CENTER ON BEHAVIORAL MEDICINE
INGESTED INTOLERANCES and TOXINS
Ingested Intolerances and Toxins-Physical: Research Article
Smith, J. D., Terpening, C.
M., Schmidt, S., & Gums, J. G. (2004). Relief of fibromyalgia
symptoms following discontinuation of dietary excitotoxins. Annals
of Pharmacotherapy, 35(6) 702-706.
Background: Fibromyalgia is a common rheumatologic disorder that is often difficult to treat effectively.
Case Summary: Four patients diagnosed with fibromyalgia syndrome for two to 17 years are described. All had undergone multiple treatment modalities with limited success. All had complete, or nearly complete, resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or MSG plus aspartame from their diet. All patients were women with multiple comorbidities prior to elimination of MSG. All have had recurrence of symptoms whenever MSG is ingested.
Discussion: Excitotoxins are molecules, such as MSG and aspartate, that act as excitatory neurotransmitters, and can lead to neurotoxicity when used in excess. We propose that these four patients may represent a subset of fibromyalgia syndrome that is induced or exacerbated by excitotoxins or, alternatively, may comprise an excitotoxin syndrome that is similar to fibromyalgia. We suggest that identification of similar patients and research with larger numbers of patients must be performed before definitive conclusions can be made.
Conclusion: The elimination of MSG and other excitotoxins from the diets of patients with fibromyalgia offers a benign treatment option that has the potential for dramatic results in a subset of patients.
1. Reiffenberger DH, Amundson LH. Fibromyalgia syndrome: a review. Am Fam Physician 1996;53:1698-704. [PubMed Citation]
2. Krsnich-Shriwise S. Fibromyalgia syndrome: an overview. Phys Ther 1997;77:68-75. [PubMed Citation]
3. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-72. [PubMed Citation]
4. Russell IJ. Advances in fibromyalgia: possible role for central neurochemicals. Am J Med Sci 1998;315:377-84. [PubMed Citation]
5. Crofford LJ. Neuroendocrine abnormalities in fibromyalgia and related disorders. Am J Med Sci 1998;315:359-66. [PubMed Citation]
6. Neeck G, Riedel W. Hormonal perturbations in fibromyalgia syndrome. Ann N Y Acad Sci 1999;876:325-38. [PubMed Citation]
7. Select Committee on GRAS Substances. Evaluation of the health aspects of protein hydrolyzates as food ingredients. Supplemental review and evaluation. SCOGS-37b-supplement 1980b. Prepared for the Food and Drug Administration under contract no. FDA 223-75-2004 by the Life Sciences Research Office, Federation of American Societies for Experimental Biology. Available from Special Publications Office, FASEB, Bethesda, MD.
8. Joint FAO/WHO Expert Committee on Food Additives L-glutamic acid and its ammonium, calcium, monosodium and potassium salts. In: Toxicological evaluation of certain food additives and contaminants. New York: Cambridge University Press. 1987:97-161.
9. International Glutamate Technical Committee. Scientific literature review on glutamates. Atlanta, GA: The Glutamate Association, 1991.
10. Yang WH, Drouin MA, Herbert M, Mao Y, Karsh J. The monosodium glutamate symptom complex: assessment in a double-blind, placebo-controlled, randomized study. J Allergy Clin Immunol 1997;99:757-62. [PubMed Citation]
11. Raiten DJ, Talbot JM, Fisher KD, eds. Life Sciences Research Office Report. Executive summary from the report. Analysis of adverse reactions to monosodium glutamate (MSG). J Nutr 1995;125 (suppl).:2892-906. s.
12. Olney JW, Farber NB, Spitznagel E, Robins LN. Increasing brain tumor rates: is there a link to aspartame?. J Neuropathol Exp Neurol 1996;55:1115-23. [PubMed Citation]
13. Van den Eeden SK, Koepsell TD, Longstreth WT, van Belle G, Daling JR, McKnight B. Aspartame ingestion and headache: a randomized crossover trial. Neurology 1994;44:1787-93. [PubMed Citation]
14. Olney JW. Excitotoxins in foods. Neurotoxicology 1994;15:535-44. [PubMed Citation]
15. Choi DW. Glutamate neurotoxicity and diseases of the nervous system. Neuron 1988;1:623-34. [PubMed Citation]
16. Fernstrom JD, Pituitary hormone secretion in normal male humans: acute responses to a large, oral dose of monosodium glutamate. J Nutr 2000;130 (suppl 4S).:1053-7. S.
17. Demitrack MA. Neuroendocrine correlates of chronic fatigue syndrome: a brief review. J Psychiatr Res 1997;31:69-82. [PubMed Citation]
18. Bennett GJ, Update on the neurophysiology of pain transmission and modulation: focus on the NMDA-receptor. J Pain Symptom Manage 2000;19 (suppl 1):S.:2-6. [PubMed Citation]
19. Bell IR, Baldwin CM, Schwartz GE, Illness from low levels of environmental chemicals: relevance to chronic fatigue syndrome and fibromyalgia. Am J Med 1998;105 (suppl 3A).:74-82. S. [PubMed Citation]
20. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-45. [PubMed Citation]