronic or severe acute health problems - like chiropractic adjustment, or antibiotic therapy for infection, or supplemental nutrients to correct an imbalance for a time, or homeopathic or herbal remedies to help gently treat symptoms and strengthen your innate healing capacity, or psychotherapy if trauma has been involved - but the diet is the real magic bullet here. Nothing nothing nothing you do is as transformative to your health as what you put in your mouth day in and day out for life. 

(Insert image of me standing in my nutrition leotard, cape billowing out behind me, saluting a giant cabbage.)

Now on to the nitty gritty of treating fibro holistically. 

For those not in the know, fibromyalgia is now understood to include a broad symptom set that includes generalized pain, which can affect the whole body but usually most greatly impacts the muscles and joints, as well as chronic headaches, very low energy and fatigue, brain fog, oversensitivity to noise and/ or touch, and digestive and sleep disturbances. It also frequently includes depression but I think it would be safe to say that anyone living with these health conditions chronically would become depressed, so unless the depression precedes the physical symptoms, it’s difficult to discern clearly if it’s is a component of, or reaction to, the condition. 

Similarly, there are other conditions that need to be investigated for their role in the fibro picture. Many of them often coalesce in this disorder, but understanding each and the order in which they developed helps a good practitioner find the roots of the imbalance. They include sleep disorders, food intolerances, environmental toxins, rheumatism, chronic Lyme disease, addictions (even to pain meds or caffeine), gluten intolerance and advanced digestive disturbances like leaky gut, parasites, and SIBO, thyroid dysfunction, brain trauma, and emotional trauma or PTSD. A holistic protocol for fibromyalgia should also include investigating hormone imbalances, as this disease is more prevalent in females - indicating a hormonal component to the pathology. Each of these should be explored for their potential role systematically. Then, and only then, will you get a clearer picture of what needs correction to create a treatment roadmap.

A few key things to look at with diet are antinutrients, which include lectins, phytates, saponins, and oxalates. These tend to show up as issues in people who have tried “healthy plant based diets” and gotten no improvement. They act as triggers to pain and inflammation and block the natural healing program your body runs. You can read more in Gunrdy’s “The Plant Paradox.” I also suspect you have hidden food intolerances. So unless you uncover these issues, it will be very hard to know which diet is best for you. 

You will need direction to address any digestive and gut biome issues. Diets for such conditions should focus on eliminating potential triggers and consuming the most easily digested, nutrient dense foods you can get. As such, bone broth is an important part of this protocol and you can start that right now at home. So, too, are digestive enzymes, but the formula depends on your digestive profile. For now, polysaccharides should be avoided until the gut biome is bolstered and any insulin dysfunction is addressed.

These are the starting points I would suggest for treating fibromyalgia holistically. 

Although you have not found effective treatment to date, Gladys, I urge you to continue to seek help. I firmly believe healing exists for all health conditions, if we only understand our bodies and the medicines of the earth well enough! Look for others to share your health journey because it can be isolating to venture into the unknown alone, and don’t give up!

As always, if you have your own health questions, don’t hesitate to send me an email.
Nonie Nutritionista

Nonie De Long is a registered orthomolecular nutritionist with a clinic in Bradford West Gwillimbury, where she offers holistic, integrative health care for physical and mental health issues. Check out her website here.

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