More and more people, especially women as they age, are suffering needless hours of incapacitation from chronic pain.
This pain manifests in their joints and tightens up their muscles until they are as stiff as boards.
This is likely a reaction to the inflammatory cytokines saturating their muscles and making their nerves hypersensitive.
Yet, they aimlessly seek help from doctors and are bounced around between acupuncture specialists, massage therapists, and wind up dependent upon highly addictive narcotics to manage the chronic symptoms.
Some doctors may suggest fibromyalgia as this catch-all phrase. This means that there is no solution other than dependence on Lyrica or painkillers to dull these debilitating sensations.
The savvier patients do their homework and search deeper into the recent studies to understand the underlying cause for their pain.
They use novel therapies like low-dose naltrexone to escape the grip of chronic pain, fibro-fog, and fatigue.
Below, we have made some in-depth discussions of the current and novel treatments for fibromyalgia to help you make an informed decision.
What is Fibromyalgia?
It is estimated that 10 million Americans are suffering from fibromyalgia in the United States. You may have fibromyalgia and not even know it.
On the flip side, if you know someone who has fibromyalgia, there is really no other explanation possible.
According to WebMD, it is the second most common musculoskeletal condition. However, because the symptoms are related to many disorders, it may be difficult to pinpoint at first.
The classic symptoms of fibromyalgia are fatigue and widespread pain in both joints and muscles. It can be easily misdiagnosed because medical science has yet to determine a definitive cause.
Although holistic living and medications are used to treat it, no cure for fibromyalgia currently exists.
The use of Lyrica to relieve pain has led to the belief that fibromyalgia is caused by difficulties in how the central nervous system processes pain signals.
People who have fibromyalgia suffer from a perception that their entire body aches like people withdrawing from opioids (See the description of opioid withdrawal pain by Dr. Marc Myer).
This may include muscle spasms, muscle knots, burning sensations, twitching, points of tenderness or a low tolerance for pain, insomnia-related disorders, ADD-like concentration/memory problems (fibro-fog), exhaustion, depression, nervousness, and worrying.
Women who rarely exercise and suffer from PTSD-related disorders, mood disorders, or diseases like arthritis, are at the highest risk for developing the disorder.
Even if you are a man with a family history of fibromyalgia who exercises regularly and is otherwise healthy, it is possible to suffer symptoms intermittently when your body is under inflammatory stress from IgE histamine-releasing food allergies or sensitivities to medications.
Fibromyalgia can also lead to gastrointestinal issues like nausea and irritable bowel syndrome, excessive urination, numbness or tingling in your extremities, headaches, dehydrated mucous membranes, photosensitivity, and other sensitivities to temperatures or sound.
Because fibromyalgia is similar to many other afflictions such as hypothyroidism, lupus, and arthritis, blood tests, and X-rays are initially used to eliminate other disorders.
How is Fibromyalgia Traditionally Treated?
Fibromyalgia can exhibit itself over a broad range of symptoms and has no standard formulation for treatment.
Most doctors will prescribe pain medications, muscle relaxers, antidepressants, and sleeping pills to help patients mitigate the negative effects.
Lyrica, Cymbalta, and Savella have been approved specifically for the treatment of fibromyalgia.
According to Pew Charitable Trusts research, these drugs have also been abused by people addicted to narcotics. It buffers the painful withdrawals when they crash and enhances the euphoric effects.
Holistic living methods require people to eat healthier, exercise more regularly, and to generally improve their overall health.
Some patients use chiropractors, yoga, acupuncture, and massage therapies to mitigate the symptoms. No matter what form of medicinal therapy you are taking, it would not hurt to mix in these risk-free methods.
What is the History of Naltrexone?
Naltrexone was initially approved by the FDA in 1984 for the treatment of opioid and alcohol dependence.
The late Dr. Bernard Bihari began to experiment with the off-label uses of naltrexone in 1985 by determining that 3mg doses were effective in enhancing the immune response in HIV+ patients.
The off-label use of naltrexone caught hold in the autoimmune and cancer fields in the 90’s when medical professionals noted its potential to regulate the immune system.
The Jarred Younger studies initiated the firm belief that naltrexone was beneficial for fibromyalgia patients. (See Studies 1, 2, 3). Since then, many other studies and conferences have followed.
Medical professionals all over the country are educating themselves and performing studies on the off-label use of low-dose naltrexone for autoimmune disorders and fibromyalgia.
What is Naltrexone?
Naltrexone is a drug that was approved by the FDA to reduce the cravings for opioids and alcohol.
It is the opposite of an opioid in the sense that it is an opioid antagonist. It binds to the opioid receptors to block the stimulation associated with the euphoric high effect.
The most popular methods of use are intramuscular injections and oral tablets. It should not be confused with naloxone which is used to reverse the overstimulation effects of narcotics.
Naltrexone is also used to treat obesity. It is now being used for the off-label use of treating fibromyalgia in low doses as a safer, cheaper, and arguably more effective alternative to prescription fibromyalgia drugs.
What are the side-effects of Naltrexone?
The common side effects are diarrhea and abdominal cramping because it blocks the same receptor associated with opiate withdrawal.
Some patients have suffered liver damage after taking excessive doses. Doctors may require liver function tests in patients who have liver problems and closer monitoring.
Many drugs like Depakote antiseizure medications and even Tylenol can cause damage to the liver if taken in high doses.
The liver toxicity should not be cause for concern if you are using the drug at recommended doses and do not suffer liver function or liver disease problems like Hepatitis. Interactions with other drugs should be discussed with your doctor.
Why is Low Dose Naltrexone Being Used to Treat Fibromyalgia?
The aforementioned pilot studies by Dr. Jarred Younger suggest that low dose naltrexone is an effective and safe treatment for fibromyalgia.
Daily doses of 50mg-300mg are typically used to treat opioid and alcohol abuse with minimal side-effects.
When taking naltrexone in doses of 1-5mg, there is almost zero risk of developing any negative side-effects beyond the discomforts of headaches, anxiety, or trouble falling asleep.
It is believed that naltrexone is effective for fibromyalgia at these doses because it reduces inflammation in the central nervous system and releases endorphins that help the body reduce and regulate pain on its own.
In this sense, it is helping to correct immune system dysfunction and the inflammation that is thought to feed chronic pain.
What are the Exclusive Features of Naltrexone?
It is believed that some aspects of fibromyalgia may result from inflammation of tissue surrounding the brain and spinal cord. The transition from acute to chronic pain is linked to inflammation in these regions.
The problem is that it has heretofore been very difficult to reduce this type of inflammation because the cells causing it are rarely activated.
Naltrexone may be one of the few medications capable of doing this at the very low cost of approximately $40/month.
Because every cell in the immune system has receptors for endorphins (the opioids produced by the body itself) it is plain to see how an antagonist that binds to the receptors on every cell in the immune system can play a vital role in correcting regulation.
How Does the Specific Mechanism of Naltrexone Work?
In one theory, it is believed that people who suffer from fibromyalgia have low beta-endorphin levels and higher levels of dynorphin and met-enkephalin.
Some doctors theorize that there is an opioid system imbalance or even a cellular resistance to endorphins like that found in type-2 diabetes insulin resistance.
If a low dose of naltrexone is taken at night to block the opioid receptors, the function of the endorphin system may begin to operate more efficiently after the drug is metabolized and the receptors are set free the next morning (See helpful YouTube video for more detail).
Because all immune cells have opioid receptors, it is believed that naltrexone has the ability to regulate the immune system.
Although fibromyalgia is not considered a per se autoimmune disease like Crohn’s disease, multiple sclerosis, and rheumatoid arthritis, it may be causally linked to dysfunction of the T-cells.
An autoimmune disorder causes the body to launch an internal war against its own tissues instead of diseases and foreign viruses.
The T-cells in our body that are destroyed by autoimmune disorders like HIV are responsible for activating and deactivating the inflammatory responses to infections.
Our cells produce cytokines to inflame tissues and objectively alert us to the need for medical attention or rest.
If low-dose naltrexone therapy is able to regulate T-cell function and reduce inflammation responses, it is believed that chronic pain can be abated.
According to Dr. Ginevra Liptan, M.D., naltrexone reacts with the glial cell receptors on the brain and spinal cord.
This glia responds to chronic pain messages after your central nervous system has become saturated.
If they are not blocked by naltrexone, they will continue to activate pain hypersensitivity in the tissues surrounding the nerves.
It is believed that Lyrica works by temporarily interrupting synaptic function from the inflamed nerves at the root of chronic pain.
The logical reason why naltrexone works better is that it deactivates these glial cells and thereby reduces the tissue inflammation at the root of chronic pain signals.
This opened up the possibilities for low-dose naltrexone to reduce other inflammatory diseases such as lupus and multiple sclerosis.
The problems faced with this therapy is that it is a generic drug that must be formulated at a compounding pharmacy at these doses.
The additional struggle is that doctors are not generally amiable to writing compounding prescriptions for off-label uses.
It is understandable that doctors would not want to isolate themselves in suggesting novel methods of care that can create malpractice liability.
It may also react with opioid pain medication management or limit its effectiveness since it is an opioid antagonist.
Low-dose naltrexone therapy has been studied heavily for multiple sclerosis (See Studies 1 and 2) and Crohn’s disease (See studies 1, 2, 3) patients over the last few years. The results are impressive and demonstrate that it is a very effective form of therapy for this class of disorders.
What are the Alternatives to Low-Dose Naltrexone for T-Cell Regulation?
There are many basic vitamins that our body needs for a healthy T-cell function that should be explored before trying prescription treatments.
Both Vitamin A and D play an important role in T-cell function. Glutathione and probiotics may play a role in T-cell regulation.
Trace minerals like zinc, iodine, and selenium are beneficial to the immune system as a whole.
Anti-inflammatory supplements including cold-pressed fish oil, Boswellia, turmeric, quercetin, reishi mushroom, and stinging nettle may also prove beneficial.
Conclusion
Patients who suffer from fibromyalgia have a diverse range of symptoms that can have a depth of causes. There are many external and internal causes for inflammation and imbalanced immune system functions.
When medical professionals begin to use experimental treatments like low-dose naltrexone on classes of patients with general trends of success noted, we can see how inflammation and immune regulation are substantially involved.
Because naltrexone is a generic drug, there is sadly a lack of financial incentive to fund major studies.
However, on the upside, there is an easier low-risk budget-based alternative treatment for anyone suffering these disorders to try themselves.
The symptoms that are possible at the low doses suggested for naltrexone therapy are a headache, insomnia, and anxiety.
These symptoms merely echo the milder symptoms of fibromyalgia itself. Such mild symptoms are effectively treatable with over-the-counter medicines like aspirin or sleeping pills.
There is a very little risk in trying naltrexone if you are otherwise healthy and not dependent on other medications that may interact.
The most difficult part of starting a low-dose naltrexone therapy treatment program may be finding the right doctor and pharmacist to provide it.