| The nature of fibromyalgia syndrome is such that | | | | taken at a particular time of day, say upon |
| most patients eventually find themselves taking | | | | waking or at bedtime. In this case, we see that |
| various nutritional supplements, vitamins, | | | | 5-HTP and, to a lesser extent, St. John's Wort can |
| botanicals, and other dietary supplements. As the | | | | cause drowsiness. The St. John's Wort dose is |
| dosing becomes more frequent, the potential for | | | | usually divided and taken three times daily, so |
| problems increases and managing one's therapy | | | | drowsiness is minimized. If sedation is the desired |
| can, at times, seem overwhelming. The key to an | | | | effect of the 5-HTP then a single large bedtime |
| effective dosing regimen, then, is to first inform | | | | dose would be required, otherwise splitting the |
| yourself and follow up with a little advance | | | | 5-HTP dose, as with the St. John's Wort, would be |
| planning. | | | | advisable. |
| Over my years of practicing pharmacy, I have | | | | Next, we need to decide which supplements need |
| consistently noticed the disturbing relationship | | | | to be taken with food and which on an empty |
| between the severity of the illness and the | | | | stomach. Our list contains only one item that |
| probability of a sub-optimal therapeutic outcome. | | | | needs to be taken on an empty stomach, Sam-e |
| Simply stated, sick people take more medicine | | | | (for better absorption). All the other supplements |
| and to ensure everything goes as intended special | | | | either need to be taken with food, or else food is |
| attention needs to be paid to when, and how, | | | | irrelevant. |
| dosing is conducted. Unlike with prescription drugs, | | | | Our third concern, and one for which much |
| however, definitive information about nutritional | | | | research still needs to be conducted, is the |
| supplements can be difficult to find, especially for | | | | potential for adverse interactions between the |
| the supplements most preferred by fibromyalgia | | | | supplements. In this case, the Sam-e, the St. |
| patients. | | | | John's Wort, and the 5-HTP all have the effect of |
| Some of these more common fibromyalgia | | | | raising the body's level of the neurotransmitter, |
| supplements include: | | | | seratonin. Taking these three together isn't going |
| - Malic acid | | | | to be advisable, so we'll drop the Sam-e which |
| - Magnesium | | | | had the empty stomach requirement, anyway. By |
| - Vitamin D | | | | keeping the St. John's Wort and 5-HTP split into |
| - Sam-e | | | | three daily doses we lower to a safe level the |
| - Ginkgo Biloba | | | | potential for interaction between these two (while |
| - Coenzyme Q10 | | | | tidily avoiding our drowsiness side effect, too). |
| - 5-HTP | | | | No matter the combination of supplements being |
| - St. John's Wort | | | | taken, this three step process of determining |
| - Glucosamine | | | | what time of day to dose, whether to dose with |
| - Chondroitin | | | | or without food, and the potential for interactions, |
| So, let's take a look at how to plan an effective | | | | will give you a clear picture of how to achieve |
| regimen around these supplements. Our first | | | | optimal outcomes with your nutritional |
| concern should be to determine if any need to be | | | | supplementation. |