Fatigue, often extreme fatigue, is a key symptom of fibromyalgia. For many, it can be even more debilitating than the pain.
Doctors generally tend to shy away from prescribing medications to treat fatigue. I suspect that's because most of them are stimulants and can be highly addicting. The anti-fatigue drug I most often hear being prescribed for fibromyalgia is Provigil, which is FDA approved for narcolepsy, obstructive sleep apnea and multiple sclerosis-related fatigue. However, Provigil tends to stop working if it is taken every day.
The problem I personally have with taking prescription drugs for fatigue is that, although they may make me feel like I have more energy, they don't address the core problem causing the fatigue. I'm afraid that if I do more because I feel more energetic, I may actually be harming my body by pushing myself too much.
Where Energy Comes From
Imagine that each cell in your body is a car. Mitochondria are the engines – or energy producers – in each cell that make your 'car' run. It is the job of the mitochondria to supply this energy in the form of adenosine triphosphate (ATP). Scientists have found that people with fibromyalgia have low levels of ATP and a reduced capacity to produce ATP in our muscles.
Supplements That Aid Energy Production
Fibromyalgia specialists like Drs. Mark Pelligrino and Charles Lapp recommend several nutritional supplements to their patients who are fighting fatigue. Following are supplements one or both of these physicians use in treating people with fibromyalgia and/or myalgic encephalomyelitis / chronic fatigue syndrome:
• Coenzyme Q10 – CoQ10 is the catalyst that makes it possible for the mitochondria to produce ATP, the molecule upon which all cellular functions in the body depend. A severe CoQ10 deficiency can cause mitochondrial dysfunction, which in turn has a serious negative impact on multiple organs and body systems.
• NADH – NADH sets off a chemical chain reaction by transforming Coenzyme Q10 into its reduced form. Then, in its reduced form, Co-Q10 becomes active and serves as the catalyst that makes it possible for the mitochondria to produce ATP. Every molecule of NADH results in the production of three molecules of ATP energy. NADH is a critical component of your body's ability to function. Without NADH, the mitochondria cannot produce energy and the cells will die.
• B12 – Many people with fibromyalgia have a relatively low B12 level. Even minor B12 deficiencies can cause anemia, fatigue, shortness of breath and weakness. B12 is best taken in a sublingual form or by injection because it is not absorbed well in the stomach.
• Acetyl-L-Carnitine – Perhaps best known for its ability to improve memory and cognitive functioning problems, Acetyl-L-Carnitine also aids in reducing fatigue. According to a 2007 study, L-Carnitine supplementation improved both physical energy levels and cognitive function in centenarians (people 100 years of age and older).
• D-Ribose – D-Ribose is a naturally-occurring sugar used in cell metabolism and the production of energy. It has been shown to increase cellular energy synthesis in the heart and skeletal muscles. A 2006 pilot study showed that D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and ME/CFS.
• Magnesium and Malic Acid – When intracellular magnesium is low, the muscles are not able to relax and make energy. The combination of magnesium and malic acid works with the muscles to help them manufacture more ATP, resulting in more energy.
• Bovine Colostrum – Studies have shown that people with fibromyalgia have decreased growth hormone levels (IGF-1). A major symptom of low growth hormone is fatigue. Bovine colostrum contains growth hormone that is essentially identical to human IGF-1. Dr. Pelligrino says that 75% of his FM patients report improvement in their energy level and ability to concentrate when taking bovine colostrum.
• Ginko Biloba – More than 34 human studies on ginko biloba show that it increases the body's production of the energy molecule ATP. This in turn boosts the brain's energy metabolism of glucose and increases electrical activity, resulting in more energy and improved cognitive functioning.
Remember that nutritional supplements have to build up in your system, so it may be a few weeks or in some cases a few months before you may begin to notice a significant difference.
Personally, I take CoQ10, NADH and B12 to combat the fatigue of FM. For the CoQ10, I use a form called Ubiquinol because it is more easily utilized by the body. I noticed the biggest increase in my energy about three weeks after adding the CoQ10. However, I realized that the NADH and B12 were also making a difference when I ran out and didn't take them for awhile.
Be sure to check with your doctor about any supplements you want to add to your treatment plan. Some supplements may interact with medications you are taking or may not be recommended with other health issues you have.