Molecular Receptors That Are Activated By Metabolites Produced By Muscle Contraction
Major advances have been made in the last 10 years in identifying metabolites produced by muscle contraction. The most likely ion channels to detect pH changes, acid-sensing ion channels , also called amiloride-sensitive ion channels or amiloride-sensitive ion currents, were cloned and sequenced in 1997 . However, initially it appeared that these channels could not play a role in detecting the normal pH values found in humans. They could not gate enough current to activate sensory endings with the small changes in pH observed in conditions known to cause muscle pain in humans, for example, a pH change from 7.4 to 7.0 that can trigger angina in the heart. showed that lactate played a role in enhancing the response of ASICs to pH values between pH 7.4 and 7.0. Thus, lactic acid, at concentrations produced during ischemia and extreme active muscle contractions, was more effective in activating muscle sensory afferents than pH reduction alone, as produced by non-ischemic events .
Later, another critical co-factor was found. ATP in the low concentrations found in muscle interstitium during normal muscle contractions greatly enhanced the sensitivity of ASICs to pH and lactate . Altogether, these combinations enable the ASIC3 receptor to gate sustained current in a range from pH 7.66.6 that is capable of activating sensory endings.
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What Do We Know About Fibromyalgia
Of the two, fibromyalgia affects about 4 million Americans and is one of the most misunderstood conditions. Many times, family members and friends dont understand what having fibromyalgia means and what it means to suffer from it.
Many patients get their diagnosis between the ages of 20 and 50, but the incidence increases with age. By age 80, about 8% of adults have fibromyalgia. according to the National Fibromyalgia Association. About 75% to 90% of those who have fibromyalgia are women.
The cause of fibromyalgia is unknown, says Dr. Bolash. Genetics, trauma or an infection may play a role. Fibromyalgia sufferers say it feels like having the flu all the time.
Symptoms include:
- Fatigue and tiredness.
Getting Adequate Rest Can Fight Short
In most cases, chronic fatigue is not substantially improved by rest. Chronic fatigue often makes it more difficult to get adequate rest. Similarly, fatigue can interfere with sleep, resulting in unrefreshing sleep, difficulty falling asleep, frequent awakening, or sleep apnea.
Rest is unlikely to relieve fatigue caused by a medical condition.
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How Is Me/cfs Diagnosed
There’s no single test to detect ME/CFS. A diagnosis is made after other possible known causes for symptoms have been excluded.
The earlier the illness is recognised, the sooner you can get help to manage your symptoms. Many people with ME/CFS find it helps to keep a diary of their symptoms so that they can take this to their GP or specialist.
Your GP will usually:
- do a physical and mental examination to rule out other conditions
- ask about recent travel, tick or insect bites, unusual infections, and drug and alcohol use
- review current medication
They may be able to make a diagnosis after 3 or 4 months of seeing a pattern of symptoms. Anyone suspected of having ME/CFS should be considered for routine blood tests to identify other possible illnesses. More investigation may be needed if the diagnosis remains in doubt.
Some people with ME/CFS also have another long-term condition and it’s important that you talk to your GP about how to manage the symptoms of the 2 conditions.
Causes Of Back Pain And Fatigue
There can be various underlying reasons for back pain. Usually, lower back pain can be caused when soft tissues become injured. A damaged disc, nerve compression, improper spinal joint movement, stretched muscles, torn or damaged muscles, all become a reason for lower back pain, which then becomes the cause for increasing fatigue.
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Caring For Someone With Me/cfs
Having a supportive community of family, friends, school, work, employers and health workers, who understand the potential seriousness of ME/CFS, can also help improve the quality of life of people living with ME/CFS.
Everyone involved in supporting someone with ME/CFS needs to understand Post Exertional Malaise, which is an abnormal, biological response to exercise or activity. This means the patient will not be able to do all of the activities they used to be able to do, and will benefit from practical and emotional support. People with ME/CFS will each have different needs and preferences, so it is important to talk with them about how best to provide support. This may include help with daily routines, family life, accessing healthcare and other personal priorities.
Related Signs And Symptoms
Body aches are often experienced in conjunction with other symptoms, which can be helpful in determining the underlying cause of your soreness. Common symptoms you might experience in addition to body aches include:
- Fatigue: You may feel tired, fatigued, exhausted, like its difficult to move, or like your body is heavy or weighed down.
- Chills: You may also shiver, feel abnormally cold without any cause, or complain that you feel chills running through your body.
- Fever: Fevers, or body temperatures of more than 100° F , are often associated with feelings of muscle achiness or soreness.
- Headache: Headaches are another symptom commonly linked to body aches.
- Sore throat: Body aches and sore throat, nasal congestion, or runny nose can be experienced simultaneously.
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Can You Get Body Aches With Pollen Allergies
Allergies can produce a variety of symptoms, but one thing everyone affected with allergies experiences is discomfort. People can be allergic to pollen, pet dander, dust, foods and plants. Pollen allergies most commonly cause nasal congestion, a runny nose, sore throat and itchy eyes. Less frequent symptoms include hives, itchy skin, cough, mood changes and body aches.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Oxidative And Nitrosative Stress
Enhanced oxidative and nitrosative stress has been reported in CFS/ME patients. For example, studies have demonstrated patients to exhibit excessive production of reactive oxygen species following physical exertion, as well as altered resting blood oxidant to antioxidant status .
Biochemical markers associated with oxidative stress have also been reported to play a pivotal role in skeletal muscle fatigue , which is often cited as a debilitating symptom experienced by CFS/ME patients . Effectively, oxidative and nitrosative stress involve the enhanced production of ROS and reactive nitrogen species , in addition to other free radicals these reactive species have the potential to disrupt cell membrane function through lipid peroxidation, as well as damage to functional proteins and DNA. This can ultimately lead to alterations in cell structure and disease initiating mutations .
Elevated ROS/RNS exhibit the capacity to profoundly impair mitochondrial function, which has been suggested to be due to the accumulation of oxidative modified mitochondrial proteins, lipids, and DNA . Moreover, these factors exhibit the potential to induce electron transport chain dysfunction, impairment in cellular bioenergetics, and ultimately skeletal muscle fatigue. Furthermore, skeletal muscle is a postmitotic tissue so it is extremely susceptible to mitochondrial oxidative damage this is due to being terminally differentiated and because of a slow cellular turnover and high metabolic rate .
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Diagnostic Criteria For Me/cfs Using The National Academy Of Medicine Clinical Criteria
For a diagnosis of ME/CFS, the person must have the following three symptoms:
Diagnosis also requires at least one of the following two symptoms:
It is important to note that these are not the only symptoms of ME/CFS, just the minimum needed to meet the diagnostic criteria.
While diagnosis requires that a person has had symptoms continually for six months, early intervention with pacing and rest can help reduce symptoms, improve quality of life and reduce the risk of exacerbating the disease. Research suggests that patients who are able to pace their activity and not push themselves tend to do better in the long term. Pacing and rest can start even prior to an official diagnosis.
While there is currently no cure and no evidence-based treatments, it is important to find a doctor who is not only sympathetic to ME/CFS, but can work with you to help manage your symptoms.
Home Remedies And Lifestyle Changes
Making some lifestyle changes may help reduce your symptoms.
Limiting or eliminating your caffeine intake can help you sleep better and ease your insomnia. You should limit or avoid nicotine and alcohol too.
Try to avoid napping during the day if its hurting your ability to sleep at night.
Create a sleep routine. Go to bed at the same time every night and aim to wake up around the same time every day.
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Postexertional Malaise And Immune Function
CFS/ME patients report a changeable pattern to their symptoms and physical and cognitive capabilities, often with severe symptom exacerbation following physical exercise . This is termed PEM, with approximately 95% of CFS/ME patients experiencing PEM . As regards the cause of PEM, it has been suggested that exercise may exhibit the ability to amplify preexisting immune abnormalities, in addition to oxidative and nitrosative stress . Immunological abnormalities have been reported following exercise in CFS/ME. For example, observations in CFS/ME symptom flare after moderate intensity exercise have been reported to be directly linked to the levels of interleukin-1 , IL-12, IL-8, IL-10, and IL-13, 8 hours after exercise . Additionally, sustained increase in plasma TNF- in CFS/ME patients and not in healthy controls has been observed after exercise . Moderate intensity exercise has also been reported to induce a larger 48-hour postexercise area under the curve for IL-10 .
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Over-the-counter pain medication and nonsteroidal anti-inflammatory drugs are effective for moderate and severe cases. However, some cases of osteoarthritis dont respond well to these medications, and doctors will usually advise patients to seek medical advice before having surgery. If osteoarthritis is not yet severe enough, doctors will often prescribe over-the-counter medication to help reduce pain. In the worst-case scenario, they may prescribe a special drug to alleviate the symptoms.
In the case of severe cases, a doctor may prescribe corticosteroid injections to reduce inflammation in the affected joints. Repeated corticosteroids, however, can be damaging to cartilage. For severe cases, the doctor may prescribe joint replacement. This is a surgical procedure that replaces the damaged joint surfaces with artificial ones. It is often an expensive and lengthy procedure, but it will reduce the pain and improve the function of the joint.
As with other types of osteoarthritis, MIV-711 has the potential to reverse or slow down the progression of the disease. The drug has also shown promise in reducing the progression of osteoarthritis. In addition, MIV-711 has the potential to reduce the symptoms of osteoarthritis in the affected joints. This drug has been developed in a laboratory and is currently being tested on a clinical trial in patients with the condition.
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Symptoms Of Fatigue In Inflammatory Arthritis
Just like there are many causes of fatigue, there are also many symptoms that may indicate what you have is inflammatory arthritis-related fatigue. Its very subjective and not quantifiable with a lab or measurable outcome, which is why fatigue can feel so frustrating and overwhelming, says Dr. Cohen. You cant quantify it, but you know its not normal.
Heres a look at some of the key symptoms to discuss with your health care team:
Extreme tiredness
Dr. Khattri says that while symptoms of fatigue and feeling tired do overlap, fatigue is often at the extreme end. You feel like you have no control.
With normal tired you know sleep can fix it, says CreakyJoints community member Lel. Fatigue decides when its over youre just a helpless bystander.
Change in energy levels
While some patients wake up feeling fatigue, others experience sudden, overwhelming changes in energy levels and simply hit a wall.
RA fatigue stops me in my tracks. I feel myself fading out suddenly, then I have to rest . It feels like sandbags dropped on me, says CreakyJoints community member Kristina H. It hits me around the same time every day, or sometimes I wake up knowing its going to be a low energy day.
Increase in flares
Poor sleep
Research shows that poor sleep can make the symptoms of fatigue worse, increasing sensitivity to pain, irritability, and making it that much harder to concentrate, says Dr. Cohen.
Brain fog
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How Is Fibromyalgia Treated
Thereâs no cure for fibromyalgia. But treatment can help manage symptoms, ease pain, and improve a personâs overall health and quality of life. Treatments include lifestyle changes and medicines.
Doctors usually ask people to start with lifestyle changes before turning to medicines. Changes doctors may recommend include:
- Regular exercise. Exercise may increase pain at first, but it can help make things better when done gradually and regularly. Some people get help from a physical therapist. Stretching and relaxation exercises can also help.
- Stress-relief methods. These can include yoga, tâai chi, and other disciplines, as well as light massage, breathing exercises, and acupuncture.
- More sleep. Getting enough sleep is one of the most effective ways to treat fibromyalgia. It can help to avoid caffeine, sugary beverages, and sugary snacks late in the day. It can also help to go to bed and get up at the same time each day and limit napping during the daytime.
- Healthy lifestyle choices. Eating healthy foods can help with fibromyalgia. Doing things you love can help too. Hobbies and other activities not only make people feel good about themselves, they also can distract them from the symptoms of fibromyalgia.
If lifestyle changes donât help on their own, a doctor may prescribe medicines such as:
- antidepressants: some can ease pain and tiredness, and help with sleep
- anti-seizure medicines: some medicines used to treat epilepsy also can treat fibromyalgia symptoms
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Treatment Options For Me/cfs
There is no cure for ME/CFS, and no prescription drugs have been developed specifically for its treatment. There are treatments to help reduce your symptoms . Work with your health care team to develop coping strategies, such as managing your activity level and taking medications to control symptoms. Focus on feeling better rather than feeling “normal.”
What Do We Know About Chronic Fatigue Syndrome
Those who have chronic fatigue syndrome, also called myalgic encephalomyelitis, or ME/CFS, report fatigue that is worsened with activity and doesnt get better after resting. Other symptoms, which may come and go, include dizziness, muscle or joint pain, headaches and trouble with concentration, sitting and standing.
The Centers for Disease Control and Prevention estimates that 836,000 to 2.5 million Americans suffer from ME/CFS, but most cases are undiagnosed. To help diagnose you, your doctor may suggest a blood and urine test after talking with you about your symptoms and medical history.
Both diagnoses are sometimes called into question as to not being real diseases, says Dr. Bolash. But the chronic pain and fatigue are real enough, and often debilitating, for those who have it.
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How Are Food Allergies/sensitivities Diagnosed
People with food allergies know exactly what food causes their allergy. They eat peanuts or a product with peanuts in it and immediately have a reaction. Their food allergy was diagnosed using either blood tests or skin tests.
In an allergy skin test, a very small drop of a liquid food extract, one for each food, is placed on the skin. The skin is then lightly pricked where the food extract was dropped. This is safe and generally not painful. Within 15 to 20 minutes, a raised bump with redness around it, similar to a mosquito bite, may appear. This shows that you are allergic to that food.
There are two accepted methods in determining a food sensitivity:
Laboratory tests
Lab tests for food sensitivities measure IgG or IgA antibodies to particular food proteins. Ideally, a lab will test both, as you can have a reaction to one but not the other. Once a food allergy is ruled out food sensitivity tests are run. For example, if you suspect you react to peanuts, ruling out a peanut allergy should be your first priority. Should the food allergy test show that you are not allergic to peanuts, your doctor may decide to investigate a peanut or legume sensitivity.
Elimination or reset diets
Your fatigue is different than the fatigue of anyone else you know. Youre a unique snowflake and your nutrition should reflect this. Food might not even be the cause of your fatigue. But the only way to find out is to experiment.
When Should I See A Doctor For Fatigue
If youve been tired for several weeks with no relief, it may be time to call your healthcare provider. He or she will ask questions about your sleep, daily activities, appetite, and exercise and will likely give you a physical exam and order lab tests.
Your treatment will be based on your history and the results of your exam and lab tests. Your doctor may prescribe medications to target underlying health problems, such as anemia or irregular thyroid activity. He or she may suggest that you eat a well-balanced diet and begin an exercise program.
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Acidosis Because Of Impaired Pdc Function
It is possible that the previously demonstrated muscle cell acidosis in CFS/ME is the consequence of downregulated PDC function and a concomitant increase in the metabolism of pyruvate to lactic acid pathway). PDC is a 3-protein complex responsible for a series of reactions that convert pyruvate to acetyl coA during aerobic respiration. Principally, when the function of this complex is reduced, pyruvate that has been generated by glycolysis accumulates within the cells and is metabolised anaerobically to lactic acid. This accumulation causes a drop in pH and concurrent deterioration in muscle function .
Therefore, impaired energy generation in muscle, an increase in the lactate/pyruvate ratio in CFS/ME patients, and a propensity towards excess intramuscular acidosis following limited exercise suggest PDC dysfunction in the muscle of CFS/ME patients, which has implications in relation to the expression of fatigue. Furthermore, as previously discussed CFS/ME patients display significant intramuscular abnormalities relating to both acid generation and clearance from tissue, which has been postulated to relate to a centrally perceived stop signal, leading to a disproportionate perception of fatigue .
