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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Want to learn more?
You might also like to read:
- Managing Chronic Pain (Realistically!)
- How To Eat To Beat Chronic Fatigue ← yes, including how to do so when you are chronically fatigued. In other words, this isn’t just dietary advice, but rather practical advice too
- When Painkillers Aren’t Helping, These Things Might
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Death by Sitting – by Carolyne Thompson
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You may be wondering: is this a lot of words to say “sit down less”?
And the answer is: there’s a lot more in here than that. Of course, yes, “sit down less” is an important take-away, but there’s a lot about the specific problems caused by sitting in chairs, the health risks are that are increased and how, and the early warning signs to watch out for.
After these chapters of woe, most of the book is given over to solutions; about taking standing and walking breaks, tying movement to productivity, why exercise alone is not enough to offset the damage of sitting, relearning ergonomic posture in the context of mitigating the harm, psychological shifts to break the habit of sitting, redefining social norms around sitting and socializing, rewiring one’s body and retraining better movements as well as postures to always immediately move out of if one finds oneself in, and much much more.
The style is light and easy to read, while still including scientific research as appropriate along with practical, actionable advice.
Bottom line: if you’d like to do better for your body than slowly killing it for however many hours a day, then this book has a wealth of advice far beyond the obvious (but important!) “sit less”.
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Sesame & Peanut Tofu
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Yesterday we learned how to elevate tofu from “nutrition” to “nutritious tasty snack” with our Basic Baked Tofu recipe; today we’re expanding on that, to take it from “nutritious tasty snack” to “very respectable meal”.
You will need
For the tofu:
- The Basic Baked Tofu that we made yesterday (consider making this to be “step zero” of today’s recipe if you don’t already have a portion in the fridge)
For the sauce:
- ⅓ cup peanut butter, ideally with no added sugar or salt (if allergic to peanuts specifically, use almond butter; if allergic to nuts generally, use tahini)
- ¼ bulb garlic, grated or crushed
- 1 tbsp tamarind paste
- 1½ tbsp tamari sauce (or low-sodium soy sauce, if a substitution is necessary)
- 1 tbsp sambal oelek (or sriracha sauce, if a substitution is necessary)
- 1 tsp ground coriander
- 1 tsp ground black pepper
- ½ tsp ground sweet cinnamon
- ½ tsp MSG (or else omit; do not substitute with salt in this case unless you have a particular craving)
- zest of 1 lime
For the vegetables:
- 14 oz broccolini / tenderstem broccoli, thick ends trimmed (failing that, any broccoli)
- 6 oz shelled edamame
- 1½ tsp toasted sesame oil
For serving:
- 4 cups cooked rice (we recommend our Tasty Versatile Rice recipe)
- ½ cup raw cashews, soaked in hot water for at least 5 minutes and then drained (if allergic, substitute cooked chickpeas, rinsed and drained)
- 1 tbsp toasted sesame seeds
- 1 handful chopped cilantro, unless you have the “this tastes like soap” gene, in which case substitute chopped parsley
Method
(we suggest you read everything at least once before doing anything)
1) Combine the sauce ingredients in a bowl and whisk well (or use a blender if you have one that’s comfortable with this relatively small quantity of ingredients). Taste it, and adjust the ingredient ratios if you’d like more saltiness, sweetness, sourness, spiciness, umami.
2) Prepare a bowl with cold water and some ice. Steam the broccolini and edamame for about 3 minutes; as soon as they become tender, dump them into the ice bathe to halt the cooking process. Let them chill for a few minutes, then drain, dry, and toss in the sesame oil.
3) Reheat the tofu if necessary (an air fryer is great for this), and then combine with half of the sauce in a bowl, tossing gently to coat well.
4) Add a little extra water to the remaining sauce, enough to make it pourable, whisking to an even consistency.
5) Assemble; do it per your preference, but we recommend the order: rice, vegetables, tofu, cashews, sauce, sesame seeds, herbs.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tofu vs Seitan – Which is Healthier?
- Plant vs Animal Protein: Head to Head
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier?
- Our Top 5 Spices: How Much Is Enough For Benefits?
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Apple Cider Vinegar vs Balsamic Vinegar – Which is Healthier?
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Our Verdict
When comparing apple cider vinegar to balsamic vinegar, we picked the apple cider vinegar.
Why?
It’s close! And it’s a simple one today and they’re both great. Taking either for blood-sugar-balancing benefits is fine, as it’s the acidity that has this effect. But:
- Of the two, balsamic vinegar is the one more likely to contain more sugars, especially if it’s been treated in any fashion, and not by you, e.g. made into a glaze or even a reduction (the latter has no need to add sugar, but sometimes companies do because it is cheaper—so we recommend making your own balsamic vinegar reduction at home)
- Of the two, apple cider vinegar is the one more likely to contain “the mother”, that is to say, the part with extra probiotic benefits (but if the vinegar has been filtered, it won’t have this—it’s just more common to be able to find unfiltered apple cider vinegar, since it has more popular attention for its health benefits than balsamic vinegar does)
So, two wins for apple cider vinegar there.
Want to learn more?
You might like to read:
- 10 Ways To Balance Your Blood Sugars
- An Apple (Cider Vinegar) A Day…
- Apple Cider Vinegar vs Apple Cider Vinegar Gummies – Which is Healthier?
Take care!
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The Diabetes Code – by Dr. Jason Fung
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.
Cure this serious disease with diet!” is often a bold-claim that overreaches scientific rigor, but in this case, it’s well-established as scientifically valid.
Caveat up-front: the only known circumstance in which this won’t work is if you have comorbidities that prevent you from following the advice.
You may be wondering: is this just the Mediterranean diet again? The answer is that the Mediterreanean diet (or similar) is part of it. But there’s a lot more to this book than that.
Dr. Fung explains to us a lot of the physiology of type 2 diabetes; how insulin resistance occurs, how it becomes a vicious cycle that we get locked into, and how to escape it.
- We learn about the role of fructose, and why fruit is very healthful whereas high-fructose corn syrup and similars are very much not.
- We learn about the role of the liver in glycogen metabolism, and how to un-fatty a fatty liver. Good news: the liver has famously strong self-regenerative abilities, if we give it a break to allow it to do so!
- We learn why portion control doesn’t work, and why intermittent fasting does (here be science).
Dr. Fung’s very readable explanations are free from needless jargon while not dumbing down. The writing style is clear and direct: “this happens this way”, “do this, not that”, etc.
Bottom line: if you have type 2 diabetes and would like to not have that (or if you are pre-diabetic and would like to avoid diabetes) this is a book for you. If you are in great metabolic health and would like to stay that way as you get older, then this is a book for you too.
Click here to check out The Diabetes Code, and get/keep your metabolic health in order!
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Carrot vs Kale – Which is Healthier?
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Our Verdict
When comparing carrot to kale, we picked the kale.
Why?
These are both known as carotene-containing heavyweights, but kale emerges victorious:
In terms of macros, carrot has more carbs while kale has more protein and fiber. An easy win there for kale.
When it comes to vitamins, both are great! But, carrots contain more of vitamins A, B5, and choline, whereas kale contains more of vitamins B1, B2, B3, B6, B9, C, E, and K. And while carrot’s strongest point is vitamin A, a cup of carrots contains around 10x the recommended daily dose of vitamin A, whereas a cup of kale contains “only” 6x the recommended daily dose of vitamin A. So, did we really need the extra in carrots? Probably not. In any case, kale already won on overall vitamin coverage, by a long way.
In the category of minerals, kale again sweeps. On the one hand, carrots contain more sodium. On the other hand, kale contains a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Not a tricky choice!
But don’t be fooled: carrots really are a nutritional powerhouse and a great food. Kale is just better—nutritionally speaking, in any case. If you’re making a carrot cake, please don’t try substituting kale; it will not work 😉
Want to learn more?
You might like to read:
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Paracetamol pack sizes and availability are changing. Here’s what you need to know
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Changes are coming into effect from February 1 about how paracetamol is sold in Australia.
This mainly affects pack sizes of paracetamol sold outside pharmacies and how paracetamol is accessed in pharmacies.
The changes, announced by Australia’s drug regulator, are in line with moves internationally to reduce the harms of liver toxicity and the risk of overdose.
However, there are no new safety concerns when paracetamol is used as directed. And children’s products are not affected.
Bowonpat Sakaew/Shutterstock What is paracetamol?
Paracetamol is commonly sold under brand names such as Panadol, Dymadon and Panamax. It’s used to treat mild pain and fever for short periods or can be prescribed for chronic (long-term) pain.
Millions of packs of this cheap and accessible medicine are sold in Australia every year.
Small packs (up to 20 tablets) have been available from supermarkets and other retailers such as petrol stations. Larger packs (up to 100 tablets) are only available from pharmacies.
Paracetamol is relatively safe when used as directed. However, at higher-than-recommended doses, it can cause liver toxicity. In severe cases and when left untreated, this can be lethal.
Why are the rules changing?
In 2022, we wrote about how the Therapeutic Goods Administration (TGA) was considering changes to paracetamol access because of an increase in people going to hospital with paracetamol poisoning.
An expert review it commissioned found there were about 40–50 deaths every year from paracetamol poisoning between 2007 and 2020. Between 2009–10 and 2016–17, hospital admissions for this increased (from 8,617 to 11,697), before reducing in 2019–20 (8,723). Most admissions were due to intentional self-poisonings, and about half of these were among people aged ten to 24.
After the report, the TGA consulted with the public to work out how to prevent paracetamol poisonings.
Options included reducing pack sizes, limiting how many packs could be bought at once, moving larger packs behind the pharmacy counter and restricting access by age.
Responses were mixed. Although responses supported the need to prevent poisonings, there were concerns about how changes might affect:
- people with chronic pain, especially those in regional areas, where it may be harder to access pharmacies and, therefore, larger packs
- people on limited incomes, if certain products were made prescription-only.
Although deaths from paracetamol poisoning are tragic and preventable, they are rare considering how much paracetamol Australians use. There is less than one death due to poisoning for every million packs sold.
Because of this, it was important the TGA addressed concerns about poisonings while making sure Australians still had easy access to this essential medicine.
If you buy large packs of paracetamol for chronic pain, you’ll need to go to the pharmacy counter. StratfordProductions/Shutterstock So what’s changing?
The key changes being introduced relate to new rules about the pack sizes that can be sold outside pharmacies, and the location of products sold in pharmacies.
From February 1, packs sold in supermarkets and places other than pharmacies will reduce from a maximum 20 tablets to 16 tablets per pack. These changes bring Australia in line with other countries. These include the United Kingdom, which restricted supermarket packs to 16 tablets in 1998, and saw reductions in poisonings.
In all jurisdictions except Queensland and Western Australia, packs sold in pharmacies larger than 50 tablets will move behind the pharmacy counter and can only be sold under pharmacist supervision. In Queensland and WA, products containing more than 16 tablets will only be available from behind the pharmacy counter and sold under pharmacist supervision.
In all jurisdictions, any packs containing more than 50 tablets will need to be sold in blister packs, rather than bottles.
Several paracetamol products are not affected by these changes. These include children’s products, slow-release formulations (for example, “osteo” products), and products already behind the pharmacy counter or only available via prescription.
What else do I need to know?
These changes have been introduced to reduce the risk of poisonings from people exceeding recommended doses. The overall safety profile of paracetamol has not changed.
Paracetamol is still available from all current locations and there are no plans to make it prescription-only or remove it from supermarkets altogether. Many companies have already been updating their packaging to ensure there are no gaps in supply.
The reduction in pack sizes of paracetamol available in supermarkets means a pack of 16 tablets will now last two days instead of two-and-a-half days if taken at the maximum dose (two tablets, four times a day). Anyone in pain that does not improve after short-term use should speak to their pharmacist or GP.
For people who use paracetamol regularly for chronic pain, it is more cost-effective to continue buying larger packs from pharmacies. As larger packs (50+ tablets) need to be kept out of sight, you will need to ask at the pharmacy counter. Pharmacists know that for many people it’s appropriate to use paracetamol daily for chronic pain.
Natasa Gisev, Clinical pharmacist and Scientia Associate Professor at the National Drug and Alcohol Research Centre, UNSW Sydney and Ria Hopkins, Postdoctoral Research Fellow, National Drug and Alcohol Research Centre, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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