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Letters From Our Readers – Q&A Session 02-06-08

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Overlapping Conditions & Treatments?

Q: I have Fibromyalgia but also osteoarthritis, bursitis, neuropathy [not from diabetes] and carpal tunnel. Some days, it’s obvious that my aching hip hurts from the bursitis just as it’s sometimes clear that my knee pain is the arthritis. But some days, I ache all over or have pains in places that leave me baffled and wondering which disease process is acting up today. I’m wondering if you can address the comorbidity of Fibromyalgia and other syndromes/diseases that cause similar symptoms, and how to sort through the many symptoms that sometimes occur together. And what about overlapping treatments? – Charlotte

A: It can be difficult to distinguish the different symptoms of multiple overlapping conditions. Martin L. Pall, PhD, has developed an exciting new theory that may help explain why so many people with Fibromyalgia also have a number of other overlapping conditions. He suggests that the nitric oxide/peroxynitrite (NO/ONOO-) cycle may be responsible for FM, ME/CFS and other syndromes. You can learn more about his theory by reading: “Nitric Oxide Cycle Theory: Will It Explain CFS, FM, and Other ‘Unexplained’ Illnesses?”

The current approach to treating many of these conditions is to treat the symptoms, but few treatments actually address the underlying cause – often because the cause remains unknown.

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FM or Psoriatic Arthropy?

Q: Could you please explain to me, and maybe others, the actual difference between FM and psoriatic arthropy?

A: Psoriatic arthropy (PA) is basically a combination of the skin disease psoriasis and the joint inflammation disease arthritis. In most cases of PA the psoriasis occurs first and is followed by the joint disease. Fibromyalgia is a central nervous system disorder that causes abnormal pain processing and results in hypersensitivity to pain.

Although the pain of FM can be felt in any part of the body, most patients report much of their pain feels like it is in their muscles, tendons and ligaments. Unlike arthritis, there is no inflammation with FM. Except for the pain, there is little similarity between PA and FM.

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Gout or FM? Gout Symptoms & Tips

Q: My right hand swelled up the size of a boxing glove, and it was very painful. I went to see a doctor and she said she thought it was gout. I took all the tests for gout and they were all negative. After a prescription and some heat, the swelling went down and the pain went away. Several weeks later, my upper right arm had a lump the size of a softball and it was painful. I went back to the doctor’s and again she felt it was gout. She even brought in another doctor and she said she felt it was gout. The swelling did go down and the pain went away.

Now I wake up with my right hand and arm stiff, painful and swollen. The only thing I can do is put them under very hot water and the pain and swelling go down. If the tests I took were negative for gout, could this be part of my FM? When I wake up in the morning, my hands are stiff (the right one is still swollen and painful as well). What I don’t understand is, my left hand is in an open position and I am not able to close it. My right hand, I can close it but I can’t open it. Could this be related to FM? – Anon

A: Most likely your pain and swollen joints are related to gout that your doctor diagnosed. Although your laboratory tests did not show any findings that are indicative of gout, this condition is often diagnosed through clinical symptoms alone. Gout is an inflammatory arthritis that is characterized by swollen joints due to an increase of uric acid accumulation in the body. This build-up of uric acid can often occur with an excessive intake of food and/or alcohol, after surgery,or during physical or emotional stress.

Typical symptoms of gout include the following:


  • Pain and swelling in a single joint, with the big toe being the most often affected, although other joints can be affected.

  • Joint is purple-red, hot, inflamed.

  • Pain occurs abruptly with symptoms lasting a few days to weeks and can re-occur spontaneously.

  • Lumps can be found (called tophi) under the skin in recurrent attacks and are often found in the arm, hands, feet, elbow or knee.

Lifestyle and dietary changes can often assist in decreasing or eliminating the recurrence of gout. Here are some tips to ensure that you do not have recurrent attacks:


  • Maintain a healthy weight through balanced nutrition.

  • Drink plenty of water each day to help the kidneys flush out excess uric acid. Goal is 64 ounces per day.

  • Eat a diet that is relatively free from foods containing purines, which can increase the amount of uric acid accumulation. High purine foods include: beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, and yeast. Foods with a moderate amount of purines include meats, poultry, fish, and shellfish not listed above. Spinach, asparagus, beans, lentils, mushrooms, and dried peas also contain moderate amounts of purines.

  • Quercetin is an anti-oxidant that can help to decrease the amount of uric acid in your body. It is typically taken with Bromelain, an anti-inflammatory enzyme. They can both be taken at dosages between 200-300 mg/day.

  • EPA from fish oils are anti-inflammatory and can help to reduce the inflammation that is caused by gout. Dosages of 1500 mg per day are useful.

Although your symptoms are not typical of Fibromyalgia, there is not a definitive answer to your questions of whether they are related to the FM. The condition that you described sounds like it is an inflammatory condition that is related to gout or arthritis. If your symptoms persist with no relief from dietary changes or supplements, you may want to consult another physician for further testing.

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Info About FibroSleepTM?

Q: Does anyone know about [the product] FibroSleep that is on this website? I was curious about it and how it works. – Sue

A: If you will go to the product page for FibroSleep, below the picture of the product, you will see three tabs. The “Description” tab gives you detailed information about each of the four ways FibroSleep works. The “Label Info” tab gives you the list of ingredients in FibroSleep and recommended dosage instructions. Under the “Reviews” tab you’ll find quotes from other customers who have used FibroSleep. This same type of information is available for each product in our online store.

You might also try doing a search for FibroSleep on the message boards to get a full range of views and comments. And, finally, you can call our toll-free customer service number (800-366-6056) and ask the customer service representatives for their insights based on daily conversations with customers and frequency of reorders.

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Dopamine Depletion and FM/

Q: I would like you to address dopamine depletion as a cause and effect of Fibromyalgia. – Sandy

A: Patrick Wood, MD, and Andrew Holman, MD, have been researching this subject for several years. According to their theory, FM is a brain dysfunction caused by stress-induced changes to the part of the brain called the hippocampus, which regulates the neurotransmitter dopamine. You can read more about this promising new theory in “Critical New Piece of Fibromyalgia Puzzle Found?”

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Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat, or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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