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Fibromyalgia
and
Female Hormonal Imbalance
If
all of the signs and symptoms of fibromyalgia aren't
enough of a physical challenge, many females (remember
that approximately 90% of those affected are female)
have the added burden of having severe premenstrual
syndrome (PMS) symptoms.
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The
physical symptoms of PMS include:
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abdominal
bloating
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backache
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breast
tenderness
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constipation
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diarrhea
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dizziness
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fatigue
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headache
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nausea
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swelling
of hands/feet.
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There
are emotional symptoms which include:
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anger
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anxiety/depression
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irritability
and nervousness
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These
physical and emotional symptoms can then produce
behavioral symptoms such as:
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clumsiness
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appetite
changes, either increased or decreased
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changes
in libido (sexual desire)
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forgetfulness
and difficulty concentrating
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sleep
disturbances
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tearfulness
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a
desire to be alone.
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The
symptoms of PMS typically occur from 5 to 11 days prior
to the onset of the menstrual period. Many of these same
females have dysmenorrhea which is the name used when
menses is accompanied by severe debilitating pain. It is
felt that many of the symptoms of PMS and much of the
excessive menstrual pain is caused by female hormonal
imbalance involving estrogen and progesterone. Achieving
hormonal balance by the use of natural products is the
goal of many with PMS and dysmenorrhea. There is also a
recognized role for supplementation with calcium,
magnesium, manganese and vitamins E and B-6.
Fibromyalgia
- Irritable Bowel Syndrome
Irritable
bowel syndrome (IBS) is one of the most distressing
symptoms of fibromyalgia. What can be so frustrating to
a person with IBS is that just as in fibromyalgia, the
medical evaluation results in a "good news,
everything is normal" comment after a medical
evaluation because there is no structural, biochemical
or infectious cause uncovered. Yet again, just as in
fibromyalgia, the person with IBS knows that even though
the studies may be normal, their symptoms are very
abnormal. These symptoms include abdominal pain and
altered bowel habits, including diarrhea, constipation
or alternating diarrhea and constipation. In addition,
there may be symptoms referable to the upper
gastrointestinal tract such as non-cardiac chest pain,
heartburn, dysphagia (difficulty in swallowing) and a
feeling of fullness in the throat. One person with
fibromyalgia and IBS has called it "the cry of the
wild gut!"
Fibromyalgia - Leaky Gut Syndrome
Complicating
the picture for those with fibromyalgia, there
is a strong correlation between fibromyalgia,
IBS and "leaky gut syndrome" (LGS).
LGS, in fact, may well be the major contributory
factor in many of the symptoms of fibromyalgia.
Here is what happens in LGS. The lining of the
intestinal tract is called the intestinal
mucosa. The mucosa is responsible for allowing
essential nutrients to be absorbed across it
into our bodies and also is the barrier which
keeps harmful microorganisms, toxins and
by-products from digestion from being absorbed.
In LGS, there is increased permeability of the
mucosa due to damage to something called "desmosomes"
which can be thought of as the "glue"
that holds the mucosal cells together. This
allows larger sized particles that are normally
not absorbed to find a passage open to them and
to pass through the mucosa and to enter the
bodily circulation. This can set up a cascade of
events that can cause many of the symptoms
present in fibromyalgia. Here are the symptoms
known to occur in the person who is known to
have increased intestinal permeability:
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1.
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fatigue
and malaise |
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2.
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arthralgias
(joint pain) |
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3.
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myalgias
(muscle pain) |
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4.
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fevers
of unknown origin |
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5.
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food
intolerances |
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6.
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abdominal
pain |
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7.
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abdominal
distension |
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8.
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diarrhea |
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9.
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skin
rashes |
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10.
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toxic
feelings |
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11.
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cognitive
and memory deficits ("fibrofog") |
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12.
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shortness
of breath |
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13.
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poor
exercise tolerance |
Certainly many of these symptoms are similar
to those of fibromyalgia. The
genesis of these symptoms is due to two
processes that occur secondary to an increased
mucosal permeability. The first is an immune
system response. Our immune system recognizes
presence of the invading large particles that
are absorbed as "non-self". The immune
system responds by attacking them by direct
contact and also by producing antibodies. Since
some of these large particles have the same
appearance as our own tissues, this immune
response can result in attacks on our
"self" through mis-recognition causing
an auto-immune reaction and condition. The
second way that increased permeability adversely
affects the body is by the stress that the
abnormally absorbed particles place on the
liver. The liver is responsible for removing
these macro (large) molecules and also to
oxidize toxins that enter in the LGS setting
because all these substances as well as normally
absorbed nutrients are first carried to the
liver via the portal vein. This can result in
placing an overload on the liver's capacity of
detoxification and removal of harmful particles,
further accentuating the symptoms produced by
increased permeability, by causing hepatocyte
(liver) cell damage, excess free radical
production and increased strain on an already
dysfunctional immune system.
A paradox in LGS is that not
only are harmful particles allowed though the
incompetent intestinal mucosa but essential
nutrients are not absorbed adequately. How
can this seeming inconsistency occur? Here is
what happens and why. Nutrient absorption is
achieved by transportation though the intestinal
mucosal cells and depends on the integrity of
these cells being maintained. However,
disruption of mucosal cells results in
disruption of the effectiveness of certain
carrier proteins that transport minerals such as
magnesium and zinc. Therefore, a total body
magnesium deficit is often seen in fibromyalgia
even in those who are using supplementation of
this essential mineral due to the fact that it
is present in the intestinal lumen but can't be
absorbed across the mucosal cell. The same can
be true for zinc. The end result in LGS is a
vicious cycle of harmful particles being
inappropriately absorbed by going around the
mucosal cells and essential nutrients not being
absorbed because they can't get through.
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