Nutritional

S-Adenosylmethionine (SAMe)

Vitamin Research - 20 £29.95, 100 £99.95
S-adenosylmethionine is a compound with anti-inflammatory, analgesic, and antidepressant effects. A six-week double-blind trial with 44 patients receiving 800mg/day reported the following results. Improvements were seen for clinical disease activity (p = 0.04), pain experienced during the sixth week (p = 0.002), fatigue (p = 0.02), morning stiffness (p = 0.03), and mood evaluated by Face Scale (p = 0.006) in the actively treated group compared to placebo. In an earlier double-blind crossover trial with 17 patients, SAMe reportedly reduced levels of depression as the amount of pain and number of trigger points decreased, which prompted the researchers to state that SAMe, "seems to be an effective and safe therapy in the management of primary fibromyalgia."

Magnesium and Malic Acid

Cardiovascular Research - Malic Acid 600mg - 90 £14.95 Allergy Research - Magnesium Malate Forte - Malic Acid 250mg and 62.5mg Magnesium (of which 60% is citrate and 40% hydroxide) - 120 £17.25

Solgar - Magnesium Citrate200mg - 60 £7.55, 120 £12.99

Many patients with fibromyalgia report significant reductions in pain using a combination of magnesium (300-600mg/day) and malic acid (1,200-1,400 mg/day). Pain levels frequently decline within 48 hours as evidenced by decreases in the Tender Point Indexes (TPI), and symptoms of fatigue reportedly improve within two weeks. Magnesium and malic acid both play important roles in the biochemical pathways leading to the production of ATP. Both substances have oxygen-sparing effects, and a deficiency of either may contribute to the hypoxia commonly found in the muscle tissue of fibromyalgia patients. In general, this combination increases energy production and reduces lactic acid, which is a source of the muscular tenderness and pain that patients experience. Caution should be used in those individuals with IBS symptoms because magnesium malate may contribute to GI distress.

5-Hydroxytryptophan (5-HTP)

Higher Nature - Serotone 5HTP 100mg - 30 £12.90, 90 £35.50
Studies have reported that a substantial number of patients with fibromyalgia have abnormalities in the normal erotonin-melatonin metabolic pathways. Two natural substances can be used to stimulate the body's ability to synthesize serotonin and melatonin. These substances are the essential amino acid tryptophan and 5-hydroxytryptophan (5-HTP). When these precursors are used in the treatment of fibromyalgia, patients report improvements in symptoms of depression, anxiety, insomnia, and body pains. In one double-blind study, 50 patients were given 100mg of 5-HTP three times daily for 30 days. At this dosage level, the patients reported significant clinical improvement in all of their symptoms. Identification of low serum serotonin levels may be the most effective way to identify which individuals will respond well to this approach.

Intestinal Health

L-Glutamine: 1,000-3,000mg, 3 times a day (conditionally essential amino acid for GI repair).
Higher Nature - Glutamine Powder 900mg - 100g £10.90, 200g £19.90
Higher Nature - Glutamine 500 mg - 30 £4.50, 90 £10.20

Acidophilus/Bifidus (dairy free) with FOS: 10-15 billion units, 2-3 times a day (replenishes beneficial flora).
BioCare - Replete - 7 day intensive programme £31.05
Biocare - Bio Acidophilus (maintenance) - 60 £17.45

Digestive Enzymes

BioCare - Polyzyme Forte - 30 £8.05, 60 £15.20, 90 £20.10
Often beneficial for patients whose disease state involves gastrointestinal problems. Since a significant number of patients with fibromyalgia fall into this category, supplementation with a full range digestive enzyme may provide relief from bloating and other GI symptoms.
Pancreatin (animal-based pancreatic digestive enzymes), plant enzymes, and bromelain (from pineapples) promote protein digestion in the gastrointestinal tract. They have also demonstrated anti-inflammatory properties. They help reduce the number of pro-inflammatory chemical mediators, like some prostaglandins and leukotrienes.

Colostrum

Envirocol - Envirocol - 60 £19.95
Colostrum from bovine sources is another powerful immune-system modulator. It stimulates a sluggish immune system or dampens an overactive immune response, as occurs with autoimmune diseases. Colostrum is a nutrient-rich milk precursor that contains immunoglobulins, growth factors, antimicrobial proteins, and carbohydrates. These compounds transfer immunity from the mother cow to the calf's gastrointestinal system immediately following birth. For about 48 hours after birth, the mother produces colostrum, which is free of milk, lactose, lactalbumin, and other allergy-inducing products. Studies show that colostrum supplementation is a safe, effective, natural way to control diarrhoea in humans. It has been documented to be helpful in the treatment of CFS and autoimmune disease.

Essential-fatty-acids

Nutri Ltd - Eskimo 3 - 105 £13.60
Udo's - Udo's Choice Oil Blend - 500ml £16.43
Essential Fatty Acids (EFA's) stimulate the synthesis of anti-inflammatory prostaglandins that block the pain and inflammatory effects of chemical mediators such as leukotriene. These can be derived from Flax Seed oil (make sure its organic), and Evening Primrose oils and Starflower Oil. An alternative way to get more anti-inflammatory essential fatty acids from the diet is to consume more cold-water fish such as salmon, trout, mackerel, sardines, swordfish, shark, cod, and halibut. These fish contain high concentrations of omega-3 fatty adds, which have been documented to blunt the inflammatory or allergic response.

Coenzyme Q10

Pharmanord - Bio Quinone Q10 Gold 100mg - 60 £37.95 *** Special Offer - £32.95 ***
Coenzyme Q10 (CoQ10) is a natural energy producing nutrient involved in a wide range of body systems. CoQ10 is located in the mitochondria, tiny power plants found in every cell in the body, and effectively supports their energy producing pathways to help fuel the body's daily activity. A potent antioxidant, CoQ10 also defends cells against free radical damage. 60-200mg daily.

NADH

Enada - Enada NADH 5mg - 30 £16.95
NADH (or nicotinamide adenine dinucleotide) is found in all living cells, and it stimulates the production of energy-storing molecules. Scientists have been aware of the importance of NADH for a long time. Unfortunately, oral doses have often been ineffective because stomach acids can destroy the delicate molecule. In response, some nutritionally oriented physicians tried raising NADH levels with intravenous injections. Today, a newly developed, enteric-coated oral tablet seems to offer better therapeutic possibilities. In a very interesting recent study, NADH (daily, in oral form) increased vigour and mental alertness in about a third of participants. Granted, these individuals were suffering from chronic fatigue syndrome--not fibromyalgia--but it was their energy level that responded. In contrast, only a small portion (less than 10%) of those taking the placebo reported such improvements. Dose: 5mg, twice a day to enhance energy production within the cell.

Antioxidants

Since the inflammatory response creates oxidative damage to tissues, the use of antioxidants helps prevent permanent dysfunction.
Alpha lipoic acid: 50-150mg daily for antioxidant effect and detoxification of heavy metals.
Solgar - Alpha Lipoic Acid 120mg - 60 £29.65
Vitamin E: 400 IU daily. A potent antioxidant.
Bio care - Vitmain E 400IU - 60 £9.90. N-Acetyl Cysteine: 500mg, 3-4 times a day. Supports glutathione synthesis and assists in detoxification.
Solgar - N-Acetyl L-Cysteine 600mg - 60 £17.75

Muti-vitamin containing a good level of B vitamins

BioCare - One-A-Day Multivitamin and Mineral - 30 £8.05, 60 £14.45, 90 £19.75

Glucosamine and Chondroitin Combination

Solgar - Glucosamine Chondroitin Complex - 60 £39.55
Glucosamine & Chondroitin is a potent combo of joint supporting nutrients. They help maintain healthy connective tissue and mobile joint function. Taken consistently it promotes the nourishment of cartilage and encourages joint elasticity.

Daily Energy Enfusion - Powder

Enzymatic Therapy - Daily Energy Enfusion - Powder - 510g £49.95
Fatigued to Fantastic!®
Citrus Flavored Drink Mix Dietary Supplement
Targeted nutritional support to help build all-day energy and endurance. Single Dose Convenience Fatigued to Fantastic!® Daily Energy EnfusionTM was designed with Jacob Teitelbaum, M.D., recognized fatigue expert and author of from Fatigued to Fantastic! Daily Energy Enfusion features a combination of 39 energy-building vitamins, minerals, amino acids, and malic acid to help build all-day energy and endurance. Dr. Teitelbaum's clinical experience shows most people will feel a difference within two to three weeks of starting Daily Energy Enfusion. He also found that most people will notice a 76% improvement in quality of life after three months of use when used in conjunction with his individualized health care program. Fatigued to Fantastic! Daily Energy Enfusion is designed to be taken with Daily Energy B Complex.