How can I exercise with fibromyalgia?
Q I have recently been diagnosed with fibromyalgia. How can I exercise and still keep an active lifestyle?

A While it can be true that even mild exertion can exacerbate symptoms of fibromyalgia, it has been found that patients who do low intensity exercise may have an improvement in symptoms, and those who exercise regularly suffer less severe symptoms than those who remain sedentary. Considering that stress has been linked to exacerbating symptoms of fibromyalgia, participating in stress-reducing activities including walking, meditation, yoga, etc., can really alleviate symptoms. Finding a doctor who specializes in treating patients with fibromyalgia is important since you may find that many doctors only reassure the patient their condition is benign and then prescribe anti-depressants and aspirin. There is an arsenal of other treatment options that they should address including nutrition, GI system, adrenal and thyroid function, viral exposure, and lifestyle issues, including mental and emotional health.

When exercising, make it about having fun and reducing stress. Try good quality and correctly proportionate B vitamins to find the energy to go out and exercise. Many people with fibromyalgia have been shown to have deficiencies in many vitamins. They should eliminate foods that promote inflammation and stimulants such as caffeine. Treating the intestinal flora, adrenals, thyroid, and mitochondria can also be important keys to treating fibromyalgia.
— Dr. Lindsey Nelson

Am I at risk for diabetes?
Q I have a family history of diabetes and was wondering what I can do to see if I am at risk?

A The standard diagnostic test for diabetes, whether it is insulin or non-insulin dependent (aka Type 1 and Type 2), is fasting blood glucose. It is a simple blood test that measures how high your blood glucose is after 8 to 12 hours of not eating. Any value over 126 mg/dl indicates diabetes. If the blood test was not done during fasting, and your blood glucose level was over 200 mg/dl and you have associated symptoms of diabetes, that would also be a confirmation of diabetes.

Blood glucose tests will only catch people who have diabetes already; it will not reflect people who are currently struggling with glucose regulation, such as hypoglycemia. It is believed that glucose dysregulation and/or hypoglycemia are the precursors to diabetes if they are not managed correctly. So another option is an OGTT, (oral glucose tolerance test.) This is a blood glucose level that is taken two hours after a glucose bolus is taken orally, which is just a sugary drink. If after two hours your body has not sufficiently released enough insulin to lower the blood glucose below 200 mg/dl, then that is an indication of diabetes, and anything over 140 mg/dl should be evaluated for glucose dysregulation. If any of the above tests are abnormal, then a blood test measuring glycosylated hemoglobin should be performed to corroborate and better evaluate the disease. Glycosylated hemoglobin provides an accurate long-term index of your average blood glucose level. It measures red blood cells that have combined or glycosylated to glucose, and since red blood cells live 100 to 120 days, this test measures how well one has been monitoring their blood glucose levels for the past 120 days. Glycosylated hemoglobin and quick finger stick glucose monitors are an important way to monitor blood sugar if it turns out that you have diabetes. Routine urine analysis may come up positive for glucose but this should always be followed up with any of the above-mentioned tests to confirm the diagnosis of diabetes.
— Dr. Lindsey Nelson

Do I need a multivitamins?
Q Why should I take a multivitamin? I’m a fifty-year-old female who is overweight and starting to feel fatigued when working in the garden and taking long walks.

A As a naturopathic physician, I would like to see my patients eat a well-balanced diet that provides all the vitamins and minerals they need every day, but that’s not always possible. A daily multivitamin is a good way to fill in the gaps. B vitamins, which our body needs every day, are found in green vegetables, which are not high on the list of preferred foods. Minerals are also in vegetables but only if the soil in which they were grown is rich in those minerals. Our need for certain vitamins and minerals may also vary with body conditions. Fighting off a cold, recovering from a vigorous workout, or dealing with stress, all require additional nutrients. Taking a daily multivitamin is a good insurance policy to help our bodies keep in top condition.

A good multivitamin should be easy to digest and absorb, and contain reasonable amounts of the major vitamins and minerals. The fat-soluble vitamins are stored in the body so should not be taken in excessive amounts. Women of child-bearing age should not take more than 5,000 IU of preformed vitamin A (retinol) per day. They can take higher levels of beta-carotene, which is the water-soluble form of vitamin A.

Studies show a daily multivitamin promotes a healthy lifestyle, may reduce excess weight gain, and reduce cognitive decline in seniors. Eat a well-balanced diet and supplement any gaps with a good quality multivitamin to support optimal health.
— Dr. Arianna Staruch

This Issue’s Experts
Lindsey Nelson, ND, is a naturopathic primary care physician and can be reached at 503-279-0205 or by email at lindsey@clearh2o.org.

Arianna Staruch, ND, is a naturopathic physician focused on women’s health issues. To contact Dr. Staruch call 503-279-0205 or email arianna@clearh2o.org.