End Fatigue
Answers to Your Questions
page 1 | page 2 | page 3 | page 4
Roxanne asks:
I have been afflicted with CFIDS for 20 years now. The ONLY time I feel better is when I was prescribed Adipex. It did not cause me to be nervous and I was able to sleep without a problem, but since my blood pressure is controlled by medication, physicians are more than just hesitant to prescribe Adipex to me. What do you suggest I do? My blood pressure is SO MUCH LESS OF A PROBLEM TO ME than my CFIDS. Also, will you be in Northern California sometime during the next six months?
Sincerely,
Roxanne
ANSWER
Dear Roxanne,
Adipex, which was 1/2 of the fen Phen combination, has been helpful in a subset of CFS patients. It tends to act as a stimulant, raising the neurotransmitter Dopamine.
I find that these medications are overused for weight loss and ADHD and UNDER used in CFS. Your physician may be hesitant to use Adipex because of your hypertension, but you may want to better control your high blood pressure naturally (we'll discuss this in an upcoming newsletter article) and with medication, and then ask your physician to try Dexedrine (5-20 mg a day). If this works as well, I would use this instead. If not, I'd retry the Adipex. These medications actually help restore balance in CFS by raising Dopamine (which is low) , raising brain wave frequencies (which may be low) and helping to stabilize immune function. Because of this, many CFS/FMS specialists will use these meds as part of treatment if needed, and I think it reasonable. I find them to be safer and more effective (and cheaper) than Provigil.
Seeing a specialist at the Fibromyalgia and Fatigue Centers, which has clinics nationwide, would be worthwhile. I will be at a conference in Sonoma in September, but it is closed to the public.
L&B,
Dr. T
Jill asks:
How long do I need to be off Prozac before trying the natural serotonin product Happiness 1-2-3? Tired of the weight gain. Just started tapering off Prozac.
Thanks!
ANSWER
Dear Jill,
Though it takes 6 weeks for the total effect of the Prozac to wear off, 3-4 weeks off the Prozac should be long enough to safely add the Happiness 1-2-3 herbal mix—even if you had been on high dose Prozac. For those on low to mid dose antidepressants, I will often simply add the herbal mix.
L&B,
Dr. T
James asks:
What kind of product(s) do you recommend for someone who is wheelchair bound due to having a form of Muscular Dystrophy (Freidrich's Ataxia) for over 30 years and is in constant pain due to the tightness in his muscles (especially legs)?
Having been his caregiver since July 1996, I have been giving him Tahitian Noni Juice (6 oz. per day) since February 2007 even though I've seen no positive results.
Last week his Chiropractor (Dr. John Roberts of Port Malabar Chiropractic in Palm Bay, Florida) recommended something which contained Valerian Root and Passion Flower for reducing the pain when he was in bed during the night.
A local sales representative of a health food store in Palm Bay, Florida (Paradise Health and Nutrition) suggested your Revitalizing Sleep Formula. As a result, I've been giving him 2 capsules of that formula every night this past week (about an hour before he goes to bed), but I believe he needs something stronger for muscle relaxation throughout the night.
ANSWER
Dear James,
I would continue with the sleep formula at 4 caps a night as these herbs are also muscle relaxants. His muscle tightness/weakness is enough that he will need several things combined. Add Magnesium 200-400 mg at bedtime (less if diarrhea) and calcium 500-600 mg at bedtime.
Friedrich's Ataxia is not so much a muscular dystrophy as a genetic defect in making fraxatin, a nutrient in your body's energy furnaces. This drops energy production and raises free radical damage. In addition, it causes nerve damage—the major process causing symptoms plus heart weakness.
There is bad news and good news. The bad news is that medicine has little to offer besides supportive care. The good news is that natural medicine may have much more to offer. I say this because natural medicine can:
| 1. | Supply antioxidants to slow down or stop the oxidative damage. Take the "Energy Revitalization System" vitamin powder and B complex from Enzymatic Therapy. Lower the dose of the powder if you get uncomfortable loose stools. The product will give you high levels of antioxidants and nutritional support to support nerve healing. In addition, take lipoic acid 300 mg twice a day,and Acetyl L-Carnitine 500 mg 2-3x day-both of which helps nerve problems in multiple studies. |
 |  |
| 2. | Boost energy production in the heart and in general using the recipe below (from my website). The key treatments for these heart problems that I use in my practice, including for abnormal heart rhythms and angina, but especially for congestive heart failure, are (in combination): 1. Ribose (Corvalen brand)—This powder that looks and tastes like sugar is a key to energy production in the body—including the heart. I recommend 1 scoop (5 gms) 3 times a day for 6 weeks, then twice a day. This nutrient is outstanding for heart disease and is the most important one. You will likely be amazed after 6 weeks on it! For a detailed discussion on Ribose, see "Ribose—to Turbo Charge Energy Production." 2. Coenzyme Q10 (use Enzymatic Therapy or Vitaline brand CHEWABLE wafers—brand and form are critical for this nutrient). Take 200-400 mg/day (I would do 400 mg/day for 6 weeks then 200 mg/day). This nutrient is especially critical for anyone on cholesterol lowering medications, even if there is no heart problem,as these medications cause Coenzyme Q10 deficiency, and this nutrient is critical for energy production. For a detailed discussion, see "Coenzyme Q10 and Energy Production." 3. Magnesium 200 mg/day and B Complex 50+ mg/day. I would get this plus over 40 other key nutrients easily by taking the Energy Revitalization System vitamin powder and B Complex. Take 1 scoop a day, but if it causes gas or loose stools, you can decrease the powder to 1/2 scoop a day. I recommend that people take the dose that feels the best up to 1 scoop a day. This product is outstanding for overall well being. I would consider adding an extra 200 mg of Magnesium at bedtime (caution—in the rare patient with kidney failure, magnesium and many other nutrients should only be taken under a licensed Holistic Health practitioner's supervision. Magnesium can also cause loose stools). Magnesium not only increases your heart muscles strength, but also markedly decreases the tendency to abnormal heart rhythms. I recommend almost everyone be on this powder, as it is made to supply outstanding overall nutritional support. After several months on the powder, as you "fill your tank" nutritionally, you may find that a lower dose (1/2 to ¾ scoop a day) of the powder feels best. 4. Acetyl L-Carnitine 500 mg 2-3x day for 4-6 months, then 500 mg/day is enough (and it can often simply be stopped). For more information, see "Acetyl L-Carnitine." |
Iron is toxic in this illness and should be avoided unless levels are low. If iron levels are high, donate blood to bring them down if able.
Give these nutrients 4 months to see the effects. The benefits for heart health are often dramatic at 6 weeks! It can take 6 months for nerves to start healing, but his energy should improve by 1 month. The products are readily available in most health food stores, websites, and at www.Vitality101.com or by phone from 9 AM to 5 PM EST at 410-573-5389 or 800-feel-btr.
Overall, Based upon current research, scientists and physicians have tried to reduce the levels of free radicals, also called oxidants, using treatment with "antioxidants." Several clinical studies in Europe suggest that antioxidants like coenzyme Q10, vitamin E, and idebenone may offer patients some limited benefit. There are currently clinical trials in the United States and Europe to evaluate the effectiveness of idebenone in patients with Friedreich's ataxia. There is also a clinical trial ongoing in France to examine the efficacy of selectively removing excess iron from the mitochondria. Several other compounds may be brought to clinical trials in the near future. To check for current trials, go to the following website: www.clinicaltrials.gov. Since the disease is caused by a reduction in fraxatin levels, many scientists are exploring ways to increase those levels through drug treatments, genetic engineering, and protein delivery systems. Sadly, many researchers not familiar with natural options are "fumbling in the dark." Natural options as we discussed can be very helpful. Please let me know how they work for you.
L&B,
Dr. T
My husband and father to our 2 year old son was diagnosed with ALS by the Mayo Clinic. He is a very health and active 36 year old man so this was a shock to us as I am sure for many others that are faced with this diagnosis. The endless hours of research brought us to your information on ALS/Lyme and we are taking aggressive actions to ensure we do everything possible to address his overall health, determine if this was a misdiagnosis and if so, what the true cause of his symptoms.
Early April we saw a Lyme Specialist who ran the following test, with the following results and has told us that Mathew's test results are consistent with Lyme.
 | CD57 = over 300 (which was said to be normal). |
| C3a = 149. |
| C4a= 8500 (which was said to be consistent with Lyme due to combination of low C3a and high C4a). |
 |  |
Current medications for Lyme taking:
| Omniceft |
| Fagyl |
| Doxycycline |
| |
I am sure you can not respond to everyone or maybe no one but I thought I would try to see if you had any information or redirection to assist in our efforts.
Thank you for any assistance.
Aim’ee
ANSWER
Dear Aim'ee,
Mathew's high CD57 and low C3a put him at a fairly low risk of Lyme and antibiotics long term were not helpful for ALS in a recent study. A high C4a and High C3a combined suggests Lyme. A high C4a by itself simply reflects activation of the innate immune system—present in ~ 90+% of those with CFS and likely many with ALS without Lyme.
I would not pursue Lyme at this time unless there was other support for its diagnosis or the antibiotics are clearly helping. This is so, even though Lyme is one of many things that could mimic ALS.
Let's look at other areas likely to be more fruitful:
| 1. | Lipoic acid 300 mg 2x day to protect nerve function. |
| |
| 2. | The Energy Revitalization System vitamin powder and B complex will supply many high dose antioxidants (including increasing your glutathione production) and nutrients critical for nerve healing. This and lipoic acid can be found in most heath food stores or at www.vitality101.com. |
| |
| 3. | Lithium 10 mg 1-2x day for its neuroprotective properties (found online and in some health food stores or prescription Lithium carbonate 300 mg has 30 mg of lithium a tab (so a 1/3 of a tab 1-2x day). |
| |
| 4. | Do an IgG and IgM blood test for HHV6 by IFA, and a CMV IgG and IgM (do both at Quest labs). If either IgM is positive, or the IgG for HHV6 virus is 1:320 or higher, or the CMV IgG is 4 or more—if it was me I would use 6 months of the antiviral valcyte (discussed in my book). |
| |
| 5. | See a holistic M.D. to look for heavy metal toxicity and consider EDTA chelation. |
| |
| 6. | See Dr. David Perlmutter (a holistic neurologist—see www.brainrecovery.com for info). He is also in Florida. |
Hope this is helpful. Let me know how things go for you.
L&B,
Dr. T
Hi Dr. T,
My internist is concerned about causing Osteoporosis if I stay on the Armour. I have not heard of this connection. In your opinion, does he have a valid concern?
Thanks,
Donna
ANSWER
Dear Donna,
The research shows that as long as your Free T4 blood test stays in the normal range, it does NOT cause osteoporosis. The TSH is NOT reliable in CFS/FMS (and frankly in general) and I would not use it to guide treatment. This is discussed in my book "From Fatigued to Fantastic!" (which also gives the scientific references). The exception was in thyroid cancer patients who were given thyroid at high dose so their T4 was in the top 10% of the normal range who were menopausal and not on hormone replacement with estrogen. Trying to train your physician is an exercise in futility though. Better to go to a holistic doctor or an FFC doctor (www.fibroandfatigue.com) who already knows this research ;-)
L&B,
Dr. T
Hi Dr. T,
Well, you were right. My Internist is not trained in the issues that I need. He thinks that I no longer need to be on the Armour. I have only been taking Armour for about six weeks now. My doc is not giving me the freedom that I need to manage this effectively.
He didn't even ask me if it was helping or not. He is totally basing his decisions on TSH. I need more time on the Armour to determine if it is helping. I am not sure if I was on the most effective dose for me, etc.
I am currently evaluating my next step. I have a few options on the table. There are one or two local docs that I could try first. I will call Dorothy Comito this week to discuss a possible trip to the FFC in Detroit. Thanks again.
L&B,
Donna
ANSWER
Dear Donna,
You're welcome. Trying to train your physician is usually a frustrating experience at best. I think you'll appreciate having physicians at FFC who are actually trained in effectively treating you and know what to do;-)
L&B,
Dr. T
Hi Guys,
Just wanted to get some feedback from anyone up for it. I've been going up weekly for I.V.'s again and I'm on my 5th one after I had a relapse. I've been having diarrhea after the last few and I'm wondering if that could be die off because my epstein barr was really high in my last bloobwork and it wasn't in my previous bloodwork. Dr. Steve wanted me to do 6 months of Valcyte but it's too expensive w/o a prescription plan. And I did start to feel better after the 3rd I.V. in this cycle. Any thoughts would be appreciated.
Thanks,
D
ANSWER
Dear D,
A number of things can cause the diarrhea, but if it is short lasting I would ignore it. If it persists, then cutting down on the magnesium supplements for 1-2 weeks and looking for and treating bowel infections would be worthwhile.
Early research and experience has shown that a subset of those with CFS/FMS have tests suggesting reactivation of HHV 6 or CMV viral infections. In these cases, antiviral therapy with Valcyte and natural therapies is often dramatically beneficial (see Treating Viral Infections in CFS-FMS). Unfortunately the 6 months of antiviral treatment with Valcyte costs around $16,000.
Depending on your income level and family size, the Valcyte may be supplied free by Roche (call Roche at 1-800-282-7780) for those without prescription coverage. For a family of 2, the income limit is $42,000/yr (they request the first 2 pages of your tax forms for verification).
L&B,
Dr. T
Mary asks:
Dear Dr. T,
First, I wanted to thank you for the wonderful products you've developed—the Energy formula has been a real lifesaver and I've recommended it to several friends.
Secondly, your staff who handle orders and problems with orders have been delightful to work with over the years.
Now, for my question. I have Hashimoto's disease and am being treated for hypothyroidism with Armour Thyroid. Two years ago, following a bad intestinal infection, which lasted for 7 weeks, it took another 7 months of intermittent severe diarrhea (and a lot of tests and experiments with different diets, supplements, medical foods, etc.) to get a diagnosis of Irritable Bowel Syndrome. The gastroenterologist started me on Welchol, which worked almost immediately to take care of the problem... until about 7 weeks ago, when another intestinal "bug" was making the rounds at the office. I'm back to totally out of control IBS. Tests show no parasites or viruses or bacteria. Right now the gastroenterologist has me on 20 mg of Lomotil, divided into 4 doses/day (I'm also still taking Welchol). The Lomotil has about halved the number of "incidents" per day (so we're down to anywhere from 2 to 6/day from 4 to 14), but things are nowhere near "normal."
I started taking ProBoost, the herbal Antiviral supplement you have, and LeukoStim, thinking that maybe the tests weren't sophisticated enough to pick things up that were still causing problems. I also tried the Colloidal Silver for a day, but it seemed to make things worse.
I'm supposed to see the gastroenterologist again on May 7th. (I asked him if maybe the Hashimoto's could make it harder to clear things from my system, but he thought that as long as my thyroid meds were optimized (which they are) that the Hashimoto's wouldn't make a difference.) Any suggestions?
Sincerely,
Mary
ANSWER
Dear Mary,
Ask your gastroenterologist to do a hydrogen breath test for:
| SIBO |
| Lactose intolerance |
| Fructose intolerance |
| |
Click here to see my article on this. If positive for SIBO, likely need to increase the thyroid dose (see discussion in my book and also click here to see my article) as low thyroid is a major cause of SIBO bowel infections.
Also, do stool testing at Genova labs by mail for fungal and bacterial cultures and O&P (800-522-4762). Most other labs will miss MOST infections. Also, check a stool test (at any lab) for C. Difficile toxin (often positive in CFS).
If these come back negative, I would consider a trial of the anti-yeast protocol in my book, including Diflucan 200 mg a day for 6-12 weeks. If the symptoms still persist, I would consider an empiric trial of Rifaximin 400 mg 3x day for 7-10 days (expensive—if not covered by insurance, substitute neomycin 500 mg 3x day for 10 days) and /or Alinia (sequentially).
"In addition, while doing the above, stop supplements containing magnesium and Vitamin C (including the vitamin powder) and milk and whole grain products for a few days as these can cause loose stools in some. If the diarrhea stops after 4 days off these, add them in 1 at a time to see what is tolerated and lower the dose of the vitamin powder to 1/2 scoop a day (can stay on the B complex capsule)."
Hope this is helpful.
L&B,
Dr. T
Hello,
I was diagnosed with CFS about five years ago. I didn't seek treatment until after I had my first child. My aches and pains, GI issues, etc. became unbearable. Now I am pregnant with my second child (22 weeks) and my symptoms are even worse. My OB and FM doc are not really on the same page in regard to addressing my pain. I have vicodin and ambien to help with everyday pain and sleep deprivation. Without a sleep aid, I can't sleep b/c of my muscle and joint pain. However, I don't take Ambien often b/c I am afraid of hurting the baby. My OB only wants me to take Benadryl or Unisom to resolve my sleeping issues and my FM doctors say Ambien is perfectly safe (against what my OB says). Same thing with the vicodin. I take as little as possible 5/330 twice a day. However, I get conflicting information about that as well. I take warm baths at least once a day to help with pain as well as get weekly massages. I also take thyroid medication and my prenatal vitamins. I want to do what is best for my baby, but I also have to take care of my child and home. I would appreciate your suggestions.
Thank you for your time.
Kim
ANSWER
Dear Kim,
It is common for FMS pain to flare after pregnancy, but people usually do better DURING the pregnancy. When people do worse during the pregnancy, below are the most common causes:
| 1. | Thyroid dose needs to be increased by 30% during pregnancy as your body's fluid volume increases that much. Many physicians are not up to date on this research. Ask your physician to allow you to increase the dose based on what feels best while keeping the Free T4 blood test level in the normal range for safety (and not in the upper 20% of the normal range). They should NOT check a TSH test which is totally NOT reliable for monitoring thyroid therapy in Fibromyalgia. |
| |
| 2. | Make sure you are adequately hydrated and, if you do not have high blood pressure, be sure you get enough salt. |
| |
| 3. | Take fish oil (mercury-free like Eskimo 3 or Nordic naturals) 1/2 - 1 tablespoon a day. |
| |
| 4. | Take calcium 500-600 mg at dinner and bedtime (do not take calcium or iron within 6 hours of thyroid as they block thyroid absorption) along with magnesium 200 mg at bedtime. If no diarrhea, can take another 200 mg of magnesium at dinner as well. |
| |
| 5. | Yeast overgrowth (manifesting as chronic nasal congestion,sinusitis and /or spastic colon) often flare during pregnancy. For now Probiotics (e.g., Activa yogurt—if they have sugar free, use that or acidophilus pearls 2 twice a day) and avoiding sugar/sweets is good. After you wean the baby, I use Diflucan 200 mg /day for 6 -12 weeks as discussed in my book. |
| |
| 6. | Ambien is considered safe in pregnancy, and I feel it is much safer for the baby for you to take it each night (along with the calcium and magnesium which also help sleep) than it is for you to be in pain and immune suppressed because you are not sleeping (and I tend to be very conservative in pregnancy—which is why I have not even recommended the herbal sleep remedies we normally use in CFS—though chamomile tea is considered safe in pregnancy). |
| |
| 7. | Check your iron levels (see discussion on which tests and how to interpret them in my book). Again, be sure any iron (including in your prenatal vitamins) is taken on an empty stomach as least 6 hours away from the thyroid dose. |
| |
| 8. | Weekly massages are good, but avoid bathing in water that is over 98 degrees (not good for baby). |
See the article on my web site on having a healthy pregnancy and pregnancy in fibromyalgia.
Hope this is helpful. Let me know how this works for you.
L&B,
Dr. T
Dear Dr. T,
I just wanted to send you a quick THANK YOU, along with a "BIG 'OLE—WAY TO GO" for your response to Ms. Brody's letter in the New York Times!!!
If "we" (sufferers of ME/CFIDS & FMS) did not have you on our side, we would be pushed around even more so than we already are!! There is NOTHING worse than being completely debilitated from these God-aweful illnesses, and having someone publish yet another article telling "us" that there is NOTHING WRONG WITH US!!!!! If only they (those who seem so fond of writing these letters/articles) could live one day of our lives, I GUARANTEE that those letters and articles would change INSTANTANEOUSLY!!!
However, I would never wish these illnesses on anyone—ever! Since I have been approx. 80% bed-ridden for over 5 years now, suffering horrifically with these 2 illnesses (along with MS), one of the many things that help me get through this part of my journey is my new way of thinking that I've actually been extremely BLESSED to have learned! Although some sufferers may not have learned this valuable lesson yet, I know that many others have, and that is—as a chronic sufferer daily, I now know that I have actually been BLESSED—not cursed—because of these illnesses!! THAT'S RIGHT—I SAID BLESSED!!!! For, if it were not for these illnesses robbing me of everything that I had worked for, lived for, and accomplished in my life up to the point of me getting ill, I may have NEVER LEARNED the beauty that there actually is in life!! I may have never learned that these illnesses are only part of my PHYSICAL BEING, and they CANNOT and WILL NOT ever be able to touch the real me—THE SPIRIT OF ME—my SOUL BEING!!!
You see, I was so busy worrying about being successful (I owned 2 businesses at the onset of these illnesses) prior to becoming ill, that I had stopped seeing the simple beauty that there is in life!! I never sacrificed who I am while achieving that success, but I did sacrifice many years of my life being too focused on success, rather than being focused on being the best ME that I can be on a daily basis!! And having all of that business success taken away from me by becoming ill (I lost everything!), I was then forced to look at what I had left!! And what I found that I had left was myself!! It took me several years of SEVERE suffering, not only physically but emotionally, before I realized that what I lost was mere things, but what I GAINED, was ME!!! I had finally learned that these illnesses may have robbed everything that I had worked so very hard for, but the one thing that they could not rob from me was me!! And that is why I say that these illnesses have become a BLESSING, not a CURSE, as I was so sure of when I first became ill!
It's funny..... I had NO intention whatsoever of writing what I just have when I sat down to write this "short" letter of thanks to you. I guess that's just how life is for me today!! If I just allow life to happen, instead of having to be in such control of it (so I thought), I've found that it's so much more HEALING for me!!
Blessings to you Dr. T for all that you do for all of us!!! We could never begin to repay you!!
With deep respect,
Terri RainSpirit S.
ANSWER
Dear Terri,
Thanks for your thoughts and blessings, and congratulations on learning the meaning and blessings that can come from any illness. Though my CFS left me homeless and knocked me out of medical school for the year, it truly was a blessing (easier to see sometimes when one has moved past the illness ;-)
A point to be aware of—Once you learn the lesson of the illness, it becomes easier to move past it. I invite you to do the questionnaire on my web site (the free short program can be done at and if you would like to have your labs analyzed as well, happy to give you a free code to do the "Long program"). The trick is to remember not to go back to what made you sick in the first place as you get well. For the MS, it is important to look for underlying infections. I would check an "HHV-6 IgG by IFA" at Quest labs. If 1:320 or higher, I would consider a trial of Valcyte (a new antiviral) for 6 months as described in my book From Fatigued to Fantastic! The medication symmetrel is also very helpful for MS induced fatigue (it is also anti-viral) and lithium may also help (a very low dose of 10-15 mg a day). If the HHV 6 test is OK, I would consider an antibiotic trial (search online for more info).
The FFC doctors and other holistic doctors can work with you on this, as well as on mercury and heavy metal detoxification.
Let me know how things go for you.
Love and Blessings,
Dr. T
Dear Dr. Teitelbaum,
I have suffered with CFS for about 35 years. I was found to have EBV which is thought to have been the cause of my problems, seeing as everything else I had been tested for has shown to be normal. I have slept most of my life away and it has been an ongoing huge struggle with complete exhaustion.
I contacted Dr. Jose Montoya a year and a half ago because I had heard of his discovery of a cure for EBV. He asked for a letter from my doctor explaining my medical history. This was provided along with certain blood tests that he required. I ended up travelling to Stanford University to see Dr. Montoya as he felt that I was an appropriate candidate for his study. He had never come across anybody who had suffered with CFS/EBV for as long as I have, and was anxious to help me. However, he had over looked that I have a very mild case of hepatitis C, and people who have this are not allowed to participate in the study. The feeling of disappointment is a huge understatement. I cannot imagine sleeping the rest of my life away. This is not a life I have, but a huge struggle, and I am not anxious to continue like this. My life is revolved around naps. I have a part-time job which is another great challenge. I have never had medical insurance, my financial situation is not that great, and I have no family or help from anybody.
I am writing to ask you if you have any suggestion as to what I can do to lower my viral load, with the hope of reducing my fatigue/weakness/brainfog/low blood pressure/exhausted adrenals?
I am desperate for any advice, and would very much appreciate any advice you can give me, as I do not know what else I can do.
Yours sincerely,
Gillian
ANSWER
Dear Gillian,
That the tests have been normal does not mean that there are not many treatments that can be very helpful. In addition, the hepatitis C, though it means you cannot be in the study, does NOT mean that you are not a candidate for Valcyte.
I recommend you see a Fibromyalgia and Fatigue Center physician or if you are in LA, Dr. Kent Holtorf in Torrance. They can prescribe the Valcyte and the antiviral IVs offered have Glycerrhizin, which help hepatitis C.
Depending on your income level and family size, the Valctye may be supplied free by Roche (call Roche at 1-800-282-7780) for those without prescription coverage. For a family of 2, the income limit is $42,000/year (they request the first 2 pages of your tax forms for verification).
In addition, as you sleep a lot, videotape yourself to see if you snore and stop breathing during sleep (sleep apnea—see From Fatigued to Fantastic! for more info) and ask your FFC physician to consider a trial of low dose Dexedrine.
L&B,
Dr. T
Could you put this in the newsletter? It may be very helpful to those with interstitial cystitis. Thanks.
Just thought I'd offer the following helpful hint: If you have interstitial cystitis and have trouble tolerating Dr. T.'s vitamin powder and Adrenal Stress End, this may solve the problem. Get some MSM powder (1000 mg per scoop). Stir a scoop of MSM in the vitamin powder and water and then drink it along with the B complex capsule. Also put one half scoop in a glass of water when you take the Adrenal Stress End. Doing these things should help you tolerate the ascorbic acid, the B vitamins, and the tyrosine. Hope it works for you. Good luck. Edna R
ANSWER
Dear Edna,
Thanks for the tip. As we discuss in Pain Free 1-2-3, MSM is one of many helpful treatments. Interstitial cystitis is severe bladder urgency and burning (like a "forever" severe bladder infection where people want their bladder surgically removed—which I do NOT recommend). It is often missed by physicians, and discussed at length in the book. Some people with IC tolerate supplements well and others poorly. If you are in the latter group, begin with tiny doses of the supplement taken with a full glass of water and increase as tolerated. And try Edna's MSM tip;-)
L&B,
Dr. T
Hello,
I heard Dr. Teitelbaum speak on radio station KPFK and have a specific question. How does a person know what may be afflicting him/her?
In particular, is the low energy, weak immune system, etc. the result of fatigue or something more serious like Lupus? Are there specific medical tests one can go through to find out?
Thank you,
Maria
ANSWER
Dear Maria,
Both the fatigue and immune dysfunction (as well as the pain and other symptoms) are reflections of the energy crisis at the heart of CFS and Fibromyalgia. There are many things that can trigger this energy crisis (lupus is one of them) and that is why we recommend a thorough work up for people with these processes. Unfortunately, most physicians are simply not trained in these illnesses (and some in their ignorance are hostile to them). Because of this, it is good to go to a doctor who specializes in these syndromes. I recommend the Fibromyalgia and Fatigue Centers which have clinics around the country (and see people who travel in from out of area as well). They will do thorough testing to look for many underlying processes.
L&B,
Dr. T
Dr. Teitelbaum,
I just read the article on your website about black cohosh and breast cancer. The article was extremely interesting to me because my girlfriend actually is a breast cancer survivor. She is 31 years old, is half Jewish and has the BRCA-1 gene mutation. She was fortunate because they found the cancer early, she had a lumpectomy and radiation (3 years ago) and has been fine ever since.
We were both wondering if she could take the Remifemin and if there are any other suggestions you have. She is taking Tamoxifen and gets hot flashes frequently. She is not as open to alternative treatments as I am, so she is reluctant to stop the Tamoxifen until we find something that is at the very least as effective as Tamoxifen. What do you recommend?
By the way, I choose Dr. Holtorf's group as my new physician (Dr. Wightman has been handling my case), and I just wanted to let you know how pleased I have been with them. They are very knowledgeable about CFS and your treatment protocol. I highly recommend them to anyone. I continue to feel stronger and stronger each year as I tweak my treatment and take care of myself. I KNOW CFS is curable. I am living proof and I thank God everyday for leading me to you and your book!
Thanks for all your help. We would appreciate any suggestions you have in regards to breast cancer/black cohosh etc.
Sincerely,
Craig S
ANSWER
Dear Craig,
Glad to hear you are feeling better with treatment, and Dr. Holtorf is excellent;-)
My reading of the scientific literature is that Black Cohosh can be taken with tamoxifen and in breast cancer. There was some publicity on the question being raised about whether black cohosh raises estrogen, but this I believe was triggered by politics and not science. The studies however show it does not raise estrogen, but simply helps decreases hot flashes by balancing autonomic function.
It is important if using black cohosh to use the form shown to be effective called Remifemin. Multiple studies using other brands were not effective while those using Remifemin were very effective in preventing hot flashes. The dosing is 2 tabs 2x day for 2 months (how long it takes to fully kick in). The dose can then often be lowered to 1 tab 2x day.
In addition, see the studies in today's newsletter on Black Cohosh decreasing the risk of breast cancer recurrence and Coenzyme Q10 and B vitamins improving tamoxifen's effectiveness.
Love and Blessings,
Dr. T
Dear Dr. T,
I am a 23 year old male. For the past month, my hands have started to turn red and tend to be very cold, even if I am hot. My fingers will swell up often (ESR is normal). If I press on the skin, the red goes away and the skin turns white for a few seconds, then the red comes back. My feet tend to be red too but often turn a bluish color. My feet tingle, and if I sit in a chair for more than 10 minutes, I get an unpleasant sensation in my feet, like all my blood is flowing to my feet. I am living out of state for 10 months (only two more until I return home) so I don't have a PCP in the area, so I went to an urgent care center nearby. The doctor there diagnosed me with Reynaud's Syndrome and gave me Procardia XL 30 mg 1x/day. I've tried it for a week, but it doesn't work. In fact, I think it is getting worse Another thing: All my life, I have consistently had a blood pressure of 110/70. Lately, my blood pressure has been 122/86. Have you ever heard of anything like this before? I'm not convinced yet that I have Reynaud's. I'm thinking of going to a specialist, but I'm not sure what kind of doctor to see: cardiologist, neurologist, dermatologist, etc. What do you suggest?
Thanks for all your help,
John
ANSWER
Hi John,
It certainly could be Raynaud's , and the procardia does not always help. Increasing magnesium intake as well as the entire "SHINE" protocol tends to help this over time as I suspect that what you are having is more likely autonomic dysfunction with altered blood flow (common in CFS/FMS because of the hypothalamic dysfunction, and generally not dangerous) which responds to overall energy restoration with "SHINE." For now, the vitamin powder plus 200-400 mg of extra magnesium at bedtime (less if diarrhea) can help after around 6 weeks. See your local physician, or better yet a CFS specialist (I recommend the Fibromyalgia and Fatigue Centers or if none in your area, consider www.HolisticBoard.org) as getting nutritional IVs with magnesium can be very helpful (don't be surprised if you "flush" or get a bit lightheaded during the IVs). Sadly, most MDs not familiar with CFS are also not familiar with these kinds of "autonomic dysfunction" symptoms.
L&B,
Dr. T
Dr. S.M. writes,
Hi Jacob,
Have had numerous C3a andC4a results in Lyme reevaluation. So far 8 patients show no elev of both C3a and C4a. C3a all normal. C4a range from normal to highly elevated. Highest result is 8022. Patients are asking what is the significance of persistent C4a elevation? Also, what parameters is Dr. Shoemaker using with elev C3a and C4a?
Best Regards,
SM, D.O.
ANSWER
Dear Dr. M,
These results are about right. Sorry for the delay in getting back on this, but I wanted to wait for the data below to come back and to discuss it with Dr. Shoemaker (did both this week).
In our current Sonoma Working Group study of ~ 30 CFS/FMS patients, 2 of the 30 had elevated C3a (elevated is a level over 940) and C4a (elevated is a level over 2830) and ~ 28/30 had elevated C4A alone.
This suggests that 2/30 needed treatment for chronic Lyme. The C4a is rarely elevated in healthy controls. It's being elevated suggests:
| 1. | The pt has a CFS-related process with activation of innate immunity. |
| |
| 2. | That there are one or several of the multiple CFS-related issues present (in Dr. Shoemaker's world view, these suggest mold, nonbacterial infections, neurotoxins, etc.) |
Basically, C4A elevated alone suggests/confirms CFS/FMS. C4A and C3A both being elevated suggest that the patient should receive long term (at least 6 months) of antibiotics for suspected chronic Lyme.
L&B,
Jacob
PS to our newsletter readers:
The doctors at the Fibromyalgia and Fatigue Centers are now using C3a and C4a testing when needed.
Because the C4a is up in over 93% of those with CFS/FMS it is reasonable to save your money and not do the C4a test. I would just do the C3a test, and if it over 940, consider treating for Lyme. In addition, to do these tests, go to Quest labs. Remind everyone you see: the phlebotomist, specimen processing, referral testing, etc. of the proper codes below for the C3a by RIA and C4a and that the tests MUST be sent out to National Jewish Hospital.
CODES: 11632-5 for the C3a, RIA and 11633-6 C4a, RIA. Both referred to National Jewish.
Click here for more on C3a and C4a testing for Lyme infections.
Dear Dr. T,
I read that for those who can't take the vitamin powder, or who want a single tablet a day, you recommend the Natrol—My Favorite Multiple—Take One vitamins. They seem so cheap and there are so many brands... How did Dr. T single out this particular one? I sure appreciate your help in researching everything.
One reason I am doing this is because my husband and I presently use a vitamin/antioxidant (3 pills per day) and like them fine; but it costs us $80 per month for both of us. Our family doctor checked out the fact sheet of ingredients on our vitamins and stated everything looked fine, but he said we are probably 'peeing out' a lot of it. I also heard a chemist make a remark that people who take expensive vitamins have' expensive pee'. When a person hears these things, you tend to think you may be wasting your money.
All of your help and expertise is GREATLY appreciated...thanks...Marsha K
ANSWER
Dear Marsha,
You're welcome ;-)
The peeing argument is a foolish one used by those with a bias against, or who are ignorant about, natural therapies. They say that since you pee them out they are a waste, but I invite them to then stop drinking water as this is "peed out" as well. This way they'll soon get out of the way of people who are optimizing their health! In addition, most medications are also "peed out" in your urine.
The Natrol—My Favorite Multiple—Take One brand has an excellent mix of nutrients for the cost and if you can just take (or get your husband or teenagers to take) 1 pill a day, it's the multivitamin I'd recommend. It has good levels of B complex and other essential vitamins and minerals compared to most "one tablet a day" vitamins. The key essential nutrient it is missing is magnesium (can't get enough in 1 pill). If you add 2-4 tabs of Fibrocare (which has magnesium) daily, the Natrol—My Favorite Multiple—Take One becomes an even better single pill a day option (and I have looked at hundreds). This combination is not anywhere near as good as the Energy Revitalization System vitamin powder (which replaces over 35 pills a day at ~ 60 cents to $1.20 a day) but is a good option for those who can't take drinks or powders.
I know it's confusing. That's why I decided my job would be one of being a patient-advocate and why I do not take money from any of the drug or nutrition companies ;-)
Love and Blessings,
Dr. T
Desiree asks:
I just read your book "From Fatigued to Fantastic!" In it, you mentioned not to take Tylenol. Does it add to your problems, or are you just suggesting other things work better? I have been taking Tylenol 4 for the past couple of years for my headaches. I only got diagnosed a a couple of months ago with FMS (looking back I can see I've had it for the last 10 years! It just got incredibly worse over this past year.) I am now taking lyrica, cymbalta, ambien and zoloft as well as the tylenol 4 and fioricet when I start to get what feels like a migraine. I just want to be sure about your statement regarding the Tylenol and be certain it is not worsening my condition.
Thank you for everything! Your book has been so helpful and made me not feel so helpless and alone!
ANSWER
Dear Desiree,
The tylenol depletes a critical anti-oxidant called glutathione which is already low in CFS/FMS. You are taking a lot (~ 2000 mg a day if the tabs are 500 mg each—plus whatever is in the fioricet) on a regular basis, and this is likely causing glutathione deficiency. This does not cause any permanent problems, but makes it harder to get better while on it. It is OK to take once in a while as needed, but I would not take it regularly.
Taking glutathione by mouth does not help (it gets digested). Getting it IV from holistic physicians works well, and taking the Energy Revitalization System vitamin powder plus a supplement called "NAC" 500-650 mg a day for 6 months will also restore your glutathione levels. Lyrica, Skelaxin, Ultram (NOT Ultracet) and Neurontin would be more effective for pain and won't lower glutathione.
To treat and prevent migraines, see the info in my book, "Pain free 1-2-3" (or see the "Cliff notes" version).
Love and Blessings,
Dr. T
Dear Dr. T,
I have ordered the ingredients you recommended for the pesticide detox. Thank you for the recipe. I need another morsel of your knowledge. I go to see my doctor on 3/24/08. I want to ask him to run a test of sorts on me to confirm my suspicions of pesticide overexposure. What should I ask him to perform? What tests would conclude and prove what I have been exposed to—blood tests or an analyzing of "fat" cells? Note: I am a guitar player. The last two days I donated to strictly learning new songs, as I refuse to give up on my pursuits in life. Today when I woke up, it was same old run over feeling. It's like the more you use your body the more it restricts. Like a boa constrictor of sorts.
Thank you for your help.
David
ANSWER
Dear David,
Unfortunately, within 2-7 days after an acute high dose pesticide exposure, most of the pesticide is out of the blood and moved into fat cells. Because of this, the blood tests are pretty useless. In addition, even for acute exposure they need to know which pesticide to test for, though they will sometimes simply look for acetylcholine inhibition. For low level chronic exposure, the blood tests are pretty useless.
Some people will rarely do a fat biopsy and analysis for pesticides, but it is not something I recommend. Better to do the "SHINE Protocol", in your case adding the detox mix and saunas or detox baths to pull out the chemicals (see below).
There is every reason to be optimistic, as this process is treatable.
L&B,
Dr. T
Detox approaches and recipe for removing insecticides/pesticides:
Detoxification—There are several simple things that you can do that can be very helpful:
| 1. | Sweating can remove toxins—especially if you shower immediately after—and can be very helpful for health. Many of the newer saunas are what are called "far infrared", and a half-hour 3-7 times a week can help detoxification. Click here for more information. |
| |
| 2. | Some of you may be more comfortable with hot baths. This is one recipe that was given to me by a wonderful practitioner (Anette Mnabhi, DO in Montgomery, IL): Recipe for a detox bath—which helps a lot with general muscle aches and pains: Ingredients: Epsom Salt (2 cups), Baking Soda (1 cup) and Hydrogen Peroxide (1/3 cup) Fill tub with hot water and add above ingredients. Soak for 20-30 minutes. You will sweat in the tub and lose toxins (which causes you to lose some water as well). It is important to drink plenty of water while you soak. You can make fresh lemon juice and mix with water and drink, or plain water, but it is essential to drink while you take the bath. If you have a tendency to get light headed easily, be cautious when getting out of the tub, or have someone nearby the first time you take a detox bath. Take a lukewarm to cool shower after getting out of the tub to rinse off the salts or you may itch. Rest for 30 minutes after the bath. |
| |
| 3. | For pesticide detoxification (usually takes 3-10 months to start working and symptoms may initially flare). Add 50 gm choline and 25 gm vitamin C to 500 cc (1 pint) of flavored water. Take 10 cc (2 teaspoons) 3x a day for 1 month then 5 cc (1 teaspoon) 2x a day. Choline can cause a fishy smell at a higher dose. If this a problem, lower the dose. Reference: Journal of Chronic Fatigue Syndrome 6 (2) 2000 p11-21. |
Feliz writes:
Well, I am getting well!!! I have tried EVERYTHING in the past, and I had begun to believe I was the hypochondriac doctors treated me like. Then I tripped across one small line in a book my father gave me, called "Tired—So Tired!" that referred me to Dr. Teitelbaum's website. I have now been taking the Energy Revitalization System, the L-Carnitine and the Ribose on a daily basis for about 10 weeks. The pain of fibromyalgia has diminished so much, I can't believe it. I am now sleeping so well that I have been able to discontinue the sleeping medications I had been on for several years. I still have some migraines, IBS, and fatigue, but even those are much less chronic. The difference in my life: my increased energy level, the lack of pain, and the diminishing "brain fog" and returning clarity of thought, are amazing.
Thank you, Dr. Teitelbaum!
ANSWER
Dear Feliz,
You're welcome! That's what this is all about. Now it's time to find those things that give you joy to do with your energy! Don't use it to go back to what made you sick in the first place;-)!
L&B,
Dr. T
Brooke asks:
Hello Dr. T,
I was previously a patient of yours in your private practice and miss you and your staff DEARLY.
Since finding another doctor after you left, I have gone downhill severely. My doctor does not advocate for me and my insurance company is refusing to pay for many of my medications such as Lyrica and Ambien CR.
My question is: How can I advocate for myself and get the insurance company to cover these medications I desperately need and am not able to afford. My doctor has written letters to no avail.
Thank you for all you do,
Brooke
ANSWER
Dear Brooke,
I would use generic Ambien instead, which is 40 cents for a 10 mg tab. As Lyrica is FDA approved for Fibromyalgia, write your insurance noting you have Fibromyalgia, which meds you've tried for the pain, That they have not worked adequately or have caused intolerable side effects, and note that as Lyrica is FDA approved for Fibromyalgia and your physician has recommended it and as you have failed other meds and are in pain, request that they note why they are not covering it, what is needed for them to cover it, and to document why they are not covering it (resulting in your being in chronic pain), and send them the letter by certified mail with a copy to your state's insurance commissioner. While most insurance covers Lyrica for FMS, some require that you or your doctor document that you tried other less expensive meds without pain relief.
L&B,
Dr. T
Just a theory, but I also have erectile dysfunction (ED), since age 40. I'm now 50. From what I've read, an erection pinches a sphincter muscle in the organ which causes the spongy tissue to engorge. If the ATP is low, then the sphincter gets too tired to clamp down and stay clamped.
Anyhow, my doc has my testosterone on the high side of normal and I take Ribose. The testosterone helped for a few weeks but now I'm back to ED. Viagra doesn't help. Circulation is great on the big toe (toenail pinch test).
I'm sure a lot of us CFS guys would love to hear any ideas!
Brian
ANSWER
Dear Brian,
Most often the ED is associated with suboptimal testosterone levels, as these are in the lowest 1/5th of the population in ~ 70% of CFS/FMS patients (male and female). A few things to consider:
| 1. | You need to check a free testosterone level along with the total testosterone, as it is the "free or unbound" testosterone that is active. Some researchers find that checking the levels of proteins that "bind or carry" testosterone (SHBG—Sex Hormone Binding Globulin) and a total testosterone level and then calculating the free testosterone level is more reliable. For now, keeping the "free testosterone" in the upper 1/3rd of the normal range should suffice. |
| |
| 2. | In many, the hormone that converts testosterone to estrogen (called "aromatases") is overactive in men. The estrogen being high then brings the ED back (so you see the "better then worse" phenomenon). Check a total Estrogen level. If over 30, I often add the medication Arimidex 1 mg 1/2 tab every 2-3 days to block conversion of testosterone to estrogen, which can help after a few weeks. If DHT levels (Dihydrotestosterone) are elevated as well, the herb Saw Palmetto 160 mg 2x day can lower this as well—decreasing the risk of prostate enlargement with slow urination, and male pattern hair loss. |
| |
| 3. | Consider also taking the amino acid supplement arginine 1000 mg/day if you do not have any herpes infections (arginine is food for herpes viruses. It is blocked by lysine, which is why high dose lysine suppresses herpes). Arginine is critical for both growth hormone production and Nitric Oxide—the latter is what triggers erections. |
| |
| 4. | Oxytocin deficiency (diagnosed by getting an IM injection of Oxytocin), elevated prolactin (diagnosed on blood testing) and other factors can also play a role, but I'd begin with the first 3 issues discussed above. |
Viagra and (better yet) Cialis can be very helpful for ED in CFS—especially after testosterone is optimized and high estrogen lowered. So consider retrying after these are done.
L&B,
Dr. T
Dr. T,
My F&F doctor has prescribed Namenda for the fibro fog but I am hesitant to try it. Have you found it to be an effective treatment? It supposedly also helps with pain or sleep too, can't remember which now. I am 46. I do have an aunt recently diagnosed with Alzheimer's but no other family history. I am using every supplement you suggest in your book for the fibro fog but it does seem quite persistent.
I searched your website but cannot find any reference to Namenda. "Your search—namenda—did not match any documents."
Thanks for your input if you have the time.
Kathy
ANSWER
Dear Kathy,
I do not use it often, but it is reasonable to use (though more for the migraines and fibro pain). I find getting adequate sleep, eliminating infections, using the Energy Revitalization System vitamin powder plus fish oil and the "Remember" supplement, and in severe cases the ADD medication Dexedrine (like Ritalin—maximum 30 mg/day—in adults 5-12.5 mg is usually optimal) to be better first choices for the brain fog. Let me know how the Namenda works for you though, as it is a reasonable Fibro medication.
L&B,
Dr. T
Jen asks:
I was so excited after hearing you with Dr. Oz yesterday on XM talking about inflammation. I plan to go out and get your book today but I have a few questions about supplements. I have been taking motrin for a year and a half now for tailbone pain. I broke my tailbone delivering my son. I am worried about what the motrin is doing to my body and I was excited to hear about willow bark, I'm going to try it. My chiropractor says my body is really inflamed and he recommended an herbal supplement called drenotrophin. I'm wondering if you have heard of it. I'm taking it but it makes me kind of shaky and slightly nauseated. I'm considering stopping it. He also had me on wheat germ oil for EFAs but I finished the bottle and I am wondering if I should get more or if there is something better. I am also taking glucosamine chondroitin complex for one month. Do you have any advice about these supplements or are there any others I should try?
Thank You so much!
Jen
ANSWER
Dear Jen,
Glad you enjoyed it ;-)
I would take the "End Pain" anti-inflammatory herbal 2 tabs 3x day plus fish oil (instead of wheat germ) 1 tablespoon a day for 6 weeks and then as needed. Both work together to settle inflammation.
Also, ask your doctor to prescribe a "Lidoderm patch" (Novocaine anesthetic in a patch) that you can wear over the painful area 16 hours a day (give it 2 weeks to see if it helps). All of this is discussed in my book, Pain Free 1-2-3. In addition, your physician can prescribe the "Nerve Pain Lotion" from ITC Pharmacy (303-663-4224) and they can mail it to you. This topical pain treatment has several medications, and is very effective for many pains without side effects. It is also discussed in the book. Rub it over painful areas 3x day for 2 weeks (give it 2 weeks to work) then as needed.
Tail bone pain often represents inflammation of the coccyx called Coccydynia. This can follow after falls, childbirth, repetitive strain or surgery. In some cases the cause is unknown. The pain can disappear by itself or with treatment, such as motrin and the treatments above, or it can continue for years, and may get worse. It is five times more common in women than men, probably because the female pelvis leaves the coccyx more exposed. It appears that in most cases the pain is caused by an unstable coccyx, which causes chronic inflammation.
To avoid pressure on the coccyx (end of the tailbone) sitting on a donut shaped pillow (especially when sitting for long periods) that carries your weight on the bones on the sides of the buttocks and takes the pressure off the tailbone at the bottom of the spine can also be helpful. Some therapists can massage the coccyx to relieve the pain (unfortunately this requires a finger in the rectum and one outside and hurts like the dickens—but helps).
L&B,
Dr. T
Marcia D, RN asks:
I was diagnosed with CFS & FM about 2 1/2 yrs ago by my family doctor. After several attempts to help my pain, including Cymbalta, he sent me to a Rheumatologist. After running some lab tests and taking Rx antiinflamatories and several other meds for over a year (my labs showed a slightly elevated Sed rate and CRP, even with the Rx antiinflamatories), he diagnosed me with Psoriaic Arthritis, which I am not sure I understand. I do have a small rash on my hand that he says is Psoriasis. I am going to a Dermatolgist in a week. My muscles hurt along with my joints and also have tender points of pain. He started me on Enbrel. I took it for 6 months and it didn't work. Then he started me on Humria. Took it for several months and then had an allergic reaction. He is not sure if it is from the Humria. I am very concerned with taking it due to the side effects and possible risk of cancer. I was supposed to start the Humria again about 1 month ago, but haven't yet. When I started the Humria, I also took your recommendations of Fish Oils, MSM and Calcium/Magnesium supplements for a couple of months and was starting to feel a little better. But when I had the allergic reaction, I stopped the supplements, because I wasn't sure if it was one of the supplements or the Humria that was causing the reaction. I have read your book, From Fatigued to Fantastic, and get your newsletters, but I feel like I don't know what to do at this point. I also have a lot of trouble sleeping and have tried several of your recommendations. The only thing that helps me sleep is Xanax (I can get 6 hours) which I really don't want to take. What is your suggestion of starting the Humria again and could any of those supplements have caused an allergic reaction (the reaction was itching and hives). I have also tried your powder drink mix and have trouble getting it down. Any suggestions for that?
Thanks so much! Your book has really helped me in so many ways and I have recommended it to several people. I am very concerned about starting back on the Humria.
Marcia
ANSWER
Dear Marcia,
Although Enbrel and Humria (Tumor necrosis factor blockers) can be helpful (especially in severe rheumatoid arthritis) I am not optimistic about it being helpful/worthwhile in your case. It is being pushed heavily to doctors because it is expensive, and we do not know the long term effects. I would use it in inflammatory arthritis when standard and natural therapies fail, but this is rare.
Regarding the psoriatic arthritis. Do you have the appearance in your fingernails of multiple little pin pricks (like someone pushed a needle into multiple spots on your nails)? If yes, I would be more comfortable that you actually have psoriatic arthritis (arthritis from psoriasis). Even so, it sounds like most of your symptoms are from a secondary fibromyalgia, and treating with the "SHINE Protocol" may likely be effective.
Get my book "Pain Free 1-2-3" and read the chapter on arthritis to learn how to eliminate that pain and on sleep to find NON addictive sleep therapies that work. Go back on the supplements one at a time as they were helping, and add glucosamine sulfate 750 mg 2x day and the "End Pain" herbal 2 tabs 3x day. Give these 6 weeks to work. Mix the vitamin powder in yogurt or apple sauce if taking it in a smoothie or water doesn't work for you, and 1/2 scoop a day is often enough.
For pain , the medications Lyrica, Ultram and Skelaxin are more likely to help than Humria or Enbrel (and are safer and cheaper), and the first 2 help sleep when taken at bedtime as a side benefit. I would also consider adding cortef up to 20 mg a day (safe, but higher doses are toxic). I recommend you see a holistic physician who is more familiar with this (www.fibroandfatigue.com for a fibro specialist and www.holisticboard.org for a general holistic physician). They can better guide you with these issues than most physicians (especially as what your Rheumatologist is doing is not working. Ask them if they are familiar with inflammatory arthritis causing a secondary Fibromyalgia).
Love and Blessings,
Dr. T
KJ asks:
Hello! Why is it that Alternative Medicine centers and doctors do not accept patient's insurance plans? Alternative medicine is VERY expensive and most people I know (myself included) cannot afford alternative health care unless insurance is accepted. Just curious as to why they don't accept insurance.
ANSWER
Dear KJ,
An important question. Unfortunately, health insurers seem to calculate payments based on an average 4-5 minute office visit, and the amount they pay for a doctor's time beyond this is less than many doctor's overheads. Because of this, doctors rely heavily on tests and procedures that pay well and (they believe) allow them to get away without taking time listening to people. This allows the regular physician to make a good living from procedures and testing — while spending very little time with the person. This works financially for the doctor but poorly for the patient, as you may have experienced, as a doctor tries treating CFS in 5 minutes.
In addition to not paying properly for time, insurance companies have labeled most holistic treatments as "experimental" and therefore will not pay for them — even if they have been shown to be much cheaper, safer and more effective than the covered treatments. For example, treating disc disease (back pain) with 6 IV injections of colchicine has been much more effective and safer than surgery, studied in over 6000 patients in one series of studies, and costs about $700 total for the 6 IVs. Surgery is well over $27,000, often ineffective and rife with side effects. Yet, insurers will pay for the standard surgery but not the holistic IVs. The effect of this is that insurers are bleeding money on ineffective expensive treatments, making safe and cheap effective treatments not available to their clients and contributing to the US having the most expensive health care system in the world, but one of the least effective among industrialized countries.
Because insurers will not pay for holistic treatments or time, most holistic physicians simply cannot participate with insurance without quickly going bankrupt. This is simply one more reflection of the disaster that has been created by allowing standard "AMA Medicine" to have a legal monopoly in the US and Europe. That the government is allowing this monopoly will eventually likely result in the collapse of our health care system if not remedied. Sadly, this has even resulted in the FDA now making it very difficult to get the colchicine treatment discussed above (see the next Q&A).
For more on this, see my 3 part series on "Healing the Health Care System."
L&B,
Dr. T
Hi,
I have just read some information posted on the FDA web site that concerns me about the use of bio-identical hormones as well as the intravenous colchicine used for back pain.
Since they are taking enforcement action against any companies marketing unapproved injectable colchicine, because of death related incidents, this deeply concerns me as I was considering this procedure for my mother who is in a lot of pain due to spinal stenosis.
On Intravenous Colchicine: http://www.fda.gov/bbs/topics/NEWS/2008/NEW01791.html
I will attach the article below for you to read. And please do get back to me as to the seriousness of this situation. I am under treatment with a doctor that gave me bio-identical hormones of which I haven't yet used and may not after reading the FDA warning on this form of treatment.
On Bio-identical Hormones: http://www.fda.gov/bbs/topics/NEWS/2008/NEW01772.html
Thank you,
Elsie D
ANSWER
Dear Elsie,
Welcome to the wonderful world of politics and medical economics.
The deaths from Colchicine were all because the persons received over 4 mg in a single dose (1 mg is the recommended dose), and then usually in those with kidney failure. That is why we are clear to give no more than 1 mg at a time — which has been very safe. Even the 20 total deaths (as of 2002 that occurred over more than a decade) at the high doses (sometimes at 50 times the recommended dose, and almost all used for gout) pale compared to the number of deaths a year from Motrin family meds (over 16,500 yearly) or unnecessary back surgery. But politics and money rule over science and common sense. Having said this, colchicine is more effective for sciatica/disc disease than for spinal stenosis (though I have seen it be helpful even for stenosis). If the spinal stenosis (as opposed to disc disease) is CLEARLY the cause of the pain, I would likely try the colchicine first anyway. Surgery is often necessary.
The bioidentical hormone action by the FDA is even more absurd. It was instigated by Wyeth — the company that makes Premarin. The FDA is not claiming that the bio-identicals are not safe. If you look at the language, they are simply saying that the compounding pharmacies have not gone through the $400-800 million dollar FDA process needed to be able to make health claims. What is bizarre is that Wyeth is pushing the FDA to action saying that estriol is not proven safe — while I've been told that at the same time the company is attempting to market estriol in Europe. Sadly, when it comes to making money, truth and the health of the public seem to become irrelevant.
What is the truth based on the science?
| 1. | Colchicine is FAR more effective and safer than surgery for disc disease. Sadly, if the IV colchicine is not available, many Americans will suffer and even die because of this FDA decision. |
| |
| 2. | Bio-identical hormones are clearly safer and more effective than Premarin and Provera in numerous studies. They are simply not patentable, so it was not financially feasible for them to be put through the FDA process (except for the patentable delivery systems, like patches). See an excellent article that actually shows what the science says. |
As a physician who does not make or lose any money based on whether you choose colchicine vs. surgery or Bioidenticals vs. synthetic (and dangerous) hormones like Premarin and Provera, let me encourage you — Don't let the politics and money win over science and your and your family's health! This is why I have my policy of not taking money from natural product or pharmaceutical companies. It allows me to stay objective in my role of being a Patient Advocate.
Love and Blessings,
Dr. T
My question is:
How do I remedy malabsorption? I've taken both prescription mineral supplements and natural supplements, but my blood test readings (and symptoms) don't improve, especially zinc and copper. The doctor told me to take betaine HCl, but this did not help, even with high doses. Now she doesn't know what to suggest.
I've had CFS for 22 years and now suspect I'm not improving (despite my diets and treatments) due to my inability to absorb vital nutrients. Currently, I'm trying a selective starch diet with no grains, potato or sugar, to see if my gut will heal, as it is chronically bloated, despite my being a little underweight. I'm also already on high doses of probiotics and have tried glutamine as well. Is there anything else I can try?
Thanks and God bless you,
Vivien,
New Zealand
ANSWER
Dear Vivien,
You need to look for the cause of the malabsorption.
First, the blood tests for zinc and copper are not especially reliable. Also, zinc and copper block each others' absorption, and low zinc is a much bigger problem than low copper — unless you're anemic.
I would consider beginning with the following:
| 1. | Check a blood test for transglutaminase IgG and IgA antibodies. If either of these are positive, there is a good chance you have celiac sprue (a special kind of wheat allergy) and need to avoid wheat and gluten. Then, if the test is positive, search online — (there is a lot of information on this). Check a blood carotene level as well. If this is normal and stool test for fat is normal, I would NOT presume severe malabsorption. |
| |
| 2. | Get a Hydrogen Breath Test for SIBO. This was discussed in a recent newsletter article. The treatment for this is optimizing thyroid function and 10 days of rifaximin (a special antibiotic). Also, avoid milk products and sugar (especially sodas) for 7-10 days to see if this helps |
| |
| 3. | Add PLANT BASED digestive enzymes (e.g. Complete Gest or Similase) 2 caps with each meal. I find animal based enzymes to be NOT effective for digestion (but good for inflammation if taken between meals). These are available on this web site or in most health food stores. Click here for more information on digestive enzymes. |
Zinc and copper are minerals and do not require digestion when taken in supplement form. Take zinc picolinate 50 mg a day for 3 months with copper 1/2 mg a day and see if zinc levels rise. If you have been taking high dose copper, it would block zinc absorption for several weeks.
In case you have inflammatory colitis, add Boswellia (frankincense) 300-400 mg 3x day. This will settle the inflammation in the gut (also good for asthma). It is present in the "End Pain" product on my site, which also has other anti-inflammatory herbs which may help colitis.
Let me know how these work for you.
L&B,
Dr. T
Hi Dr. Teitelbaum,
I have a person up in Ontario, Canada who has been had CFS since she gave birth to twins at the age of 20. She is in her 20's and not satisfied with any of the doctors that she has seen. Do you have any contacts or physicians that you know of in Canada. I recommended the Fibromyalgia and Fatigue Centers to her and she would be ok with that but I just wanted to check first to see if there were any physicians closer to her. She said Detroit was about four hours away. I hope that your year has been great thus far. We are very busy here and I am continuing to send students to the Fibromyalgia and Fatigue Centers as much as possible.
Hope, Peace and Joy Always,
Sincerely,
Karen Grove
(Editor's note—Karen runs a wonderful self help organization for Fibromyalgia and CFS called the Grove Approach. For information, see www.thegroveapproach.com).
ANSWER
Dear Karen,
Unfortunately, it is very hard to find a CFS expert that applies the SHINE protocol for CFS/FMS in Canada (sadly, I have no names to offer).It is very difficult for Canadian physicians because of the severe prejudice against CFS/ME in the Canadian system. It is worth travelling to the US to see one of the Fibromyalgia and Fatigue Centers. I invite Canadian physicians using the "SHINE Protocol" to e-mail me their names, addresses, specialties and contact info, and I'll be happy to put it in a future newsletter.
For postpartum (after child birth) CFS/ME/FMS it is especially important to:
| 1. | Take fish oil and magnesium (I would do fish oil and the Energy Revitalization System vitamin powder). |
| |
| 2. | Optimize hormone levels (especially thyroid and progesterone—even if labs are normal). |
| |
| 3. | Treat the Candida. |
Are the twins sleeping through the night in their own bed yet?
I think you would will really like a new doctor, Nosson Goldfarb, who is now at the Cleveland FFC. He is very knowledgeable and compassionate already, and will be a quick study.
For women who are now pregnant, The article "Having a Healthy Pregnancy" will be very helpful as will the "Natural Treatments for Infertility" article for those with infertility.
Love and Blessings,
Dr. T
Diane asks:
What is your opinion of Hyperbaric Oxygen Therapy (HBOT)? I am extremely chemically sensitive and can hardly any supplements by mouth, and I'm hoping to boost my white cell function with HBOT thereby killing off infection in my body. I've already tried NAET and it hasn't worked for me. Any thoughts on the HBOT?
ANSWER
Dear Diane,
I have not used it in the past for MCS but some excellent doctors use it (see below). I am more likely to recommend it for neurologic illnesses. To improve immunity I am more likely to:
| 1. | Add Gamma globulin IM (2 cc a week or 4 cc every 2 weeks). |
| |
| 2. | Eliminate bowel infections (yeast, SIBO, parasites) that trigger leaky gut and stress the immune system. |
| |
| 3. | Add low dose cortef (up to 20 mg/day—more is toxic). |
| |
| 4. | Look for and treat Lyme, HHV6 and other infections. |
There is a placebo controlled study using HBOT currently being done by Professor Kenny DeMeirleir of Belgium. He is a superb CFS specialist and researcher, who has done much of the RNAse L research. His initial, non-placebo controlled study found HBOT to be effective. Dr. Cheney feels it may help, but is concerned that the system handling oxygen free radicals is already over stressed, so it can help or harm. Dr. Stuppy, another excellent CFS researcher, feels that the HBOT helps to kill off Lyme and other infections. Therefore, it is reasonable to try. If you try it, let me know how it works for you.
Love and Blessings,
Dr. T
Judy asks:
I was a patient of yours in the early 90's in Annapolis. I don't have CFS or FM, but I have terrible panic attacks. Currently on Prozac and exercising, but they have gotten so bad, I can't drive again. I am 42 and have terrible periods now. I know it must be some sort of hormonal imbalance. I was wondering what you would recommend since I am on disability for bipolar and anxiety now and have limited resources. The condition like CFS/FM makes me just want to give up. Any recommendations you could make would be helpful.
Thanks,
Judy
ANSWER
Hi Judy;-)
For a natural approach you can do on your own, I would add Calming Balance (on www.vitality101.com ) at the higher dose for 2-6 weeks, then you can lower to the dose needed to keep you calm. Also be on the Energy Revitalization System vitamin powder for the B vitamins, inositol, and magnesium. If you cannot afford natural treatments but have prescription insurance, ask your physician to add low dose trazodone (I would likely limit to ~ 150 mg a day as you are also on prozac). With Bipolar/Manic-depressive aspects to your panic, neurontin (gabapentin) is also very helpful and available in generic—and worth trying.
L&B,
Dr. T.
Dear Doctor Teitelbaum,
I love your emails, and have the utmost regard for your knowledge. However, your article about chocolate leaves me with some questions. Please see below:
What's the Truth About Dark Chocolate?
The hot news is that dark chocolate with at least 70% cocoa will lower your blood pressure, decrease your insulin resistance, dilate your coronary arteries, decrease your chances of getting a blood clot, lower the bad LDL cholesterol... but at what expense to your figure?
Yes, dark chocolate has polyphenols and flavonoids, which are antioxidants. Flavonoids are also found in red wine and green tea.
The key to these studies is the quantity needed to have the benefits described above: 3.5 ounces of dark chocolate = 100 grams. The cocoa needs to contain approximately 446 mg of flavanols, which is the amount in the study, to:
• Reduce bad cholesterol (LDL) by 10%.
• Decrease blood pressure by approximately 10 points.
• Decrease the stickiness of platelets (which can prevent unwanted clotting).
• Dilate the coronary arteries.
• Decrease insulin resistance.
A 3.5 ounce bar of dark chocolate** has a calorie count of anywhere from about 476 to upwards of 550 calories.
The moral of the story? Enjoy a small piece of dark chocolate, understanding that any real health benefits would be costly!
Footnote: ** which needs to contain approximately 446mg of flavanols; the amount used in the study *JAMA *2007;298:49-60, *Circulation *2007; 116:2376-2382
Thank you for your time in reading this, and I do would welcome your commentary.
Best regards,
Donna
ANSWER
Dear Donna,
Excellent question (I love when someone looks at the whole picture) ;-)!
Although many of the studies used a dose similar to 3.5 ounces, smaller amounts also can have significant benefits (e.g antioxidant benefits would not really need that high of a threshold level). Therefore, though they used higher "dosing" of chocolate (with its attendant higher calories) in studies, this is not to say the higher dose needs to be used. Five individually wrapped pieces of Godiva, sugar free, special creamy dark chocolate, for example, only has 190 calories—a very reasonable "dessert/self-reward" level for a day. This is on par with a 12 oz soda—but MUCH healthier. The point is that people need to have a way to do things that feel good that are healthy. Looking at how the JAMA article you note deals with chocolate, however, raises an important insight into how medical recommendations work (or don't).
An important piece of data that most physicians are never given is the "dose response curve" for most medications—especially relative to toxicity. What this means is that for many medications, the large majority of the medications' benefits occurs at well below the common starting dose. Most of the side effects occur from the higher dosing though that is offering little benefit (Prozac is an example of this. 10 mg has been reported to give most of the effect). This means that by starting at 1/2 the lowest recommended dose, you can get most of the benefits without the side effects. I suspect this approach works very well for chocolate as well ;-)
Love and Blessings,
Dr. T
K.D. asks:
I have a question regarding your Happiness 1-2-3 formula. Is it safe for teens to use? I have a 14 year-old that could really benefit from it. Thanks for all your help!
ANSWER
Dear KD,
For most herbals, most studies have been done in adults (as is the case with most medications), so we go based on our clinical judgment and the long term safety record for the herbal. As a general rule of thumb, as teens are adult sized, once the child is 12 years old, I am OK with using natural products as if they were an adult. The exception would be any substances that might raise testosterone (e.g. DHEA or body building steroids in the health food stores) as this may cause the bones to stop growing sooner—stunting growth. These are preferably used under a holistic practitioners care—even in adults. I am comfortable using the Happiness 1-2-3 in my patients over 12 years old.
L&B,
Jacob Teitelbaum, M.D.
Lisa M asks:
Is there a danger in taking too much magnesium? I plan to start taking Bone Health, which contains 100% DV. I would also like to take Energy Revitalization which contains 50% DV and Fibrocare which contains 150 mg. Which vitamins & minerals should we be careful not to take too much of?
ANSWER
Dear Lisa,
Except for rare folks with kidney failure, the only significant toxicity if your magnesium level goes too high is uncomfortable diarrhea, in which case I would lower the dose.
Unless OK'd by your holistic physician, avoid getting over:
• Vitamin A 8,000 units a day as it could cause birth defects.
• Selenium 200 mcg.
• Vitamin B6 over 300 mg/day.
• Vitamin D over 5,000 units a day.
L&B,
Dr. T
Valerie asks:
I am a 47 year old peri-menopausal woman who has been experiencing chronic pelvic pain that began approximately two and 1/2 years ago. Just recently, through an MRI, I was diagnosed as having adenomyosis along with extremely heavy periods. Over the course of these past several years I've gained much weight, developed skin allergies, experienced loss of libido and struggled with depression, which increased after a week of using synthetic hormones (doctor prescribed). I decided this was definitely not the route I wanted to take. I am trying to avoid a hysterectomy, and basically just tired of feeling sick and tired. Do you think your protocol could help me?
ANSWER
Dear Valerie,
It certainly can.
First of all, do not presume that all of the heavy bleeding is due to your adenomyosis (which is when the tissue that lines the inside of the uterus finds its way into the uterine muscle). The treatments below help heavy periods in general and can help adenomyosis as well. In addition, much of the pain may be secondary pelvic muscle pain from the adenomyosis, which responds well to the SHINE protocol. In addition, this is the kind of pain that can respond well to Motrin or Celebrex (avoid for arthritis, but great taken 2-3 days before your period for menstrual and adenomyosis pain). The End Pain herbal (2 tabs 3x day—begin 2-3 days at the point in your cycle before the pain usually starts).
Begin with a holistic physician who can optimize your bioidentical hormone treatments (including testosterone). Have them use the lower dosing of natural progesterone as progesterone helps anxiety but can worsen depression if the dose goes too high. Optimizing iron (drive the ferritin blood test up to at least 60) and thyroid treatment (even if your labs are OK ) can help slow periods. If heavy bleeding persists, I often give vitamin A 50,000 units a day for 3-6 months and this can stop heavy periods (called dysfunctional uterine bleeding) but this treatment must be monitored by a holistic MD. You may also find that when you treat with the thyroid and testosterone, the NATURAL bioidentical progesterone (not Provera or progestins which are dangerous) will be well tolerated, and you can take a high enough dose to simply stop your periods. Birth control pills you do not cycle can also help here, and as the problem will stop with menopause, I would stop the periods with the hormones before I would do surgery if we can avoid the depression.
The doctors at the Fibromyalgia and Fatigue Centers are bio-identical hormone experts, as are many Board Certified Holistic physicians..
L&B,
Dr. T
Dear Dr. T,
My diagnosis came in January 2000 and I have suffered greatly from Fibromyalgia and CFS. The worst part is the loneliness of this illness, when friends and family don't believe you're ill.
Good News!! I've been on your SHINE protocol for over a month and recently have been feeling infinitely better. I don't wake up in pain and body stiffness. My outlook is so improved, I find myself making and keeping social commitments! You are a Godsend. I love your email articles as I look forward to your next "best" solution to these chronic conditions.
I brag about you all of the time!!
Rebecca S
Mt. Laurel, NJ
It has been 5 years since I was stricken with CFS, and just over 3 since I began treatment with Dr. Teitelbaum (Nov 2004). My health continues to improve, and in the last six months I reached another milestone. I began a 3x/week exercise program! Previously, I was unable to exercise regularly without crashing. Now, I do 20 minutes on a stationary bike, 15 minutes on a recumbent cross trainer (seated stepper), and I walk six times around the perimeter of a regulation-size basketball court! I am truly amazed at how well I can tolerate this level of exertion! I believe that retirement and our relocation to the Southwest have enhanced my recovery, but most of the credit goes to Dr. T's protocol.
I take my daily dose of the Energy Revitalization System, and get a monthly IV injection (Myers cocktail). I have located a certified holistic practitioner in Santa Fe who understands CFS and Dr. T's work. At this point, I am leading a close-to-normal life—something I never thought I'd see again!
Just thought you and Dr. Teitelbaum would be interested in my progress. Hope you are well. I check Dr. T's speaking schedule regularly, and look forward to seeing him in New Mexico or Arizona one of these days.
Warm regards,
Kathi
Albuquerque
I have been taking thyroxine since last September. During that time my doctor has prescribed amitripyline to help me sleep (50 mg) and I have taken it on and off. I ran out and was going to ring and ask for some more but—now my head is a bit clearer—decided to read the little white paper in the thyroxine box. It says that thyroxine interacts with amitripyline. Could you tell me what effect it might have been having on the thyroxine? I would like to be a bit more informed before I speak to my doctor just in case she does not like to admit she has made a booboo. I thought that their computer system was sophisticated enough to give them a warning if they put 2 medications that interacted on the same prescription but obviously I was wrong!
ANSWER
The 2 medications are commonly used together. In those prone to abnormal heart rhythms, elavil (amitriptyline) can accentuate these—especially in high dosing or at toxic levels. This is much less common at low dosing like 10-50 mg. If one is having abnormal rhythms, giving the thyroid hormone (though very healthy for the heart relative to having a low thyroid) can accentuate the problem if the levels of thyroid are too high. It sounds like the doctor's prescribing both together was reasonable. I usually prefer other natural and prescription aids over amitriptyline, though, because it is high in side effects.
L&B,
Jacob Teitelbaum, M.D.
Laura M asks:
Dear Dr Teitelbaum,
I find your information fascinating and I thank you for so generously sharing it and helping so many!
I wonder if you could please shed any light on my condition. I developed a very strange neurological problem a year after starting T4 + T3 treatment for Hashimoto's thyroiditis. When my body is 'shutting down' for the night I get a feeling like an electric shock, or a sharp hot pain, or a hard jerk/twitch inside my body (my body actually rarely moves at all) which wakes me up—usually this is around my chest but I can have the sensations in any part of my body. Often this feels awful and is traumatic, so I then can't sleep for hours while the pattern repeats itself over and over. As you can imagine I have often felt that this problem is causing me to fall apart, but the 8 doctors I have consulted don't know what it is and just try to prescribe me anti-depressants, beta blockers or sleeping pills.
I am on a lower-than-necessary dose of thyroid replacement as it seems that higher doses worsen the problem; otherwise I've had MRI, EKG and EEG and appear to be normal. A saliva adrenal test showed low adrenaline but I can't take B vitamins without feeling ill and I'm not sure other adrenal-boosting supplements have helped (and if that is indeed the source of my problem). If you have any insights at all into this I can't tell you how grateful I would be... I have found a few other people suffering through the same problems (but I seem to be worst!). But we haven't had any help from the medical profession at all.
Of course, I am tired most of the time and looking forward to receiving your book!
Gratefully yours,
Laura M
ANSWER
Dear Laura,
It sounds like it is likely one of several things (none of which are dangerous):
| 1. | As muscles release, as can occur with falling asleep, they sometimes "catch" and spasm. Especially if the spasm pinches a muscle, it can cause the shooting/electric pains. This can be especially noticeable in the chest area (especially in the mid-chest and 2 inches below the left breast/nipple area where muscle insertion sites are most sensitive). If the areas are localized (largely in the same area from night to night) a lidocaine patch (Lidoderm) over the area at night may help after 2 weeks. This pain may be accentuated by #2 and #3 below. |
| |
| 2. | Myoclonic jerks—When we slip into sleep and dream state, our muscles "disconnect from our brains" so that we don't walk around in our sleep when we dream of walking. Usually this disconnect is smooth, but it is not uncommon to have it not be smooth, leaving one feeling like they are dropping from a few inches above the bed. This can also throw spasm prone muscles into spasm. This is a totally benign phenomenon and the answer is to treat the underlying muscle spasm/FMS as discussed in my book so the pain stops. In rare cases like yours where it is a problem, neurontin taken an hour before bedtime may also help. In addition, the supplement 5-HTP (300 mg 1-2 hours before bedtime—takes 6-12 weeks to work—only take with prescription antidepressants if OK'd by your Holistic Practitioner) has helped in some studies, as has (I would try in this order) Klonopin plus Valproic acid, or Dilantin. In severe cases like yours, several of these treatments work well in combination when any single one does not. |
| |
| 3. | Acid reflux at night may also trigger/drive the chest pains. Consider taking 20 mg pepcid an hour before bedtime for a week to see if it decreases the symptoms. |
I would try taking the treatments about an hour before bedtime, and using the rest of the SHINE protocol as discussed in the book (FFTF). Let me know how these work for you, and of course get your doctor's OK before doing these things.
L&B,
Jacob
Dear Jacob,
I have read all I can find on fibro. One symptom I have that I have not seen an answer to is my temperature intolerance. I have noticed others comment that they have temperature intolerance, but no one has suggested how to treat it. If a room gets only slightly warm, my head will be absolutely dripping with sweat. And if I get too warm, I will actually get sick to my stomach and weak. My face gets bright red and I look really ill. On the flip side, I also have trouble staying warm if it is really cold outside. But that is easier to live with. This is different than my hot flashes. I am 56, and post menopausal. I do not have diabetes. I am doing better health wise and would like to go back to work part-time, but I cannot until I get this symptom under control. I know you have mentioned the hypothalamus is responsible for temperature regulation. Is there a way to treat this??? This is really debilitating.
Linda
ANSWER
Dear Linda,
This is a common problem in CFS/FMS and even for others under severe stress and usually reflects the poor autonomic temperature regulation caused by the hypothalamic dysfunction (see pg 17 of the From Fatigued to Fantastic! book). Treating with the "SHINE Protocol" discussed in the book will usually help this over time. In addition, having a CFS specialist look for underlying infections (I recommend the Fibromyalgia and Fatigue Centers www.fibroandfatigue.com as they are trained to look for these and most physicians will miss them) and overactive thyroid, as well as low estrogen would also be important.
While going after the underlying causes, making sure you have optimal amounts of Magnesium and B vitamins (I recommend the "Energy Revitalization System" vitamin powder) and taking the herb Black Cohosh (use the Remifemin form) 2 caps 2x day for 2 months then 1 twice a day as symptoms come under control can help give symptomatic relief after 6-8 weeks. These can be found in most health food stores or at www.vitality101.com.
L&B,
Jacob
Hi Jacob,
I received your supplements 2 weeks ago. I have not had this amount of energy since I was a teenager (a while back LOL ). Very few pain issues, using tylenol, and Lyrica only once in a while at night.
The swollen glands in my neck and under my arm disappeared in 24 hours.
A very odd rash originally diagnosed 4 years ago as Granuloma anulare on my hands bilaterally, is slowly clearing up. My family is in shock, as am I ( but I'm too busy laughing ) at the drastic, fantastic change in my health.
Be afraid—I'm sending a lot of people your way !!!
Thank you again,
Kathleen C, RN
ANSWER
Dear Kathleen,
Thanks! ;-)
Glad you're feeling better—that's what it's all about.
Isn't it amazing what happens when you give your body what it needs! ;-)
Love and Blessings,
Dr. T
Hi Jacob,
Hope this email finds you happy, healthy and terrific!
I'm working with a gentleman in his early seventies that has statin (cholesterol lowering medication) induced muscle damage. He has muscle pain, general weakness and nerve damage. Over the last year he has used a variety of supplements with some degree of benefit, however it could be better.
Recently, he started using the Fatigue to Fantastic kit and reports that he is responding and feels he's making progress. He's also taking 300 mg CoQ-10, 2 gm Carnitine and 250 mg Alpha Lipoic Acid. I had him on 2 tsp Ribose Powder but it made him too antsy.
Have you any experience with long term statin damage patients? Anything you can think of that I may be over looking?
My next recommendation was to add 1 tsp of Ribose to the Energy Revitalization System vitamin powder and see how he tolerates a lower dose. I also wanted him to consider a liquid protein (15 gm) before bedtime to work on the muscles. Any experience with creatine?
Any advice would be a blessing!
All the best,
Tom S
Paradise Health & Nutrition
Melbourne, Florida
ANSWER
Dear Tom,
For the statin damage, I would do these 4 treatments:
1. CoEnzyme Q10 200-400 mg a day.
2. Acetyl-L-Carnitine 500 mg 3x day.
3. Energy Revitalization System vitamin powder.
4. Retry D-Ribose (Corvalen) at a lower dose and with food.
5. For 6 months add lipoic acid 300 mg 2x day.
Creatine won't hurt but is unlikely to help unless he wants to bulk up.
If pain persists, it may have triggered a secondary fibromyalgia and use the "SHINE protocol" in the From Fatigued to Fantastic! book. Also, be sure a sedimentation rate and CPK blood tests are checked to be sure these are not elevated (if either is, let's discuss further) and check a free testosterone to be sure this is optimized. If you do not have an MD in town to work with, I highly recommend the Fibromyalgia and Fatigue Center (www.fibroandfatigue.com). They see many out of town patients and can be very helpful in working with you
L&B,
Jacob
Dear Jacob,
Wonder if you can help me with this...
I am seeing a 34 year old male patient who since age 17 has had severe morning headaches, which wipe him out for the day. The deeper he sleeps the worse he feels the next day. He has seen tons of doctors, been treated with migraine protocols, cortisol, anti-depressants, Depakote, tegretol plus much more.
I am treating a low B12 but no difference with that. His blood work is otherwise OK, except interestingly a morning fasting insulin was less than 2. Serum cortisol was fine but saliva cortisol quite low. Glyco HGB was mid 5's. Neuro exam normal and has had a bunch of MRIs normal. He says mornings after he dreams are the worst. He feels better in late afternoon.
This has really disrupted his life.
Any thoughts?
Dr. Alan W
ANSWER
Dear Alan,
First things that come to mind are:
1. Morning tension headaches from the head being in a funny position when sleeping (especially if muscles tighten with vivid dreams). Have him come in to see you or a physiatrist first thing in the morning when he has the headache, and see if palpating any of the head and neck muscles reproduces/affects the pain. If yes, this is near confirmatory for muscle pain, and get a special neck pillow (e.g. from Brookstone) and try some muscle relaxants at bedtime (e.g. Flexeril, Skelaxin, and perhaps even Lyrica 200-250 mg) to see if this helps, plus give Myers/nutritional IVs for at least 6 doses.
2. Less likely but possible is that he is going hypoglycemic during sleep. Have him eat some protein (e.g. ~ 3 oz turkey) before going to bed and take 2.5-7.5 mg cortef at bedtime. If this worsens the problem, stop it. If it helps (would do so first night), continue it.
L&B,
Jacob
My son was involved in a boating accident 6 weeks ago and remains disabled. It was determined he suffered whiplash, a concussion, and damage to his inner ear, among other things. For 6 weeks, he has been very dizzy as well as in pain and has gone through extensive testing for numerous inner ear problems. He finished today with a round of neurological tests, including MRI of his inner ear, brain, and upper spine, and EEG. The doctor's conclusion is that what he is suffering is normal for the type of trauma he suffered, and said he just has to wait out the nerve repair, which he indicated would be weeks, maybe months away.
While this is good news in a way, the repercussions include his losing his job. So my question to you—Do you know of any ways, alternative or traditional—to speed the healing of nerves? I appreciate your considering this.
Denise
ANSWER
Dear Denise,
A few issues:
1. To help speed nerve healing, the key nutrients are Vitamin B12 (consider 500-5000 mcg of methylcobalmin sublingual tabs) and Vitamin B6 50-100 mg/day plus inositol 500-1000 mg/day. Lipoic acid 300 mg 2x day may also help. Healing may be more key here than regrowth (a slow process—if memory serves~ 1 mm a day).
2. With closed head injuries, the little micro bleeds result in iron release with secondary free radical injury. High dose anti-oxidants (vitamin C 500-1000 mg /day, Vit E 100 iu, SE 200 mcg, NAC 250-750 mg, etc) can help turn off this reaction. In addition, much of the secondary CFS and fibromyalgia seen from head injury is due to pituitary injury and secondary hormonal deficiencies—which are usually missed by the physician.
3. Ginger (tea or like the pink stuff in Japanese restaurants) may take a bit of the edge off the dizziness.
Except for the lipoic acid, all of the nutrients above can be found in adequate doses in the Energy Revitalization System vitamin powder (in most health food stores and online) or easily found individually as well.
L&B,
Jacob
Dear Dr. T,
I read the article below that says that food poisoning can cause problems years later.
Food Poisoning Can Haunt Health for Years
"WASHINGTON - It's a dirty little secret of food poisoning: E. coli and certain other foodborne illnesses can sometimes trigger serious health problems months or years after patients survived that initial bout." (The full article is at http://www.msnbc.msn.com/id/22771973/.)
Sounds like this could be a factor in many of us CFS/FM (ME) ppl too. FYI.
Brian P
ANSWER
Dear Brian,
The role of post infectious CFS/FMS and of ongoing "Opportunistic" infections (chronic infections which could not get a long term foot hold in a healthy person) is massive, and we continue to explore it. When seeing these late problems from food poisoning though, in the absence of the immediate associated kidney problems, it is tricky to presume the food poisoning 20 years ago had anything to do with this week's hangnail (why tie it to the food poisoning vs. any of a thousand other factors). I would worry less about old food poisoning than the current bowel and other infections (there are many(;-) These include SIBO (Small Intestinal Bacterial Overgrowth), yeast and parasites. For persistent problems after an acute food poisoning though, consider yeast treatment followed by treating for neurotoxins.
L&B,
Jacob Teitelbaum MD
Anita asks:
Dear Dr. T,
My mom was diagnosed with Polymyalgia Rheumatica almost 3 years ago and has been on prednisone ever since. She can't seem to decrease her dose below 4 mg without increasing her pain significantly. We just found out that the drug Fosamax, which she takes for Osteoporosis, has been linked to bone and muscle pain and wonder if it's contributing to her pain. I'd like her to discontinue taking it and begin taking the Bone Health you offer (unless it would be better for her to take Strontium separately). Will any of the ingredients in the Bone Health negatively interact with the prednisone? Also, should she take 3 or 6 pills per day? If you have any other information on this disease we would so appreciate your help.
Thank you,
Anita
ANSWER
Dear Anita,
This is a decision that of course has to be made between your mom and her physician, and sadly most physicians have never heard of Strontium as a nutrient (let alone having seen the research). I would recommend that you and your mom discuss the issue with her physician and show him the following from the FDA (see at end of this answer). Let the doctor know your concern that her PMR (Polymyalgia Rheumatica) pain may actually be from the Fosamax (and also can come from most cholesterol lowering drugs—called statins). Ask the doctor if:
1. Mom can stop the Fosamax for 4 months. Let him know you'll add nutritional support and show him the section from the Pain Free 1-2-3 book on Osteoporosis (I have also attached it) and add the Bone Health 3 tabs 2x day till osteoporosis resolves, then 3 a day. This can be taken with the prednisone.
2. Ask him to consider changing prednisone 4 mg to cortef 20 mg each AM. This has been shown to be safe for long term use (including for bones) and usually works as well for the PMR (see safety of ultra low dose cortef article and the discussion in the new edition of From Fatigued to Fantastic!).
3. We have found clinically that people get less toxicity from prednisone if the DHEA-s level is optimized (DHEA is over the counter). I aim for a level of 150 mcg/dl in women and 400-450 in men.
4. Some cases of PMR are triggered by wheat allergy, and a trial of a gluten free diet for 3-4 months is reasonable in severe cases or using NAET (www.naet.com) to eliminate the allergies (they will look for and treat a number of sensitivities, so needing ~ 25 sessions in normal).
5. The End Pain formula on my web site and in health food stores can also be very helpful, as can fish oil (both are excellent for inflammation). Give them 6 weeks to work.
If your physician is open minded and will work with you, excellent. If not, consider a Board Certified holistic physician. You can find one at www.Holisticboard.org.
L&B,
Dr. T
Information on Bisphosphonates
(Marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa.)
FDA ALERT [1/7/2008] - FDA is highlighting the possibility of severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain in patients taking bisphosphonates. Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics.
The severe musculoskeletal pain may occur within days, months, or years after starting a bisphosphonate. Some patients have reported complete relief of symptoms after discontinuing the bisphosphonate, whereas others have reported slow or incomplete resolution. The risk factors for and incidence of severe musculoskeletal pain associated with bisphosphonates are unknown.
This severe musculoskeletal pain is in contrast to the acute phase response characterized by fever, chills, bone pain, myalgias, and arthralgias that sometimes accompanies initial administration of intravenous bisphosphonates and may occur with initial exposure to once-weekly or once-monthly doses of oral bisphosphonates. The symptoms related to the acute phase response tend to resolve within several days with continued drug use. Healthcare professionals should consider whether bisphosphonate use might be responsible for severe musculoskeletal pain in patients who present with these symptoms and consider temporary or permanent discontinuation of the drug.
Dear Dr. T,
Kutapressin therapy:
Any experience using this? Recommendations greatly appreciated.
Thanks,
Maria
ANSWER
Dear Maria,
Nexavir is the newest incarnation of Kutapressin, an injectable liver extract that seems to have anti viral properties. It has been fairly helpful in those with suspected viral infections and CFS—especially when given with gamma globulin IM. Die off reactions can be seen. The main down side is that it requires an SQ injection of 1 cc 1-2 times daily (like an insulin shot). Those who have tried dropping to every other day usually find it does not work, and it is mildly pricey. At this point, if I suspect chronic viral infection, if HHV 6 IgG blood test (done at Quest labs—ask for HHV-6 IgG by IFA) is 1:320 or higher or CMV IgG is 4 or higher, I would use Valcyte and IM injections of gamma globulin (IgG). If these tests are negative, I would use Nexavir and IM IgG. I would do the anti-viral IVs in both situations. All of these are available at the Fibromyalgia and Fatigue Centers.
Below is the section from the new edition of my From Fatigued to Fantastic! book discussing these areas.
L&B,
Dr. T
Natural Antiviral Treatments Available by Prescription
There are two treatments that deserve special mention. The first is a natural anti-viral derived from animal livers. Called Nexavir (formerly sold as Kutapressin), it is given by daily injection, either subcutaneously or intramuscularly. In my practice, I have seen dramatic improvement with regular use of the Nexavir. However, daily injections are a must, and the few patients who only used it three times a week did not get much, if any, benefit. The downside is that it costs $19 a day, and the symptoms may return when the injections are discontinued.
The second natural prescription treatment is gamma globulin. These are the actual antibody infection fighters derived from the serum of numerous blood donors. The serum is first treated to kill off any infections the donors may have had and then the antibodies are harvested. Although these antibodies can be helpful against both bacterial and viral infections, in patients with latter we have seen a die off reaction (initial flaring of symptoms) with each injection of gamma globulin. I am now advising patients to start with the Nexavir first and add the gamma globulin 1-3 weeks later. I recommend 2 cc be given intramuscularly 1 to 2 times a week for 6 weeks, and then as needed. Although it can also be given through an IV, this delivery method is very expensive and does not seem to bring any additional benefit.
Deanna M RN asks:
My husband is in the navy and we just received orders to Okinawa, Japan. Before we enter the country we need to get the Japanese Encephalitis Vaccine. This is a live vaccine. I'm concerned about getting this vaccination since it is a live virus. I was diagnosed with CFIDS/FM in 2005. I'm controlled very well with meds and exercise... running about 3 miles 4 times a week. Should I be worried about receiving this vaccine? I was told by the MD that you can be sick for up to 30 days around the time you receive it.
Thank you!
ANSWER
Dear Deanna,
Unless you have a history of bad reactions to vaccines, I would likely simply take it if you need it to get into the country. If they have an exclusion that those who have diseases of immune suppression (e.g. AIDS) should not take it, then you may use that as a way to be exempted with your CFIDS (Chronic Fatigue and Immune Dysfunction Syndrome).
Frankly though, if it were me I would simply take it. The stress of battling them or getting the infection would more likely flare your illness than the vaccine. Most folks with CFS handle vaccines just fine (and actually often feel better after them). A recent study showed the flu vaccine was handled OK in CFS and another showed that taking a special vaccine regularly decreased Fibromyalgia pain.
If it were me, I would not worry about it and simply take it.
L&B,
Dr. T
Dear Dr. T,
I am looking for some easy, practical tips for dealing with different potential diet deal-breakers. I’d like to discuss why these situations are so tempting and get some practical tips on sticking to diets despite them:
• Making menu choices at a restaurant
• Going grocery shopping
• Office parties and treats
• Being on vacation
• Refueling after exercise
• Not being able to sleep and wanting a midnight snack
Also would love to hear about any other situations the doctor thinks are potential deal-breakers.
Thanks!
Julie
ANSWER
Dear Julie,
It seems Americans are on a perpetual diet when often it is not what we eat, but rather our metabolism (fixable) and even infections (a common cold virus is found 3x as often in obese people, and triggers fat cells). This is the topic of my newsletter this week (going out soon) which I can forward to you in case you ever want to cover these issues.
Regarding dieting, a few key points readers need to know:
1. A very low calorie diet is self defeating. Your body thinks there is a famine, your metabolism plummets, and you then gain weight eating almost nothing. Then you give up the diet and gain twice as much weight for the same amount of food. Eat at least 1500 calories a day, avoiding sugar and going low carb.
2. High protein, low carb tends to work well in moderation. A simple diet that works: eliminate all sugars and grains (e.g. wheat).
3. Sugars and carbs trigger insulin release which packs on the fat. Use sugar substitutes (stevia is best; the stevia by Body Ecology and the one by Stevita are the 2 best tasting. Saccharin is safe. I consider Nutrasweet to be toxic to many people. The jury is out on Splenda). I will add the 3 magic words to "Avoid sugar" which are "except for chocolate!" Chocolate is a healthy food if it is dark chocolate. Get the best tasting ones you can (Godiva and Russell Stover both have a yummy line of sugar free chocolates) and limit it to 3 ounces a day. Savor and enjoy.
4. When struggling with whether to have something, simply take a small portion and WALK AWAY FROM THE SERVING DISH with the portion in hand. Since you have it in hand, it's easy. Then savor it with no guilt. 80% of the pleasure comes from the first few bites—most of the calories come from the rest. If you feel guilty when you eat something, you won't even notice the taste as it goes down—so NO Guilt.
5. It takes ½ hour for the message to get from your stomach to your brain when you're full. Because of this, simply take small portions to start. It's easier to do when you know in ½ hour you can go back for more if you still want some. But you won't.
6. In restaurants, tell them to wrap ½ of the meal to go before they even bring it to you. In the US, portions are supersized. The ½ portion will fill you and leave you feeling great if you wait the ½ hour for the signal to get to your brain that you are full.
7. For a midnight snack, try a few ounces of low fat turkey. The protein and tryptophan in the turkey both will help you sleep.
8. In the grocery store, shop around the outer part of the store (where refrigeration usually is, so veggies and meat) instead of the center where the processed foods are.
9. To refuel during and after exercise, add 5-10 grams of a special sugar called D-Ribose to your drinking water. It has a zero glycemic index (actually less than zero—it lowers sugar), increased energy an average of 45% in a study I recently published, and prevents post exercise soreness.
10. If you're on vacation, enjoy yourself and ease up on the diet a bit. Simply keep sugars in moderation, and still get the ½ portion (or split a salad, soup or appetizer, and one main dish with a friend).
For more information on dieting, see What to Do When You Can't Lose the Weight.
Hope this has been helpful.
L&B,
Jacob Teitelbaum MD
Dear Dr. T,
Congratulations on all your recent success! I witnessed the Dr. Oz discussion of you on Oprah. You made it Doc and really deserve it with all your love and hard work.
I have a quick question and need your help.
I read somewhere that narcotic pain meds and pain meds deplete glutathione, but I cannot find a good reference. Do you have some data on this?
My particular patient (and I have many on pain meds) is on oxycontin for nerve damage after chemo tx for testicular cancer. He needs to take the oxycontin (has reduced his dosage dramatically) but still needs it. His cancer markers have come down to normal since I have given him protein shakes, EF, and glutathione (recancostat). I want him to continue because he has only recently completed his chemo and continues to take the pain meds. My thought is, if he continues the pain meds, but does not continue the glutathione support, then his immune health might suffer.
Do you have any comments on narcotic pain meds and glutathione?
Happy Holidays
Gay Riley, MS, RD, CCN
ANSWER
Dear Gay,
This only is a problem if they contain Tylenol (acetaminophen). That is why high doses can be liver toxic and the antidote given in the emergency room is high dose NAC (N-Acetyl-Cysteine) to replete glutathione (though they should also give IV Glutathione).
The problem is that many narcotics (eg. percocet, darvocet, and most that end in "cet") also have aCETomenophen 500-750 mg per tablet. If patients take these, plus Tylenol or other meds, they can easily go over the 4000 mg day threshold for developing liver injury from Tylenol. In fact, doctors see more liver and acute toxicity from the Tylenol in the narcotics than the narcotics themselves. I recommend that people taking Tylenol or acetaminophen chronically take 500-1000 mg of NAC (N-Acetyl-Cysteine) a day to optimize glutathione. Adding the Energy Revitalization System vitamin powder will also boost glutathione levels and has 250 mg of NAC in it (enough NAC if you're only taking 500-1000 mg of acetaminophen a day).
I have no problem giving glutathione and glutathione supporting therapies to patients on pain medications—including tylenol or oxycontin. Some doctors (usually those who are against natural remedies) avoid anti-oxidants during chemo and radiation therapy as some of these (especially radiation) work by oxidative damage. My reading of the scientific data (and that of most holistic practitioners) is that this is not a problem (and actually adding antioxidants to the cancer therapy is beneficial). If your patient is done with the chemo (at least for now) it makes this even more of a non-issue.
Also, Acetyl-L-Carnitine (500 mg 2x day) can help chemo induced nerve pain-though it takes months to a year to see the effect. I would also add lipoic acid 300 mg 2x day and the Energy Revitalization System vitamin powder (for the B6, inositol, B12 and magnesium—all of which can help nerve function). In addition, other meds are much more effective than narcotics and oxycontin for nerve pain. I recommend he see the chapter on nerve pain in my book "Pain Free 1-2-3!"
L&B,
Dr. T
D asks:
Dr T,
I am a semi pro athlete, been healthy all my life until Jan of 07. In the 70's I competed in karate in Japan, in the 80's I was a World Champion weightlifter, 90's Olympic trials in Rowing and in 2000 World Cup in kayak. From 2000 to 2007 I was a semi pro Ironman triathlete competing all over the world, Hawaii to Cancun to UK and more.
My problem has paralyzed me and I can't get any answers. I've been in the hospital for full workups with only lower t-cells, slightly elevated WBC, and slight blood in urine. Please review my overview below. Your feedback would be appreciated.
• Sept 2006: swollen slightly painful lymph node under jaw persisted but ignored.
• Jan 3: Just felt ill slight urethral pain at end of penis.
• Jan 23: Pain in lower prostate, urinary area from mountain bike that night. Night sweats began. Painful to sit for 2 months.
• Feb: Night sweats lasted entire month. Felt weak and ill.
• Mar-Sept:
1. Sensation of body temperature dramatically higher. NO FEVER but feels like I have a serious fever, especially afternoons (I used to be able to run 10-20 miles in 80-90 degree weather; Now I cannot tolerate higher temperatures or any real training).
2. Cervical, axillary and groin lymph nodes hurt but not enlarged. Hurt off and on, especially after training.
3. General malaise. Just don't feel well ever, but worse in afternoons. It is terrible. I used to feel good all the time, rarely sick.
4. Urination and ejaculation do not feel right. "Feels like something wrong."
5.Slight lower left abdominal pain that has persisted since Jan.
6. Inability to train, compete, coach properly and feeling very bad for so long. Has created depression, anxiety and severe sadness. Especially since no real diagnosis found.
7. My Theory is that persistent damage to prostate from mountain bike causing night sweats and shock to system set off a viral infection or immunological dysfunction or CFS.
FOR REVIEW....
• Had hospital medical workups—infectious disease, oncology, urology, colon, endocrine.
• Some Docs say this might be Chronic Fatigue Syndrome but others rule it out.
• Tests done at FL Hospital and ORMC. 7 hospital stays. Full workups. Revealed nothing.
• MRI and Cat Scans showed minor calcification in prostate. Nothing dramatic.
• PSA was .O2.
• Normal SED rate.
• Normal Blood cultures taken Apr, May, Aug, Sept.
• Tests for many infections—all NEGATIVE.
• Negative HIV, HEP 1 2 3, Lyme disease, Cat scratch disease, and many others.
• Slightly lower T-cells.
• X rays ruled out lymphoma.
• CRP was only slightly elevated.
• Cortisol test normal.
• Cystoscopy showed minor damage to prostate. Urethra was slightly constricted.
• Nothing to cause my symptoms as urologist dictated.
• Rectal scope and colonoscopy normal. NOT SHOWN IN RECORDS.
• Colon biopsy normal. NOT SHOWN IN RECORDS.
• ANA and Rheumatoid levels normal.
Thank You.
ANSWER
Dear D,
I understand how frustrating it is for you and suspect you have a low grade infectious prostatitis. Unfortunately, unless it is acute/fulminant, many urologists say it is "fine" or call it prostadynia. The infections can take many forms. I suspect yours is mostly antibiotic sensitive and in my clinic, I likely would already have you on 6 weeks of cipro or doxycycline as a therapeutic trial to see if it helps, plus quercitin 500-1000 mg a day (has antiviral properties against enteroviral infections—a suspected cause of prostadynia) plus the anti-yeast regimen described in my book. Find a holistic physician who will work with you on these or go to a Fibromyalgia and Fatigue Center and show this to the physician you see (www.fibroandfatigue.com). I would also check a free and total testosterone level and, if it is in the lowest 25% of the normal range for your age, I would consider treatment with natural testosterone (be aware that this could disqualify you from some races).
L&B,
Jacob Teitelbaum MD
Hi Dr T,
My two closest friends were both diagnosed with hypothyroidism recently—one with Hashimotos, the other not. In looking at hypothyroidism in FFTF I came away with the impression that of the four possible causes of hypothyroidism three have the possibility that the body will heal and take over for the synthetic hormone, only Hashimotos doesn't. Then I realized that what you really said was more along the lines of "if you're suffering from CFS, and the body begins to heal, THEN the body may take over the thyroid hormone creation on its own." Was I correct about interpreting your words on that—that the possibility of healing is if there's something else wrong in the body (CFS) which heals?
And are there the same four possible causes of hypothyroidism for those who don't have CFS? And the same possibility of the body healing and taking over its own thyroid hormone production?
My one friend was told that there are no side effects, ever, with the synthetic hormone. Another friend, who is a chiropractor, said that's not true as when on the synthetic hormone the body stops producing what thyroid hormone it was producing, so that you need to take more synthetic hormone over time. Do you know which is more true based on the current understanding of hypothyroidism?
Also, what can vegetarians who can't take Armour thyroid (which comes from animal thyroid) do to get bio-identical thyroid? I figured with both of my best friends suffering from hypothyroidism, it was time for me to get better informed!
Thanks for letting me ask.
Kathy
ANSWER
Dear Kathy,
Low thyroid caused by inflammation (thyroid-itis; "itis"=inflammation) is more likely to cause permanent damage to the thyroid requiring long term thyroid supplementation. Even with any of the forms of thyroiditis though (including haashimoto's), there is a degree of healing that can occur—and this can be enough to not need supplementation over time. As with most organs in the body (e.g. people can donate one of their 2 kidneys and do fine), the thyroid has excess available function to spare, so it could still function optimally despite the damage.
In CFS, where the low thyroid function is often associated with a normal thyroid gland but faulty control system which can fully recover, there is a greater likelihood of being able to come off thyroid and not need it long term as the person heals.
So, with thyroiditis one is more likely to need long term thyroid supplementation than with CFS—regardless of the cause of thyroiditis. Most cases of non CFS low thyroid are thyroiditis, surgery/radioactive iodine or iodine deficiency. Nonetheless, even with thyroiditis it is possible to heal enough to not need it.
The question then arises, should one use synthetic thyroid (synthroid, levoxyl, levothroid) which is pure T4 or Bio-identical T4/T3 mixes (Armour Thyroid, compounded thyroid). The T4 is the hormone made by the thyroid but is NOT active. The body converts T4 to the active T3 hormone. Although all of these can cause thyroid suppression, this is usually short term and not a problem. One simply slowly weans off the thyroid when ready. The issue is more effectiveness. As the body needs the T3 hormone component (T4 is not active till converted to the T3 hormone), and many people have difficulty with either converting T4 to T3 or resistance to T3 requiring high dosing (research that most endocrinologists are not aware of ), I find that most patients do best with the T4/T3 combination (Armour Thyroid, compounded thyroid) and I will usually begin with these.
As the thyroid hormones are bio-identical whether or not they are pig or synthetic, either is OK—as long as one uses the mix of T4 PLUS T3.
The pig /dessicated thyroid has the benefit of having the other nutritional factors in it that make up the thyroid gland (this is the basis of using the glandulars sold in health food stores) but the down side of being more likely to trigger allergic reactions in those that are allergic to their own thyroid tissue (as in hashimoto's). As there are good arguments both ways and both the synthetic T4/T3 mixes and Armour Thyroid (dessicated) work well clinically, it is simply a matter of personal preference.
If having the T4/T3 mix compounded (to use the synthetics), there are 2 key points:
1. I like a ratio of 4 parts T4 per 1 part T3. This is a bit more T3 than normal in the body, but is clinically needed for a number of reasons (enough to write a book on).
2. There is a major problem with getting the potency of T3 correct in compounded products. Because of this I have all T3 products made at ITC Compounding Pharmacy (they ship all over the country; 303-663-4224 is the number for the doctor to call in the prescription). Conversely, one can get cytomel in regular pharmacies and add it to synthroid, but this requires usually taking many different tablets daily instead of 1 capsule and can get confusing.
Love & Blessings,
Dr. T
Dear Dr. Teitelbaum,
I have been reading everything I can on your website, having been diagnosed first with fibromyalgia about a year ago and then with Chronic Fatigue through your program just recently. I also suspect I have celiac disease because I know I have a problem with wheat/gluten.
I have a question I haven't found an answer for yet. Although I consider my dental hygene habits pretty good and eat no sugar my teeth are now full of cavities. I had maybe one cavity in 30 years and now I have a dozen at a time. From various things I have been reading I am afraid my body may be pulling nutrients from my bones and teeth because it is unable to absorb them otherwise. I have also read things about bacteria causing dental problems.
Do you have any ideas or suggestions as to what is causing this and how to make it stop?
Thank you so much. I can't say how much I appreciate all the information and help you have provided.
Thank you.
Sincerely,
Molly
ANSWER
Dear Molly
You're welcome ;-)
An increase in cavities is a common problem in CFS and FMS. It most often is caused by the dry mouth associated with the illness and medications used (especially elavil/amitryptaline). In addition, acid reflux is common and can aggravate cavity formation. I recommend my patients who have this:
1. Be switched off of meds that cause dry mouth.
2. Avoid sweets and use sugar FREE gum (which actually decreases cavities) and sugar FREE lemon drops (lemon stimulates saliva).
3. Take fish oil (I recommend Eskimo 3 or Nordic Naturals which are free of toxins and are not rancid) 1-3 tsp/day for 3 months then 1 tsp (or 3 caps) a day plus B complex and magnesium (both found in the Energy Revitalization System vitamin powder) which help improve both the dry eyes and dry mouth (called sicca syndrome—confused by some doctors as being Sjogren's Syndrome which it usually is NOT in CFS).
In addition, hot and cold sensitivity of the teeth is often caused by referred pain from muscle spasm in the face. Dentists are not aware of this and often do unnecessary root canals in this setting, so I avoid the root canals unless the dental x-rays show a clear problem and use the pain gels discussed in my book "Pain Free 1-2-3" over the tender muscles instead—which often eliminates the tooth sensitivity.
Hope this is helpful.
Love & Blessings,
Jacob Teitelbaum MD
How effective is food sensitivity testing and a rotation diet for those with CFS/FMS? I just read how Yvonne Keeny eliminated her fibromyalgia in 6 weeks from a rotation diet and supplements. Is this something you use frequently in your practice? If not, why not? Thank you!!
EW
ANSWER
Dear EW,
Food allergies are a significant issue in CFS/Fibromyalgia and in many other illnesses. This is discussed in my newest edition of "From Fatigued to Fantastic!" (Oct 2007, Penguin/Avery). In fact, we find this issue to be so important, our foundation funded a study using a special allergy elimination and testing technique (see www.NAET.com ) which uses a specialized form of acupressure and muscle testing to find and eliminate allergies. In the study 30 autistic children were treated with the NAET. By the end of a year of weekly treatments, 23/30 autistic children were back in regular schools (vs. 0/30 in the untreated control group). I have also seen CFS and Fibromyalgia go away with NAET. It takes 25-50 simple once a week treatments (can be done without needles). I got interested in it when a single 20 minute treatment eliminated my life long hay fever and I have discussed this issue on Oprah and Friends with Dr Oz, CNN and many other national shows as well—so the info is getting out there.
Unfortunately, food allergy blood testing is horribly unreliable. One study showed that if I drew 3 tubes of blood from you and sent them to any single lab (except one which is now closed) labeled with different names, each would come back saying you were allergic to 30-50 foods—but which foods would vary dramatically from tube to tube (all drawn from the same person)! I tease doctors that if they going to do food allergy blood testing, don't bother drawing the blood. Just take any result from the lab and write your patient's name on it. Even with a random result though, you may get lucky and have the offending foods show up.
So how do I approach food allergies? I find that when I treat the low adrenal and bowel yeast and other infections many of the food allergies go away. If symptoms persist despite going through my treatment protocol, or earlier if symptoms and a total IgE blood level suggests a high allergy load, I recommend the person begin NAET and perhaps an allergy elimination diet.
Love & Blessings,
Jacob Teitelbaum MD
Corah asks:
I was diagnosed with fibromyalgia when I was 16 years old (I'm now 26). I woke up one morning nearly paralyzed because of excruciating pain... as the day progressed I was finally able to move, but have since had pain all over, stiffness, and fatigue. After months of tests, nothing was found wrong except a slightly elevated SED rate and then pain at the pressure points for FM, hence the diagnoses. I am now having some strange headaches and my doctor is running some tests. He checked my SED rate and it is at 29. I believe this is near to what it was when I was diagnosed with FM. I know this isn't that high. I started reading a bit online about the SED rate and it looks to me like having a high SED rate would be indicative of something other than FM though. So I guess my question is... is it typical for FM patients to have an elevated SED rate or should I be pursuing further diagnostic testing for something else (such as lupus)? Or seeing as the number is only slightly elevated, is it something I shouldn't worry about (which is what my doctor is suggesting)? Thanks so much!
ANSWER
Dear Corah,
Although a sed rate (also called ESR or Sedimentation Rate) of 29 is only modestly elevated and usually ok to ignore in most illnesses, in CFS and fibromyalgia most people run a very low sed rate (e.g. 0 to 5) and 29 is very worthy of triggering a workup for infections, inflammation, autoimmune illness, etc plus using a therapeutic trial of cortef 15 mg/day and a natural anti-inflammatory (the End Pain or Pain Formula products 2 tabs 3x day for 6 weeks, then as needed) including fish oil. Although it sounds like you have a good doctor, it seems like their experience with CFS/FMS is limited and I would recommend a consultation with a Fibromyalgia and Fatigue Center physician (www.fibroandfatigue.com). They see patients from all over the world.
Love & Blessings,
Jacob Teitelbaum MD
Karen from the Netherlands asks:
Dear Dr. Teitelbaum,
There is a question I would very much like to ask you. I have a big big problem with taking hydrocortisone. My personal protocol indicates I need it. As a pharmacist I´ve always learned that hydrocortisone should only be given in very specific circumstances, and that there are a lot of side effects. I know the doses given in your protocol are much lower than usual and I am studying all the literature available but still am extremely uncomfortable with taking hydrocortisone, also because I am very sensitive to medication (which has resulted to some scary moments in the past). Is it at all possible to follow your protocol without taking the hydrocortisone and would it be less effective (in other words: would I be denying myself a possible cure if I wouldn´t dare to take it)?
Thank you.
With kind regards,
Karen
ANSWER
Dear Karen,
I understand your concerns and it took me years of reviewing the medical literature before I was convinced of its safety in low dose. I strongly recommend a book "Safe Uses of Cortisone" by Professor William Jefferies (click here to find it on Amazon in the US).
After reading it I think you will be much more comfortable with the treatment.
You can certainly improve without the cortisone by treating the rest of the protocol, and the Adrenal Stress End product on my web site (or its components if not available in the Netherlands ) can also help restore adrenal function in many cases without taking cortisol. In severe cases though, it may not be enough and your body may require some cortisol by mouth. In this case, some people are more comfortable using an adrenal glandular that is non prescription that contains cortisol (called Isocort), but I still think getting the prescription form is safer.
In addition, I recommend a well referenced article in the "From Fatigued to Fantastic!" Notes section of my web site written by my friend, Dr. Kent Holtorf. Click here to go directly to Dr. Holtorf's article.
I think reading this will also leave you more comfortable (and save you the $90 cost of Professor Jefferies book).
In addition, for a superb and very knowledgeable CFS/FMS physician in the Netherlands, I recommend Dr. Paul Van Meerendonk, who can guide you wonderfully. His e-mail if you would like to contact him is p.meerendonk@planet.nl.
Love & Blessings,
Jacob Teitelbaum MD
Margaret asks:
Why do you not recommend anyone over 20 yrs old not try florinef for NMH?
Thanks!
ANSWER
Dear Margaret,
Although it is OK to use if you are over 20 years old, it is less likely to help in adults with CFS. Our experience is that it is more likely to help in those under 20 years old, but is not likely to help if older (though we have seen exceptions). This was seen also in an NIH study in CFS where 14% of adults on florinef improved vs. 10% on placebo.
If it is helping you though, I would stay with it.
In adults (and children as well) we find the low blood pressure issues (NMH - Neurally Mediated Hypotension) respond best to:
1. Salt and water loading
2. Dexedrine (MAXIMUM 30 mg/day-usual dose 5-10 mg/day to decrease addition risk)
3. Prozac or Zoloft
4. Midodrine (Proamatine)
5. DDAVP (rare use)
In this order, they can be combined.
Love & Blessings,
Jacob Teitelbaum MD
Marilee asks:
Every article I've read says to take strontium away from calcium or it won't be absorbed, yet your Bone Health formula puts them both in the same product. So, which is true?
Also, must strontium be taken on an empty stomach and must you wait an hour to eat? That is what I was told, but a friend was told to take it with food.
Thank you.
Marilee
ANSWER
Dear Marilee,
These are excellent questions, but much more complex than it seems. I will also address 2 other questions also asked about Bone Health:
1. Why in my book I recommend the Bone Health product but go on to say that Strontium ranelate is what should be used, but then the Bone Health product contains strontium carbonate.
2. Why the calcium is carbonate? Is there a reason for the choice of strontium carbonate and calcium carbonate?
These are excellent questions, but much more complex than they seem at first glance. There are a few key issues to factor in:
1. Both calcium and strontium are absorbed by the same mechanism in the bowels, so there is some competition. It is estimated that one will absorb twice as much calcium as strontium when combined. Because there are high levels of strontium in Bone Health relative to the diet (which has 1-5 mg/day) and too much strontium may inhibit bone formation, I am OK with the drop in strontium absorption. Though the 680 mg/day used in some studies seemed safe over the 3 years of follow up, I doubt these very high levels are either needed or optimal, and my recommendation over time has been to lower the dosing.
2. A bigger concern is taking high levels of strontium without adequate calcium intake. This is the main time the strontium could be bone inhibiting. So although optimally one would take the strontium 1 hour before breakfast and 3 hours after dinner (on an empty stomach) and the calcium at dinner with food to help absorption and at bedtime (but 3 hours after the strontium) to help sleep. As you can see, it becomes a full time job juggling this and most people would not be able to stay with it or would miss the calcium or strontium doses—causing their own problems.
3. Strontium also inhibits calcium absorption by decreasing the conversion of 1 type of vitamin D (25 OHD) to another (1,25 OHD). In our society, especially in CFS/Fibromyalgia, 1,25 OHD is already too high relative to 25 OHD (stimulated by chronic infections) causing an immune system imbalance that is problematic. By taking the high dose Vitamin D in the Bone Health with the strontium, one can optimize Vitamin D while decreasing excess conversion to 1,25 OHD and still maintaining excellent calcium absorption.
Because of this, though a classic approach would be to take strontium on an empty stomach away from calcium, in real life this is often impractical (most people are lucky to remember a 1 a day birth control pill!). Because of this, I prefer to combine everything to be taken morning and night (I prefer this for almost all treatments—just put it by your toothbrush) and then to adjust the dosing of the individual nutrients in the supplement to compensate for this. This makes it simpler, improves compliance, and makes it more likely to work in the long run.
4. In the book, I note that all forms of strontium work but the ranelate has mildly better absorption. It is, however, more expensive and you can get the same effect at a significantly lower cost by simply upping the dose a bit, so we do it that way.
5. There are numerous conflicting studies over which form of calcium is best absorbed, with the usual result being that it is the brand that is made by the company who paid for the study (same thing as is seen with pharmaceuticals). I do not think the form of calcium is very important except that many (if not most) tablets do not dissolve and get NO absorption. That's why in my Pain Free 1-2-3! book I talk about the key issue with calcium being that it be a powder, liquid or chewable so that it dissolves and is absorbed, and this is the case with Bone Health.
I hope this has been helpful.
Love & Blessings,
Jacob Teitelbaum MD
Most of my friends seem to be developing heart disease as we age. I have congestive heart failure, my wife has abnormal heart rhythms, and my best friend has angina. All our doctors have to offer are pills and surgery, and these haven't been too effective. What can help us naturally, without all of these side effects?
We appreciate your help.
Bill
ANSWER
Dear Bill,
The heart is the hardest working muscle in the body. With heart failure, the muscle is weakening. With angina, there may not be heart muscle weakness, but increasing heart efficiency can decrease its work and therefore the tendency to chest pain and abnormal heart rhythms as well. Fortunately there are many natural ways to improve heart muscle function.
The key treatments for these heart problems that I use in my practice, including for abnormal heart rhythms and angina, but especially for congestive heart failure, are (in combination):
1. Ribose (Corvalen brand) - This powder that looks and tastes like sugar is a key to energy production in the body—including the heart. I recommend 1 scoop (5 gms) 3 times a day for 6 weeks, then twice a day. This nutrient is outstanding for heart disease and is the most important one. You will likely be amazed after 6 weeks on it!
2. CoEnzyme Q10 (use Enzymatic Therapy or Vitaline brand CHEWABLE wafers—brand and form are critical for this nutrient). Take 200-400 mg/day (I would do 400 mg/day for 6 weeks then 200 mg/day). This nutrient is especially critical for anyone on cholesterol lowering medications, even if there is no heart problem,as these medications cause CoEnzyme Q10 deficiency, and this nutrient is critical for energy production.
3. Magnesium 200 mg/day and B Complex 50+ mg/day. I would get this plus over 40 other key nutrients easily by taking the Energy Revitalization System vitamin powder and B Complex. Take 1 scoop a day, but if it causes gas or loose stools, can decrease the powder to 1/2 scoop a day. Take the dose that feels the best up to 1 scoop a day. This product is outstanding for overall well being. I would consider adding an extra 200 mg of Magnesium at bedtime. (Caution - in the rare patient with kidney failure, magnesium and many other nutrients should only be taken under a licensed Holistic Health practitioner's supervision. Magnesium can also cause loose stools.)
4. Acetyl-L-Carnitine 500 mg 2x day for 6 weeks, then 500 mg/day is enough (and it can often simply be stopped).
Give these nutrients 6 weeks to see the optimal effects. The benefits for heart health are often dramatic! The products are readily available in many health food stores, web sites, and at www.Vitality101.com or by phone from 9 AM to 5 PM EST at 410-573-5389 (or 800-feel-btr).
Love & Blessings,
Jacob Teitelbaum MD
JoAnne G asks:
I'm writing to you not only on my own behalf but for so many breast cancer patients who are suffering from the same chronic pain I am. I was diagnosed with Stage 2, estrogen + breast cancer in 2004. I was 46 yrs old. I had a lumpectomy, chemo & radiation, & am now on Femara. The chemo caused menopause & I elected to have a supra-cervical hysterectomy following treatment. Ever since treatment, surgery & now Femara, I suffer from daily, significant muscle, joint & bone pain. I do twice/week Yoga & walk 40 min. about 5 times a week despite its causing severe muscle tightness & pain in the muscles, bones & joints. The only relief I get is from hot baths & showers & the occasional, low dose Percocet which I take as a last resort. I'm willing to take supplements, but am afraid to take anything that may stimulate the production of hormones which could lead to a cancer recurrence. Can you help me with this problem which seems to be so common among BC patients I talk to?
Thank you.
ANSWER
Dear JoAnne
This is a difficult problem for women—especially when they are given Tamoxifan or other hormone blockers for their breast cancers. This is a common trigger for fibromyalgia.
The good news is that even without being able to take estrogen, testosterone or DHEA hormones, most women in this setting respond well to the "SHINE Protocol" discussed in my "From Fatigued to Fantastic!" book and used by physicians at the Fibromyalgia and Fatigue Centers nationally.
Specific treatments that also help the hot flashes (a.k.a. "autonomic instability") caused by the lack of estrogen includes an herb called Black Cohosh. The only form that works is a special extract called "Remifemin" by Enzymatic therapy (shown to work in many studies and the only one used in most reputable studies now). I give 2 twice a day for 2 months and then 1 twice a day is usually enough. Give it 2 months to work. Settling the hot flashes helps sleep and decreases pain. Some groups that misinform about natural remedies in what I believe is an attempt to scare people (natural products are competition for pharmaceuticals) have put out rumors that black cohosh has estrogen activity that could flare breast cancer, but this is rubbish and black cohosh likely inhibits breast cancer (see the article Black cohosh stops breast cancer growth in the lab).
In addition, some oncologists are allowing estrogen in certain cases, so discuss this with yours. Interestingly, estriol (NOT estradiol) appears to likely inhibit breast cancer (see the HRT Inset discussion in the newest edition of my "From Fatigued to Fantastic!" book—offering yet another possibility for your oncologist—take the article and footnotes/references with you when you see them).
Love & Blessings,
Dr. T
Hi Jacob,
Loved the Q and A's! Great info. I noticed that you talk about Elavil. I have so many clients that take it and the weight gain is horrendous. Can you comment on that as a side effect and how you would recommend to manage it if Elavil is the med of choice?
I didn't realize Elavil was used for pain. My oral surgeon keeps trying to get me to take it for my TMJ which is really bad but I resist. I prefer to manage the pain with an occasional pain med or 1/2, lots of chiropractic tx, acupuncture, mouth guards, TNS therapy, and my supplements including the EF regime. Most of the time that helps. The Elavil made me so foggy and dumb. Anyway, I have a client now that gained 55 pounds in one year. She did not really do anything differently as far as diet and the weight gain started with the Elavil.
I absolutely loved what you say about the pain meds. If you are in pain, the goal is to be Pain Free…My goal always.
Sincerely,
Gay
ANSWER
Dear Gay,
Thanks!
Because it is high in side effects, Elavil is one of the LAST meds I use (there are dozens I prefer) except in cases of neuropathic pain and/or pelvic pain syndromes (vulvodynia, interstitial cystitis).
For TMJ, I would fix the bite and treat with the same "SHINE Protocol" as for FMS. I would use the topical pain gels discussed in my Pain Free 1-2-3 book and apply them over the tender areas over the masseter and other face muscles. If oral meds were needed, I would begin with Ultram and skelaxin (along with the topical creams/gels—which can be ordered by mail by prescription from ITC compounding pharmacy @ 303-663-4224—ask for the nerve pain lotion and apply a thin layer 3x day and give it 2 weeks to work). Elavil is NOT my drug of choice for TMJ or Fibromyalgia pain (it's about 20 down on the list!)
L & B,
Dr. T
Hi Dr. T,
What do you suggest for sleeping natural wise? L-Theanine? Someone recommended GABA and Inositol—300mg each. Melatonin doesn't seem to be working—maybe because my hormones are out of whack as I have not menstruated for 4 months, etc.
Aside from protein powders, which I alternate, what will prevent the loss of muscle mass I am experiencing? (I went from 98 to 88 lbs in August and have not been gaining it back; I'm 90 lbs now).
Do you ever use the 22 Allergens RAST ENZYME MOLDS blood test? Think it's worth investing in?
Many thanks!!
Lola
ANSWER
Dear Lola,
Theanine 50-200 mg can be very helpful, as can Wild Lettuce, Jamaican Dogwood, Hops, Valerian and Passion Flower. This mix of 6 herbs is superb and can all be found in the "Revitalizing Sleep Formula" by Enzymatic Therapy. Take 1-4 caps 30-60 minutes before bedtime.
Melatonin 1/2-3 mg can also help as can taking calcium and magnesium at bedtime. 5 HTP 200-400 mg can help, but should only be used under a holistic practitioners supervision if you are also on serotonin-raising medications, as otherwise the serotonin can go too high and be dangerous.
Using a lavender containing pillow and taking a hot bath before bed can also help.
My Fatigued to Fantastic! book also discusses sleep hygiene and many other helpful treatments at length.
I do not use GABA as it causes nausea in most people by the time they take enough to really help. However it is OK to try (it does help some folks).
Inositol helps anxiety, but is not as helpful for sleep.
Optimizing progesterone and estrogen with bioidentical natural hormones can be very helpful.
Optimizing hormones, especially adrenal, DHEA, testosterone and Growth hormone (increased by sex, exercise and sleep) can improve muscle mass. You need a good medical evaluation to rule out other causes of weight loss (infections, high thyroid, cancer, etc). Creatine 3 gms a day may help a bit as well (2-5 pounds worth).
I find blood tests for allergies to NOT be reliable.
Love and Blessings,
Dr. T
Hi Dr. T,
I am SO sorry to bother you again but I am still going crazy trying to figure out what I have after 5 months of suffering. As my illness came on suddenly and really hit the nervous system and lowered the white blood cells I am interested in this link about Lyme from your website.
I did have an AB Serum blood test in August that came back negative but a Voll electrodermal screening just found some Ehrlichia Sennetsu bacteria. I know it takes different antibiotics than the regular Lyme but I wonder what the person who wrote the link above suggests for testing if not the Western Blot, etc.—especially for co-infections!
Thanks,
L
ANSWER
Dear Lola,
The whole area of testing for lyme and other infections is very difficult and controversial. Standard Lyme screening plus western Blot testing misses 1/2 of people who have Lyme (see Lyme Testing Not Much Better than Guessing). The reliability of Voll testing is not known, and may pick up "energy signatures" of infection without actual infection being present. Igenix testing is more sensitive, but it is not clear how often it says people have Lyme when they do not.
Because of this, testing for infections needs to be done by someone familiar with the issues seen in CFS. Unfortunately, most infectious disease specialists are NOT and will severely underdiagnose chronic infections. One must look at the mix of symptoms the person presents, as some who are concerned that they may have Lyme actually have fibromyalgia without the infection. Others have viral infections, yeast, etc. Yet others do have Lyme. Because of this, your issues cannot be properly addressed without a thorough evaluation, and I recommend you see a Fibromyalgia and Fatigue Center physician as they are well trained in this (www.fibroandfatigue.com).
I would note that a newer approach to diagnosing Lyme has some promise. Dr Shoemaker's recent research suggests that if both the C4a and C3a blood tests are elevated, one should suspect Lyme, and that this applies to chronic as well as new cases.
Love and Blessings,
Dr. T
Hi Dr. T,
I was looking through some medical records and found a lab test done on 3/16/05 but had no follow through. I don't want to bug you but I am having total body burning pretty severe and this total body burning is fairly recent AND getting worse—long standing burning in legs but not total body, so desperate for relief.
Also just got Lyme westernblot back from IgeneX lab—2 bands positive on IgG and negative IgM. Conventional labs in the past tested negative for Lyme.
The Candida AB IGG was 1.61 (>1.00 positive).
Candida AB IGA 1.90 (>1.00 positive).
Candida AB IGM 1.29 (>1.00 positive).
Wondering if I should be treated for the Candida? I am extremely miserable and not able to function or sleep with this degree of burning pain. I checked your book about treatment and I am confused (guess it is brain fog) and not sure. I am worried about the drugs too because I have liver cysts.
Thanks for your help Dr. T. I am really desperate! I made an appt. with Dr. Holtoff's clinic but they can't get me in until February with the nurse practitioner. I feel like I am dying, no kidding!
J
ANSWER
Dear J,
Sounds like either neuropathic pain or Allodynia (common in CFS/FMS). It is good to see a neurologist to rule out specific causes of neuropathy (expect a lot of tests and no conclusive result, which is OK and pretty much a good result). Need to rule out diabetes, low B12, low thyroid, etc. Be sure you are on the Energy Revitalization System vitamin powder and lipoic acid 300 mg 2x day. Then read the chapter in my "Pain Free 1-2-3" book on neuropathic pain to see how to treat it.
PS—Dr Holtorf's office can help here too. But read the chapter to go in with ideas for treatment to give the NP regarding the nerve pain (she'll know how to treat the fibro—which often will also eliminate the nerve pain—but you want to be kept comfortable while waiting for the FMS treatment to kick in. May want to start with Lyrica and /or Neurontin plus Elavil 25 mg at bedtime).
The blood tests for yeast are meaningless as I believe all CFS/FMS patients should be treated for yeast. I do not know that I have ever seen a negative Lyme test from IgeniX so who knows what that means (reasonable again to treat with the antibiotics empirically given your symptoms, so the test adds some support and many experts more knowledgeable than I in the area trust it).
L & B,
Dr. T
I just feel so badly and I feel there is no reason to continue to live. I am 71 yrs. old, have been disabled since birth, doctors predicted I would not live beyond 20 years old. I surely fooled him. I always accepted my disability, even worked for 11 1/2 years. In 1983 I had pulmonary arrest and ended up with a tracheotomy and on a respirator 24/7, and I'm still on the respirator 24/7.
My problem now is suffering so much severe pain. I believe it's nerve pain because my feet and legs have numbness, tingling and needles and I have very bad pain when someone touches my toes and feet. I have been taking the Pain Tablet, Grape Seed, and whatever Dr. Becker recommends to take. My pain doctor has been prescribing Percocet for so very many years. I try to cut down taking it, but I am not sure what to do. My pain is so bad that I cry so much day after day. That is why I feel it's not worth living.
Please, please help me.
Eleanor
ANSWER
Dear Eleanor,
Your goal should be getting pain free—not getting off the Percocet! Although it is abused in some situations, in chronic pain the Percocet is simply one more gift that God sends us to use. That's why I often tell the story below (at the end of this answer).
I know you can be pain free. In the over 3000 pain patients I've treated, I can count on my fingers (don't even need my toes) the ones I have not been able to get adequate pain relief. That most physicians (God bless them) are clueless about how to treat pain (they are simply not trained in this) does not mean you can't be pain free. You can!
Start by going to a pain specialist (Physiatrist) who KNOWS how to treat neuropathic pain. To find one, go to the American Academy of Pain Management web site (www.aapainmanage.org) and click on the "patients" link on the left and then on finding a physician. Meanwhile, I have an excellent chapter on treating nerve (Neuropathic) pain in my Pain Free 1-2-3! book (available at www.vitality101.com, from Amazon, or your local bookstore). Simply following the directions in this chapter (and bring them up with and discuss them with your doctor so you can start immediately while getting an appointment with a knowledgeable pain specialist) will likely result in dramatic relief. The medications Lyrica, Elavil, Neurontin, Ultram, and Cymbalta, for example, are much more effective for nerve pain than Percocet (and can be taken with the Percocet) and are less likely to suppress your breathing. If they are too sedating, begin with a lower dose and work up so your body can adjust. Also USE THE PAIN CREAMS I DISCUSS IN THE CHAPTER! They are great for pain, especially nerve pain (which is likely what you have) with no side effects. Give all treatments 2-6 weeks to work and people can begin the creams and a medication by mouth simultaneously. Your doctor can call a prescription for the pain creams to ITC pharmacy (a compounding pharmacy 303-663-4224) and ask for the "Nerve pain lotion". I have my patients apply it to the painful areas if the skin is intact (not to open sores) rubbed in in a very thin layer (a little goes a long way) 3 times a day (using up to 3-4 "pea sized" amounts at a time).
In addition, nutritional deficiencies and low thyroid (also discussed in the book ) can contribute to nerve pain. I would take the Energy Revitalization System vitamin powder (1/2 to 1 scoop a day) with the B vitamin that comes with it, lipoic acid 300 mg 2x day and acetyl-l - carnitine 500-1000 mg 2x day (all available in most health food stores or at www.vitality101.com ). It may take 3-12 months, but these can help nerve pain. Also, make sure your thyroid hormone levels are not low and that your vitamin B12 blood level is over 540 (if less, ask for B 12 shots using METHYLcobalmin, 1000-3000 mcg per dose for 10-15 injections—I'd give an injection every 1-3 days). If your doctor won't give the shots, B 12 is already in the Energy Revitalization System.
Eleanor, you can get relief. It is time for YOU to GET PAIN FREE NOW!
Love and Blessings,
Jacob Teitelbaum MD
Author - Pain Free 1-2-3!
Eleanor, God loves you. Please read this story:
I suspect that you get no bonus points in heaven for having suffered through the pain instead of taking the medications needed to be comfortable. I often tell my patients the story about the pious man who lived in Johnstown during the Johnstown flood. The National Guard came into the city and told everyone they had to evacuate or they would drown. This man refused to leave, saying that he had faith in God and that God would protect him. The floodwaters came and soon the Coast Guard boat arrived, floating by his second story window. They beseeched him to climb in the boat and be saved but he refused, once again saying that he had faith in God to protect him. Pretty soon he was up on the top of his roof and a helicopter came by and yelled at him to get in. Once again he refused-and the man drowned. He went to heaven, and God came by. The man was very angry at God and said, "I had full faith in you and you let me drown!" God said, "What are you talking about? I sent the National Guard, the Coast Guard, and a helicopter!" The medications are like the National Guard, the Coast Guard, and the helicopter. It's okay to use them!
QUESTION
Hi,
I have another question. I have carried on with the products as advised and am also currently doing a detox for mercury.
I discussed awhile ago about glandular fever [mono] which the doctors still find present in my system. I have been taking Valtrex for this but I think you mentioned thymic protein [Pro Boost] as well. Since I first became sick I have had tenderness around the area of my liver (bottom front of right hand rib cage). It also feels quite hard or swollen as well and pretty painful when pushed firmly. I have been scanned for gall stones, which was negative, and had liver tests which were all fine. From research I find that it has been suggested this liver soreness is the result of viral infection (due to swelling of the liver the surrounding tissue becomes sore). What do you think? Is it fair then to say that as long as I have this soreness a virus is still present or could it be another issue related to toxicity? Are there any further tests you would recommend? Am I mis-diagnosing myself?
I already take liver specific herbs (e.g. milk thistle) and also cleansers, such as barley grass and Chlorella.
I hope you can shed some light on this as the pain is very noticeable and my doctors don't know.
Thanks for your time.
Matt
ANSWER
Dear Matt,
Having mono is one of many common viral triggers for CFS. Unfortunately, unless I am dealing with the acute infection, I have abandoned using Valtrex, as despite Dr Lerner's research, I have found it to be not helpful in this setting. Valcyte (a newer anti-viral) has, however, been dramatically beneficial in a subset of CFS patients with HHV 6, CMV, and likely also Epstein Barr (mono) viral infection(s).
Most often (and very commonly) people with CFS/Fibromyalgia have marked tenderness below the bottom rib coming from where the muscles attach to the bottom rib. It can be in back, front, left or right, but most often front right, over the liver. If the liver evaluation is normal (which it usually is) it is almost always muscle pain as noted above. The way to tell is to push up from below the bottom rib so your fingers are pushing on the bottom of the lower rib. Give it a good and steady push. Does this reproduce the pain? If yes, as there is nothing between your fingers and the ribs besides skin and muscle, it confirms the pain is from the muscle. This is confusing as muscle pain feels like it is coming from the deep organs in this location. When I treat the muscle pain, the pain resolves. It is NOT dangerous-just scary (till you know what it is) and annoying.
Dr. T,
I recommended the Fibromyalgia and Fatigue Center to a friend because Dr. Pierotti has cured me of my CFS/fibro after 13 years of suffering. She is hesitant to do any of the meds, supplements, and IVs because she has sensitivities to everything. What advice would you give someone with this concern? I told her to go with the treatments anyway.
John
ANSWER
Dear John,
Glad you went there to get the help you needed! I encourage you to pass along info about your experience to others so that they know that help is available.
Let her know that it is common for CFS/FMS patients to have a lot of sensitivities, and that the FFC physicians are used to working with these issues. Also, I recommend a special acupressure technique called NAET (see www.naet.com) which is excellent at clearing these sensitivities. It is very much an art, and some practitioners are better than others, so once she finds ones near her (via the web site), ask around to see who the best one is. I would do the NAET along with the FFC treatments. To give an idea of the power of NAET, our foundation recently funded a study using it in Autism. 23 of the 30 autistic children in the treatment group were back in regular schools after 1 year of treatments (1 a week) vs 0/30 in the untreated control group.
L & B,
Dr. T
page 1 | page 2 | page 3 | page 4
News & Announcements
|
|