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I think that most research in fibromyalgia is going in the wrong direction by following the serotonin pathway instead of concentrating on the levels of mitochondria in the muscles. Mitochondria are the power plants of our cells. They use glucose to make adenosine triphosphate (ATP), which muscles use as energy. In patients who suffer from fibromyalgia, there's a lack of mitochondria in the muscles in the areas where they feel pain. Without the mitochondria, the muscles get their energy from a different source called the lactic acid pathway. This involves utilizing muscle tissue itself to produce energy, and it results in quantities of lactic acid building up in the muscles, which causes pain.

Imagine running a marathon with no training. Think about what your legs would feel like the next day — sore and stiff because your muscles would be filled with lactic acid. This is what the fibromyalgia patient feels every day.

So to treat fibromyalgia, you have to increase the levels of mitochondria in the muscles. One way to do this is to exercise, which makes the body add mitochondria to the muscles. The problem is that fibromyalgia patients are usually fatigued, making exercise difficult. Nonetheless, patients should exercise within their tolerable limits.

Ribose, a component of ATP, figures prominently in several important metabolic processes in the body. Ribose supplementation has been shown to be beneficial when combined with malic acid and magnesium. All three are crucial in the synthesis of ATP.

Turmeric is a natural COX-2 inhibitor that can decrease fibromyalgia pain. Ginger is also known to be a potent natural anti-inflammatory. S-adenosyl-methionine (SAMe) has been shown to be useful in both decreasing the pain and helping relieve the depression commonly seen in fibromyalgia patients. A recent study published in Clinical Rheumatology showed that a combination of the amino acids trypsin and bromelain combined with rutin relieved pain just as well as many drugs. This study concentrated on osteoarthritis, but the therapy should help relieve the pain of fibromyalgia as well.

Omega-3 supplementation ought to be a part of any fibromyalgia treatment plan. Omega-3s increase production of certain prostaglandins — chemical mediators — in the body. Omega-3s turn off inflammatory prostaglandins and promote production of anti-inflammatory ones.

As always, follow the manufacturer's recommendations on the label for all supplements and herbs mentioned above.

I've been diagnosed with fibromyalgia. What can I do to treat myself? There's little available from conventional medicine for my condition.

— D.V., Atlanta

Dr. Ervolino is happy to answer your health questions.

PHOTO (BLACK & WHITE)

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By Frank Ervolino, ND

Frank Ervolino, ND, lives in Palm City, Florida. He's on the staff of Jupiter Medical Center Hospital as an acupuncturist. He received his doctorate of naturopathic medicine and a master's of science degree in acupuncture from Bastyr University in Seattle, Washington.

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