fibromyalgia can be resolved by medical herbalism
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DESCRIPTIONA recent public awareness survey by the National Fibromyalgia Association illustrates a significant lack of understanding about Fibromyalgia: nearly half of the general public (45%) has never heard of Fibromyalgia, many people who are knowledgeable about the disorder incorrectly believe that nothing can be done to manage it, and nearly half (48%) of all healthcare providers are reluctant to diagnose a patient with the condition (National Fibromyalgia Association, 2007).
- 1. FIBROMYALGIA CAN BE RESOLVEDBY MEDICAL HERBALISMA talk by Morwenna GivenMedical Herbalistwww.medicusherbis.com03/12/2014 1
2. WHO AM I?I amMORWENNA GIVENBA MA ( Oxon ) BSC m.OHA BHG RHA Medical Herbalist practising in downtownToronto treating a variety of disease fromconstipation to cancerI trained in the UK in university, hospital & clinicenvironments on an evidence base basis03/12/2014 2 3. TRAININGTraining MedicalHerbalistvs. MedicalDoctorvs. NaturopathDegree Yes Yes YesProf.body Yes1542Yes1540Yesc.1901Hospital training Yes Yes NoSurgery No Yes NoEvidenceYes Yes NobasedSpecialist Yes Yes NoA medical herbalist only uses plants & professional supplements to treat holisticallyA medical herbalist has 2-3 times more training than an MD in Both conventionaldrugs and plant medicine Drug interactions & contraindications & DosageNutrition and preventive medicine 03/12/2014 3 4. What is Fibromyalgia? Fibromyalgia, an illness characterized bychronic, widespread pain and tenderness, isestimated to affect about 5 million U.S. adults.Fibromyalgia was formerly classified as aninflammatory musculoskeletal disease but isnow considered to be an illness that primarilyaffects the central nervous system.( Medscape 2008 )03/12/2014 4 5. MEDICAL STUDENT TEACHING 2011 Fibromyalgia (FM) is a common, idiopathic, chronic musculoskeletal pain conditionassociated with widespread pain, tenderness in various anatomically definedtender points on the body, fatigue, sleep abnormalities, and commoncomorbidities with psychiatric and medical disorders (Arnold, Bradley, Clauw,Glass, & Goldenberg, 2009). An estimated 6 million (2% of the US population)men, women, and children have been diagnosed with FM (Krypel, Rospond, &Chen) with the overwhelming majority being middle-aged women (7:1) (Lawrence,Felson, & Helmick, 2008). Although FM is the most common presentation of painin general medicine and rheumatology (Perrot, Dickenson, & Bennett, 2008), itcontinues to be under-recognized and misunderstood. The lack of understandingof the pathophysiology of FM has made this condition frustrating for patients andclinicians alike (Harris & Clauw, 2009). A recent public awareness survey by theNational Fibromyalgia Association illustrates a significant lack of understandingabout FM: nearly half of the general public (45%) has never heard of FM, manypeople who are knowledgeable about the disorder incorrectly believe that nothingcan be done to manage it, and nearly half (48%) of all healthcare providers arereluctant to diagnose a patient with the condition (National FibromyalgiaAssociation, 2007). Medscape 201103/12/2014 5 6. MERCK Pain on 11 out of 18 points on the body Widespread pain for 3 months minimum Pain widespread in axial skeleton and rightand left of the body on deep palpation. Pain gradual diffuse and achy Co morbidities As described in the Merck Manual 18th Ed.03/12/2014 6 7. DOES NOT FIT In other words this is a disorder whichconventional medicine cannot neatly classify as itis multi aetiological in origin requiring multi levelresolution Conventional medicine is organised vertically in asystem in which specialists ignore each othercreating further problems with no suitable drugsfor chronic auto immune disease and wheresurgery is inappropriate03/12/2014 7 8. NOTHING NEW Fibromyalgia is not a new diseaseFirst recorded as far back as the 16th century, medical literature containsdescriptions of clinical manifestations of musculoskeletal pain. In 1904, Sir WilliamGowers, coined the term "fibrositis": the idea that there were changes in themuscular beds and connective tissue that represented inflammation. Those changeswere never found, so that is 1 reason we no longer use the word "-itis. In 1975, thefirst objective findings that were ever associated with the disorder were discovered byDr Harvey Moldofsky, a Canadian psychiatrist working in sleep medicine and suggestedthat FM be reclassified as a nonrestorative sleep syndrome. Today there are stillparties who believe that FM is a primary sleep disorder. The current post war WW2 organisation of conventional medicine basedon acute disease with single action drug mechanisms The current construct cannot deal with chronic disease and there are nodrugs for lifestyle03/12/2014 8 9. epidemiology Not present in any significance in the 3rd world A chronic disease of the western world butnot new dis/ease of excess Women 7:1 Men Some evidence to suggest overweight lowersocio-economic groups more susceptible andBRICK countries now showing the syndrome03/12/2014 9 10. HOMEOSTASIS As a medical herbalist which treatswholistically and aims to return the body tohomeostasis I understand syndromes such asfibromyalgia as I operate on a thephysiological multi cellular level inter relatingwith all aspects of the body. Our biochemicaltraining allows us to understand how thediffering aspects of this syndrome actuallyrelate to the symptoms of dysbiosis and ofwhich pain is merely a symptom03/12/2014 10 11. Treatment by Conventional Physicians Muscle biopsy studies do not conclusively show abnormalities specific forFM, moth-eaten fibers, ragged red fibers, and type II fiber atrophy indicatethat muscles are often involved in the pathogenesis of FM. One of themost important findings is that the regulation of deep tissuemicrocirculation is abnormal in FM, which may result in sensitization ofintramuscular nociceptors. Abnormalities may lead to lowered pH duringmild to moderate muscle load sufficient for activation of musclenociceptors. Altogether, this may result in peripheral sensitization ofafferent pain pathways, which then provides impulse input to centralpathways resulting in central sensitization. A better understanding of peripheral and central pain mechanisms in FMwill aid in the development of new and effective therapies for patients.Some of the clinical implications include pharmacological andnonpharmacological therapies that modify peripheral and/or centralmechanisms operant in FM.03/12/2014 11 12. Treatments (2) These treatments may consist of cognitive-behavioraltherapies, treatment with antidepressants (particularlyserotonin-norepinephrine re-uptake inhibitors) andantiepileptic drugs, just to name a few. At this time,stress reduction, restful sleep, and exercise are knownto positively affect FM pain mechanisms. NO ADDRESSING OF CAUSES, NO EVALUATION OFDEFICIENCES WITHIN THE BODY, or LIFESTYLE ISSUES03/12/2014 12 13. drugs Commonly prescribed drugs are: Tricyclic anti depressants and SSRIs Non opioid analgesics Opioids NSAIDS Muscle relaxants ALL HAVE SERIOUS SIDE EFFECTS & THEY JUSTDEAL WITH SYMPTOMS03/12/2014 13 14. Side effects Addiction Ulcers Incontinence Insomnia/nightmares Weight gain Impaired hepatic function03/12/2014 14 15. Conventional drugs Benzodiazepine tranquillisers e.g. Xanax sideeffects as below + ataxia, rashes, libido decreased Anti depressants: SSRIs Prozac Sleeping drugs - Amitriptyline e.g. Venflaxamine, Elavil weightgain dry mouth/eyes, constipation, decreasedperspiration & arrhythmias, addictive, impactnormal muscle function03/12/2014 15 16. Drugs (2) Muscle relaxants anti spasmodics and similarto anti depressants in pharmacologicalmechanism. Pain opioids, NSAIDs, CABA (tramadol) All the drugs have very limited effectiveness,only treat the symptoms and cause major sideeffects over short and long term03/12/2014 16 17. Aetiologies Genetic Psychogenic & social causes Nutrition CFS & other co morbidities Environmental toxins Neuroendocrine Stress HPA axis Hypothyroidism ( especiallyin Ontario Immune deficiencies Hormone deficiencies Physical trauma Whiplash Neuroplasticity Cerebral circulation Phosphate deficiency GH & impaired Calciummetabolism03/12/2014 17 18. Typical symptoms Muscle stiffness &aching Tender points Disturbed sleep Fatigue Sensitivity to temperature Bruxism IBS/ Digestive disturbance Reproductive hormone im-balance Genito/urinary issues Sensory overload Brain fog Depression Dry mouth and eyes Headaches Rhinitis sinus issues Skin, hair, nail problems03/12/2014 18 19. Drivers Hyperstimulation of the CNS with raised levels ofglutamate, low tryptophan serotonin Increased levels of IL6 and other prostaglandins immune dysfunction Hyperstimulation of peripheral pain receptors Relationship to beta estrodiol & womens hormones Thyroid malfunction / hormone imbalance GH Ca metabolism impaired, Vit D deficiency,03/12/2014 19 20. How do I treat Each patient is an individual and assessed accordingly in a 2hour consultation Symptoms and causes addressed - andgiven a bottle of tincture ( medicine ) to take as directed and atea, supplements if relevant. A physical examination may beapplicable and blood pressure taken. Bloodwork may berequested. Exercise is discussed and recommended including: CBT, Yoga ,Tai Chi ,Aerobic exercise which have all shown to bebeneficial03/12/2014 20 21. Let food be thy medicine andmedicine thy food Hippocrates Diet is key in any chronic auto immune disease and is believed to bepart of the aetiology FRUITS AND VEGETABLES , basic principles & Palaeolithic diet Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44.A program consisting of a phytonutrient-rich medical food and anelimination diet ameliorated fibromyalgia symptoms and promotedtoxic-element detoxification in a pilot trial.Lamb JJ, et al.Dept. of Molecular and Cellular Biology, MetaProteomicsLLC, Gig Harbor, Washington, USA.03/12/2014 21 22. Reduce the drivers Chemical imbalances in the brain corrected Inflammation reduced Immune system modulated Hormonal imbalances corrected Environmental issues addressed03/12/2014 22 23. Solution! PLANTS ARE MULT FACETED AND MULTIFACTORIAL OPERATING ON BIOCHEMICALPATHWAYS WE ARE ONLY BEGINNING TOUNDERSTAND capable of treating CHRONICDISEASE WITH NO SIDE EFFECTS. ' Everything man needs to maintain goodhealth can be found in nature - the