End Fatigue
Answers to Your Questions
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Cynthia asks:
Dear Dr. T,
I am writing on behalf of my 27 year old son who was diagnosed with acute prostatitis in January, 2008. After 4 months of antibiotic treatment there is little improvement. He is currently taking 500 mg Cipro twice a day and 100 mg of Doxycycline. He has also been hospitalized for the condition. Ten days after coming out of the hospital he felt better, but now he has relapsed. I heard you on Doctor Oz's program and I was hoping you could recommend an alternative course of action.
Sincerely,
Cynthia
ANSWER
Dear Cynthia,
It would depend on the cause of the persistent prostatitis. Though antibiotics get into the prostate slowly, these antibiotics should do the job if it is bacterial. Where physicians do a worse job is when there is a secondary fungal or viral infection, or if he has pelvic floor muscle pain causing symptoms (all contribute to a process called prostadynia, which is often mistaken for prostatitis). It would be necessary for me to do a prostate exam to give a more accurate answer, but I would recommend your son also see a holistic physician (click here to find one) who can treat for secondary fungal overgrowth (likely after the antibiotics—see Candida discussion in my book From Fatigued to Fantastic! ) with Diflucan 200 mg a day for 6-12 weeks and a low sugar diet as well as considering natural immune support. In addition, I would add Quercitin (in health food stores) 500 mg 2x day for 3 months as this can help prostate symptoms (it helps suppress enterovirus, which can be involved in the prostate). Standard medicine ignores fungal and viral issues in prostate problems and does a poor job of augmenting immune function in persistent infections.
Some pain specialists (click here to find one) are also familiar with pelvic floor pain and can assess for this.
Hope this is helpful. Let me know how things work out for your son.
L&B,
Dr. T
Brenda asks:
Dear Dr. T,
First, thank you so much for your Fatigued to Fantastic system! I am 40 years old and I have suffered from exhaustion and brain fog since I was pregnant with my now 13 year old son, and within two days of using the berry drink mix and B vitamins (Energy Revitalization System), I was awake and clear-headed like I haven't been for almost 14 years! I had a blood test a year ago that showed that my thyroid level was a little low, and hypothyroidism runs in my family. I have gained 30 pounds in the last year that I just can't lose. My doctor does not think my level is low enough to medicate. I had an allergic reaction to iodine contrast used in a test 25 years ago, and an allergic reaction to shellfish during my pregnancy with my son. Can I take a thyroid supplement that contains iodine? Can you suggest something that will help me lose this weight? Thank you again—I am telling everyone that I know about your website and products!
Brenda
ANSWER
Dear Brenda,
Glad it is helping.
Let me make a simple statement—If you were my patient, you would be on Armour thyroid, despite normal tests and despite the iodine allergy—period.
As iodine is critical to life, true allergies to dietary amounts (e.g., 200 mcg/day) are fairly rare. Some people with Hashimoto's Thyroiditis (the most common cause of low thyroid—check your Anti-TPO antibody test and see if it is elevated) have a "reaction" to iodine as it activates thyroid function. This usually passes with time and they feel better overall on the iodine. If one has had a severe reaction to iodine (anaphylaxis with throat swelling or trouble breathing) I would not take iodine supplements without a doctors OK—but would still use thyroid hormone if needed.
If your doctor will not give you thyroid, I recommend you see a holistic physician who will (visit the Fibromyalgia & Fatigue Centers or Holistic Board websites).
L&B,
Dr. T
After a sudden onset of FM 2 years ago, I still can not find a good practitioner in Belgium. Do you know a good specialist in Belgium?
Kind regards,
Kathleen
ANSWER
Dear Kathleen,
Professor Kenny DeMeirleir, MD in Belgium is a wonderful CFS specialist and I highly recommend him. Paul Van Meerendonk in the Netherlands is also excellent.
L&B,
Dr. T
Dear Dr. Teitelbaum,
"Hello from Scotland!" Hope you and your family are well. My husband Joe and I are OK, but he just lost his brother last week. I have been doing relatively well until two weeks ago. I am on all the supplements you recommend and have been on Lyrica for several months now after being on Gabapentin initially. I seem to be doing better, and I have gone without the daily 100 mg dose of Tramadol for pain. I just read on EIR that Cymbalta has been approved by the FDA for Fibromyalgia. Should I try this drug in lieu of Lyrica? Is it easy to switch drugs without any reactions? I am seeing my doctor this week, and wonder what you think. I take 300 mg of Tramadol at night with 25 mg of Elavil and Carisoprodol for bad muscle cramps in my legs. I am currently taking 300 mg per day of Lyrica. In the AM I take Citalopram and Lyrica. The most bothering problem is dry mouth, blurred vision, and not being able to remember words when I am speaking. I find that Joe is finishing my sentences quite a bit. I am wondering if the Cymbalta might cut down on these "senior moments."
The other problem which has recurred this week is multiple Candida outbreaks, with tongue sores, and breakouts on the trunk of my body with red, hot and itchy areas. After taking several weeks of an antifungal, I did not expect it to return again so soon. I have tried to cut down on sugars and carbs.
I look forward to hearing from you, and what you would advise me to do.
Blessings and Peace,
Linda
ANSWER
Aloha Linda,
Please extend Joe my condolences.
The Elavil is a major culprit for dry mouth and eyes, and the first medication I would aim to stop.
If the pain meds are largely for night time leg cramps, I would treat the cramps as follows:
 | 1. | Calcium 500-1,000 mg chewable, plus magnesium 200-300 mg at bedtime. |
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| 2. | Quinine pills at bed or at bedside to take if you wake with the cramps. |
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| 3. | Here's an odd treatment, but it often works. No idea why. Put a bar of soap (or use 2 bars of different brands) under your bottom sheet by the foot of your bed. Stops many folk's night cramps. No one knows why. |
Given the fibromyalgia, be sure your leg "cramps" are not really "Restless Leg Syndrome" where your legs are jumpy/restless all night causing the pain. If this is occurring, see this section in my book, From Fatigued to Fantistic!
Cymbalta can be added to Lyrica, or added while the dose of Lyrica is lowered to 150 mg, to see if it helps the brain fog (but it may just be the fibro—see "brain fog" discussion in my book). The citalopram is more closely related to Cymbalta, so if on a high dose of this (over 20 mg) they may want to lower the dose or stop it. Cymbalta, tramadol, elavil and citalopram all raise serotonin levels, so combining them can cause serotonin to go too high. This situation, called serotonergic syndrome, is potentially dangerous (and rarely even fatal). Symptoms are fast pulse, anxiety, and when more severe, fever. CFS and fibro can cause all these symptoms as well, but when I see someone with racing heart, I recommend lowering the dose of serotonin raising medications for a week to see it comes down.
I would go back on the diflucan (fluconazole) 200 mg a day for 3-6 months, avoid sweets, and take probiotics and yogurt with live culture daily for the yeast/Candida.
L&B,
Dr. T
Cobi asks:
Dear Dr. Teitelbaum,
I bought your book and its great, you are very generous with your knowledge and I appreciate that. I also like your very informative newsletters. The recent one about viruses was jam packed with info. Can you do a newsletter article about chronic bacterial infections?
Some things I'd be interested in:
| A. | For the most common bacteria, what lab values are worth treating vs. those seen in the general population? |
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| B. | Treatment strategies—i.e. monotherapy with minocycline vs. cycling different drugs vs. using a few at a time (Marshall protocol, Dr. Stratton etc.)? |
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If you can comment specifically about my case, i.e which results might be worth addressing and treatment possibilities, I would be grateful.
Thank you very much,
Cobi
My recent Bacteria/Parasite labs:
 | C. pneumoniae IgG 1:128 H |
| C. pneumoniae IgA 1:16 H |
| M. pneumoniae Ab (IgG) EIA 2.71 H: Ehrlichia chaffeensis IgG 1:128 H |
| Ehrlichia chaffeensis DNA, PCR: None Detected |
| Bartonella species: B. Henselae: IGG 1:64 H |
| Bartonella DNA, PCR: None Detected |
| Digestive Stool Analysis: Citrobacter freundii |
| Rectal Smear for Parasites: E. hartmani |
| IgeneX Western Blot (IGG, IGM): Normal |
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Thank You
ANSWER
Dear Cobi,
I will add the issue of antibiotic sensitive infections to my newsletter topic list—in fact it is the lead article this issue.
Because only the IgG and not IgM testing was positive, it is unclear if these are significant. Often, antibiotics need to be given without relying on labs, simply to see if they help as we discuss in my book, From Fatigued to Fantastic!.
Your rectal swab showed an amebic parasite infection, and I recommend treating ALL parasites, even those normally considered "non pathogenic" (i.e., not a problem) because of the immune suppression seen in CFS/FMS.
L&B,
Dr. T
Mike asks:
Dear Dr. T,
I am a 50 year old male with diagnosis CFS for 5 years. I try to follow your SHINE protocol and it helps. The question I have is this: When I catch a cold or infection, my energy goes up significantly. I have told my doctor and he has no explanation. I have an hypothesis that when I get a cold my immune system has something to go after, which makes me wonder if I should pursue valctye treatment. I am currently getting the HHV-6, CMV and EBV titers done. Any help or theory as to why I see such a boost in energy with illness would be appreciated.
ANSWER
Dear Mike,
You are not alone in having this experience. The infection stimulates your immune system which may temporarily help you fight other infections. This is similar to a program in Scandanavia giving weekly vaccines to do the same over years which has been successful. I agree with pursuing the testing to see if you are a valcyte candidate. I would also consider getting anti-viral IVs if you have a Fibromyalgia and Fatigue Center near you and ask your doctor to give you Gamma globulin (Gammar) 4 cc IM injection every 2 weeks for 6 doses, then as needed. Let me know how this works for you.
L&B,
Dr. T
John Michaels asks:
Dr. T,
I am a CFS patient and my doctor strongly suspects an ongoing chronic bacterial or mycoplasma type infection in my case. Unfortunately, my ferritin level (21) and iron saturation level (22) are both at the very bottom of the "normal" range. Because of the chronic bacterial infection, both my doctor and I are "conflicted" on whether to treat the iron deficiency with iron therapy. This is because several experts on chronic bacterial infections (including Garth Nicolson) sometimes recommend avoiding iron therapy when a chronic bacterial infection is suspected, as iron is known to feed the growth of bacterial pathogens. Would you recommend treating with iron in my case? Would you use iron therapy and antibiotic therapy concurrently?
Thank You!
John M.
ANSWER
Dear John,
I would use the iron and antibiotics together, though taken at different times of day. Low iron harms the bacteria (your body actually pulls iron out of the blood for this reason) but also suppresses immunity. If you had a ferritin over 40 I would pass on the iron. As it is under, I would use it.
L&B,
Dr. T
Diane asks:
Hello Doc: It's Diane, the reporter you met. I have a friend who has polyps in her sinuses and she has been sick for quite some time. She is very congested, been coughing, head pressure and pain, chest congestion, asthma, fatigue, low fevers, etc.
She was supposed to have surgery to remove the polyps and she canceled because she got bronchitis. Should she have polyps removed, or is there something she should do. She got worse after the hurricane in Florida. She also found out she has respiratory yeast, probably from all the antibiotics. Do you have any ideas—do you know anyone in South Florida she can see?
Should she see another ENT? She has seen some ENT's and they put her on nasal sprays with steriods and antibiotics, etc.
Any ideas for her?
Thanks so much.
Diane
P.S.—Hope all is well with you.
ANSWER
Dear Diane,
Without examining her, I cannot advise her, but this is what I would do if it were me:
| 1. | Have my doctor prescribe the "Sinusitis Nose Spray" from Cape Pharmacy (they mail it—call prescription to 410-757-3522) and use it 1-2 sprays on each side 2-3x day for 6-12 weeks, then as needed. |
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| 2. | Be sure the polyps are not associated with aspirin induced asthma (if yes, let's discuss). |
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| 3. | Add Diflucan 200 mg a day for 6-12 weeks. |
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| 4. | Do nasal rinses, the vitamin powder, probiotics and ProBoost as discussed in my book, From Fatigued to Fantastic! |
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| 5. | If blood IgE level is elevated, treat allergies and add cromolyn nose spray. |
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| 6. | Make sure there was no toxic mold in the home or office from after the hurricane. |
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| 7. | If the problems persist after 12 weeks, I’d then do surgery. |
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L&B,
Dr. T
Linda asks:
Dr. Teitelbaum,
I met you last year at the Natural Products show in Anaheim and also spoke with you after your lecture in Salt Lake City last year. (We walked out to the parking lot with a few others). I have also recently visited with Dr. Whittaker.
My question is: It has been suggested recently by three heart surgeons that I have a pacemaker due to a slow heart rate and long pauses. In a 48 hour holter test my heart rate was as low as 31 beats a minute (BPM) with pauses as long as 4.9 seconds during sleep and 4.5 seconds while awake. 17% of the time my heart rate was lower than 50 with an average heart rate of 70 BPM over the 48 hour period. I cancelled the surgery a few days ago and am looking for the possibility of other options. I am 49 and have been diagnosed with FMS and likely Chronic Fatigue. It is not severe but limiting. I take good care of myself and am not overweight. Are there any connections that you know of to FMS and my problem with the heart?
Thank you!!!
Linda
ANSWER
Dear Linda,
Definitely do the surgery. If is fairly safe and easy to recover from and you'll likely feel so much better. CFS is associated with heart issues, but high degree heart block is not a common one. On the other hand, heart block can cause severe episodic fatigue and other symptoms.
You know I am not a big fan of medications or surgery—but go now and get the surgery :-) I bet you'll be glad you did!
L&B,
Dr. T
Dear Dr. Teitelbaum,
I contacted you last year . You were kind enough to help us. You have also helped my cousin Lydia.
I have another question for you, if you will. I am a pastor and I have given the link to your Vitality 101 page on managing depression naturally to a number of people whom I counsel. One of these is a post-partum mom who has a mix of anxiety and depression. She saw a nurse practitioner today at the Marino Center for Progressive Health in Cambridge who did not know whether the herbal ingredients would affect the baby. Can you tell me if the Happiness 1-2-3! formula is safe for a breast feeding mom? This woman has started taking the fish oil capsules. She is tempted by medication but her husband and I have dissuaded her so far.
Thank you for your assistance.
Christian
ANSWER
Dear Christian,
I tend to be very cautious about what mom's take during pregnancy and nursing, and most herbs (like most meds) have not been studied during pregnancy/nursing.
For postpartum depression, I recommend she use the fish oil and BIOIDENTICAL progesterone, both of which can be used while nursing. She can add in the Happiness 1-2-3! after the baby is weaned.
L&B,
Dr. T
Sheryl asks:
First I want to thank you for your book and for D-Ribose which have both helped me so much. The Ribose has really worked for me! (I took part in the Fall, 2006 study with Corvalen Labs.)
Question: I read in your newsletter that Ribose is not only good for CFS/FM but also for congestive heart failure which my 99+ yr. old father has. I know Ribose can lower blood sugar after taking it. However, being a sugar itself, what is its overall or long term effect on blood sugar? Will it raise it? Dad does not have Diabetes, but his blood sugar is gradually creeping up and being watched very closely by his doctor.
Thank you!
Sheryl
ANSWER
Dear Sheryl,
You're welcome;-)
Ribose has a zero glycemic index and does not trigger diabetes like other sugars. It would be good for him to use, and consider the heart failure treatment approach discussed in Treating Heart Problems Naturally.
L&B,
Dr. T
Michelle asks:
Dr. T,
YOU ARE MY LAST HOPE!!!!
I was diagnosed with narcolepsy about 4 years ago. I also have Fibromyalgia. I read your book and I am currently taking the Corvalen, the Energy Revitalization System, and also the Acetyl-L-Carnitine. I have been taking them for 2 weeks now. On top of that, I am also taking my narcolepsy medicine (adderall and cymbalta for the cataplexy). I was under the impression that people with narcolepsy never go into that stage 3 and 4 of sleep. So my question is, is it possible for me to get into those stages of sleep? This is really important for me to know because I have so much trouble sleeping, so to get one night of good solid sleep would be the greatest gift ever!! I have also been taking your Revitalizing Sleep Formula herbal (4 pills every night) and unisom. But it still doesn't make me sleep. It helps me relax a little, but not sleep. On top of that, all the doctors that I've ever been to tell me not to take any sleeping pills. So, I'm doing this against their wishes, because basically, I WANT TO SLEEP!!! So, is it possible for people with narcolepsy to actually get a good night sleep? This is very important for me to know because you said in your book that sleep was the most important thing to getting well. I completely agree with you. So, I need to know if there is any hope for a good night sleep for me.
Thanks for your help!
Sincerely,
Michelle
ANSWER
Dear Michelle,
In my Fibro patients with narcolepsy, I still give sleep meds as needed to ensure 8 hours sleep a night. One can begin with Xyrem (approved for narcolepsy) to keep your narcolepsy doctors happy, but I add in Ambien and other sleep meds that increase stage 3-4 sleep.
You may want to find a physician (www.fibroandfatigue.com) that can treat both the sleep and narcolepsy.
L&B,
Dr. T
I read from other Chronic Fatigue and FM forums that women, including my wife, suffer from loss of Libido. Is there any help that can be offered them?
My wife's estrogen, progesterone levels are "normal," testosterone levels are high normal. Even the PCP wondered if her sex drive was high but "NO... what sex drive?" was her answer. Is DHT a problem in women too?
Thanks in advance.
Brian
PS: Controlling the DHT with Saw Palmetto 160 mg BID seems to be working for me.
ANSWER
Dear Brian,
73% of those with CFS have loss of libido. Though low testosterone can contribute, it is one of many factors. Treating with the entire "SHINE Protocol" often helps libido as well as fatigue, but it usually takes ~ 6 months for libido to improve. A trial of Viagra or Cialis is sometimes helpful as well—even for women. Herbals and other treatments (see below from my treatment protocol) can help, though often take 6 weeks (viagra/cialis can work that day).
Does she have vulvar pain with intercourse? If yes, this needs to be treated as well. DHT is less of an issue in women, but could be present if her testosterone is high.
L&B,
Dr. T
Sexual Dysfunction/Loss of Libido—This is a common problem, found in 73% of CFS/FMS patients. Make sure your testosterone levels are adequate.
| ___ 173A. | For women: Desire (Ultraceuticals) or Hot Plants For Her (Enzymatic Therapy) | Maca Root Extract 400-800 mg/day, Rhodiola Rosea Extract 150-300 mg/day, Ashwagandha Root Extract 250-500 mg/day, Siberian Ginseng Extract 150-300 mg/day,Ginkgo Biloba Extract 50-240 mg/day, Diindolymethane (DIM) 100-200 mg/day, Macuna Pruriens Extract (15% L-dopa) 100-200 mg/day. |
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| ___ 173B. | For men: Potency Plus (Ultraceuticals) or Hot Plants For Him (Enzymatic Therapy) | Maca Root Extract 400-800 mg/day, Rhodiola Rosea Extract 150-300 mg/day, Epimedium Extract 100-200 mg/day, Longjack Extract 50-100 mg/day, Panax Ginseng 100-200 mg/day, Ginkgo Biloba Extract 50-240 mg/day, Diindolymethane (DIM) 100-200 mg/day, Macuna Pruriens Extract (15% L-dopa) 50-200 mg/day, Tribulus Terrestris Extract 100-200 mg/day. |
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| ___ 174. | Antidepressant induced sexual dysfunction can be treated with___ ginkgo biloba 120 mg twice daily, ___ Dexedrine—25 mg each morning, ___ Symmetral 100 mg twice daily, or switching to Wellbutrin (see #171). |
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| ___ 175. | Viagra (Rx) - 100 mg—take ¼ -1 tab 1 hour before intercourse on an empty stomach for erectile dysfunction (do not use with nitroglycerin or underlying heart disease). Chew and dissolve under tongue for faster effect. |
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| ___ 176. | Cialis (Rx) - 20 mg—take one half to one tablet 15 minutes before intercourse for erectile dysfunction (do not use with nitroglycerin or underlying heart disease). |
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Vulvadynia—Treat with Elavil (or Doxepin) and Neurontin (oral or topical). Suboptimal testosterone can also cause Vulvadynia.
Hannah asks:
I have CFS and I want to move to the more permanent and 5-year lasting contraceptive, Merena, which is an IUD that releases a small amount of progesterone into the uterus over time. I am currently on the patch that has progesterone and estrogen (works fine with me). I had been on the shot prior to that which was all progesterone and I hated it due to its side effects. My doctor suggested I research the effects of progesterone on people with CFS before committing to the merena since I had some nasty side effects from the shot that may or may not be because I have CFS. Do you recommend any place to read about such studies or do you have any information on the effects of progesterone on people with CFS. I really don't want to risk having kids, which is why I want to move to a more permanent and more successful birth control. Thank you!
ANSWER
Dear Hannah,
The issue in CFS is not so much the progesterone as whether it is the bio-identical progesterone (in which case it helps sleep and anxiety and muscle pain, but can worsen depression) vs. synthetic progestins (such as provera and what was in the injection) which tends to have nasty side effects in general and should not really be on the market for safety issues. The estrogen in the patches are bio-identical and better than premarin for safety, but I am not aware of patches with progesterone so I do not know the type that was in your patch.
In general, the bio-identical estrogen and progesterone are better for CFS/FMS symptom relief, but are not adequately reliable as birth control. Because of this, we do consider the synthetics for birth control.
I think the question to ask your OB is how much progesterone is released daily from the IUD relative to what you received in the past. If it is a very small amount, it may be worth the risk of trying it, realizing that the IUD can be removed if it causes problems and you could switch to barrier contraception or a tubal ligation vs. a low estrogen birth control pill. This is the approach I would look at in your case. For information on Provera (synthetic progesterone) vs. natural progesterone, see p 109-111 in the new edition of From Fatigued to Fantastic (and I invite you to give your doctor a copy of this section as well).
L&B,
Dr. T
Tammy asks:
Your new article regarding having a healthy pregnancy suggests taking the Energy Revitalization System. My OB/GYN has told me that it has too much vitamin A. I am taking prenatal vitamins, that upset my stomach quite a bit. In your opinion, can I just replace the prenatal with the Energy Revitalization System? Will I still get the needed vitamins? I have also just switched to Armour Thyroid.
ANSWER
Dear Tammy,
I recommend that people take the Energy Revitalization System plus calcium, iron and fish oil instead of their prenatal. I suspect that what your OB missed is that half the vitamin A is beta carotene (which is quite safe for pregnancy) and that the vitamin powder only has 3,500 units of vitamin A which is near the RDA of 2,500+ units for pregnant women and under the ~ 4,300 units a day RDA for breast feeding women. The vitamin A in pregnancy has been shown to also decrease iron deficiency anemia by helping mobilize iron.
On the other hand, over 8,000 units of vitamin A (NOT counting beta carotene which is not a problem) can cause birth defects, and this is why I caution to not over do it. Overall, the vitamin powder is MUCH more nutritionally optimized than the prenatals. Do add the calcium, iron (if needed) and fish oil though.
L&B,
Dr. T
QUESTION
HELP! I am finding how behind and rigid Mayo Clinic is here in Scottsdale. I'm there because of 5 sclerotic lesions that have been found in my right shoulder, 2 in my right knee and in both hands. They say it's of no significance. But each area has started with severe pain, and each one still hurts and big surprise they hurt where they found the lesions. Some have been called Fibroma, my hands bony islands, and my knee fibroma and something else. My hands have started to swell and hurt so bad, just bumping them into my side is excruciating. I've always tested negative for Rheumatoid factor.
I along with my GP have been following your protocol as much as my insurance will allow. With Levothyroxine we had my free T3 and T4 right where you recommend, as well the total numbers of both. (Armour and Cytomel caused my T3 to skyrocket.) The problem is my TSH is either < -0.02 or now 0.10. Which with Mayo treating only with TSH they want to cut back my Levo. I've seen an answer before when you said if your TSH is that low that other things should be checked. Can you please give me some ideas to give them. As with everything else you have done, I along with many, will be forever in your debt. I also found out I was low in Testosterone and we've now got it under control and where you recommend (don't know if this has any effect or not.)
My wife and I helped a young girl struggling to finish high school, spending day after day in bed, Doctor after Doctor. After I heard her symptoms, we had little doubt. With your Daily infusion, B complex and pearls, she is now in her second year of college. All the thanks we got was meant for you. For so many you offer what nobody else does and that's hope.
I can never thank you enough.
ANSWER
The first question of course is how they made the diagnosis of "fibrotic lesions." If not a biopsy, it raises the question of whether they are simply trigger points that respond to the overall treatments in the Pain Free 1-2-3! book and the pain gels discussed in the chapter on prescription therapies(and your doctor can begin with these—he can simply call ITC pharmacy and prescribe the "Pain Lotion" (303-663-4224). In patients with CFS and Fibromyalgia the TSH is clearly not a reliable test and should not even be checked when monitoring thyroid Rx (and I suspect this is so in general).In my patients, I recommend adjusting thyroid to the dose that feels best while keeping the free T4 in the normal range. Mayo will disagree and you are free to ignore them. I would read the section in the From Fatigued to Fantastic! book for more info and supporting references for your physician.
L&B,
Dr. T
QUESTION
My daughter has CFS. She was diagnosed July 2005. She was 15. She has recovered somewhat and is able to do most things. She has a very supportive Dr. She has even been able to do light exercise this past two months without having a flare-up. Now it seems like she cannot get a hold of her weight. She eats very healthy but gains weight if she eats like a normal teen. She watches everything that she puts in her mouth. And once the weight is on it never comes off. She also feels bloated, has diarrhea when she overeats even a little and can only eat small amounts. She also craves carbs (but who doesn't). Her med's are as follows: 1000mg valtrex, L-carnitine, multi vitamin and a fiber pill. Her weight issue weighs on her mind and that STRESS we don't need. Again, it's not how much she weighs but rather the speed in which the weight goes on and does not come off.
ANSWER
See my article on treating the weight gain of CFS from my book, Pain Free 1-2-3!. What jumps out is she needs her thyroid hormone optimized (that the test is normal means nothing) and candida treated (also discussed in my books).
Sounds like your doctor has been a gem, but it is worth seeing a CFS expert. I recommend the Fibromyalgia and Fatigue Centers (see www.fibroandfatigue.com ). They see patients worldwide.
L&B,
Dr. T
QUESTION
I have been doing colonics. I went through 14 treatments and I plan on doing one every two weeks now. What do you think? I had IBS for 20 years and I feel younger and so good. I just do not know if it will last. In the past I took 30 supplements a day and still have yeast and fungus (as I found out through the colonic). Now my tummy is flatter. How do I stay this way without always doing colonics? (Lost 10 lbs too. I am 59 and 119 lbs.) Do you think colonics is good for me?
ANSWER
I think the colonics can be helpful, but would recommend you be under the guidance of a naturopathic physician (NP—see the AANP site www.naturopathic.org ) who can guide you on doing them safely and treating the underlying yeast issues as well.
L&B,
Dr. T
QUESTION
I have had CFS for nearly 2 years and currently use some of your recommended protocol from your online program combined with approaches recommended by my doctor. He has recommended Benfotiamine to increase TPP. Is this an effective therapy? Should it ne taken orally with meals, or in some other manner? What daily dose is recommended? Any guidance you can offer, or other therapy to increase TPP will be greatly appreciated.
ANSWER
I am not familiar with benfotiamine so I cannot comment on it. We stopped giving TPP injections as other treatments were much more effective. I'd recommend the Energy Revitalization System vitamin powder and B-Complex (which you are likely on) plus Ribose 5000 mg 3x day for 3 weeks then 2x day (called CORvalen) as a better way to increase TPP and energy production (TPP is basically thiamine plus energy). Both are in stores and at www.vitality101.com.
L&B,
Dr. T
QUESTION
I was diagnosed several years ago with graves and was given Rai. I was doing okay until around January. My levels have been in the hyper stage for about 9 months. My doctor told me to stop taking my synthroid for a couple days. Then my levels went to 17 hypo. I ended up in the hospital with severe anxiety and depression. Can it be my adrenals? Even though they did a 24 hour urine and blood test, they came back normal. In the AM I always feel so terrible but always feel better in the afternoon and evening. Sometimes when I wake up I feel like there is something missing in my brain. Is hard to explain. Any suggestions?? Thanks
ANSWER
It could be the adrenals or thyroid despite the tests being normal. I would recommend you read the sections on these in my book From Fatigued to Fantastic! as the symptoms can guide you. I also recommend doctors at the Fibromyalgia and Fatigue Centers.
L&B,
Dr. T
QUESTION
My mother has MAI, which is a bacterial infection of her lungs. After being misdiagnosed and not given the proper medication to fight and kill this infection she was treated by other doctors. Now the problem is her severe under weight problem. She use to be 100-110 pounds. Now she is barely 80 pounds with an appetite that varies. How can I supplement her diet with nutrients and vitamins to help her out so she can get better, get her appetite back and gain some of her weight back? Vitamin pills bother her stomach. Your help would be greatly appreciated.
ANSWER
I would use high fat (not high sugar) foods, eggs, pastas, chocolate, bread,etc to help her gain weight. A medication called periactin can also act as an appetite stimulant. Her doctor should also look for other causes of weight loss. MAI can be hard to eradicate, and I would want a second opinion from a university based infectious disease doctor given the continued weight loss. Seeing a nutritionist is also helpful. I would recommend 1/4-1/2 scoop of the Energy Revitalization System vitamin powder (available at www.vitality101.com) as tolerated 1-2x day. Powders can be easily adjusted and are better tolerated than pills. You can mix it in yogurt or make a smoothie with it as well.
L&B,
Dr. T
QUESTION
Is Proboost Thymic A contraindicated in chronic lymphocytic leukemia?
ANSWER
As it tends to balance immune function, it is likely OK. But because it has not been studied in this setting and this is a cancer of the immune system, I would err on the side of safety and not use it (or other immune augmenters) in CLL.
L&B,
Dr. T
QUESTION
I had a pituitary tumor removed ten years ago and have never been the same. Have had some sort of fibro/exercise intolerance thing ever since but no pain and very random. One day fine, the next day horrible. Can last for days or months. Not fatigued, just very weak. Have you ever seen something, a syndrome that looks like CFS or fibro in patients that have had this surgery?
ANSWER
Pituitary adenomas, with or without treatment/surgery, are common triggers for CFS/Fibro as they cause hormonal deficiencies with normal blood tests. These then can trigger the rest of the process. This responds very well to treatment. See www.fibroandfatigue.com for a doctor who can help you.
L&B,
Dr. T
QUESTION
I heard you on Conscious Talk on Monday and wondered what the green tea supplement is that you were talking about. I couldn't quite get the name of it.
ANSWER
I was speaking of L-Theanine (it must be the Sun Theanine form found in many companies' products) which is derived from green tea. The dose is 100-200 mg at bedtime for sleep or 100-200 mg 1-4x day for anxiety. It is also present in the Calming Balance formula on our web site store (www.vitality101.com).
L&B,
Dr. T
QUESTION
I am a pharmacy student on rotation in an anticoagulation clinic. One of our patients is taking your product (pain formula and revitalization formula). Is there any research on how your products affect other medications, specifically warfarin (coumadin)?
ANSWER
All products can potentially interact with Coumadin. We use these in our patients on Coumadin, but check INRs after several days (as we do when we make any change) for safety. We have not seen a problem. The main interactions to be aware of would be that the magnesium in the vitamin powder may modestly decrease neurontin or cipro absorption, but we simply modify the dose. Calcium or iron can block thyroid absorption, and have therefore been left out of the formulas. Although the sleep herbs may potentiate the effects of sleep med's, this is not at a level that has been clinically problematic (and is actually a clinically useful synergy). The pain formula ingredients do not have significant interactions, but I'd check INRs on Coumadin as above, especially because of the willow bark.
L&B,
Dr. T
QUESTION
Can you explain to me what positive IgG means in a blood test? I was tested for food allergies and came up IgG positive to every food except meat, citrus, rice and potatoes. I tried an elimination diet and found it impossible to stick to. I read on your site that you said to ignore IgG readings in blood tests? Does this mean these are not significant? I am suffering from numerous unexplained symptoms and am starting to wonder if I have a mild case of chronic fatigue. I was diagnosed with Gastroparesis earlier this year and my stomach was my main problem but I also suffer from fatigue, unexplained illness and feeling feverish, achy muscles all through my back (no joint pain), inability to exercise without feeling drained for days afterwards, heat intolerance and intolerance to sun exposure (makes me feel very sick), extreme motion sickness and I catch every single cold and virus going around. I had 6 colds in a row last year. Also occasional bladder spasms, reynaud's syndrome in my hands and toes, unexplained weight gain of 10 lbs, and one miscarriage in March of '06. My mother had lupus and passed away in 2003. I don't know if I have some unexplained autoimmune condition or possibly CFS? I had a negative ANA and normal thyroid reading. So far none of my other blood work has shown anything. Thank you so much if you are able to respond. I feel like I am going crazy not knowing what is going on in my body.
ANSWER
A positive IgG means that you had that infection sometime in the past when checking for infection. When checking for food I don't think it means much of anything, and food allergy blood tests are largely unreliable. I recommend instead using an acupressure technique to test for and eliminate food allergies. This technique is called NAET and information and a practitioner near you can be found at www.NAET.com. To give you an idea, this eliminated my lifelong hay fever in 20 minutes.
This certainly sounds like you have a chronic fatigue syndrome related process, especially if you also have difficulty sleeping. The blood tests are simply not reliable for diagnosing hypothyroidism in this condition (and I believe in general). I recommend that you see a physician at the Fibromyalgia and Fatigue Centers. They have clinics throughout the US and see patients from all over the world (www.FibroAndFatigue.com).
L&B,
Dr. T
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