Supplement Discussion on Fibromyalgia

Choosing Nutritional Supplements For Fibromyalgia Patients

Each time you or I purchase a vitamin or nutritional supplement- whether at our local pharmacy, grocery, or favorite internet shop- we are validating the formulation and design decisions made by that particular manufacturer. The problem is that we usually aren’t aware of these design choices, making it impossible to accurately evaluate similar products.

Of course, some of the design decisions are obvious, and it is a relatively simple matter for us make our selection based upon them. For instance, a manufacturer’s choice of ingredients is usually the first thing we would want to know in making our purchasing decision, and we shouldn’t have much difficulty determining this information. Unfortunately, other important design decisions aren’t listed on the label for us. In fact, without some diligence, we probably wouldn’t even be aware that many of these decisions have been made.

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Wise product selection requires that we know a little about the design process. I’m not suggesting a course in pharmacokinetics, but we do need to understand the conceptual design process that occurs before production ever begins.

Product design usually begins with broad goals which are narrowed rather quickly as the process proceeds. For example, the goal in designing a fibromyalgia supplement might be to create a small, easily swallowed capsule of an odorless, tasteless, and completely safe ingredient requiring infrequent dosing while completely eliminating all symptoms of fibromyalgia. For many reasons, these goals need to narrowed, and from here the design process begins.

Dosage design is primarily a series of compromises made in getting from the ideal product to the marketable product. In our example, the elimination of all fibromyalgia symptoms isn’t a realistic goal, so every manufacturer must make the same compromise and use an ingredient that actually exists. Other choices, however, are not so clear, and different manufacturers will reach different conclusions.

For instance, the goal of creating an extremely small capsule may conflict with the goal of infrequent dosing. In fact, the goals may be mutually exclusive, and one manufacturer may subsequently choose to go with small capsules dosed multiple times daily, while another may choose large capsules with infrequent dosing. For fibromyalgia patients with dysphagia, this is not a trivial issue and may well be the determining factor in wise product selection. After all, if the capsule is too big to be swallowed, it isn’t very likely to be effective.

By the time the design process is over, many compromises will have been made, and products that began with similar design goals may wind up being quite distinct from one another. The importance placed on a particular design choice is often a matter of personal preference, but fibromyalgia patients should always be aware of several key design concepts.

1. Science Matters

When it comes to nutritional supplements, good research can be difficult to find. This makes it important to be faithful to the quality studies that do exist. For the fibromyalgia patient, this means following the protocols used in clinical research. Typical supplements aren’t designed this way. For instance, a magnesium supplement designed for the general populace would likely be sub-potent for a fibromyalgia patient.

2. The Dosing Schedule Should Be Simple

Fibromyalgia patients forget stuff; they misplace things; they get confused. If frequent dosing is required, or if the schedule varies, dosing mistakes are likely to be made. Pill boxes and timers may help, but dosing schedules should always be kept as simple as possible.

3. Keep It Small and Smooth

Dysphagia is a common symptom of fibromyalgia, so dosage sizes need to be kept to a minimum, and they should be encapsulated or film-coated so as to be as smooth as possible. Consideration should be given to how easily the dosage form can be divided or crushed. For some fibromyalgia patients, liquid dosage forms will be the only option, so these formulations should always be evaluated.

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4. Taste And Smell Are Important, Too

Just as size and texture are unusually important to fibromyalgia patients, so are taste and smell. Fibromyalgia can heighten these senses to the point that tastes and smells barely noticed by healthy individuals can cause extreme discomfort in fibromyalgia patients.

5. Exile The Excipients

Sometimes, formulation decisions are made that aren’t necessarily in the patient’s best interest, such as when dyes are added to make a product more visually attractive. Excipients (non-active ingredients) are added to dosage forms for a number of reasons, and while many are essential, some are not. This is of particular concern to fibromyalgia patients who often have multiple chemical sensitivities. While a detailed examination of individual excipients is beyond the scope of this article, more information on this topic is available.[1]

6. Find A Good Source

It is a dirty secret of the vitamin and supplement industry that most ingredients are imported- usually from China or India. Many times, even products touted as "Made in the USA" are actually created using imported raw materials. The situation is so severe that, at times, it may be impossible to find domestic sources for a particular ingredient. Given the recent contamination cases involving imported food products, finding a reputable source is more important than ever and should not be overlooked.

7. More Isn’t Always Better

Some manufacturers seem to think that simply having the most ingredients is the goal of dosage formulation, and I must admit it makes for an impressive label as long as you don’t look at the numbers. Having all those ingredient comes at the cost of not being able to have very much of any one ingredient. In some formulations, the bulk of the ingredients are available only in token quantities. For fibromyalgia patients, in particular, this low-dose exposure would seem to be a bad design principle.

8. Sometimes New b0f Is Just New

A similarly ineffective design principle (from the patient’s perspective) is the practice of putting the newest, trendiest, or most exotic ingredients in a product. While it can drive market share for the manufacturer, it usually does little good for the fibromyalgia patient. Sometimes new is just new, and waiting for the science to catch up is the wisest course of action.

9. Kill The Miracle Cures

Miracle cures for fibromyalgia do not exist- not through nutritional supplements, prescription medications, dietary modifications, psychotherapy, hypnosis or books. Fibromyalgia doesn’t have a switch that simply can be turned off. Instead, we are dealing with degrees of relief. I would personally be very skeptical of the design principles behind any product marketed as a miracle, cure, or secret. Remember, extraordinary claims should always require extraordinary evidence.

This list is not definitive by any means, but it does cover the basic design concepts that fibromyalgia patients should consider before purchasing vitamins or supplements. An informed decision should lead to proper product selection, and ultimately, a better quality of life.

Author: L Payton

[1] Fibromyalgia Supplements & Pharmaceutical Excipients

Larry Payton is a biochemist and pharmacist with over 10 years of practical experience. His current passion involves developing the Myalganex System, nutritional supplements targeted specifically for the fibromyalgia patient.

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