A reader wrote about constant pain. One common cause of pain in FM is low oxygen level – typically caused by one or more of the following:

• Vasoconstriction (narrowing of blood vessels, reducing oxygen delivery volume)
• Fibrin deposits (blocking access of the blood’s oxygen into tissue)
• Coagulation (thick blood) – blood moves slower, so less oxygen is delivered.

Some literature:

• Hyperbaric oxygen therapy can diminish fibromyalgia syndrome–prospective clinical trial [2015].
• Pain severity is associated with muscle strength and peak oxygen uptake in adults with fibromyalgia [2014]. “lesser values of … peak VO2 uptake were predictive of greater pain severity scores.”
• Noninvasive optical characterization of muscle blood flow, oxygenation, and metabolism in women with fibromyalgia [2012]. “However, tissue relative oxygen extraction fraction during exercise in subjects with FM was significantly lower than in healthy controls, and the half-times of oxygenation recovery … were significantly longer following fatiguing exercise and cuff occlusion.” – i.e. the ability to deliver oxygen is impaired.
• “Women with fibromyalgia had greater impaired of functional capacity, exacerbation of pain and exertion during the 6 Minute Walk Test  when compared to healthy women… In the fibromyalgia group, there was a negative correlation between distance in 6MWT  and oxygen consumption”[2011] the further walks, the less oxygen was consumed… contrary to normal people…  [2011]

Vasodilators

I have often taken a vasodilator. Brain fog and the occasion pain disappeared. Which one, flushing niacin, which often create a major flush on occasion still. Unfortunately, the reader is unable to take niacin. The following are alternatives, my first choice would be 800 mg of magnesium per day, while slow — magnesium is reported to improve fibromyalgia [1995]

• L-arginine is an amino acid that is a vasodilator. According to studies, it is higher in urine of CFS patients[2006], but is generally low  [1993]. It also shifts the Firmicutes-to-Bacteroidetes ratio to favor Bacteroidetes [2014] which unfortunately is the same type of shift seen in CFS “a higher relative abundance of Bacteroidetes and lower abundance of Firmicutes observed in ME/CFS patients compared to healthy controls.” [2015]
• ” It is suspected that the cerebral vasodilator effects of Danshen and Gegen produced either on their own or in combination, can help patients with obstructive cerebrovascular diseases.” [2014]
  • The anti-hypertensive effect of Danshen (Salvia miltiorrhiza) and Gegen (Pueraria lobata) formula in rats and its underlying mechanisms of vasorelaxation [2011].
• Long-term intake of rosemary and common thyme herbs inhibits experimental thrombosis without prolongation of bleeding time [2008]. “both rosemary and common thyme significantly inhibited platelet reactivity and enhanced the flow-mediated vasodilation.”
  • “Common thyme and rosemary showed significant antithrombotic activity in vitro and in vivo. Neither herb affected flow-mediated vasodilation.” [2005]
• Chakalaka-induced vasodilatation in patients with chronic myeloid leukaemia on tyrosine kinase inhibitors [2009]. Chakalaka is a South African vegetable relish,
• ” our study confirmed the functional effects of fennel derived-nitrites using in vitro and ex vivo models that describe the promotion of angiogenesis, cell migration, and vasorelaxation.” [2012]
• ” the effects of a dietary supplement containing β-hydroxy-β-methylbutyrate (HMB), glutamine and arginine on endothelial-dependent vasodilation of older adults…revealed a 27% increase in flow-mediated dilation among the treatment group” [2016]
  • • Glutamine, N-acetyl cysteine and zinc in combination improves symptoms http://www.ncbi.nlm.nih.gov/pubmed/19112401 (2008)
• “The current meta-analysis, therefore, does not provide unambiguous evidence to support the use of fat-soluble vitamin supplements (Vitamin D and E) to improve fasting flow-mediated vasodilation in adults.” [2015]
• “Garlic-derived polysulfides stimulate the production of the vascular gasotransmitter hydrogen sulfide (H2S) a… which induce smooth muscle cell relaxation, vasodilation, and BP reduction.” [2014]
• Some sites mention [source] [source]
  • Catuaba Catuaba, Erythroxylum catuaba
  • Cayenne Pepper Cayenne Pepper, Capsicum minimum
  • Ginger Root Ginger Root, Zingiber officinale
  • Ginkgo biloba Ginkgo biloba, Ginkgo biloba L.
  • Gotu Kola Gotu Kola, Centella asiatica (L.)
  • Jiaogulan Jiaogulan, Gynostemma pentaphyllum
  • Lemon Balm
  • Lotus Lotus, Nelumbo nucifera
  • Nettle
  • Olive Leaf
  • Orange Orange, Citrus sinensis, Citrus spp.
  • Parsley Parsley, Petroselinum crispum
  • Schisandra Schisandra, Schisandra chinensis
  • Skullcap
  • Valerian
  • “According to Linus Pauling Institute, magnesium supplement at a dose of 730 milligrams per day can cause a 12-percent improvement in the normal dilation response of arteries. ” [source]

Fibrin Removers

Back in 2012, I did a series of posts on those available as supplements

• Serrapeptase
• Nattokinease
• Lumbrokinease
• Bromelain

All of these also increases penetration of antibiotics into tissue (up to 10x higher concentrations).

Coagulation (thick blood)

This is more complex, this post lists some items.