Lattanzio Silvia Maria, Imbesi Francesca
Department of Biomedical Sciences, University of Padova, Padova, Italy.
Neurological Department, Ospedale Niguarda Ca' Granda, Milan, Italy.
Front Med (Lausanne). 2018 Apr 30;5:94. doi: 10.3389/fmed.2018.00094. eCollection 2018.
A 34-year-old woman suffered from significant chronic pain, depression, non-restorative sleep, chronic fatigue, severe morning stiffness, leg cramps, irritable bowel syndrome, hypersensitivity to cold, concentration difficulties, and forgetfulness. Blood tests were negative for rheumatic disorders. The patient was diagnosed with Fibromyalgia syndrome (FMS). Due to the lack of effectiveness of pharmacological therapies in FMS, she approached a novel metabolic proposal for the symptomatic remission. Its core idea is supporting serotonin synthesis by allowing a proper absorption of tryptophan assumed with food, while avoiding, or at least minimizing the presence of interfering non-absorbed molecules, such as fructose and sorbitol. Such a strategy resulted in a rapid improvement of symptoms after only few days on diet, up to the remission of most symptoms in 2 months. Depression, widespread chronic pain, chronic fatigue, non-restorative sleep, morning stiffness, and the majority of the comorbidities remitted. Energy and vitality were recovered by the patient as prior to the onset of the disease, reverting the occupational and social disabilities. The patient episodically challenged herself breaking the dietary protocol leading to its negative test and to the evaluation of its benefit. These breaks correlated with the recurrence of the symptoms, supporting the correctness of the biochemical hypothesis underlying the diet design toward remission of symptoms, but not as a final cure. We propose this as a low risk and accessible therapeutic protocol for the symptomatic remission in FMS with virtually no costs other than those related to vitamin and mineral salt supplements in case of deficiencies. A pilot study is required to further ground this metabolic approach, and to finally evaluate its inclusion in the guidelines for clinical management of FMS.
一名34岁女性患有严重的慢性疼痛、抑郁、睡眠不佳、慢性疲劳、严重晨僵、腿部痉挛、肠易激综合征、对寒冷敏感、注意力不集中和健忘。血液检查风湿性疾病呈阴性。该患者被诊断为纤维肌痛综合征(FMS)。由于药物治疗对FMS无效,她采用了一种新的代谢方案以实现症状缓解。其核心思想是通过使食物中摄入的色氨酸得到适当吸收来支持血清素合成,同时避免或至少尽量减少干扰性未吸收分子(如果糖和山梨醇)的存在。这样的策略在饮食几天后症状迅速改善,2个月内大多数症状得以缓解。抑郁、广泛的慢性疼痛、慢性疲劳、睡眠不佳、晨僵以及大多数合并症都得到了缓解。患者恢复了发病前的精力和活力,扭转了职业和社会残疾状况。患者偶尔违反饮食方案,结果导致症状复发,这支持了饮食设计背后生化假说对症状缓解的正确性,但并非最终治愈方法。我们建议将此作为一种低风险且易于实施的治疗方案,用于FMS的症状缓解,除了在缺乏维生素和矿物质盐时补充相关物质外,几乎没有其他成本。需要进行一项试点研究来进一步夯实这种代谢方法,并最终评估其是否纳入FMS临床管理指南。