Fibromyalgia
Dr. Weyrich's Naturopathic Functional Medicine Notebook
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Etiology
The cause of fibromyalgia is unknown, but mitochondrial dysfunction appears to be the most credible. Note that Dr. Weyrich has argued that mitochondrial dysfunction may be secondary to overgrowth with yeasts and fungi, and [Shaw2008] has pointed out that elevated urinary levels of tartaric acid and other markers of overgrowth with yeasts and fungi are associated with fibromyalgia.Diagnosis
- Organic Acid Test (elevated markers for gut dysbiosis).
- Basal Body Temperature (depressed if hypothyroid or mitochondrial dysfunction)
- Heavy metal urinalysis with provocation (possible cause of mitochondrial dysfunction).
Differential Diagnosis
- Vitamin B12 deficiency [stuart2006].
Treatment
- Treat dysbiosis if present.
- Supplement with malic acid if Organic Acid Test shows that urine tartaric acid is elevated [Russell1995].
- Supplement with magnesium (why?) [Shaw2008].
Pathophysiology
Elevated levels of tartaric acid (3-hydroxymalic acid or 2,3-hydroxy-succinic acid) are associated with fibromyalgia. Tartaric acid is an analog of the Krebs cycle intermediate malic acid that inhibits the Krebs cycle enzyme fumarase that converts fumaric acid to malic acid [Shaw2008] [Russell1995].ICD-9 Codes
| ICD9-Code | Description | Comments |
|---|---|---|
References
Unless specifically noted above, references used in the construction of this web page include the following:[FDM] Lecture notes from Functional Medicine University.
[SCNM] Lecture notes from Southwest College of Naturopathic Medicine.
[UT] Lecture notes from the University of Tennessee graduate programs in Chemistry and Biochemistry.
[Shaw2008] Shaw W. Biological Treatments for Autism & PDD, Third Edition. (2008).
[Rachlin1994] Rachlin ES. Myoffacial Pain and Fibromyalgia. St. Louis: Mosby (1994). Cited by [Starr2005].
[Russell1995] Russell IJ, Michalek JE, Flechas JD, Abraham GE. Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol. 1995 May;22(5):953-8.
[Sonkin1997] Sonkin L. Therapeutic trials with thyroid hormones in chemically normal thyroid patients with myofascial pain and complaints suggesting mild thyroid insufficiency. Journal of Back and Musculoskeletoan Rehabilitation 8(83):85 (1997). [Cited by Starr2005].
[Starr2005] Mark Starr. Hypothyroidism Type 2: The Epidemic. Columbia, MO: Mark Starr Trust (2005).
[Stuart2006] J.J. Stuart & S.M. Pacholok. Could it be B12? An Epidemic of Misdiagnoses. Sanger, CA: Quill Driver Books/Word Dancer Press (2006).
Copyright © 2007-2010 Dr. Weyrich (Naturopathic Medical license number 07-1008). The information on this site is for educational purposes only. It is not intended to diagnose, treat or cure any disease or illness. The statements on this website have not been evaluated by the Food and Drug Administration.
This web page is http://www.DrWeyrich.com/disorders/fibromyalgia.html - Phone Dr. Weyrich at (480) 423-6952