I agree with Sivagj... I haven't needed to use meds since I went totally (celiac style) gluten free and I don't use sugar that much (except Lindt dark 90% chocolate once in a while which has 2x fat to sugar ratio) and the only dairy I use is predigested, lol, cheese and yogourt (esp Greek for protein). I do take reishi mushroom extract in the morning which helps the mitochondria energy issues in my case, but I never push that on anyone else, everyone is different. The food thing is huge though, I would suggest trying that for at least 6 months and see how you feel, pain & energywise. Use whatever soothes your pain after exercise be it cold packs or heatpacks/warm bath. Self massage works well for me as does guided imagery.

"@ canadjineh, how do you know if mitochondria energy issues, is that a specific disease/disorder?"
@Snowy0wl, I've done a lot of research reading published scientific papers about FM on PubMed and Medscape (legit sites for doctors and other medical professionals - I was a Physio Rehab Specialist). I will try to re-find the exact article for you but may have to post whole paragraphs from it if I can't link from member-limited sites. In FM the mitochondria in the cells do not work normally. This is in addition to the overabundance of Substance P throughout the cerebral spinal fluid, and the dopamine and serotonin disregulation in the brain.

CONTINUED FROM PREVIOUS POST^^

"" Dysfunction of the hypothalamic-pituitary-adrenal axis

Studies of the neuroendocrine aspects of fibromyalgia have found dysfunction of the HPA axis.[35] The HPA axis is a critical component of the stress-adaptation response. The sequence of HPA action is that corticotropin-releasing hormone (CRH) from the hypothalamus stimulates the anterior pituitary to release adrenocorticotropic hormone (ACTH). In turn, ACTH stimulates the adrenal cortex to produce glucocorticoids (eg, cortisol).

Some authors have noted that 5 main measurable neuroendocrine abnormalities are associated with dysfunction of the HPA axis.[36] These are as follows:

•Low free cortisol levels in 24-hour urine samples

•Loss of the normal circadian rhythm, with an elevated evening cortisol level (when it should be at its lowest level)

•Insulin-induced hypoglycemia associated with an overproduction of ACTH

•Low levels of growth hormone

•Stimulated ACTH secretion leading to insufficient adrenal release of glucocorticoids

Circadian regulation and the stress-induced stimulation of the HPA axis are, in part, regulated by serotonin. Perturbations in serotonin metabolism (as well as premorbid abnormalities of the HPA axis) may explain the abnormalities of the HPA axis in fibromyalgia. Dysfunction of the HPA axis may exaggerate the effects of abnormal serotonin metabolism. Hypoactivity of the HPA axis may cause low central serotonin levels.

Growth hormone

Growth hormone, produced during delta sleep, is involved in tissue repair. Therefore, disrupted stage 4 (delta) sleep associated with fibromyalgia may account for low levels of growth hormone. Growth hormone stimulates the production of insulinlike growth factor I (IGF-I) in the liver. Some authors have found that most patients with fibromyalgia have low levels of IGF-I and that low levels are specific and sensitive for fibromyalgia.[37]

Nerve growth factor

In some studies, nerve growth factor was found to be 4 times higher in the CSF of patients with fibromyalgia than it was in the CSF of individuals without the condition. Nerve growth factor enhances the production of substance P in afferent neurons, increasing an individual's sensitivity to or awareness of pain. Nerve growth factor also may play a role in spreading or redistributing perceived pain signals.

Cognitive impairment

Fibromyalgia is associated with a decline in short-term, working, episodic, semantic (predominantly verbal), and procedural (skills) memory. Imaging modalities such as single-photon emission computed tomography (SPECT) scanning have helped to define some of the abnormalities linked to this cognitive dysfunction. SPECT shows decreased blood flow in the right and left caudate nuclei and thalami.

Functional magnetic resonance imaging (fMRI) can show brain activity by depicting increased blood flow to areas actively engaged in a task. Increased blood flow and, hence, increased oxygenation have different magnetic properties. These properties can be detected and measured using fMRI.

In a study of persons performing a task requiring memory (alphabetization), persons with fibromyalgia performed almost as well as controls, but fMRI showed that more brain areas were activated during the memory task in persons with fibromyalgia than in controls, because the task was harder for the patients to perform. In another study, working memory and episodic memory scores of patients with fibromyalgia were similar to those of healthy controls who were 20 years older.[38]

Another study measured neural activation during response inhibition using fMRI. Patients with fibromyalgia had lower activation in the inhibition and attention networks but increased activation in other areas. The study indicates that inhibition and pain perception may use overlapping networks, which may cause resources to be unavailable for other processes when they are taken up by pain processing.[39]

Cognitive dysfunction has been linked to CNS imbalances. Abnormal levels of such neurotransmitters as substance P, serotonin, dopamine, norepinephrine, and epinephrine may cause cognitive dysfunction. Neuroendocrine imbalance of the HPA axis may play a role. Another possible cause of cognitive dysfunction is the distracting quality of pain in fibromyalgia. Cognitive performance of patients with fibromyalgia is correlated with their reported level of pain.

Brain damage from the effects of stress hormones may be involved in the cognitive dysfunction in fibromyalgia. Researchers are exploring this possibility by measuring tissue volumes in the hippocampus. Others studies have implicated yeast overload, water retention, and glial cell abnormalities as causes of cognitive dysfunction in fibromyalgia.

Sleep disruption

Sleep dysfunction is considered an integral feature of fibromyalgia. About 70% of patients recognize a connection between poor sleep and increased pain, along with feeling unrefreshed, fatigued, and emotionally distressed.[40, 41] Several studies have linked abnormal sleep with these symptoms. Sleep studies have shown that patients with fibromyalgia have disordered sleep physiology.

Sleep is not a state of massive system shutdown. On the contrary, the brain is active during sleep, constantly communicating with the body. Many neurohormones, antibodies, and other molecules are synthesized during sleep; therefore, when sleep is disrupted, biochemical abnormalities can occur, leading to multisystem disturbances.

To understand abnormal sleep architecture, it is essential to know the basics of normal sleep. Sleep can be divided into 2 main parts: nonrapid eye movement (NREM) and rapid eye movement (REM), which alternate cyclically through the night, always starting with NREM sleep. In each successive cycle through the night, NREM sleep decreases, and REM sleep increases. Each cycle, NREM plus REM, lasts about 90 minutes.

NREM is divided into 4 stages:

•Stage 1 is initial drowsiness

•Stage 2 is light sleep

•Stages 3 and 4 are progressively deeper levels of sleep.

In stages 3 and 4, an electroencephalogram (EEG) will show delta waves, which are high-amplitude (>75 mV) waves that move slowly (0.5-2 Hz). Much of the body's regulatory work, as well as the synthesis of many substances (eg, antibodies, growth hormone, other neurochemicals), occurs during NREM sleep.

REM sleep has a low-voltage, mixed-frequency pattern on EEGs and is considered dream sleep. In this stage, the body has a complete loss of muscle tone, known as flaccid paralysis, and it cannot move. During this part of sleep, consolidation of memories may occur, but disagreement still exists as to what takes place with regard to memory during REM sleep. Some investigators have found that during waking hours, the brain generates alpha waves with a frequency of 7.5-11 Hz.

The disordered sleep physiology in fibromyalgia has been identified as a sleep anomaly of alpha-wave intrusion, which occurs during NREM stage 4 sleep. This intrusion into deep sleep causes the patient to awaken or to be aroused to a lighter level of sleep. Some investigators describe the altered sleep physiology and somatic symptoms as a nonrestorative sleep syndrome.

Sleep dysfunction is believed to be linked to the numerous metabolic disturbances associated with fibromyalgia, including abnormal levels of neurotransmitters (serotonin, substance P) and neuroendocrine and immune substances (growth hormone, cortisol, interleukin-1). These metabolic imbalances are thought to be responsible—through impairment of tissue repair and disturbance of the immunoregulatory role of sleep—for the increased symptoms associated with this sleep disorder of alpha-wave intrusion.

Most alpha-wave intrusions occur during the first few hours of sleep, decreasing throughout the night to normal levels by early morning. This hypothesis correlates well with patients' frequent reporting that their best sleep is obtained in the early morning hours, just before arising.

Many fibromyalgia patients also have primary sleep disorders that can reduce sleep quality, such as obstructive sleep apnea, restless legs syndrome, or periodic limb movement disorder. All patients should be screened for the presence of primary sleep disorders before assuming that reduced sleep quality is due to fibromyalgia. ""

Here's a website that may help with medical information on all her issues: From the National Institutes of Health (US gvmt.)
http://www.nlm.nih.gov/medlineplus/fibromyalgia.html

You are welcome to friend me if you'd like for a bit more help and encouragement on this subject.
Liana

Shannon, I too am low-ish carbing (usually around 100 net g/day - which is relatively low compared to the 'normal' North American diet). I always say, use what you must to function. We wouldn't chastise a diabetic who must inject insulin to function/live, why treat ourselves any differently. It's just good to look at all possible modalities to deal with pain & sleep issues and keep a positive outlook. I like to keep a mental 'gratefulness journal' to help me focus on at least one positive thing in my day no matter how bad I'm feeling at any given time. The mental game is a huge part of ANY medical issue imho.

Bump... for those needing more FM info (for their doctors, themselves, or their SO's)