Why Fibromyalgia Is Not An Acceptable Diagnosis

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Dr. Efrat Lamandre makes the case that fibromyalgia is less of a useful diagnosis and more of a rubber stamp, much like the role historically often fulfilled by “heart failure” as an official cause of death (because certainly, that heart sure did stop beating). It’s a way of answering the question without answering the question.

…and what to look for instead

Fibromyalgia is characterized by chronic pain, tenderness, sleep disturbances, fatigue, and other symptoms. It’s often considered an “invisible” illness, because it’s the kind that’s easy to dismiss if you’re not the one carrying it. A broken leg, one can point at and see it’s broken; a respiratory infection, one can see its effects and even test for presence of the pathogen and/or its antigens. But fibromyalgia? “It hurts and I’m tired” doesn’t quite cut it.

Much like “heart failure” as a cause of death when nothing else is indicated, fibromyalgia is a diagnosis that gets applied when known causes of chronic pain have been ruled out.

Dr. Lamandre advocates for functional medicine and seeking the underlying causes of the symptoms, rather than the industry standard approach, which is to just manage the symptoms themselves with medications (of course, managing the symptoms with medications has its place; there is no need to suffer needlessly if pain relief can be used; it’s just not a sufficient response).

She notes that potential triggers for fibromyalgia include microbiome imbalances, food sensitivities, thyroid issues, nutrient deficiencies, adrenal fatigue, mitochondrial dysfunction, mold toxicity, Lyme disease, and more. Is this really just one illness? Maybe, but quite possibly not.

In short… If you are given a diagnosis of fibromyalgia, she advises that you insist doctors keep on looking, because that’s not an answer.

For more on all of this, enjoy:

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You might also like to read:

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  • Let’s Get Letting Go (Of These Three Things)

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    Let It Go…

    This is Dr. Mitika Kanabar. She’s triple board-certified in addiction medicine, lifestyle medicine, and family medicine.

    What does she want us to know?

    Let go of what’s not good for you

    Take a moment to release any tension you were holding, perhaps in your shoulders or jaw.

    Now release the breath you might have been holding while doing that.

    Dr. Kanabar is a keen yoga practitioner, and recommends it for alleviating stress, as well as its more general somatic benefits. And yes, stress is in large part somatic too!

    One method she recommends for de-stressing quickly is to imagine holding a pin-wheel (the kind that whirls around when blown), and imagine slowly blowing it. The slowness of the exhalation here not only means we exhale more (shallow breathing starts with the out-breath!), but also gives us time to focus on the present moment.

    Having done that, she recommends to ask yourself:

    1. What can you change right now?
    2. What about next time?
    3. How can you do better?

    And then the much more relaxing questions:

    1. What can you not change?
    2. What can you let go?
    3. Whom can you ask for help?

    Why did we ask the first questions first? It’s a lot like a psychological version of the physical process of progressive relaxation, involving first a deliberate tensing up, and then a greater relaxation:

    How To Deal With The Body’s “Wrong” Stress Response

    The diet that’s not good for you

    Dr. Kanabar also recommends letting go of the diet that’s not good for you, too. In particular, she recommends dropping alcohol, sugar, and animal products.

    Note: from a purely health perspective, general scientific consensus is that fermented dairy products are healthy in small amounts, as are well-sourced fish and poultry in moderation, assuming they’re not ultraprocessed or fried. However, we’re reporting Dr. Kanabar’s advice as it is.

    Dr. Kanabar recommends either doing a 21-day challenge of abstention (and likely finding after 21 days that, in fact, you’re fine without), or taking a slow-and-gentle approach.

    Some things will be easier one way or the other, and in particular if you drink heavily or use some other substance that gives withdrawal symptoms if withdrawn, the slow-and-gentle approach will be best:

    Which Addiction-Quitting Methods Work Best?

    If it’s sugar you’re quitting, you might like to check out:

    Food Addictions: When It’s More Than “Just” Cravings

    If it’s meat, though (in particular, quitting red meat is a big win for your health), the following can help:

    The Whys and Hows of Cutting Meats Out Of Your Diet

    Want more from Dr. Kanabar?

    There’s one more thing she advises to let go of, and that’s excessive use of technology (the kind with screens) in the evening, and not just because of the blue light thing.

    With full appreciation of the irony of a one-hour video about too much screentime:

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    Enjoy!

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  • In Defense of Food – by Michael Pollan

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    Eat more like the French. Or the Italians. Or the Japanese. Or…

    Somehow, whatever we eat is not good enough, and we should always be doing it differently!

    Michael Pollan takes a more down-to-Earth approach.

    He kicks off by questioning the wisdom of thinking of our food only in terms of nutritional profiles, and overthinking healthy-eating. He concludes, as many do, that a “common-sense, moderate” approach is needed.

    And yet, most people who believe they are taking a “common-sense, moderate” approach to health are in fact over-fed yet under-nourished.

    So, how to fix this?

    He offers us a reframe: to think of food as a relationship, and health being a product of it:

    • If we are constantly stressing about a relationship, it’s probably not good.
    • On the other hand, if we are completely thoughtless about it, it’s probably not good either.
    • But if we can outline some good, basic principles and celebrate it with a whole heart? It’s probably at the very least decent.

    The style is very casual and readable throughout. His conclusions, by the way, can be summed up as “Eat real food, make it mostly plants, and make it not too much”.

    However, to summarize it thusly undercuts a lot of the actual value of the book, which is the principles for discerning what is “real food” and what is “not too much”.

    Bottom line: if you’re tired of complicated eating plans, this book can help produce something very simple, attainable, and really quite good.

    Click here to check out In Defense of Food, for some good, hearty eating.

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  • Is TikTok right? Can adding a teaspoon of cinnamon to your coffee help you burn fat?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Cinnamon has been long used around the world in both sweet and savoury dishes and drinks.

    But a new TikTok trend claims adding a teaspoon of cinnamon to your daily coffee (and some cocoa to make it more palatable) for one week can help you burn fat. Is there any truth to this?

    Evannovostro/Shutterstock

    Not all cinnamon is the same

    There are two types of cinnamon, both of which come from grinding the bark of the cinnamomum tree and may include several naturally occurring active ingredients.

    Cassia cinnamon is the most common type available in grocery stores. It has a bitter taste and contains higher levels of one of the active ingredient cinnamaldehyde, a compound that gives cinnamon its flavour and odour. About 95% of cassia cinnamon is cinnamaldehyde.

    The other is Ceylon cinnamon, which tastes sweeter. It contains about 50-60% cinnamaldehyde.

    Does cinnamon burn fat? What does the research say?

    A review of 35 studies examined whether consuming cinnamon could affect waist circumference, which is linked to increased body fat levels. It found cinnamon doses below 1.5 grams per day (around half a teaspoon) decreased waist circumference by 1.68cm. However, consuming more than 1.5g/day did not have a significant effect.

    A meta-analysis of 21 clinical trials with 1,480 total participants found cinnamon also reduced body mass index (BMI) by 0.40kg/m² and body weight by 0.92kg. But it did not change the participants’ composition of fat or lean mass.

    Another umbrella review, which included all the meta-analyses, found a small effect of cinnamon on weight loss. Participants lost an average of 0.67kg and reduced their BMI by 0.45kg/m².

    Spoon of cinnamon
    The effect appears small. Radu Sebastian/Shutterstock

    So overall, the weight loss we see from these high-quality studies is very small, ranging anywhere from two to six months and mostly with no change in body composition.

    The studies included people with different diseases, and most were from the Middle East and/or the Indian subcontinent. So we can’t be certain we would see this effect in people with other health profiles and in other countries. They were also conducted over different lengths of time from two to six months.

    The supplements were different, depending on the study. Some had the active ingredient extracted from cinnamon, others used cinnamon powder. Doses varied from 0.36g to 10g per day.

    They also used the two different types of cinnamon – but none of the studies used cinnamon from the grocery store.

    How could cinnamon result in small amounts of weight loss?

    There are several possible mechanisms.

    It appears to allow blood glucose (sugar) to enter the body’s cells more quickly. This lowers blood glucose levels and can make insulin work more effectively.

    It also seems to improve the way we break down fat when we need it for energy.

    Finally, it may make us feel fuller for longer by slowing down how quickly the food is released from our stomach into the small intestine.

    What are the risks?

    Cinnamon is generally regarded as safe when used as a spice in cooking and food.

    However, in recent months the United States and Australia have issued health alerts about the level of lead and other heavy metals in some cinnamon preparations.

    Lead enters as a contaminant during growth (from the environment) and in harvesting. In some cases, it has been suggested there may have been intentional contamination.

    Some people can have side effects from cinnamon, including gastrointestinal pain and allergic reactions.

    One of the active ingredients, coumarin, can be toxic for some people’s livers. This has prompted the European Food Authority to set a limit of 0.1mg/kg of body weight.

    Cassia cinnamon contains up to 1% of coumarin, and the Ceylon variety contains much less, 0.004%. So for people weighing above 60kg, 2 teaspoons (6g) of cassia cinnamon would bring them over the safe limit.

    What about the coffee and cocoa?

    Many people may think coffee can also help us lose weight. However there isn’t good evidence to support this yet.

    An observational study found drinking one cup of regular coffee was linked to a reduction in weight that is gained over four years, but by a very small amount: an average of 0.12kg.

    Good-quality cocoa and dark chocolate have also been shown to reduce weight. But again, the weight loss was small (between 0.2 and 0.4kg) and only after consuming it for four to eight weeks.

    So what does this all mean?

    Using cinnamon may have a very small effect on weight, but it’s unlikely to deliver meaningful weight loss without other lifestyle adjustments.

    We also need to remember these trials used products that differ from the cinnamon we buy in the shops. How we store and how long we keep cinnamon might also impact or degrade the active ingredients.

    And consuming more isn’t going to provide additional benefit. In fact, it could increase your risk of side effects.

    So if you enjoy the taste of cinnamon in your coffee, continue to add it, but given its strong taste, you’re likely to only want to add a little.

    And no matter how much we’d like this to be true, we certainly won’t gain any fat-loss benefits by consuming cinnamon on doughnuts or in buns, due to their high kilojoule count.

    If you want to lose weight, there are evidence-backed approaches that won’t spoil your morning coffee.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Anti-Inflammatory Khichri & Tadka

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is halfway between a daal and a risotto; it’s delicious and it’s full of protein, fiber, heathy fats, and flavors. And those flavors? Mostly from health-giving phytochemicals of one kind of another.

    You will need

    For the khichri:

    • 1 oz chana dal
    • 1 oz red lentils
    • 1 oz brown lentils
    • 1 oz quinoa
    • 4 oz wholegrain basmati rice
    • 1 tbsp chia seeds
    • 1 tsp ground turmeric
    • ½ tsp MSG or 1 tsp low-sodium salt

    For the tadka:

    • 2 tbsp avocado oil (or other oil suitable for high temperatures—so, not olive oil on this occasion!)
    • ¼ bulb garlic, thinly sliced
    • 1 fresh red chili (adjust per heat preferences)
    • 1 fresh green chili (adjust per heat preferences)
    • 1 tsp cumin seeds
    • 6 curry leaves
    • 12 twists of freshly ground black pepper

    To serve:

    • Optional: flatbreads or poppadoms
    • Optional: lemon wedges or lime wedges
    • Optional: chopped cilantro or parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Simmer the khichri ingredients in 5 cups of water, stirring occasionally if necessary, until it has a risotto-like consistency; this will probably take about 30–40 minutes. This time can be greatly reduced by using a pressure cooker, but obviously you won’t be able to check or stir, so do that only if you know what you’re doing cooking those grains and pseudograins in there, and what settings/timings to use for your specific device.

    2) Make the tadka when the khichri is nearly ready, by heating the 2 tbsp of avocado oil in a skillet until very hot but not smoking, Add the rest of the ingredients from the tadka section, and cook until the garlic is nice and golden.

    3) Pour the tadka over the khichri to serve, with any of the optional accompaniments we mentioned.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Longevity for the Lazy – by Dr. Richard Malish

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    There are some people who devote all their resources to longevity, which can become a full-time occupation, not to mention a very expensive endeavor. This book’s for those who want to get the best possible “bang for buck” by doing the things that have the most favorable cost:worth ratio.

    Dr. Malish covers what can be done easily for personal longevity, as well as what technological advances can be enjoyed that those before us didn’t have as options. He also discusses the diseases that are most likely to kill us, and how to avoid those.

    He preaches a proactive approach, but one that is simple and consistent and based in good science, and good statistics. Indeed, while he’s served 20 years as an army doctor and a cardiologist, he now works as a healthcare policy consultant, so he is well-placed to advise.

    The style of the book is halfway between regular pop-science and a textbook; you can either read it cover-to-cover, or skim first though the key points, highlight boxes, summaries, and the like. He also provides a time-phased task list, for those who like things to be laid out like that.

    Bottom line: this is a very good, methodical guide to living longer without making it a full-time occupation.

    Click here to check out Longevity For The Lazy, and enjoy healthy longevity that gives you time free to enjoy it!

    Don’t Forget…

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  • Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)

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    There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:

    Under pressure

    When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.

    Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower

    *10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.

    Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.

    Dr. Dhand’s advice for patients and families is:

    • Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
    • Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
    • Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.

    For more on all of this, enjoy:

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    Want to learn more?

    You might also like to read:

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    Take care!

    Don’t Forget…

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