Mangosteen and Fibromyalgia

Fibromyalgia is a condition characterized by musculoskeletal pain which is widespread (meaning pain on both sides of the body above and below the waist), and chronic (lasting months or years). The pain is accompanied by fatigue (with or without disturbed sleep), and tender points in the muscles, as I will describe later.

However, the true impact of fibromyalgia upon it victims is far greater than simply the unrelenting  pain  and  the  utter  exhaustion  described  in  medical  texts  simply  as  “fatigue.” Anxiety and depression are almost universal findings in patients, as well. Chronic fatigue syndrome, irritable bowel syndrome, headaches and panic disorder frequently co-exist with fibromyalgia.

80% of patients are women, generally between 30 and 50 years old. Reports vary on how prevalent the disease is, however, 6,000,000 sufferers in the US appears to be an accurate figure and the number of patients continues to climb at an alarming rate.

While some medical experts feel that they can trace the disease back to the 17th century under a variety of names, most believe that the disease is a new entity that has emerged only in the last four decades of the 20th century.

The cause of fibromyalgia remains unknown although precipitating factors include:

  • Chronic fatigue syndrome
  • Flu-like viral illnesses
  •  HIV infection
  • Physical trauma such as that caused by motor vehicle accidents
  • Psychological shock or emotional trauma
  • Bacterial infections such as Lyme disease
  • Medications (steroid us particularly)


In my own experience, viral infections appear to be the most common precipitants and the only ones from the list that can reasonably account for the observed spread of the disease that now resembles an epidemic. The lack of a clear cause for fibromyalgia persists despite exhaustive research into the disease in the past ten years.



The American College of Rheumatology proposed diagnostic criteria in 1990 that required widespread pain of at least three months duration in combination with pain on palpation of at least 11 of 18 specific tender points (see diagram). However, in 2004, this definition seems outmoded and many physicians have modified the criteria for diagnosis.


Despite decades of research and attempts at treatment, until the arrival of mangosteen, no therapy had ever been effective in more than 45% of patients. Because of this resounding failure, I have titled this section ‘intervention’ rather than ‘treatment’.

Graded aerobic exercise has been proven to alleviate pain and reduce sleep abnormalities (stage IV sleep is disturbed in fibromyalgia). The effects are long-lasting if the patient faithfully exercises. Magnetic mattresses were found to be helpful in one study as was electro- acupuncture. Many dietary interventions have been tried, but only a low salt vegan diet produced favorable results over the long term. Naturopathic and chiropractic interventions have unfortunately not provided impressive results.

In standard (allopathic) medicine a broad spectrum of medications have been used but, to my knowledge, no medicine has obtained an official indication for the treatment of fibromyalgia. This fact explains the frustration that physicians experience when they try to treat fibromyalgia sufferers. However, the doctor’s frustration and confusion is dwarfed by that of the patients who so often suffer without relief.

Amitriptyline, an older antidepressant drug (along with other drugs in the same class) has been useful in relieving some pain, SSRI’s or the ProzacTM, PaxilTM, ZoloftTM  type of drugs are usually  prescribed  as  well  but  studies  do  not  support  their  claims  for  relief  from  the fibromyalgia symptoms although they often help with the accompanying anxiety and depression.

Anti-inflammatory drugs have not been found to be useful in the treatment of symptoms.

The use of narcotic pain relievers is controversial but many physicians (myself included) used them, in spite of their adverse side effects, when pain could not be reliably relieved by any other means. Now, with the advent of the mangosteen, I no longer need to prescribe the narcotics.



The pain of fibromyalgia resembles the pain of neurological disease. It is often described as

Positron Emission Tomography (PET) scans of the brain show reduced blood flow to the parts of the brain where pain is perceived and processed. Abnormalities in neurotransmitters (chemicals that carry instructions between nerve cells) have also been consistently found in fibromyalgia  patients.  These  findings  all  lead  to  the  conclusion  that  fibromyalgia  causes damage to the central nervous system, which results in, distorted pain perception in the rest of the body. Hypalgesia (heightened pain perception) and allodynia (pain from an innocuous stimulus such as a puff of cool air on skin) are just two of the several pain distortions.

The mangosteen contains a selective COX 2 inhibitor, the only botanical proven by research to possess such properties. COX 2 is an enzyme constitutive (i.e. always present) in the cerebro- spinal fluid and directly involved in pain perception. The suppression of COX 2 by mangosteen is the presumptive means by which fibromyalgia pain is modified. However, the speed with which it acts varies widely from individual to individual. Some experience improvement in a week or two while others may need to wait up to three months for it effects to be felt.


Sleep disturbance is a common finding in fibromyalgia. The deepest stage of sleep (stage IV)
which is essential for sleep to be restorative as far as energy and vigor are concerned, is most

impaired. The causal link between sleep disturbance and fibromyalgia however, is not clear nor is sleep disturbance present in every case of fibromyalgia. When it does exist, the xanthones of the mangosteen appear capable of restoring normal restorative sleep, in my clinical experience.


Fatigue that becomes incapacitating during exacerbations of the illness makes differentiation from chronic fatigue syndrome (which often co-exists) difficult. Often the fatigue more than the pain of the disorder causes patients to become depressed. Mangosteen’s ability to provide energy is welcomed by fibromyalgia patients. When depression and anxiety are present, they are often relieved as well.


The tender points (see figure 1) in the muscle and superficial tissues are largely used to establish a diagnosis. The application of minor pressure with a finger over any of these points produces exquisite pain although muscle biopsy of the tender points has not revealed inflammation or significant muscle fiber degeneration. In most patients, there are variations from the diagnostic patterns of tender points as noted in the diagram.


Mangosteen effectively relieves the pain, muscle tenderness, fatigue and sleep disturbance of fibromyalgia. Although no other intervention has ever helped even 45% of patients, in my experience, mangosteen can bring relief, either partial or complete, to over 60% of sufferers. For this reason, it appears to be the most effective treatment available for a disease that afflicts millions.

Finally, daily mangosteen use brings infection fighting xanthones into the body and lessens the likelihood of infections that can cause fibromyalgia.



One to two ounces (30 – 60 ml) before every meal. Dr. Templeman is a primary care physician, board certified in both the United States and Canada, with over twenty years of clinical experience.

As  Medical Director of  Phytoceutical Research, Dr.  Templeman is  responsible for  the development of  research projects, and the evaluation of clinical data. He is sought after internationally as a speaker and author on health, nutrition, and the healing properties of the mangosteen fruit.

Dr. Templeman travels regularly to Southeast Asia, where he has established numerous partnerships with scientists in several countries in order to do further research on the mangosteen fruit and the powerful Xanthones exclusive to this botanical.

In addition to his existing responsibilities, Dr. Templeman regularly offers his services as a volunteer physician in the third would, providing essential medical aid to the poverty stricken in isolated communities. Dr. Templeman and his wife Michele are the parents of 10 children and they currently reside in Utah.

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