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About David Brady, DC, ND, CCN
Dr. Brady is a leading naturopathic medical doctor at Whole Body Medicine in Fairfield, Connecticut. He is the VP of Health Sciences and the director of the Human Nutrition Institute at the University of Bridgeport and the chief medical officer of Designs for Health, Inc., and Diagnostic Solutions Laboratory, LLC. Dr. Brady is a highly sought after presenter and prolific author of medical papers and research articles on fibromyalgia as well as a dedicated champion and advocate for patients suffering with a fibromyalgia diagnosis. Learn more at DrDavidBrady.com and FibroFix.com.
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At The Fibro Fix Summit, you’ll learn why proper diagnosis and treatment of fibromyalgia (FM), as well as other fatigue- and pain-related disorders, is a neglected and poorly understood niche in medicine. These experts will discuss FM and the many disorders improperly labeled as FM, to provide real action steps and solutions.
Books Discussed in this Podcast
03:05 Dr. Brady’s Fibromyalgia Journey: Before attending medical school, Dr. Brady trained as a chiropractor. At that time, fibromyalgia was just becoming a diagnosis. He began seeing patients with fatigue, body pain, gut problems, anxiety, and sleep problems. He was not equipped to deal with them, nor were his colleagues. He decided to become an expert on it. No one else was. He read everything he could on fibromyalgia. He found a kindred spirit in Dr. Michael Schneider, a researcher in integrative medicine also originally trained as a chiropractor. They reached out to world expert researchers in fibromyalgia and began incorporating what they learned into the soft tissue seminars they taught. What they discovered was that fibromyalgia is not a muscle disorder. They began to write about what they learned in peer reviewed medical journals.
05:28 Fibromyalgia Diagnosis: Classic fibromyalgia is a pain processing disorder of the central nervous system. Many other illnesses can cause similar symptoms and can be erroneously diagnosed as fibromyalgia. Proper diagnosis is half the cure. Patients who are incorrectly diagnosed with fibromyalgia are put on fibromyalgia medications: anti-depressants, anti-epileptics, or pain-relieving medications with their side effects
07:09 Taking the Information to the Patients: Dr. Brady and Dr. Schneider’s papers have been read and cited all over the world. Dr. Brady wanted to take his over 20 years of clinical experience and knowledge to the people who are suffering from fibromyalgia. It changed things at a grass-roots level. Patients become their own well-educated self-advocates. Dr. Brady’s book has questionnaires to help determine whether a person’s health issue is indeed fibromyalgia.
09:15 Defining Criteria of Fibromyalgia: There is no fibromyalgia biomarker. There are three major elements: the patient’s story or history, an examination and labs/imaging. The most meaningful of these is the history, as is the case in most diagnosis. Classic fibromyalgia is almost exclusively found in women. Age of diagnosis is usually between 30 and 60 years of age. They have pain in their soft tissue, global pain, not just a few areas. The problem is not in the tissues or joints. It is in the brain and how the brain processes information. They have profound fatigue and some level of mood disorder, like depression, panic disorder or anxiety. They have a racing mind, which causes problems getting to sleep and causes them to feel unrefreshed from their sleep, feeling like they never slept. They also have vague gastrointestinal symptoms like constipation, diarrhea, gas, bloating, and distention. The examination is to determine where they perceive their pain. Labs are powerful because they may determine what else it might be. It is a diagnosis of exclusion. The organic acid test can determine whether their mitochondria are working well to make energy in their cells. Classic fibromyalgia often has low serotonin levels, elevated substance p levels, and elevated catecholamine levels. A sleep study may show a distinct sleep pattern dysfunction called alpha wave intrusion found in fibromyalgia patients. There is also a potential of a genetic predisposition.
15:28 Stress/Trauma Correlation: There is a strong correlation with significant stress, trauma, or abuse most often experienced in early childhood during the development of the nervous system. It can be damaging to the nervous system if we felt fundamentally unsafe or threatened. We become hypervigilant, waiting for the next attack, and this never really calms. This happens deep in the limbic system or emotional brain. It can cause aberrant patterns in how we deal with stress or any kind of stimulation entering the nervous system. Fibromyalgia may emerge as we lose our resiliency with ageing.
16:13 Could Fibromyalgia be an Adaptive Response? It is like inflammation. It is beneficial to some point and then it can become destructive. Stress response is a survival mechanism. A constant stress state is unsustainable and destructive. It is catabolic, breaking us down. It is supposed to be a temporary process to make energy. In fibromyalgia, there is a pattern of prolonged stress fatiguing the adrenal response into flat line cortisol. Also, the catecholamines are elevated, causing hyper vigilance. This can keep us from going into relaxed restorative states like deep delta wave sleep.
20:59 Lack of Desensitization: As an analogy, when you get up in the morning and put on a shirt, you feel the difference between not having and having your shirt on. However, you don’t want your nervous system telling you constantly all day that you have your shirt on. Our non-threatening events are downregulated sensory information. In fibromyalgia patients the information is being sent constantly all day. The brain is barraged with sensory information. Even a light touch may be taken as pain. This is called allodynia.
22:37 Body Treatments: The treatment needs to be directed centrally. For classic fibromyalgia, muscle/body treatments like massage, acupuncture, chiropractic, ultrasound and electrical muscle stimulation do not work. If patients do get better using these modalities, they have either been misdiagnosed or have other issues besides fibromyalgia.
24:25 Commonly Misdiagnosed: A study found that internal medicine, rheumatology or family practice practitioners give a correct fibromyalgia diagnosis only 34% of the time.
26:35 Self Care Action Steps: Dr. Brady’s book also provides a foundational 21 day program which modulates diet to take out inflammatory, antigenic, immune stimulating foods. It provides a metabolic reset or detox to get the mitochondria working better. Specific movement and exercise, stress mitigation techniques including guided imagery, progressive relaxation and ways to calm the mind, cognitive behavioral therapies and Dr. Brady provides advice on specific nutraceutical nutritional supplements, botanical medicines that can effect neurotransmitters, stress response, and pain perception. It will help with deep quality sleep. Dr. Brady also discusses in his book the medications that are used in the treatment of fibromyalgia, on and off label. He outlines when each may or may not be useful.
28:29 Neurotransmission and Pain Processing: Serotonin, as well as GABA, are important neurotransmitters that help us feel satisfied and content. Serotonin helps us drive into deep restorative stages of sleep and pain perception/tolerance. It is inversely related to another neurochemical known as substance P that modulates pain responses. People with global pain syndromes have low central nervous system serotonin, in the brain and in the serum that bathes the spinal cord. As serotonin levels decrease, our perception to pain goes up and negatively impacting our ability to get to sleep and our mood is diminished. In addition, substance P rises. The rise in substance P brings on hyper-perception.
30:32 Modulating Serotonin Levels: Fibromyalgia patients are given things that allow their bodies to make more serotonin naturally like tryptophan, especially 5 hydroxy-tryptophan. Melatonin is given at night. Other nutraceuticals and sedating adaptogenic botanicals, precursors to calming neurotransmitters, including the neurotransmitters themselves, like GABA, are given to calm the nervous system. These can be effective if given strategically at the right dose.
33:21 Inflammation and Fibromyalgia: Fibromyalgia is not an overtly or systemically inflammatory disorder. Microglial cells will indicate, however, that there is micro-inflammation in the brain. Its purpose and cause is not known. Dysbiosis of the gut can potentially cross the blood-brain barrier and inflame the immune system of the brain creating deep brain inflammation and deep brain mediated pain. However, this mechanism does not fully explain fibromyalgia. Low dose naltrexone, vitamin D and even statin medications are micro-anti-inflammatories. These pleomorphic agents block micro-inflammatory cascades, including in the brain. Vitamin D interacts with genes that create transcription of the enzyme that converts 5-hydroxy-tryptophan from your dietary tryptophan into serotonin. Serotonin production is directly tied to vitamin D status.
37:00 Impacts upon Sleep: Many fibromyalgia patients are fatigued, so they believe that they need to sleep. They can sleep 14 -16 hours and still awaken feeling like they never slept. Often it is not a sleep quantity issue. It is a sleep quality issue. We restore and repair our body and brain during a portion of sleep known as non-REM slow wave sleep or delta wave sleep. Fibromyalgia patients have alpha wave intrusion. Alpha waves are characteristic of the very beginning of sleep, relaxation and light sleep and block the deep sleep waves. This also happens with people who use a lot of sleep medications. They do not drive you into deep restorative sleep.
39:04 Improving Sleep Quality: Dr. Brady uses sleep hygiene, circadian rhythm therapy and other techniques. It includes raising levels of serotonin and melatonin and reducing stress response with nutraceuticals, botanicals and sometimes medication. It includes blocking blue spectrum light in the evening. Calming cognitive behavioral therapy practices are done in the evening, like progressive relaxation, deep breathing, meditation, or prayer. During the day it is advised that we get bright light exposure that is or mimics sunlight during the middle part of the day. Predictable sleep patterns help as well. Be up by 7 a.m. and get into the light, get some physical activity, and eat some protein early in the morning. Don’t eat a lot in the evening. If you have pain, you don’t sleep well. If you don’t sleep well, missing the deep restorative levels of sleep, you become hyper-perception to pain.
41:43 The Fibro-Fix Summit: Dr. Brady interviewed over 30 experts from around the world for this summit about fibromyalgia and the other disorders that are most often mistaken for fibromyalgia.
43:03 Dr. Brady’s Morning Routine: Upon waking, Dr. Brady spends a few moments on reflection and thankfulness. He starts the day with good quality food, primarily protein in the form of a shake/smoothie. He drinks tea, but has very little caffeine.
45:40 Dr. Brady’s Favorite Nutrient: His favorite used to be fish oil for its anti-inflammatory qualities. Now, though, with the plethora of research on the benefits of curcumin, he has shifted. He utilizes medicine from the spice rack in his foods. Spices were used originally for their medicinal value over their taste. It was the medicine of the day. Cooking was a delivery mechanism.
47:37 Dr. Brady’s Elevator Pitch: Eat whole fresh real food. If you eat foods of convenience, science food, or Franken-food you will never be healthy. There is nothing that impacts our health more and influences our genome as the foods we eat every day. We are either giving our bodies good information or bad information. We have poisoned by our own food supply.