You Don’t Have to Suffer with It
By Madhuri Cawley, P.A., M.A.



Traditional medicine would have us believe that Fibromyalgia is an elusive condition. It has been relegated to the specialty of Rheumatology because the primary symptom is pain. Their treatment paradigm is similar to that for other “illnesses”, ie. relieve the symptoms. Muscle relaxants and analgesics are used for joint and muscle pain, sleep medications used for insomnia, and psychotropic and seizure drugs are used to handle anxiety and depression.

Fibromyalgia is defined as widespread pain for three or more months in 11 or more of 18 designated tender points on the body. In many people, there are fewer than 11 tender points. There are accompanying symptoms which vary from person to person, but typically may include fatigue, sleeping difficulties, irritable bowels, systemic inflammation, depression and anxiety.

Historically, the term “Fibromyalgia” was coined in 1976. Prior to that it was called “muscular rheumatism” in 1592, “neuralgia” in 1841, “fibrositis” in 1904 and “psychogenic rheumatism” meaning of psychological causation, in the 1930’s. This historical naming follows a pattern of ascribing a psychological basis for unexplainable symptoms, a common practice in medicine.

Unfortunately, there can be a prejudice and stigma for people who have this diagnosis as well as a frustration, as depression may be the effect, not necessarily the cause. A point of clarity is that depression can deplete the immune response, so it can be both cause and effect.

Because so many people are disabled by Fibromyalgia, there is research being done, looking for underlying causes. There is some evidence of biological markers called APA or Anti-polymer Antibodies in people with Fibromyalgia. An antibody is a substance our bodies make when there has been exposure to an infection, toxin or an antigen, an allergic substance.

There is research looking into other etiologies including exploring possible infections which have predisposed one to Fibromyalgia. My professional experience with viruses like Epstein Barr and Mono is they seem to lead to chronic fatigue and often pain complexes.

Hormonal deficiencies and neurotransmitter irregularities are also being reviewed. However, with evidence of these findings, symptoms relief is still the mainstay of treatment, as traditional medicine does not have adequate paradigms to address impaired immune systems, hormonal and neurotransmitter deficiencies.

Determining exactly what hormones are out of balance and replacing those with bio-identical formulas is a big key. Finding the sites of infection and treating those, the gastrointestinal tract, primarily. With past viruses, the adrenal glands would need to be restored with bio-identical Dhea and Cortisol, as needed, and other supportive supplements. Looking at amino acid profiles and replenishing deficiencies which support healthy neurotransmitters. Testing for metal toxicity in the body which can lead to infections and break down normal immune functioning is important for healing rather than band-aiding symptoms.

Consider the age of people, especially women, who get diagnosed with autoimmune conditions, like Lupus and Hashimoto’s Thyroiditis. Mostly, the diagnoses are made at puberty and peri-menopause. These are times when the body is undergoing dramatic shifts in hormones, either amping up or shutting down.

I have found in some adolescent women that their hormones do not stabilize until their mid-20’s and sometimes never. Women having children in their 20’s and 30’s can do so with very little hormones. Therefore their hormone deficiencies will be underestimated, except they can experience PMS and endometriosis.

I have seen women who have no menses and low levels on lab testing, easily getting pregnant. Hormonal shifts take place after pregnancy and delivery, sometimes plummeting women into post-partum depression. PMS usually occurs after child delivery, although it can certainly take place in adolescence. Instead of treating with antidepressants, look to the hormones.

I experience these and other immune or hormonally-deficient conditions can and are being reversed. I am equating these as the same, although there can certainly be other factors in autoimmunity, but seemingly not in Fibromyalgia. Checking hormonal status at every stage of life, and treating accordingly, can proactively prevent ill health and distressing symptoms.

During the time between mid-30’s through mid-50’s, a woman can be in peri-menopause. Hormones may need to be checked every six months during these years. In addition to estradiol, estrone, progesterone, and free and total testosterone, dhea-s, cortisol and thyroid hormones should be checked at least once per year, or more often if found to be deficient or in excess.

Men with Fibromyalgia typically have chronic fatigue too, and they may be estrogen dominant, which means they have too much estrogen in their system relative to male hormones. Woman, of course, can become androgen dominant as well. Examples of conditions produced by this are polycystic ovaries, cystic acne and excess body and/or facial hair. Men and women with Fibromyalgia can have thyroid and adrenal excesses or deficiencies as mentioned above. They usually have histories of multiple physical and emotional trauma.

Another condition that can be found with Fibromyalgia is polycythemia vera, increased number of red blood cells and total blood volume. This is not extremely common but worth mentioning. Thickened blood or hypercoagulation can cause pain. It also potentially increases the risk of cardiovascular events.

Polycythemia vera is caused by either a dietary deficiency of B12 and Folic Acid, or can be inherited genetically. Correcting the vitamin deficiency is easy, and in the instances of inherited PCV, therapeutic phlebotomy or donation of blood to a blood bank, help alleviate the symptoms of this condition. The frequency of a phlebotomy or “blood letting”, is determined by the amount of excess red blood cells, and is usually from every month when levels are quite high, to 3 to 4 times per year. I suggest that a complete blood count be checked every 4 to 6 months in people with PCV. It is important to avoid giving blood too often which can create an iron deficiency.

Taking blood thinners such as coumadin or even aspirin is not recommended except in life-threatening cardiac circumstances because there are too many side effects and drug interactions. Inflammation in the system can be detected by the blood biomarker C-Reactive Protein. Finding an elevated level, we can reduce the inflammation as well as the risk for cardiovascular events.

Appropriate and lasting treatments of Fibromyalgia include the following: 1) Find the causes and treat those on every level, down to the basic biochemistries and hormones. Eliminate infections and toxins. Tylenol should not be used continuously for pain relief, or at all, as it can cause liver damage and has been implicated in some cases of high blood pressure. There are natural substances which help to relieve pain because they are addressing the causes of pain: quercitin, tumeric, bromelain, ginger and other anti-oxidants.

2) Diet plays a big role. Too much sugar and refined or processed carbohydrates which turn into sugar and fat in the body, create among other chemical imbalances, an excess of pain-causing prostaglandins. Prostaglandins are hormone-like substances which either contribute to pain, PGE2, or relieve pain in an endorphin-like fashion, PGE1 and PGE3. These are derived from healthy essential fatty acids, omega 3’s and 6’s. Saturated fats and rancid oils cause inflammation and pain in the body.

3) Exercise, primarily low-impact stretching, yoga, dance and tai chi help relieve stress, excess cortisol, and tightened muscles and fascia. These forms of exercise open joint spaces and allow for natural synovial fluid to bathe and lubricate.

4) Injury and not being hydrated enough with good, clean water, can lead to “dryer” joint spaces. For most people, it is important to drink at least two liters of mineralized water per day. In hot and dry climates, more is needed.

5) Mental and emotional balancing. This has certainly been said before by me and others, yet bears emphasizing. Find ways to resolve disharmony and dysfunction in your life. Take responsibility for all words, thoughts and actions. A healthy mind creates a healthy body. Eliminate criticism and judgment of self and others as much as possible.

6) Develop spiritual practices and living. These things are ongoing. Daily, one must commit to taking care of and nurturing oneself. This is the way to healing and being proactive in preventing chronic, degenerative disease. The symptoms of Fibromyalgia can be relieved. I know from personal, as well as professional experience. I wish you well!

Madhuri Cawley, P.A., M.A., has been serving women and men for over 30 years through her natural medical practice, specializing in thyroid and other bio-identical hormones. Her treatment involves comprehensively balancing the whole person by diagnosing underlying causes of symptoms and illness. She is available for individual or group consultation and classes, and can be reached at (760) 295-5392, e-mail  or at :

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