Kent Holtorf, MD, medical director, Holtorf Medical Group Center for Endocrine, Neurological and Infection related illness, Torrance, Calif., reports that after a comprehensive literature study that the majority of CFS and FMS patients display abnormal adrenal function–due to hypothalamic-pituitary dysfunction. He believes that the majority of patients could be treated for this adrenal dysfunction.

Holtorf’s believes his study suggests that a treatment protocol of early administration of cortisol may help improve and reduce the symptoms of chronic fatigue syndrome and fibromyalgia. He confirmed his research in an observational study following the conditions of 500 patients from his clinic, where the patients who were given cortisol as part of their treatment:

• 94% showed improvement by the 4th visit;
• 75% noted significant improvement;
• 62% reported substantial improvement; and
• Energy levels and a general sense of well-being for patients doubled by the 4th visit.

The effectiveness of this multi-system treatment was further confirmed through the analysis of the cumulative findings of over 40 independent physicians and over 5,000 patients. Cortisol treatment carries significantly less risk and a greater potential for benefit than treatments considered to be the standard of care for both conditions, according to Holtorf. As shown in the Journal of Chronic Fatigue Syndrome study, cortisol doses of 5-to-15mg a day have been shown to be safe, with little or no associated risk, while having the potential for significant benefit for CFS and FM patients–according to Holtorf’s article in the Journal of Chronic Fatigue Syndrome.

Richard E. Harris, PhD, research assistant professor, Division of Rheumatology of Internal Medicine, University of Michigan Medical School, believes he has found the link between fibromyalgia pain and the neurotransmitter molecule glutamate.

The glutamate molecule helps convey information between neurons in the nervous system. When glutamate is released from one neuron it binds to the receptors on the next neuron, which causes the the newly attached neuron to become excited (or more active.) Glutamate was targeted for Harris’ study because previous studies using functional magnetic resonance imaging (fMRI), had established that the insula region of the brain in fibromyalgia patients was highly active.

For 4 weeks participants were given either real acupuncture treatments or sham acupuncture treatments to reduce pain. The sham treatment involved using a sharp device to prick the skin in order to mimic a real acupuncture sensation.

After 4 weeks of treatment both the participants receiving the real acupuncture and sham acupuncture self-reported reductions in pain. What is significant is that the patients who reported the greatest reduction in pain also had the greatest reduction of glutamate in the insula region of the brain. Harris’ believes that glutamate may play a role in fibromyalgia and could possibly be used as a biomarker of the disease’s severity.

Because the study involved a small number of participants, Harris feels additional studies need to be done to verify the role of glutamate in fibromyalgia.

If you are in California you can join their Walk of Fame on May 10, 2008. The walk/run will be held at The Block at Orange, in Orange, Calif. For more information and to register for the event visit their site.

Want to coordinate your own Walk of FAME, NFA provides a step-by-step guide.

Already planning your own event for Fibromyalgia Awareness Day. Contact NFA so they can help spread the word.

Perhaps you would like to attend the NFA symposium on fibromyalgia, but are unable. NFA has made their 2006 Fibromyalgia Symposium available on 11 separate DVD–which can be purchased separately at a reasonable price. The list of speakers and topics covered on the DVDs are available as a PDF file.

The Mayo Clinic suggests fibromyalgia patients:

• Make a list of family and friends who can help. On a day when symptoms are mild, make a list of people who can help, and on days when symptoms are more severe, enlist their support.
• Identify other resources. Resources in the community, such as a support group, may be available to help during a really difficult day.
• Make a schedule. Write down the tasks that must be completed every day. Think about what’s necessary and what can wait.
• Find distractions. Identify activities that distract from signs and symptoms of the condition. Family and friends also can provide distraction.
• Plan to relax. Set aside time for daily relaxation. Activities might include meditating, writing in a journal, listening to music or taking a bath.

Additional information on fibromyalgia is provided by the Mayo Clinic:

• Introduction to fibromyalgia 
• Fibromyalgia signs and symptoms
• Causes
• Risk factors
• When to seek medical advice
• Screening and diagnosis
• Complications
• Treatment
• Self-care
• Coping skills
• Complementary and alternative medicine

The stress-illness connection has been considered to be cortisol. When danger is perceived a chain reaction of signals releases various hormones–most notably epinephrine (adrenaline), norepinephrine, and cortisol–from the adrenal glands above each kidney. These hormones boost the heart rate, increase respiration, and increase the availability of glucose in the blood producing the “fight or flight” reaction.

Normally, cortisol levels return to normal after 40-60 minutes, but during that time various processes either shut or slow down including: digestion, reproduction, physical growth, and some aspects of the immune system.

Although we often think of stressors as big things like abuse, illness, divorce, grieving, or getting fired. Now research shows that little things can add up to negatively impact on our health like–traffic, workplace politics, noisy neighbors, a long line at the supermarket or bank.

With prolonged stress cortisol inhibits the growth of new neurons, and can cause increased growth of the amygdala–the portion of the brain that controls fear and other emotional responses. Stress hormones also inhibit neuron growth in parts of the hippocampus–an essential area of the brain in forming new memories. The result is that the brain’s ability to put emotional memories in context is impaired. These brain changes are thought to be by some researchers at the heart of the stress — depression link as well as post-traumatic stress disorder (PTSD).

Besides heart disease, PTSD, and depression, chronic stress has been linked to ailments as diverse as intestinal problems, gum disease, erectile dysfunction, adult-onset diabetes, growth problems and even cancer. Chronic rises in stress hormones have been shown to accelerate the growth of precancerous cells and tumors; they also lower the body’s resistance to HIV and cancer-causing viruses like human papilloma virus (precursor to cervical cancer in women).

Stress is known to actually enhance one important immune response–inflammation. Ordinarily, inflammation is how a healthy body deals with damaged tissue. The infected or injured cells produce cytokines, which is a chemical that attracts immune cells to the site to help repair it. Cytokines also travel to the brain and are responsible for initiating sickness behavior. Overactive cytokine production has been found to put individuals at greater risk for a variety of aging-related illnesses.

Cytokine is has also been implicated in the link between stress and depression. People suffering from clinical depression have shown 40-50% higher concentrations of certain inflammatory cytokines. And about 50% of cancer patients whose immune responses are artificially boosted through the administration of cytokines show depressive symptoms.

Sleep may be part of this puzzle too, as disturbed sleep, which often goes with anxiety and depression, increases levels of proinflammatory cytokines in the body.

Stress is not inevitable. Even if you are a determined workaholic glued to your cell phone or a fearful and angry urban neurotic, stress-reduction methods are readily available to cope with stress in the short term and even alter perceptions of stressors in the long term.

More information about stress research currently being done in psychology, medicine, neuroscience, and genetics can be found in the December 2007 issue of the Observer. A monthly magazine of the Association for Psychological Science.

Bee’s eclectic life is a blog by a 50′s something mother of 2 adult children who has dealt with fibromyalgia most of her life. She provides a chronology of the major events in her life and the part that fibromyalgia has played in them.

Her blog, I hate that fibromyalgia drug commercial, points out the irony of a current television commercial which purports a treatment for fibromyalgia that is mistaken by many people as a cure for the disease. What she says is frustrating is to be told for over 40 years that fibromyalgia was in her head, then to have a drug advertised to treat the symptoms.

Now, with a healthy scepticism, she takes the time to research and consider things before becoming excited. For her there are no cures—yet.

Research studies at the Mayo Clinic show that a new imaging technology holds promise for a definitive diagnosis of myofascial and, perhaps eventually, new treatments for people who have the syndrome.

Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create clear and detailed cross-sectional images of the body’s internal tissues and organs. The method developed by the Mayo Clinic researchers is called magnetic resonance elastography (MRE), which uses standard MRI equipment with a few modifications.

An MRE involves placing a vibrating metal plate on the patient, which causes their muscles to contract and stiffen. When the muscles contract and stiffen the elasticity of muscles can be measured as well as detection of abnormal hardening of tissues, which in myofascial pain syndrome can cause pain.

Because there is no single, specific diagnostic laboratory test, diagnosis can be difficult. Physicians rely on patient history, self-reported symptoms, a physical examination, and an accurate manual tender-point examination.

Signs and symptoms of fibromyalgia can vary, depending on the weather, stress, physical activity or even the time of day. Common signs and symptoms include:

• Widespread pain
• Fatigue and sleep disturbances
• Irritable bowel syndrome (IBS)
• Headaches and facial pain
• Heightened sensitivity

The sooner your fibromyalgia symptoms are diagnosed, the sooner they can be treated. Find out how to ensure you don’t spend years searching for fibromyalgia diagnosis.

Sativex® is a spray made from the extract of two chemovars of cannabis. Tetrahydrocannabinol (THC) is the primary element and the other element is cannabidol, which contains the plant’s full range of natural phytocannabinoids and terpenoids. Before anyone gets hot and heavy about the ‘high’ of the elements used, a study found that those test subjects who received a placebo experienced no greater intoxication scores than those who received the cannabis derivative, Sativex®.

In 2005, Canada gave Sativex® approval status under their Notice of Compliance with Conditions, which requires the manufacturer to pursue further clinical trials. This decision was based, in part, on studies for the medication done in Europe. Because of Canada’s approval, and the European studies, the Federal Drug Administration (FDA) has fast tracked the approval process to allow clinical trials I & II to be by-passed and to begin phase III clinical trials. Some view the FDA’s move as a possible shift away from politically motivated decisions and toward decisions based on good scientific and medical judgment.

GW Pharmaceuticals manufactures Sativex® and in Canada markets it by Bayer HealthCare. The efficacy studies primarily focus on reducing multiple-sclerosis (MS) pain. Approximately 17 to 52% of people with MS experience pain related symptoms, and of those, 32% say it is their worst symptom for the disease. Patient’s cancer pain will also be studied, but pain relief for other conditions have already been noticed, like rheumatoid arthritis pain, allodynia (severe pain from stimuli that are normally painless–caused by damage to the central nervous system (CNS), and brachial plexus pain–pain caused from damage of the nerves that conduct signals from the spine to the shoulder, arm and hand.

Currently there are numerous clinical trials recruiting for studies related to the use of Sativex® and pain control.

Healthy volunteers were given a placebo cigarette or a marijuana cigarette that contained either 2%, 4%, or 8% delta-9-tetrahydrocannabinol (THC) by weight. The subjects’ skin was first exposed to the irritant capsaicin, an alkaloid derived from hot chili peppers. The irritant mimics the type of neuropathic pain experienced by patients with HIV/AIDS, diabetes, or shingles–a brief, intense pain followed by a longer-lasting secondary pain.

The analgesic effects of the cannabis took about 45 minutes before it had an impact on the pain. The results showed cannabis does have a therapeutic value at a medium-dose level (4% THC by weight). The low and higher dosages (2% & 8% THC by weight) were not as beneficial. It was suggested that the less-effective higher dosage of THC is something seen among other medications, such as antidepressants.

A large scale study is needed to measure the efficacy of cannabis, the researchers note. Medical marijuana could play an important role in treating patients who don’t respond well to the usual pain relievers or can not tolerate drugs such as ibuprofen or opioids used for severe pain.

The study was funded by a California state initiative passed in 1999 for rigorous study of the safety and efficacy of medicinal cannabis in treating diseases.