Cordero, M.D. et al., "Coenzyme Q10 Distribution in Blood is Altered in Patients with Fibromyalgia"

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Last Updated: 08 November 2015 08 November 2015

Cordero, M.D. et al., "Coenzyme Q10 Distribution in Blood is Altered in Patients with Fibromyalgia," Clin Biochem 42, Nos. 7-8 (2009): 732-735. 

Objective. Coenzyme Q-10 (CoQ (10)) is an essential electron carrier in the mitochondrial respiratory chain and a strong antioxidant. Signs and symptoms associated with muscular alteration and mitochondrial dysfunction, including oxidative stress, have been observed in patients with fibromyalgia (FM). The aim was to study CoQ (10) levels in plasma and mononuclear cells, and oxidative stress in FM patients.

Methods. We studied CoQ (10) level by HPLC in plasma and peripheral mononuclear cells obtained from patients with FM and healthy control subjects. Oxidative stress markers were analyzed in both plasma and mononuclear cells from FM patients.

Results. Higher level of oxidative stress markers in plasma was observed in FM patients in respect to control subjects. CoQ (10) level in plasma samples from FM patients was doubled compared to healthy controls, and in blood mononuclear cells isolated from 37 FM patients was found to be about 40% lower. Higher levels of reactive oxygen species (ROS) production was observed in mononuclear cells from FM patients compared to controls, and a significant decrease was induced by the presence of CoQ (10). [N.B. ROS are produced when cells are under oxidative stress. They damage cells.]

Conclusion. The distribution of CoQ (10) in blood components was altered in FM patients. Also, our results confirm the oxidative stress background of this disease probably due to a defect on the distribution and metabolism of CoQ (10) in cells and tissues. The protection caused in mononuclear cells by CoQ (10) would indicate the benefit of its supplementation in FM patients.

Books about Pain and Pain Management

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Last Updated: 20 November 2015 20 November 2015

The Massachusetts CFIDS/ME & FM Association does not assume any responsibility for the outcome of treatments or other self-care strategies described in any of the listed books, that might be undertaken by readers and we recommend individuals always consult with their healthcare providers before trying any new treatment, supplement, or healthcare product.

 Pain Free 1-2-3: A Proven Program for Eliminating Chronic Pain Now, by Jacob Teitelbaum, MD, 2005, ISBN: 0071464573.   

Pain Free 1-2-3 is another informative and engaging book to come from Dr. Jacob Teitelbaum, author of the well-known guide for ME/CFS and Fibromyalgia (FM), From Fatigued to Fantastic (now in its 3rd edition). The target audience for this particular book consists of individuals with FM, myofascial pain or chronic pain. Though Dr. Teitelbaum touched on the importance of decreasing or eliminating pain when someone has ME/CFS and/or FM in all the editions of his first book, this book allows him to expand on this topic and it nicely complements the first series. 

Dr. Teitelbaum starts out by explaining what sorts of things can help to promote healing and repair tissues as well as what sort of things may put stress on one’s body and cause pain. The treatment strategy formulated by Dr. Teitelbaum (which he claims can eliminate chronic pain) includes recommendations such as: striving to get the best possible nutrition and quality sleep, correcting one’s hormonal deficiencies, learning how to identify and eliminate pain triggers (including getting treated for any persistent infections since they put a strain on the immune system), and learning about the many types of pain and how to deal with each of these. [N.B. There is no solution to the pain from lactic acid build-up due to mitochondrial dysfunction except time and bed rest. Your body has to break down the lactic acid to dispel the pain.—Ed.]

The second half of the book summarizes numerous treatment options, including herbal /natural remedies and alternative therapies, prescription therapies, and/or a combination of both approaches. He also states the best order in which to try these and how they will be most beneficial. (It is understood that treatments should be pursued while under the care of one’s doctor.)       

Though this book offers a lot of practical information, the way it is marketed (i.e., the flashy titles, making things sound so easy to do, or making rather incredible claims) is a negative and may actually discourage interest in this book. It is not clear why Dr. Teitelbaum has chosen this type of delivery style considering his extensive knowledge about ME/CFS and FM and chronic pain as the medical director of the Center for Effective CFS/Fibromyalgia Therapies in Maryland. On the positive side, if readers can get past the packaging, they will appreciate the value of the information in this book and will sense the author’s optimism and desire to enlighten readers.

Trigger Point Therapy for Low Back Pain: A Self-treatment Workbook (New Harbinger Self-Help Workbook), by Sharon Sauer, CMTPT, LMT and Mary Biancalana, MS, CMTPT, LMT, 2009, ISBN: 1572245638.   

As the title implies, this book is intended for individuals who suffer from low back pain and who would like to learn more about what is causing their pain and find out what they could do to alleviate some of the pain. The type of pain discussed in this book is muscle pain, more specifically, pain coming from the tightening of the myofascia—the thin, fibrous tissue that encloses layers of muscles and supports the musculature of the body. Changes within this tissue present as “trigger points” which are painful knots that develop in the muscle fiber and cause constriction of nerves and blood vessels and this in turn, causes pain and referred pain.

Myofascial trigger point therapy is a type of bodywork done by medical practitioners and/or trained therapists using manual and physical techniques to find (through palpation) and reduce these knots and myofascial constriction, but considerable relief can be also achieved at home though various self-applied methods. Therefore, this book contains what two knowledgeable therapists in this field and members of the International Myopain Society, Sharon Sauer and Mary Biancalana, want to share with readers.

The authors write from personal and professional experience and are very careful and sensible in how they communicate with readers. Their first recommendation is that anyone with low back pain be thoroughly evaluated by a primary care physician and/or specialist for all possible causes. Patients are also urged to get their doctors’ approval before participating in any of the home exercises and/or seeking therapy from licensed practitioners using this discipline.

This is a very user-friendly book, which is not overly long (as it concentrates only on muscle groups involved in lower back muscle pain), and in which the information is conveniently broken down into 17 small chapters. Once the basics are covered, a chapter is devoted to each of the ten specific muscle groups associated with low back and/or buttock pain, as well as trigger points that are activated and causing pain.

Symptoms and patterns of muscle pain/referred pain for each group are well explained and in many cases, accompanied by illustrations and diagrams. One chapter, in particular, seems very helpful because it provides a reference chart listing general problems and the muscle groups associated with these, including a notation as to which chapter discusses this particular muscle group.

Treatment recommendations, within each chapter for each muscle group, consist mainly of helpful stretches, ways to apply pressure against painful areas and promote release of knots, range of motion exercises with easy to follow diagrams, and instructions for how to use self-care tools and other therapies (i.e., backnobber, therapy balls, pillows, use of heat, etc.).

This book is effective in enlightening readers about myofascial pain and trigger point therapy. As mentioned before, content is limited to the lower back muscle groups.  It is important to note this book solely concentrates on trigger point therapy and this type of pain and it does not include any information on fibromyalgia in particular. We do not think this is a problem because the at-home techniques and tips could be beneficial and this type of intervention has been included in recent fibromyalgia publications.

 Sciatica Solutions: Diagnosis, Treatment, and Cure of Spinal and Piriformis Problems, by Loren Fishman, MD and Carol Ardman, 2006, ISBN: 0393330419.

Dr. Loren Fishman, a specialist in rehabilitation medicine, researcher and professor at Columbia College of Physicians and Surgeons, and his wife, Carol Ardman, a freelance writer and editor, wrote this book because of the misunderstanding that surrounds sciatica and associated problems. This is a genuine problem noticed by Dr. Fishman himself, who has over thirty years of clinical experience. Therefore, they wanted to provide a book which clarifies this type of pain, explains how to better recognize it, reviews the kind of tests or care one might consider getting for it, and explains the wide range of treatment options, both conventional and alternative.

This is not a book about general back pain, which is often muscular in nature, but one that focuses on sciatica—a pain, neurological in origin, that typically runs along the sciatic nerve and causes distinct set of symptoms and pain patterns in the buttocks and the legs (i.e., numbness, “electric shocks”, and other peculiar sensations).

The book is divided into two parts. In the first part, Dr. Fishman goes over the multiple causes of sciatic-type pain and describes how it feels, but also differentiates it from other conditions which are often mistaken for it.

One chapter reviews basic components and functions of the nervous system (i.e., the interaction of the brain, spinal cord, the nerve fibers and nerve roots). Of particular interest are the illustrations of the spine, nerve root patterns and diagnostic diagrams.

Another chapter is dedicated to the diagnostic and nerve function tests used to diagnose sciatica-related problems or to evaluate nerve damage.

The last chapter in the first part offers an extensive review of the conditions associated with sciatica. Here too, the in-depth explanation of the Piriformis Syndrome—a condition affecting the buttocks when the sciatic nerve becomes entrapped and compressed, was found to be especially informative and unique to this book.

The second part of the book deals with treatment options and many things that patients can do on their own. It is understood that patients will have first sought appropriate medical care and evaluation from their primary care providers or specialists.

Recommendations include such things as strengthening abdominal, torso and core muscles, becoming educated about different exercise/movement techniques, and paying attention to daily routines, posture, and even one’s clothing, handbags and footwear.

Medical treatments, such as physical therapy, medical devices, and various mechanical techniques are reviewed.

An overview is provided on frequently used medications, injections and other invasive treatments, as well as various surgical procedures (including brief descriptions and reasons for these surgeries).

The book concludes with many types of nonmedical alternative techniques and the importance of nutrition and lifestyle changes. Dr. Fishman is a strong proponent of alternative treatments, like yoga, and promoting patient education.

This book is easy to read and comprehend, even though it contains some technical information. The authors have done a good job in how they have explained or illustrated this information. Their writing style is friendly and speaks to the readers.

This book would be especially beneficial for individuals who are just starting out with sciatica, because it provides them with the knowledge they need to make informed decisions. Individuals who might already be receiving medical care for this problem will find parts of this book helpful because it provides a better understanding about the mechanisms driving the pain and offers additional ways to manage it.

XMRV Not Found in Blood Working Group Study

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Last Updated: 24 November 2015 24 November 2015

In a study reported online in Science on Sept. 22, 2011, and presented the following day at the IACFS/ME Conference in Ottawa, Canada by the senior investigator, Dr. Graham Simmons, the XMRV Scientific Research Working Group (SRWG) announced that in a 9-lab study, XMRV/MLV was not reproducibly detected in blood samples.

Blood samples from 15 subjects previously reported to be XMRV/MLV-positive and 15 healthy blood donors previously determined to be XMRV/MLV-negative were distributed among 9 labs in a blinded fashion. These labs performed tests to detect viral nucleic acid, antibody, and viral replication.

Seven labs found no evidence of virus in any samples; two labs did detect virus in some samples, but the results were not replicated between the two labs, and similar viral activity was found in both positive samples and controls.

The authors concluded that present assays (laboratory tests) could not reliably detect XMRV/MLV in blood samples, and therefore routine screening of the blood supply was not warranted.

However, during the question period following his presentation at the Conference, Dr. Simmons confirmed the current recommendation that patients with a diagnosis of CFS or ME not give blood.

Published online 22 September 2011 [DOI:10.1126/science.1213841]. 

Fibromyalgia studies 2012

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Last Updated: 08 November 2015 08 November 2015

This is a recap of studies and relevant articles on Fibromyalgia which were published during 2012 (formerly posted on our News around the Web page).

"Working Memory Impairment in Fibromyalgia Patients Associated with Altered Frontoparietal Memory Network" (PLoS One) A study conducted by Korean researchers using functional magnetic resonance imaging (fMRI) to demonstrate differences in working memory between FM patients and healthy subjects.

“Cardiac autonomic impairment and chronotropic incompetence in fibromyalgia”
(da Cunha Ribeiro et al, Arthritis Research & Therapy 2011, 13:R190 doi:10.1186/ar3519) Research by a team of rheumatologists at University of Sao Paulo School of Medicine, Brazil, that found some patients with FM experienced various cardiac irregularities in response to exercise.

“Autonomic dysfunction in women with fibromyalgia” — an editorial in response to the article published by Ribeiro and colleagues in Arthritis Research & Therapy, supporting the finding of autonomic dysfunction at rest in FM patients.

Research on Fibromyalgia Skin Sensitivities (Fibromyalgia Network) Researchers provide answers about what might be causing itchy or burning sensations and other skin sensitivities frequently experienced in FM.

New Device Cuts Fibromyalgia Pain in Pilot Study (Clinical Psychiatry News Digital Network) Results from a small pilot study of FM patients who were treated with an investigational transcranial stimulation device designed to target a region deep in the brain linked to chronic pain.

Pamuk, O.N. et al., "Increased Frequencies of Hysterectomy and Early Menopause in Fibromyalgia Patients: A Comparative Study"

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Last Updated: 27 February 2009 27 February 2009

Pamuk, O.N. et al., "Increased Frequencies of Hysterectomy and Early Menopause in Fibromyalgia Patients: A Comparative Study," Clin Rheumatol Jan 24 (2009). [Epub ahead of print] PMID: 19169621

Methods and Results. The objective was to determine the relationship between symptoms of fibromyalgia (FM) and early menopause and hysterectomy.

We included 115 postmenopausal patients with FM (mean age 54.6 +/- 7.6) and 67 rheumatoid arthritis (RA) patients (mean age 55.5 +/- 9) into our study. All patients were questioned about the severity of their symptoms of FM, anxiety, and depression by using a visual analog scale and FM impact questionnaire. Patients' history of menopause and hysterectomy were recorded.

Menopause at age less than 45 years was accepted to mean "early". The frequencies of early menopause (38.3% vs. 13.4%, p < 0.001) and hysterectomy (16.5% vs. 6%, p 0.05). FM-related symptoms started in 30 patients (26.1%) with FM with menopause or within the first postmenopausal year. When the clinical features of FM patients whose symptoms started within the first menopausal year were compared to other FM patients; it was observed that the frequency of early menopause was higher in the former group (p < 0.048). The Duke anxiety and depression score was higher in patients with hysterectomy whose FM symptoms started within the first year of post-hysterectomy than other FM patients (9.1 +/- 2.7 vs. 6.7 +/-2.7, p < 0.022).

Conclusion. Early menopause and hysterectomy may be one of the factors contributing to the development of FM.