Inflammation, Fibromyalgia, and Deceptive Marketing Tactics

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Ok, so I wish I could stop going on angry rants on this blog.  But, ironically, some of my rants have turned out to be among my most popular posts… so I’m going to keep going with this one.

One of the things that bothers me most about the majority of the online content regarding fibromyalgia is the idea that fibromyalgia sufferers must fight inflammation.

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Before I go any further, let’s talk about inflammation for a little while.  In general, I think it makes sense to break inflammation down into two categories: localized inflammation and systemic inflammation.  Localized inflammation occurs in one specific part of your body: you have a wound that’s healing, or you have tendinitis in your elbow.

Systemic inflammation, on the other hand, is a whole-body thing, and usually takes place as some sort of disease process.  For example, lupus is “an autoimmune disease characterized by acute and chronic inflammation of various tissues of the body.

Decades ago, when researchers first began to look at fibromyalgia, they suspected that some sort of systemic inflammation might be involved.  They questioned whether fibromyalgia might be an auto-immune condition, such as lupus or rheumatoid arthritis.  They were looking for some sort of obvious physical changes in the body; looking for inflammation in the joints, and focusing on on the idea of “tender points.”

Yet none of this research really revealed any of the physical signs they were looking for.  Basically, doctors couldn’t find anything “wrong” with fibromyalgia sufferers.  For a while, doctors measured the number of “tender points” on a patient’s body, but as this 2010 American College of Rheumatology briefing asserts, the tender point test has been shown to not be a reliable means of diagnosing fibromyalgia.

As researchers began to rule out the idea of fibromyalgia being some sort of autoimmune or inflammatory condition, they began to pick up on the idea of central sensitization.   Proposed by scientist Clifford Woolf in 1983, the idea of central sensitization is that people’s nerves can be altered by an extremely painful physical experience.  The way these nerves function can change in response to this experience and leave the person with a heightened sensitivity to pain.  This heightened sensitivity persists, even after the initial injury has healed.

Now most scientists believe central sensitization to be the cause of fibromyalgia.  While there are a lot of things we don’t yet know about it, what we do know is that it is not caused by an abnormal inflammatory response, like rheumatoid arthritis or lupus.  This is why fibromyalgia sufferers have historically been dismissed by doctors—by all objective diagnostic tests, we appear normal.

The fact that so many fibromyalgia sufferers have been dismissed by doctors is what makes us so susceptible to frauds, fads, and bad information.

I can’t even count the number of times I’ve been reading an article on the Huffington Post or ABC news and seen a “Suggested Article” at the bottom screen that reads something along the lines of “Problem with inflammation? You might have Fibromyalgia.”

I’m here to tell you that no, you don’t.  Chronic systemic inflammation is not a symptom of fibromyalgia.

There are simple blood tests which doctors use to determine whether or not a patient has a problem with systemic inflammation.   C-reactive protein and erythrocyte sedimentation rate are two of the most basic measures of inflammation.

If you are concerned about your health, go to your doctor and ask for these blood tests.  If this is a problem that’s been going on for a long time, chances are he or she has probably already ordered them.  You can always ask for them again– I don’t remember ever having to pay some sort of huge copay for them, as they’re pretty basic– but if they come back normal, you do not have a problem with inflammation.

For the first few years after I developed chronic pain, I spent a lot of time wondering if I had a problem with inflammation, thanks mainly to the erroneous information I found in the Internet.  None of the doctors I saw ever seemed to take me seriously.  After I took an anatomy class and learned about the tests that can measure inflammation, I realized why.  I had had these blood tests performed several times a year, and the results were always normal.

This is why I get so angry about these articles and websites that just seem to prey on people’s fears.  I spent years worrying if I was on the road to developing lupus or arthritis or any number of autoimmune conditions, thanks in large part to the misinformation these people spread.

Let’s not be victims of unethical marketing tactics.  If you have a problem with chronic, persistent pain, ask your doctor for the blood tests I mentioned.  If they come back normal, you are going to be okay.  If they come back abnormal, it is time to see a specialist.  The thing to remember is that there are treatments for autoimmune and inflammatory conditions.  If your inflammatory response is so messed up that you need treatment, it will show up on a blood test.  Otherwise, thank your lucky stars and start reading up about how to work with a sensitized nervous system.

**The picture above is actually of a blood sample taken from a dog. How cool is that?  Thank you to Nottingham Vet School for putting it on Flickr.

Nutrition Skepticism is Healthy

This is a great article on the nutrition “myths” that get circulated in the health and fitness industry.”  It’s from BBoy Science— a site which I really enjoy.

I thought this post was incredibly vindicating, especially the part about “Anti-Inflammatory Foods.”  I’ve encountered this concept time and time again in the alternative health world.

The author sums up the concept perfectly:

“Anti-oxidant foods are supposed to neutralize ‘free radicals.’ Free radicals are chemicals that naturally occur in your body, and are involved in some very important things – like killing infections and cleaning up by-products, and much more. However, they are also thought to be one of the things responsible for aging, and perhaps cancer.”

Proponents of the anti-inflammatory diet believe “… that free radicals can sometimes go a little too far in their clean up job. Kind of like how dad would throw out perfectly good cardboard for making crafts when you were a kid. Eating more anti-oxidants is thought to keep those pesky free radicals from going to far. Interesting theory, and sounds sciencey enough right?”

He outlines several problems with the idea that inflammation needs to be fought at all costs.  For one, there isn’t actually any evidence that people who eat a diet high in “anti-inflammatory foods” have a lower incidence of chronic disease.  In addition, the inflammatory response is actually part of the healing process– when you slow it down, you might also be slowing down healing.

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I really appreciated this part of the article in particular, because it is relevant to my own life.

When I first started having my digestive troubles in my early twenties, I had a hard time finding a doctor to take me seriously.  (I finally found an explanation, five gastroenterologists later).

After gastroenterologist number three, I decided to give up on doctors for a while.  I went to the health food store down the street– it’s kind of famous in my town, and people come from a 50 mile radius to shop there– and met with their “alternative health nurse nutritionist.”  Basically, she is an RN who has some kind of alternative/holistic nutrition certification.

I told her what my symptoms were, and she gave me dietary recommendations, as well as a long and expensive list of products to buy.

One of the things she was going to have me do was eat anti-inflammatory foods.   She also had me taking several large capsules of curcumin, which is an extract taken from turmeric (you know, the herb).  Many people believe it has anti-inflammatory properties.

I always thought this idea was a little bit fishy.  Apparently Tony Ingraham is on the same page as me.  He writes,

“Furthermore, is lowering inflammation even a good idea? There are serious side effects to anti-inflammatory drugs, so why not in foods as well?”

People shouldn’t assume that just because something is “natural,” or it comes from a food, that it is better than medication.  I would never just take ibuprofen willy-nilly without keeping track of my dosage, so why would I do that with a food that happens to have medicinal properties?  The nurse’s advice just seemed so unspecific… take 5 capsules a day, but also try to include as much turmeric in my cooking as possible.

If I could find a way to use food to take the place of ibuprofen once in a while, that would be great.  Ibuprofen is so hard on my stomach– I couldn’t take it regularly, even if I wanted to. But like ibuprofen, I would want to know the exact dosage I was getting, and I wouldn’t be shoveling it down every day by the truck load, like people seem to imply we should do with anti-inflammatory foods.

Needless to say, the nurse’s recommendations didn’t end up helping me.

Anyway, definitely check this article out, and take a look at BBoy Science in general– it’s a great site!