CASE STUDY: Female with Fibromyalgia

Published on
August 9, 2011

Patient was initially seen in January of 2006. She had been diagnosed five years prior with fibromyalgia by her rheumatologist after ruling out other rheumatologic and autoimmune diagnoses. At that time, she was prescribed dulaxetine and gabapentin. Her pain was described as “constant” and “often intense”, limiting her daily activities. She has a history of poor sleep habits and constantly feeling unrefreshed in the morning. Otherwise, osteoporosis and depression were her only other comorbidities. Her daily intake of nutritional supplements included: 1000mg of strontium carbonate, 1200mg of calcium citrate, 400IU of vitamin D in divided doses. Upon physical examination, fifteen of the eighteen FMS points were positive upon 5kg of digital pressure. Sphygmomanometry-evoked allodynia (SEA) occurred at 140 mm Hg of pressure. Only mild hypertonicity was found throughout her upper trapezii and paraspinal musculature. SpectraCell testing revealed functional intracellular deficiencies of vitamin B6, vitamin D, magnesium, and coenzyme Q10. Her total antioxidant function measured 51.2%. Based upon these deficiencies, she was administered the following daily nutritional supplement protocol:

B-Complex weighted with extra B6 (250mg)

500mg of magnesium glycinate

1000IU of vitamin D3

200mg of Coenzyme Q10

She was also instructed to consume one cup of pomegranate juice per day. Foods containing the deficient nutrients were advised to be consumed.

Follow up SpectraCell testing was performed six months later.

All deficiencies were resolved except for CoQ10. Her SPECTROX™ results increased to 68.1%. Sphygmomanometry-evoked allodynia (SEA) occurred at 170 mm Hg of pressure. Overall, her fibromyalgia symptoms were greatly improved. She was able to perform more of her activities without “suffering the consequences”. She still had some pain from the fibromyalgia, but this was only a “shadow” of the previous pain. In addition, she is waking up in the morning with more energy. Her rheumatologist has taken her off gabapentin and duloxetine. It was recommended to increase CoQ10 to 300mg per day and continue at a lower dose of the daily protocol until following up with another SpectraCell test in one year.

B6 and magnesium synergistically assist the conversion of tryptophan into serotonin (which, in turn, is converted into melatonin). As a result, improvements in sleep and mood resulted. Magnesium has been used as a treatment for FMS for many years. However, SpectraCell can differentiate those patients who will better respond, thereby saving everyone time, money, and pain. Magnesium is the body’s ‘calcium channel blocker’ in the NMDA receptor, preventing the release of Substance P and various inflammatory cytokines. CoQ10 is the electron transporter than facilitates ATP production. Although in previous studies serum levels of CoQ10 (not intracellular levels) were found to be normal in FMS patients, one study demonstrated that many patients did improve when administered Coq10. Perhaps, intracellular studies would have clarified which patients were truly deficient and, therefore, would benefit for CoQ10 therapy. Vitamin D has entered as a potential key substance in evaluating fibromyalgic patients. Studies have shown that serum levels of 25-OH vitamin D correlate inversely with depression and pain of FMS. One of the symptoms of moderate Vitamin D deficiency is wide spread muscle pain. It is now commonly used in various autoimmune disorders. Being that Vitamin D is a potent antioxidant, this might have been responsible for part of the improvement in this patient’s SPECTROX™ test.