The best diet for optimal blood sugar control & health
Author: kaitiscotland
I am a Scottish doctor who is working to improve the outcomes for people who have diabetes using a low carb diet, and advanced insulin techniques when necessary. Professionally I provide expert witness reports in the clinical forensic and family medicine areas and I also provide complementary therapies. I enjoy cooking, cinema, reading, travel and cats.
After a heart attack, the risk of sudden death is influenced by your past levels of physical activity.
People who performed moderate levels of leisure time exercise reduced their risk by 33% and those who performed high levels of exercise reduced the risk by 45%.
This study combined data from ten European longitudinal studies and found 30,000 people who had a heart attack. Around 5,000 people (18%) died within 28 days. Of these, 3,000 (62%) died instantly.
European Journal of Preventative Cardiology
Fish oil supplements however had no worthwhile cardioprotective effects according to a Cochrane Systemic Review done several years ago. A study looking at secondary prevention in 70-80 year olds, recently found similar effects. There was no difference between the omega 3 fish oil supplemented group and placebo over two years.
NICE are recommending that the anti diabetes drug Semiglutide is used for its anorexic properties in non diabetics who meet certain criteria.
Trials have found that patients given diet and exercise advice plus Semiglutide lost 12% more weight than lifestyle advice alone.
The drug is given in a weekly, self administered injection. My comment: I have used similar drugs with my type two patients and they were all surprised at how easy this was to do and how effective the drug was as an appetite suppressant.
To be considered for the treatment you have to have a BMI of at least 35 and have a related co-morbidity.
If you have a BMI between 30 and 34.9 you may be eligible for the drug if you are of South Asian, Chinese, black African or Caribbean family background or if you have been referred to a tier 3 weight loss service. This is because the drug is cheaper and safer than bariatric surgery and also because certain ethnic groups are more at risk of co-morbidity at lower BMIs than those of white European ancestry.
My comment: I can envisage that there will be huge market for this drug. One issue is that patients tend to regain weight on stopping and I understand that newcomers are expected to stay on the drug for two years.
Adapted from Update on Advice for Physical Activity in Type 2 Diabetes by Marlene Busko http://www.medscape.com 11 Feb 2022
The American College of Sports Medicine has updated advice from The ACSM/ADA joint statement in 2010 for type two diabetics. Their recommendations have been published in full in the February issue of Medicine and Science in Sports and Exercise.
The key information is that everyone with type two diabetes should engage in regular physical activity, reduce sedentary time, and break up sitting with frequent activity breaks. Workouts can be modified if necessary. Anyone who wants to lose weight should consider workouts of moderately high volume 4 or 5 times a week.
Regular aerobic exercise improve glycaemic management. Blood sugar spikes are reduced and you can expect a reduction in A1c between 0.5-0.7%.
High intensity resistance exercise, when performed safely, is better than low to moderate intensity resistance exercise for glucose management and to reduce the amount of insulin you need to take. You can expect to an improvement in strength of 10-15%, improved bone mineral density, lower blood pressure, improved lipid profile, higher skeletal muscle mass and improved insulin sensitivity.
Exercise after meals, such as taking an after dinner walk, at an easy pace, helps stabilise blood sugar levels.
You should reduce sedentary time by taking regular activity breaks. These will result in small improvements in post meal blood sugars particularly in those who have more insulin resistance or who are overweight.
To prevent low blood sugars during or after exercise, people who take insulin, or drugs that promote insulin release, should reduce the amount injected if they can, reduce the medication, or if necessary increase carbohydrate intake.
If you are on beta blockers, you can’t rely on a heart monitor to measure your workout intensity. You can use a perceived exertion scale instead, eg Borg. Be guided as to the required intensity by a certified exercise professional.
Weight loss of more than 5% can improve A1c, lipids, and blood pressure. Visceral fat can be reduced by moderate exercise 4 or 5 days a week.
In young people who have type two diabetes, intensive lifestyle interventions plus metformin were no better than metformin alone for blood sugar control. Their physical activity goals should be the same as non diabetic individuals.
Those who did regular exercise before and after bariatric surgery, got better surgical outcomes.
In 2017, more than 17 million American adults reported experiencing at least one major depressive episode. (1) In 2020, as we deal with the COVID-19 pandemic, racial injustice, and increased stress and uncertainty, those numbers appear to be rising. According to one study, stressors related to the pandemic led to a three-fold increase in the rates of depression across all demographic groups studied. (2) If you’re struggling, you’re not alone. Embracing a root-cause-based Functional Medicine approach to depression may help you get relief, potentially without the use of antidepressants.
The Functional Medicine approach to depression involves identifying the root cause, like chronic stress or sleep deprivation. iStock/PeopleImages
While antidepressants can be life-saving for some people—and, if you’re currently taking antidepressants, you should not stop doing so without the guidance and support of your doctor—they’re not a good fit for everyone. For some people, they don’t alleviate depressive symptoms, and for others, they cause a new set of disruptive side effects. Other people don’t want to take antidepressants long-term or they can’t afford the financial investment to do so. Whatever your reason, there is a way to address the root cause of your depression directly, without long-term antidepressant usage: Functional Medicine.
The Functional Medicine approach to depression—and in fact, the Functional Medicine approach to any chronic condition—is to identify and address the root cause of the problem. That means treatment is focused on fixing the reason for your depression, whether that’s gut dysbiosis, chronic stress, infection, or another of the 10 possible causes I discuss below. Keep reading for more information on what could be causing your depression and how a Functional Medicine-based approach can help.
The Conventional Treatment for Depression: Antidepressants
Depression takes a heavy toll on physical health, day-to-day functionality, and relationships. It causes symptoms like: (3)
Profound feelings of sadness
Hopelessness
Fatigue
Feelings of guilt or worthlessness
A loss of interest in activities
Changes in sleep and appetite patterns
Irritability
Difficulty concentrating
Moving or talking more slowly than normal
Restlessness
Unexplained aches, pains, cramps, headaches, and even digestive problems
Thoughts of death or suicide
And while some people may experience just one depressive episode in their lives, multiple episodes are common. (4)
Antidepressants are the most common conventional treatment for depression. In fact, between 2011 and 2014, one in eight Americans aged 12 and up reported taking an antidepressant the previous month. (5)
Some research suggests that antidepressants are not as effective as they’re often claimed to be. Initial treatment may be effective at mitigating symptoms only around half the time, and antidepressants may not have any benefit over placebo for mild and moderate depression. (6, 7, 8, 9, 10) What’s more, these drugs can also cause side effects, like: (11)
Anxiety
Decreased libido
Nausea
Weight gain
Dry mouth
Constipation
Dizziness
Tiredness and/or insomnia
Sweating
I’m not here to say that antidepressants have no place in treating depression. That’s because, for some people, they are effective at alleviating their symptoms without causing worrying side effects. Put simply, they work for them. But unfortunately, that isn’t true for everyone, and even if they do relieve symptoms, antidepressants do nothing to address the underlying cause of depression.
For those of you who haven’t found relief in antidepressants, a Functional Medicine-based psychiatric approach may offer the help you’re looking for. And a key component to that approach? Identifying the root cause of your depression.
10 Root Causes of Depression
Most of us are familiar with the conventional explanation for depression: the chemical imbalance theory. This theory states that depression is caused by imbalanced neurotransmitters in the brain, and antidepressants are needed to manipulate the levels of those neurotransmitters—which should, in theory, correct the problem.
There’s quite a bit wrong with the chemical imbalance theory—namely, research indicates that only 25 percent of people with depression have low levels of neurotransmitters, and others have high levels of them. (12) It also fails to recognize the link we see between chronic inflammation and depression. This means if you’re not part of that comparatively small group of people experiencing a neurotransmitter imbalance, antidepressants won’t correct the problem. For that, you’ll need to address the real root cause of your depression.
1. Blood Sugar Dysregulation and Obesity
Insulin influences your central nervous system, impacts neuronal circuitry formation, and affects synaptic plasticity—meaning it plays an important role in your mental health. If your blood sugar is dysregulated and you’re experiencing insulin resistance, your brain will feel the effects along with the rest of your body, and anxiety and depression may result. (13, 14)
Obesity is closely tied with blood sugar dysregulation and depression. This connection is likely multifactorial and complex; but, as obesity is an inflammatory state, and we see evidence that people with obesity have higher levels of inflammatory signaling molecules called cytokines, it’s probable that inflammation plays a critical role in the obesity-depression connection. (15, 16)
2. Chronic Stress
Chronic stress can also have an inflammatory effect on your body. Your nervous system mediates inflammation and the body’s immune response; if something goes awry, depression, anxiety, and other mood imbalances can result. (17, 18, 19)
The relationship between your stress levels and your hypothalamus–pituitary–adrenal (HPA) axis is complex. In a healthy relationship, an acutely stressful event should spur your sympathetic nervous system into action, triggering the HPA to release stress hormones to help you respond to the stressor. After that event, your parasympathetic nervous system should take over, decreasing activity in your HPA axis and reducing stress hormone production. (20) However, if you’re experiencing chronic stress, your sympathetic nervous system and HPA axis can remain chronically activated, causing a host of health problems (depression included).
Your HPA axis also acts on your thyroid gland—any stress-related disruption in HPA axis function could lead to problems with your thyroid, which can also cause symptoms of depression.
3. Environmental Factors
Environmental toxins can also impact your mental health.Indoor mold exposure can trigger a complex inflammatory response that leads to several cognitive side effects, including depression. (21, 22) Mold exposure can trigger the release of inflammatory cytokines and impair neuronal plasticity (which can both lead to symptoms of depression). (23, 24, 25)
Air pollution is another toxin that can impact mental health (and your overall well-being and longevity). Ambient air pollution can lead to neuroinflammation, which increases the risk of depression. Those effects appear to be especially significant for people who encountered air pollution during the first 10 years of their lives. (26)
Some research also suggests that radiation produced by electromagnetic fields (EMFs) may also have a connection with depression. EMFs may contribute to depression by changing the activity of voltage-gated calcium channels in the brain. This can lead to a host of neuropsychiatric symptoms, like fatigue, headaches, insomnia, irritability, and a depressive mood. (27, 28)
4. Genetics
Certain genetic variants are potentially associated with depression:
The methylenetetrahydrofolate reductase (MTHFR) gene: Variants in the MTHFR gene are linked to depression (as well as anxiety, autism, and schizophrenia). (29)
The glutamic acid decarboxylase (GAD) gene: GAD variants may decrease the conversion of glutamate to gamma aminobutyric acid (GABA), which can result in major depressive disorder. (30)
I want to note here that our understanding of the genetic risks associated with depression is far from complete. If you have one of these variants, take that information with a grain of salt—consumer genetic testing has its own potential pitfalls, and your genes aren’t the only factor that influences your health. Often, the exposome (all of those external health determinants like your diet, lifestyle, and environment) is the primary driver behind your overall well-being.
5. Infection
Research suggests that several chronic infections are associated with depression, including:
The mechanism behind this connection could be described by the pathogen-host defense theory of depression (credit to the very forward-thinking Dr. Charles Raison for this theory). According to this idea, some of the behavioral symptoms of depression may actually be behavioral responses to infection, suggesting that human depression evolved out of sickness. (35, 36) Chronic infections are also associated with chronic inflammation, which is linked to symptoms of depression. (37)
6. Leaky Gut and Gut Dysbiosis
Your gut health impacts your mental health through the gut–brain axis. This axis transmits messages to and from the gut and the central nervous system via inflammatory mediators, gut microbial metabolites, stress hormones, neurotransmitters, and the vagus nerve. (38)
Intestinal barrier integrity and a balanced gut microbiome are two crucial components of a healthy gut—if these are disrupted, your gut health (and, potentially, your mental health) will be impacted.
Leaky gut is a condition where the intestinal barrier allows undesirable and incompatible substances from the gut to “leak” into the bloodstream. This includes endotoxins called lipopolysaccharides, which provoke the release of inflammatory cytokines after entering the bloodstream. (39) Robust research also shows that changes in the makeup of our gut microbiome are associated with major depressive disorder. (40) Factors shown to disrupt the intestinal barrier and gut microbiota may increase the risk of future mental illness. (41)
7. Loneliness, Trauma, and Social Determinants of Health
Our social support system plays an enormous role in our ability to maintain our health. That can include our network of friends, loved ones, and family, and it’s impacted by social determinants of health, like our race and socioeconomic status.
Social isolation is linked with greater incidences of depression (among other serious health conditions), while those who have a strong social support network tend to have better health and lower levels of inflammation. (42, 43) Loneliness is linked with a higher risk of death, even after controlling for factors like physical health, alcohol consumption, and smoking. (44)
Trauma can also be a trigger for depression. Experiencing trauma during childhood (including even childhood bullying) can strongly predict future risk of depression and other mental health disorders, possibly by altering the function of the HPA axis long-term and contributing to chronic, systemic inflammation. (45, 46, 47) Trauma experienced during adulthood can also cause depression; that can include things like:
Serving in the military
Involvement in a serious accident or natural disaster
The COVID-19 pandemic can also be defined as a traumatic event in and of itself, and experiencing things like the death of a loved one, job loss, and financial trouble can all certainly be traumatic. (48, 49)
Social determinants of health also have a major impact on our risk level when it comes to developing depression. These can include:
Access to healthy food
Local air and water quality
Education
Neighborhood
Socioeconomic status
Education
Race
Gender
It’s well worth discussing these determinants of health now, as we grapple publicly with social justice and racism. Health and social inequality are connected—in fact, research shows that experiencing racism or even anticipating racist encounters contributes to chronic stress and low-grade inflammation, both risk factors for depression. (50, 51, 52)
8. Sedentary Lifestyle
Regular exercise is linked to good mental health, but a sedentary lifestyle is associated with depression in people of all ages. (53, 54) As an interesting side note, while exercise initially produces inflammatory cytokines (which are associated with depression), an induction of anti-inflammatory substances quickly follows. (55) This is known as a hormetic effect, where an initial stressor creates a compensatory response in the body—and that has positive, long-term consequences for health. (56)
9. Sleep Deprivation and Artificial Light Exposure
As more and more of us spend most of our waking hours in front of a screen, our modern lives are becoming progressively more marked by increased exposure to artificial light. That has worrying effects on our sleep. Nighttime light exposure suppresses the production of melatonin and leads to increased sleeplessness, and is linked to an increased risk of depression, even after controlling for sleep quality and chronic health conditions. (57, 58, 59, 60)
10. Standard American Diet
Research shows that the consumption of ultra-processed foods is associated with depression—and the Standard American Diet is chock-full of them. (61, 62) The Standard American Diet harms the gut microbiome and can lead to leaky gut. (63) Nutritional deficiencies are also a concern with this diet.
Functional Medicine Treatment Options for Depression
Your diet and lifestyle habits impact every facet of your well-being, mental health included, so making adjustments in these areas is an important step if you are struggling with depression. As our understanding of the mechanisms behind depression grows, other potential treatments are coming to the forefront, as well, like bright light therapy, Eye Movement Desensitization and Reprocessing (EMDR), cognitive behavioral therapy, and even psychedelics. Building up your personal resilience can also help weather stressful situations in the future—and this is an especially useful tool for getting through the stress and uncertainty caused by the COVID-19 pandemic.
Change Your Diet
As I mentioned, a diet rich in ultra-processed foods is linked with depression; however, an anti-inflammatory, ancestral diet is associated with robust mental health. (64) An ancestral diet is also nutrient dense, making it a great option for ensuring that you get the nutrients that are beneficial for mental health, like:
An ancestral diet is also a gut-healthy diet. It’s rich in healthy fiber and free from foods that exacerbate gut conditions—and I recommend adding fermented foods for additional probiotic benefits.
Adopt Healthy Lifestyle Interventions
Picking up healthier habits can also help alleviate your depression. That could include:
Cognitive behavioral therapy is a form of talk therapy that is focused on changing patterns of thinking and behaviors that don’t support mental health. People who undergo this form of therapy learn new methods for coping, like: (75)
Facing their fears
Developing confidence
Learning to calm the mind
Using problem-solving skills to deal with tough situations
There are also several emerging treatments for depression available, like:
Bright light therapy: This involves daily exposure to a full-spectrum, 10,000 lux light, and has been shown to help relieve seasonal affective disorder and depression. (76)
EMDR: This form of therapy stimulates the two hemispheres of the brain, often through eye movements or specialized devices. Originally intended as a treatment for trauma, it’s been shown to be effective for recurrent depression. (77)
Psychedelics: When used in controlled, therapeutic environments, research suggests that people with depression may experience some benefit from psilocybin, LSD, or ketamine. (78, 79, 80)
Build Your Ability to Adapt in Any Circumstances
Cultivating more adaptability can be a powerful tool to use in dealing with depression. This is a crucial trait we all need to deal with uncertainty—and clearly, we need it now more than ever. We can each develop the internal and external resources needed for this, often described with the acronym “HERO.” (In positive psychology, this is known as “psychological capital.”) HERO stands for:
Adapted from Diabetes in Control Antibiotic Treatment increases risk for type one diabetes by Chardae Whitner May 15 2021
Both prenatal and first year of life antibiotic exposure may increase the risk for developing type one diabetes in childhood.
It is believed that early life risk factors which include antibiotic treatment can influence the risk of type one diabetes by affecting the gut microbiome. This affects the development of the immune system. Type one diabetes children have been found to have lower microbial diversity in their gut compared to children without diabetes. Antibiotic exposure in early life delays microbiota maturation.
Sweden has the highest rates of type one diabetes in the world despite a relatively low antibiotic prescription rate. They studied siblings, some affected by diabetes and some not. They looked at antibiotic prescriptions, mode of delivery, sex, birth year and genetic predisposition to type one diabetes. The children studied were born between 2005 and 2013. 797,318 children were studied.
Overall 800 prescriptions for antibiotics were issued in the first year of life. These were most commonly for ear infections, then respiratory tract infections, urinary tract infections, and then skin and soft tissue infections.
Exposure to antibiotics prenatally was associated with an increase in type one diabetes in childhood of 1.15 (so weakly associated). Antibiotic exposure in the first year of life raised this a little to 1.19. (still weak. You would need to have 1,475 babies have antibiotics to have one extra case of childhood diabetes before the age of ten).
Siblings of type ones have a risk of 1.36, so this is a stronger risk than antibiotic exposure.
Caesarian section did give an increased rate of type one diabetes in childhood but sex, genetic predisposition and birth year did not. The risk was 1.10 in vaginally delivered babies and 1.60 in the little caesars. So this was again a bit stronger than sibling risk.
Wernroth, Mona-Lisa et al. Early childhood antibiotic treatment for otitis media and other respiratory tract infections is associated with risk of type one diabetes. Diabetes Care May 2020.
My comment: My son Steven has type one diabetes and had a strong family history on his dad’s side of autoimmune disorders including type one diabetes in several generations. He also was a caesarian section delivery and also had a peri-orbital skin infection when he was about seven months old that required antibiotics. Poor wee soul! These days no one gets a caesarian section without a good reason and antibiotics are well thought out. There isn’t much you can do about being a sibling of someone with diabetes. What you can do is take vitamin D in pregnancy and give it to your children from birth onwards.
Ketogenic diets have been used to treat drug resistant epilepsy in children for over one hundred years.
Now they are being used for other neurological conditions such as schizophrenia, depression, bipolar disorder and binge eating disorder.
There is strong evidence that common biological pathologies underlie these conditions such as abnormal glucose metabolism, neurotransmitter imbalances, oxidative stress and inflammation. These factors are all improved with a ketogenic diet.
Controlled clinical trials have shown improvement in: Obesity, Type Two Diabetes, Multiple Sclerosis, Epilepsy, Alzheimer’s disease and Autistic Spectrum Disorder.
Uncontrolled clinical trials have shown improvement in: Parkinson’s disease and Schizophrenia.
Case series and animal models have shown improvement in: Cardiovascular Disease, Binge eating disorder, Major Depressive disorder, Bipolar disorder and ADHD.
It is estimated that people who have mental illness live around 7 to 10 years less than those who do not have a mental illness. Sometimes this is due to suicide, but more often it is due to concurrent diabetes, heart disease, respiratory disease, infectious disease and cancer. All of these conditions are raised in people with mental illness. Sometimes this is due to poor health behaviours such as smoking or other lifestyle issues, and drug side effects can also cause problems. But even in people of a healthy weight and who are not on drugs, if they have mental illness, they are also more likely to have physical illness. Could switching the body and brain away from glucose use towards fat and ketone use improve matters?
Cerebral glucose hypometabolism and insulin resistance are features of Alzheimer’s disease, Parkinson’s disease, Schizophrenia, and Epilepsy. In one recent Cochrane review of epilepsy, as many as 55% of patients had complete remission of their fits on a ketogenic diet.
GABA/glutamate imbalance is a feature of Epilepsy and Schizophrenia. Oxidative stress is a feature of Schizophrenia, Bipolar disorder and Major Depressive Disorder. Oxidative stress and inflammation are mutually reinforcing processes. Major Depressive Disorder, Schizophrenia have these issues.
The Virta Health Group has demonstrated that a ketogenic diet is a well tolerated and effective strategy for treating type two diabetes. It reversed the condition in 54% of patients compared to 5% who received standard care. Alzheimer’s patients also improved on a ketogenic diet and also benefitted from medium chain triglyceride supplementation. (MCTs). Parkinson’s disease, Huntington’s disease and Multiple Sclerosis patients also showed improvement in studies. About 50 to 80% of patients with Alzheimer’s disease have cross over symptoms with schizophrenia, Bipolar disorder and major depressive disorder. These conditions all share common metabolic abnormalities.
It is thought that the ketogenic diet affects the gut microbiome and gut issues are thought to influence Autistic Spectrum Disorder. Two clinical trials reported sometimes complete symptom remission in patients with Childhood Autism when treated with a ketogenic diet.
Some case studies involve psychiatric patients who embarked on ketogenic diets for weight loss and gut problems, only to find a massive improvement in their mental conditions as well. Dr Christopher Palmer reported about an elderly woman with over 50 years of schizophrenia who was able to stop all her antipsychotic medication and has been symptom free for over 12 years. Another middle aged woman who had schizophenia and depression went into complete remission and was able to get her degree and a full time job in the last four years. Both remain unmedicated and on their ketogenic diets.
Results with Binge eating disorder have also been impressive. These patients are usually on 20-30g of carbohydrate a day.
Adapted from article by Chris Kresser 16 April 2021
We seem to be told on a regular basis that eating red meat is bad for our health. Recent studies have clarified this stance somewhat.
A study published in the American Journal of Clinical Nutrition examined both fresh and processed meat intake from almost 135,000 participants from 21 different countries.
They found no association with fresh red meat intake and the risk of early death, heart disease, cancer and stroke but did find a small association between processed meat consumption and a higher risk of cardiovascular disease and death. A strength of the study is that they carefully matched the groups that ate more or less meat with each other so that they were similar in sex, age, body mass index, smoking and drinking.
Another study was a meta-analysis of 59 systematic reviews published in the Annals of Nutrition and Metabolism which examined the association of dietary fat intake and a variety of health outcomes.
They found no association with total fat, monounsaturated fatty acids, polyunsaturated fatty acids, and saturated fatty acids with risks of chronic diseases.
Since we don’t eat food in isolation, there could be important differences depending on whether you eat red meat in a dietary background of highly processed and refined foods or with a whole foods diet.
The contextual importance of meat as part of an overall dietary pattern is important and here are some information to explain this.
Some amines in meat have been shown to increase cancer risk but eating cruciferous vegetables and spices, and cooking meat at lower temperatures such as stewing or low temperature roasting, lowers amines too.
The increased absorption of iron from meat from the gut has also been flagged as a possible reason for excess cancer risk, but eating fruits and vegetables reduces iron absorption in the gut.
Eating vegetables with meat seems to have a protective effect against cancer. Thus eating a nutrient dense, whole foods diet with a broad variety of both animal and plant food is probably the best diet for the majority of the population. If you do choose to eat a lot of red meat or processed meat, keep cooking temperatures low if you can, and enjoy vegetables as part of your meal.
2 teaspoons Worcester Sauce (or sherry vinegar or red wine)
2 teaspoons tomato puree
500mls Guinness or other strong dark beer
300mls meat broth
2 teaspoons sugar
salt and freshly ground black pepper to taste
Heat the oven to 180 degrees if you prefer to use your oven rather than the stove top for later stages of cooking.
In a large bowl mix the salt and pepper into the beef.
In a large casserole, simmer the butter and oil until the butter has melted. Add the meat in batches and brown it quickly, about a minute each batch. Set aside the browned meat.
Fry the onions and carrots for two minutes.
Put the meat back in the casserole and add the Worcestershire sauce, tomato puree, Guinness, hot meat broth and sugar. Add more black pepper and salt and bring to a boil.
Cover the casserole, reduce the heat, and cook slowly on the stove top or oven according to your preference.
From Geobel A et al Journal of Clinical Investigation 1 Jul 2021
Many of the symptoms in fibromyalgia syndrome (FMS) are caused by antibodies increasing the activity of pain sensing nerves throughout the body according to new research led by the Institute of Psychiatry, Psychology and Neuroscience at King’s College London.
This is at odds of the currently held view that the condition arises centrally in the brain.
The researchers injected mice with antibodies of people who have FMS and saw that the mice rapidly developed increasing sensitivity to pressure and cold as well as reduced movement grip strength.
In contrast, mice who were injected with antibodies from healthy people were unaffected.
The injected mice recovered from their symptoms after a few weeks once they had cleared the antibodies from their systems. The researchers wonder if treatments that would reduced antibodies in patients with FMS could become an effective treatment.
Dr David Andersson, the lead investigator said, ” Treatment for FMS is currently focused on gentle aerobic exercise, and drug and psychological therapies designed to manage pain, although these have been proven to be ineffective in patients. There is an enormous unmet clinical need. Our work has uncovered a whole new area of possible therapeutic options and should give real hope to fibromyalgia patients”.
Adapted from Westergaard et al Cephalalgia 23 June 2021
People with a history of chronic headache are significantly more likely to have poor social support and loneliness than those without a headache history.
Other chronic illnesses, mental illness and indeed death, are also more common when a person lacks social relationships.
This study was undertaken in Denmark in over 55 thousand people.
2.7% of people reported chronic headache and in 66% of these medication over use was a major factor. Poor social support was cited by 20 % of the participants who did not have chronic headache and in almost 37% of those who did.
Loneliness was reported by almost 8% of the people without headache and in almost 24% of those who did have chronic headache.
Stress was reported by 24% of those with no headache and in almost 61% of those who did.
The researchers did not differentiate between different headache diagnoses such as migraine and tension headaches.
My comment: As a GP, I was surprised that only 2.7% of the population said they had chronic headache, because it feels like a lot more in the surgery. It is a very common presentation to GPs. I can understand why poor social support could make stress more difficult to bear and produce headaches, and I can also see that people with headaches may want to limit social interaction. What doctors don’t tend to do is to look at improving social interaction as a means of ameliorating headache in patients.
Diabetes Diet 