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A Healthy You

Fibromyalgia, Chronic Pain, Chronic Migraines

Chronic Pain

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Chronic pain is a pervasive issue and fibromyalgia is a very common form. It is a chronic condition whose symptoms include muscle and tissue pain, fatigue, depression, and sleep disturbances.

Recent data suggests that central sensitization, in which neurons in your spinal cord become sensitized by inflammation or cell damage, may be involved in the way fibromyalgia sufferers process pain.

Certain chemicals in the foods you eat may trigger the release of neurotransmitters that heighten this sensitivity.

Although there have been only a handful of studies on diet and fibromyalgia, the following eating rules can’t hurt, and may help, when dealing with chronic pain.

Limit Sugar as Much as Possible. Increased insulin levels will typically dramatically worsen pain. So you will want to limit all sugars and this would typically include fresh fruit juices. Whole fresh fruit is the preferred method for consuming fruit products.

If you are overweight, have high blood pressure, high cholesterol or diabetes, you will also want to limit grains as much as possible as they are metabolized very similarly to sugars. This would also include organic unprocessed grains. Wheat and gluten grains are the top ones to avoid.

Eat fresh foods. Eating a diet of fresh foods, devoid of preservatives and additives, may ease symptoms triggered by coexisting conditions such as irritable bowel syndrome (IBS).

It’s also a good idea to buy organic food when possible, as it’s best to avoid pesticides and chemicals. However, fresh is best. So if you have to choose between local, fresh, non-organic and organic but wilting – go with fresh, and clean properly.

Avoid caffeine. Fibromyalgia is believed to be linked to an imbalance of brain chemicals that control mood, and it is often linked with inadequate sleep and fatigue. The temptation is to artificially and temporarily eliminate feelings of fatigue with stimulants like caffeine, but this approach does more harm than good in the long run. Though caffeine provides an initial boost of energy, it is no substitute for sleep, and is likely to keep you awake.

Try avoiding nightshade vegetables. Nightshade vegetables like tomatoes, potatoes, and eggplant may trigger arthritis and pain conditions in some people.

Be Careful with Your Fats. Animal based omega-3 fats like DHA and EPA have been touted as a heart-healthy food, and they may help with pain, as well. They can help reduce inflammation and improve brain function. At the same time, you want to eliminate all trans fat and fried foods, as these will promote inflammation.

Use yeast sparingly. Consuming yeast may also contribute to the growth of yeast fungus, which can contribute to pain.

Avoid pasteurized dairy. Many fibromyalgia sufferers have trouble digesting milk and dairy products. However, many find that raw dairy products, especially from grass fed organic sources, are well tolerated.

Cut down on carbs. About 90 percent of fibromyalgia patients have low adrenal functioning, which affects metabolism of carbohydrates and may lead to hypoglycemia.

Avoid aspartame. The artificial sweetener found in some diet sodas and many sugar-free sweets is part of a chemical group called excitotoxins, which activate neurons that can increase your sensitivity to pain.

Avoid additives. Food additives such as monosodium glutamate (MSG) often cause trouble for pain patients. MSG is an excitatory neurotransmitter that may stimulate pain receptors; glutamate levels in spinal fluid have been shown to correlate with pain levels in fibromyalgia patients.

Stay away from junk food. Limit or eliminate fast food, candy, and vending-machine products. In addition to contributing to weight gain and the development of unhealthy eating habits, these diet-wreckers may also irritate your muscles, disrupt your sleep, and compromise your immune system.

Things That Help Fibromyalgia Pain

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Eliminate odors or fragrances. Beware of the invisible trigger lingering in the air. Odors and fragrances have been known to irritate fibro sufferers. I’ve found it especially beneficial by simply changing my laundry detergent to be fragrance-free. Several years ago I stopped wearing perfumes and scented-lotions. Why? Because it causes headaches and increases my allergies. The difference is amazing.

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Drink tea. Once a day or at the sign of allergy-symptoms, I will take a moment to enjoy a cup of tea. Caffeine-free is usually best but do whatever works for you. I have found chamomile and peppermint tea to be especially helpful.

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Take supplements. Our immune system goes on a roller coaster. Supplementing vitamins and nutrients will help your body to build a better wall of defense. Again, find what works for you or get some recommendations from your doctor. I also suffer from endometriosis, so I take vitamin E, echinacea, and acidophilus. A lot of people with fibro may benefit from taking B-complex vitamins to calm the overstimulated nerves.

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Attempt exercise and yoga. It’s a known fact that fibromyalgia sufferers have a lot of muscle stiffness and tenderness. Did you know that exercise can actually help relieve that? If you haven’t been working out, I’d suggest doing a couple laps around your neighborhood. Nothing more than a mile, and work your way up each week. Try some basic yoga moves to stretch out those sore body parts. Start with five minutes and work your way up.

A man in a restorative yoga posture

Be calm and meditate. Stressors throughout the day can take a toll on your body. Meditation is extremely helpful in clearing your mind and hitting the “refresh button” on your overstimulated brain. If you have a hard time sitting up on your own, you can prop your back against a wall or piece of furniture. Inhale slowly through your nose to a count of three, and exhale through your mouth. Then repeat.

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Change your diet. Again, there are a lot of unknown triggers in food. Often times you can cut out certain foods from your diet in order to decrease frustrating symptoms. Consider cutting gluten, soy, and dairy from your diet. But remember, this is a science experiment, and you’ll need a couple weeks to determine what works and what doesn’t.

'I limit myself to one glass of wine a day.'

Decrease or eliminate tobacco and alcohol. Bummer, I know. The honest truth is that your body will feel much better by eliminating or reducing extra unnecessary toxins.
Keep it dark and quiet. I am thankful for my job for many reasons, but one of them is that I work from home. Every day I sit in a dark room with dim lighting and a comfortable chair. It helps me to stay well and reduce flares.

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It’s not good to sleep on the couch. Go to your bed.

Get sleep. Easier said than done, right? Let’s keep this basic, though. Try getting your body into a routine of waking up and going to bed at a reasonable time. Take naps as much as you can. Listen to your body – you will know if your body needs more rest.
Taking care of YOU is not only important for your health, but for your loved ones too. You will be a better version of yourself if you make some positive and healthy changes!

Salt Deficiency Trigger Migraines

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Author: Angela A Stanton, PhD

I had migraines for well over 20 years. I am not alone; about 12% of the US population has migraines. Initially, I thought I had headaches but my “headaches” were accompanied by symptoms that are not normally part of headaches: anxiety, IBS, RLS, nausea, sensitivity to darkness, light, smells, and everything seemed irritating. I learned later that these symptoms are part of prodome; a sort of early warning that a migraine is coming.
I have a PhD in NeuroEconomics. My work had less to do with the economics side of this degree and more to do with the neuroscience. As I was working through my PhD, I had migraines, but with the demands of school, two kids and a husband, I neither had the time nor the understanding to attempt a scientific study for finding the cause of migraines. I did what everyone else with migraines does: I took pain killers. When the pain killers didn’t work, I took triptans (serotonin medications). When those medications didn’t work, I went to the emergency room (ER) to get an IV with electrolytes and injections of heavy narcotic medications.

Eventually, nothing worked and I had to find something to help with my migraines. I applied the knowledge I gained from my education to find a cause for my migraines. What I learned was that the cause was right in front of me all along. Migraines could be triggered by dehydration and sodium or salt deficits. Although this is not a theory that has been tested yet, consider the first treatment a migraineur receives in the ER – IV fluids with electrolytes. This is an important clue that in hindsight should have tipped me off. Let me explain.

Neuron Activity and Migraines

In order to understand the connection of electrolytes to migraines, looking at an individual brain cell (neuron) is critical. The image and the function of cells is in every biology 101 book. I realized though, that the basic necessity of the neuron’s survival itself had not been examined by scientists in the context of migraines. Most migraine research begins with the pain of migraine. Scientists often consider that pain to be the cause, so they look for pain relief as their solution. But pain is a symptom rather than the cause. In fact, migraine itself is a symptom of something out of balance in the brain. The real cause is a biochemical imbalance in and around the neurons. Amazingly, ER nurses who use IV electrolyte treatments for migraine have been trained to do the right thing without realizing the importance of what they were doing. Why exactly do nurses start migraine treatment with electrolytes? I asked one nurse and she said: “you are dehydrated.” Interesting, I thought, since I drink plenty of water. How can I be dehydrated?

What is Hydration?

Being hydrated and drinking water are only partially connected. “Hydrate, a term used to indicate that a substance contains water” implies that water is only part of hydration. Electrolytes that I received for my migraines were not just water but brine containing many essential micro nutrients, minerals, and, most importantly, salt. If you look at a cell, it has a membrane that separates it from the external environment with bumps and pores on it. Anything that wants to go into the cell or come out of it must do so on the demand of the cell or by osmosis via channels. This indicates that drinking only water can dehydrate since it can enter the cells via osmotic channels through the membrane but larger elements cannot. However, there are many elements inside the cell, such as sodium (Na+) and potassium (K+) among other things. Via osmosis, K+ may leave the cell if the K+ concentration outside of the cells is smaller than on the inside, thereby dehydrating the cells but NA+ is too large to leave or to enter. This can lead to a very dangerous health condition called water toxicity in which all nutrients leak through the osmotic gradient leaving too much water behind.

Salt Deficiency, Hydration and the Neuron

NaCl (salt) breaks up into ions and separate based on polarity in the body. Na+ (sodium) is inside the cells and its job is to attract and hold onto water, thereby hydrate. The job of Cl- is to maintain optimal hydration fluid levels outside of the cell. Note that Na is positively charged (+) and Cl is negatively charged (–) and these polarity differences result in voltage differences. Cells without proper quantity of Na+ and Cl- are not capable of voltage generation of the right magnitude. One of the functions of this specific voltage magnitude is the enabling of the sodium-potassium pumps that are located on the membrane of the neuron. Without proper voltage for the pumps, they may not be able to open to the outside or to the inside of the neuron. When a cell cannot open to the outside or to the inside, no exchange of nutrition can take place. Cells without sodium cannot retain water and remain dehydrated. Could malfunctioning pumps, brought on by low salt concentrations, be one of the triggers of migraine?

Sodium Potassium Pump

Low Salt Initiates a Cascade of Problems

We have several other issues without the proper electrolyte fluids inside the cells. Electrolytes carry magnesium, for example. Magnesium is used by the cells like a key to open the pumps. If there is no magnesium inside the cells, even if there is plenty of water and salt, the pumps cannot open. Phosphates provide the energy for the magnesium to open the pumps and so phosphates are also needed inside the cell. There are high voltage calcium channels in neuron membranes as well. Without high voltage, the calcium channels cannot work. Thus, even if there is enough voltage to hydrate the neuron and to create neurotransmitters, they are stuck without functioning high voltage calcium channels. Lack of calcium is not a serious problem since our bones are calcium storage sites from which calcium can always be drawn. Of course, osteoporosis is the outcome of low calcium availability to the cells. The brain also often swells in response to neural biochemical imbalance. The swelling itself has a variety of explanations, but not yet a coherent scientifically proven reason.

Migraines and Dehydration Triggers

Let me connect dehydration, lack of voltage, lack of sodium-potassium pump functioning, osmotic leakage, calcium channels, and migraines all together into one picture so you can see the connection.

Neurons without electrolytes in their environment cannot function. They are idle, dying, or dead—this is defined by new research just published in the Journal of Neuroscience as “brain depression”. Neurons are connected to communicate with each other. When neurons in a region don’t function, neighboring neurons try to awaken them—this is referred to as the spreading of electricity in the parts of the brain that are not in depression in the same scientific article. This is seen as aura in those with migraines in the occipital lobe of the brain. For migraines in other regions, the healthy neurons signal pain sensing nerves located in the meninges, a tissue separating the brain from the skull (there is no pain sensing nerve inside the brain). Migraine is pain signaled by pain-sensor neurons in the meninges and so the location of where we feel pain is not necessarily connected to the location that causes pain. If migraines occur seldom, they are not concern for alarm. If migraines are frequent, over 15 a month for several months, they are considered to be chronic. Chronic migraines may change the shape and function of the brain as well as make it more prone to strokes.

Salt Deficient Migraines

Currently, there are no published studies linking low salt to migraine onset and to my knowledge, there are no studies underway to investigate the effect of salt deficient diets on migraine. The evidence I have supporting this hypothesis first evolved by connecting the common clinical practice of IV electrolytes for migraineurs to the physiology of sodium-potassium pumps on the neurons. Next, I tested it on myself. It worked. Subsequently, others who have applied electrolyte hydration protocol have found that they can prevent or treat their migraines without medicines. After 20 years of migraines, I have been migraine free for four years now as a result of proper and regulated hydration, assisted by apps on my smart phone.

There is nothing like migraine free and medicine free life. While this may not be the only cause of migraines, it is physiologically likely that salt deficiency and dehydration can initiate a migraine. Together, with the theory and applied evidence by the many who use the hydration protocol, it is my belief that salt deficiency and dehydration ought to be considered as a possible cause and the hydration protocol be applied as the first line of treatment for migraine pain instead of medicines. Clinical trials with salt and hydration versus placebo may be an option albeit giving placebo to a person with migraine may not pass ethical committees’ scrutiny for experimenting.

About the author. Dr. Stanton received her BSc at UCLA in mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford, PhD in NeuroEconomics at Claremont Graduate University, and fMRI certification at Harvard University. Follow her on Twitter at: @MigraineBook.

Additional References

Altered Hypothalamic Functional Connectivity with Autonomic Circuits and the Locus Coeruleus in Migraine, Eric A. Moulton et al. PLOSOne; April 17, 2014
MRI shows brain abnormalities in migraine patients, March 26, 2013, Radiological Society of North America
The Cerebellum and Migraine, Maurice Vincent, MD, PhD and Nouchine Hadjikhani, MD,
Headache. Jun 2007; 47(6): 820-833.doi: 10.1111/j.1526-4610.2006.00715.x
Parenchymal spin-lock fMRI signals associated with cortical spreading depression
Joonas A Autio et al., Journal of Cerebral Blood Flow & Metabolism 34, 768-775 (May 2014) | doi:10.1038/jcbfm.2014.16

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