End Fatigue
Answers to Your Questions
page 1 | page 2
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 Fibromyalg