End Fatigue
Answers to Your Questions
Is kelp causing neck pain?
Thought you might find this interesting. Powell has read your books and knows about Dr. Jorge Flechas' work. I think Powell is brilliant — not right about everything — but pretty smart. I think you may have met him.
Powell has no idea why 1,200 mg of kelp caused my Adam's apple to ache. He thinks I might be allergic to something in kelp. The pain went away when I stopped the kelp.
Another potential issue in my case, always overlooked by other doctors, has been my slightly high ferritin levels. My mother was the same. Dr. Powell is concerned that I may have a genetic problem with hemocromatosis. I will have lab tests run for this.
Paula
ANSWER
Dear Paula,
A few thoughts —
Kelp is a large iodine source, and the thyroid is by the Adams apple (which tends to be less prominent or absent in women as well) and a more likely source of the discomfort in the neck. It raises a question of thyroiditis being present, or even simply the thyroid being stimulated by the iodine. If tender over the thyroid, consider thyroiditis as a possibility. Even if not, do an anti-TPO antibody. If elevated, this most often means Hashimoto's Thyroiditis and though these folks need iodine, it can initially cause side effects.
If the iron percentage saturation is under 40%, it makes hemochromatosis much less likely and I would look at inflammation as a cause of the elevated ferritin (can tell this by an elevated sed rate, or CRP blood test, or a thyroid inflammation test) and then treat the inflammation itself. If the iron percentage saturation is over 45% definitely check for hemochromatosis.
L&B,
Dr. T
Treating Lyme in CFS.
Dear Dr. T,
I can't believe your incredibly fast response, I can't thank you enough!
I don't want to abuse your kindness but if I could tap your wisdom once more, I have another issue that is concerning me deeply. To add to my already chronic CFS/FM and systemic candida, I got bit by a tick on Aug 28th but didn't get the reaction until Sept 1st (bullseye, etc). I saw my doctor and she put me on 100 mg of Doxycycline twice a day for 21 days (finishing this Monday coming). I'm concerned as many of the symptoms of Lyme are similar to what I'm already experiencing and I am not sure if the meds have worked. My immune system is in a weakened state so I think it wouldn't be difficult for this condition to proliferate. While it was about 35 years ago, I was on tetracycline for about 8 years for acne (guess where the candida problem began) and am also concerned that my body may have some sort of resistance to this Doxycycline. Obviously taking these meds is playing more havoc with the candida but I'm taking a lot of high quality acidophilus/probiotics to counteract this. I want to start your candida protocol but believe this needs to be taken care of first. It's a real Catch 22.
My doctor is new to this situation and I was hoping once again to get your advice as to how best to ensure myself against getting Lyme. Should I go on for a longer term of meds; should we change to amoxicillin or the like? I'm very worried.... I also might mention that I live in Toronto, Canada and some tests and such are not always available here.
Thank you so much once again for your kindness and compassion!
Sharon
ANSWER
Dear Sharon,
You're welcome ;-)
When caught early (as in your case) the 21 day doxycycline course does a good job, though I would likely extend it to 6 weeks given the immune dysfunction. It's when the Lyme infection has been there months to years that it is harder to eradicate.
Resistance is not an issue here. It is the infection/bacteria that develops the resistance — not the body. As the Lyme infection was not in your body when you used the antibiotic in the past, this is not an issue.
I would add the probiotics after you are done with the antibiotic, and consider taking the Anti-Yeast and Diflucan with the antibiotic (whenever you can get it — stay on the antibiotic now), continuing the diflucan for 6 weeks after and the Anti-Yeast for 3 months after the antibiotic is completed.
L&B,
Dr. T
What can I take if I am breast feeding? Is Ribose OK? Postpartum depression? Balancing adrenal and thyroid?
Hi Dr. T,
I hope that you can help me or at least answer my question.
I am a 41 year old lactating woman and feel that I have CFS based on all of my symptoms. My symptoms started 6 months postpartum. I believe I "blew a fuse" after chronic sleep deprivation and the stresses of having a colicky newborn round the clock with little help. I have been nursing for almost 3 years.
I have been working with a naturopath for the last 2 1/2 years, and I have been on a low dose of natural thyroid (1 grain per day) since then. My body temperature is still very low at 96.8, but when I try to increase my thyroid meds, my hair starts falling out and I get the full feeling in my throat. I don't seem to be able to handle more than 1 grain per day. I have also been diagnosed with Hashimoto's Disease. A year and 1/2 ago my adrenal saliva test showed my cortisol was below normal first thing in the morning (which was why I felt like I couldn't get out of bed) and was highest at midnight. For a while I seemed to do better but now I am back to feeling like I got hit by a mack truck every morning and don't have the energy to get out of bed. We recently tried treating my adrenals with a glandular (CORTOL ACE) however, it seems too much for me (1 capsule 350 mg) and I can't sleep as a result. Last July I had a short time where I felt slightly better and tried to exercise on the treadmill only to find that I couldn't sleep that night. I get tested every 3 months for my thyroid and sometimes I encounter a "storm" where I my TSH level goes from 1.75 to .5 and I show signs of hyperthyroidism. This has happened twice. But 99% of the time I show signs of the classic hypothyroid person.
My last hormonal panel showed my estrogen all over the map — sometimes high, sometimes very low, and my progesterone always low. I don't know if this is because of my age and this is peri-menopause or it is related to the dysfunction of the hypothalamus, I was on a bioidentical progesterone to help regulate my period and to assist with PMS. I have since stopped because my periods got regulated.
Currently, I have severe brain fog — many times I can't find the right word (or any word!) no memory, no libido, low blood pressure, am gaining weight (despite nursing!) unrefreshing sleep or the inability to sleep at times, inability to handle stress, and cannot exercise without the consequences of not being able to sleep as a result.
I would like to start your protocol and the supplements that are recommended. However, I hesitate because of lactating and I'm not sure if they are safe. I have been taking the End Fatigue Daily Energy B Complex for several months and wanted to try the Ribose, but is it safe while nursing? I looked it up on the web but found conflicting answers as to its safety while lactating.
I know this is a lot of information and you are a busy man. I am just desperate and want get my life back and feel better. Any information you could provide as to safety of supplements, recommendations etc. would be greatly appreciated. I think what you are doing for people is amazing and you are to be commended ten fold. Thank you for your time.
Sincerely,
Laura C
ANSWER
Dear Laura,
Sorry it took so long to respond , but I have been happily swamped. I would note that during pregnancy, I recommend using mostly thyroid, adrenal support and nutritional support and am very cautious with most herbs. I feel a bit more comfortable adding some things during lactation (basically, those things safe for children or shown to be safe in lactation). This means I would add the progesterone, ribose, and some sleep herbs.
I would be OK with adding the Revitalizing Sleep Formula, Ribose (Corvalen 1 scoop 2x day), and The Energy Revitalization System vitamin powder when lactating. The vitamin powder has 85 mg of vitamin B6 in the capsule, so I would NOT add other supplements with B6 as vitamin B6 doses over 200 mg a day may inhibit lactation (though the doses that do this are closer to 600 mg but I prefer to be cautious). See the specific answers to your questions below. I hope they are helpful.
 | A. | Postpartum CFS is common, associated with the hormonal changes. |
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| B. | We sometimes see swings between high and low thyroid in thyroiditis, and we lower the thyroid dose or even give thyroid blockers in severe cases — but this problem is rarely severe with Hashimoto's. I would use the cortef (your naturopath can use Isocort by Bezwekian ) but not more than 2-3 pellets or 10-15 mg cortef and only in the morning. In addition, a mix of herbs called "Sleep Tonight" by Enzymatic Therapy is especially helpful for those with switched cortisol levels that are high at night and low in the morning (see More Help for Insomnia). I would also consider resuming the progesterone at bedtime as this can help sleep. |
It sounds like your naturopath is doing a good job. Please pass him or her my regards.
Love & Blessings,
Dr. T
Doing much better having added adrenal support to her thyroid. Does she need estrogen/progesterone? Why did she get worse when the thyroid dose was raised? (Follow up to the question above.)
Dear Dr. T:
Let me first send you a THANK YOU from the bottom of my heart for responding to me. I know that you are an extremely busy man, so that being said, I realize that taking the time to respond to me personally is pretty unbelievable. I am truly appreciative. I thought I'd let you know that things have changed dramatically since this first email that I proposed to you. I have no idea why, but suspect it has to do with the Hashimoto's aspect of what I am dealing with.
Please know that if you are unable to respond to this email, I completely understand. I will try to keep this as concise as possible...
Soon after this email I had another blood draw and found out my TSH was indeed high (again) 5.68 with my antibodies sky high. This accounts for my dead tired feeling again. As I mentioned previously, every time I exercised I found I couldn't sleep, etc. and despite trying everything, could never lose weight. I always thought that I wasn't on enough thyroid meds but every time I increased it, I inevitably exhibited signs of hyperthyroidism.
I recently started on Isocort and the results have been AMAZING. The weight dropped off within 2 weeks time. I am currently on 1 grain of thyroid first thing followed by 2 pellets of Isocort and then 1/2 grain thyroid at noon followed by two more pellets of Isocort. My theory is that my T3 was pooling in my blood and every time I exercised or stressed my adrenals, the T3 "dumped" into my cells causing hyper symptoms. I also had a adrenal saliva test recently. No major deficiencies in the a.m. (borderline normal) but slight depression in the late afternoon and evening. So I guess that you could say I am using the Isocort mostly to help the thyroid meds get to my cells???
Here are my questions: For someone with Hashimoto's who seems to have difficult getting the T3 to their cells, is it safe/advisable to stay on the Isocort indefinitely? Is the there any other way of addressing this issue (poor T3 cell usage)? My fear is if/when I go off the Isocort, my thryoid meds will once again be "inadequate."
And the last question — Is it dangerous to treat only the adrenals and thyroid without addressing all of the hormones together (e.g., progesterone, estradiol, testosterone, etc.)? The reason I pose this question is I seemed to have stabilized a bit with PMS symptoms, hormonal headaches, etc. over the last year or so, however, since starting the Isocort, I have noticed an feeling of hormonal unbalance much more so.
I know I have taken much of your time, so let me say thank you and apologize at the same time.
Sincerely,
A THOUSAND THANK YOU'S...
Laura C
ANSWER
Dear Laura,
It is OK to stay on up to 6 Isocort tablets a day, even if long term. The issue is likely more straight forward than it seems. It is common for low thyroid (or even low alternating with high thyroid) to occur with low adrenal. Increasing the thyroid is good, but causes an increased stress on the adrenals, which are already weak. Because of this, raising your thyroid dose caused the symptoms of low blood sugar/low adrenal which you are interpreting as (I suspect incorrectly) being too much thyroid. This is why I had recommended Isocort in my earlier email and why your naturopath gave it. Adrenal function can be normal on testing, despite being inadequate for your body's needs.
Once the thyroid and adrenals are balanced as your naturopath has done, the estrogen/progesterone only need to be treated if symptoms suggest the need.
Glad you're feeling better ;-)
L&B,
Dr. T
Symmetrel helping CFS and widespread rash—dermatologists don't know cause.
Hi Dr. T.
Thank you for all that you do in relationship to CFIDS.
My journey has been amazing, as I look back in retrospect. I am on Symmetrel now and feel like I received my life back at least compared to the last decade plus. I am even back to work full time. It has only been a month but I am trying and able. Of course I am not cured but I have the ability to function most part of the day without collapsing to my bed. I have a question for you and it has to do with a strange skin eruption on my hands and feet and is now spreading up my legs. It had been benign for a decade or so. Until I started taking the symmetrel. I don't know if it is a coincidence or not. This skin issue was small dots on my palms and soles of feet. They had a black dot center. No one seems to know what this is. I think it is a virus of some sort and when I took ill it appeared and stayed. I had doctors back then say it's nothing. I have doctors thinking (now) it might be scabies (NOT), acne (NOT), blockage of my sweat glands (NOT). I have not been to a dermatologist this time around (have been in the past). and then I thought I would see if you have any ideas.
It could also be fungal in nature because it is itchy. I have tried different creams but no success (Kenalog, lotrimin, etc.). Also, no matter how much I soak my feet and apply cream they are really really dry. If you have any thoughts on this I would appreciate it. My faith in doctors is very limited, since I find it a waste of my time and energy and money to go to see someone, such as a specialist and I leave not having any success. Not one doctor has taken a scraping and looked at it under a microscope? Why? Maybe they would be able to fix it if they had an idea of what they are looking at. Is this a coincidence and could it be related to this virus related to CFIDS? Any thoughts and suggestions would be very much appreciated.
Thank you for your time and energy.
Loretta
ANSWER
Dear Loretta,
There are 2 key effects of the Symmetrel:
| 1. | Antiviral, so the rash could be: |
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| | | A. | A die-off reaction seen when chronic infections are killed off. |
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| B. | Your immune system recovering and now fighting something else (such as the yeast/Candida). |
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| 2. | Raising dopamine—unlikely to cause the rash. |
I would consider stopping the Symmetrel and see if the rash starts to go away.
If yes, then:
| A. | It is likely the symmetrel (could retry the symmetrel and see if the rash recurs to confirm). If so, I would add the treatments (especially Valcyte and IM Gamma Globulin ) in my article on eliminating viral infections. These approaches are more likely to kill off the infection permanently, and give the same benefit as the Symmetrel. Interestingly, a recent study by Dr. Liv Bode, German scientists showed that stomach Borna virus infections are very common in CFS, and often improve with the use of Symmetrel (amantadine). |
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| B. | I would add tyrosine 500 mg each morning (a nutrient that can raise dopamine) and consider other dopamine raising medications (wellbutrin, dexedrine). |
If no improvement in the rash occurs while off the symmetrel, then it likely is not the symmetrel and you can resume it. The most common cause of unexplained rashes in CFS/FMS is Candida. A 6 week trial of Diflucan 200 mg a day (may also get a die-off reaction when treating this) will tell you if this is the case (also do the rest of the yeast/Candida treatments discussed in my book From Fatigued to Fantastic! or in my article Candida—Eliminating Yeast/Fungal Overgrowth. The rash itself will be negative for the yeast (it is a skin reaction to yeast elsewhere in the body—called an "ID Reaction") so a skin biopsy/scraping is unlikely to help (but won't hurt) but the Diflucan usually makes the rash improve within 6 weeks if it is caused by yeast/Candida.
I hope this is helpful.
Love & Blessings,
Dr. T
Is Hyperbaric oxygen safe and helpful in CFS?
Betty asks:
In the newsletter about the recent seminar you attended you mentioned work by Dr. Paul Cheney showed that oxygen is toxic in CFS. Does this include hyperbaric oxygen treatment?
Thanks, Betty
ANSWER
Dear Betty,
This is controversial. Paul feels it is, but Professor De Meirleir's work has shown it to be helpful. I think Paul has a very different type of CFS patient group than the rest of us see. I would be open to trying hyperbaric and see how it feels to you.
L&B,
Dr. T
QUESTION
Are CFS and FMS autoimmune illnesses?
Lisa asks:
Dr.T,
First, thank you so much for being one doctor that recognizes this as a true illness with treatment that gives us hope for a normal life again.
My question is: Isn't this condition essentially an autoimmune disease that impairs hypothalamus function? Aren't fibromyalgia and chronic fatigue just two of the conditions that result from disease? Has this overarching disease/condition been named or recognized as a distinct condition?
I have been to over 13+ doctors demanding an answer to the actual cause of the condition as well as treating the symptoms. Why hasn't the medical community at large from rheumatologists to neurologists recognized the complexity of this condition?
I will be visiting your center in Ohio next week. I am looking not only to feeling better, but to bring awareness to others. What do you recommend, how can I get involved?
Thank you,
Lisa
ANSWER
Dear Lisa,
CFS/FMS are immune illnesses where the multiple secondary infections or other stresses can suppress hypothalamic function. Autoimmune illnesses make up 1 of many triggers that can also cause stress which suppresses the hypothalamus, so some call this a "secondary fibromyalgia."
Physicians have not been trained in part because there is no definitive test to diagnose these syndromes (though there are many abnormalities). In addition, it takes hours to treat properly, and insurance companies will not pay for the time. Because of this, it is good that you are seeing someone who specializes in the illness. Dr. Goldfarb at the Cleveland FFC is wonderful, and you will enjoy working with him.
Once you get well with his treatment (give it 3-4 months to start working), you will then have something to teach others!
Love & Blessings,
Dr. T
Feels better on thyroid, but her doctor won’t give enough.
Sharon asks:
I have been on thyroid therapy since I bought your first book "From Fatigued to Fantastic!" My doctor now wants to decrease my dosage because he says my t4 levels are 4 times what they should be. However, on 100 mcg and 112mcg doses, I can hardly put one foot in front of the other. I went back to the 125 mcg dosage and am feeling better. What can I tell my doctor so as not to decrease the dosage?
Thanks for all the great info you provide for all of us. It is great to know we don't just have to "live" with this condition, but can do something about it and hopefully recover. Thank you, in advance.
Sharon
ANSWER
Dear Sharon,
Tell him that a significant body of fibromyalgia/CFS research supports the difficulty with converting T4 to T3 hormone, and ask if he'll switch you to Cytomel (T3—see the instructions in my book for dosing T3). In addition, T3 receptor resistance is often present, with doses as high as 120 mcg of T3 sometimes being needed. If he won't switch, and it is a good way to first begin as well, ask him to add 25-30 mcg of T3 (called Cytomel) to your T4 dose or to even 100 mcg of the T4/synthroid. This way you'll get what you need and your blood test for T4 will go down, making him happy. If he is closed to all of these ideas, find a physician familiar with CFS/FMS who can treat you properly. I would look at the Fibromyalgia & Fatigue Centers to find one.
One thought though. It is unusual for T4 to go "4x normal" on 125 mcg of thyroid. It may be worth double checking to be sure you do not have an OVER active thyroid.
Love & Blessings,
Dr. T
What does a funny smell in my house mean?
Diane asks:
I noticed an unpleasant odor in my house, and then started to smell it everywhere I went. Then I realized that this "dirty dish rag" smell was only perceived by me! I am not stuffed up, but my nasal passages and one ear are sensitive to the air I breathe in.
Could this be a fungal or yeast infection in my sinuses? I do use your Energy Revitalization System.
Thank you.
ANSWER
Dear Diane,
If you only smell it in your house, it is likely to be in your house rather than your nose/sinuses. Look for mold exposure in your home as it could cause CFS. For more on "Sick Building Syndrome" visit the Visual Contrast Sensitivity Test Center. If you are now smelling it outside your house, a few things:
| 1. | If it is associated with light and sound sensitivity, it is likely part of the CFS sensitivity. Neurontin is good for this. If associated with MCS (multiple chemical sensitivity) consider carbon monoxide poisoning (even from years ago). See research by Albert Donnay. |
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| 2. | Take zinc 25 mg 2x day for 3-6 months. Low zinc, common in CFS/FMS, can affect smell. |
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| 3. | Bacterial infections can do this, and the prescription sinusitis nose spray from ITC Pharmacy can help, as can silver nose spray. The treatment of sinusitis in general is discussed in Chronic Sinusitis—Actually a Yeast Infection. |
Love & Blessings,
Dr. T
Is there help for Collagenous Colitis?
Donna asks:
I have been diagnosed as having collagenous colitis. Is this the spastic colon you refer to when talking about yeast? I have FM and probably chronic sinusitis and am just very confused about what tack to take next. I am seeing a doctor at a FFC, so am already taking Corvalen, etc. I have not had a sinus infection in several years, but have very frequent drainage down back of my throat, lots of trying to get the mucus down my throat, and waking up to a half filled throat feeling like I am about to choke. Anyway, what's next, SIBO, or Diflucan? Or tests? Thanks so much for your help to all of us.
ANSWER
Dear Donna,
No. This is a very rare colon inflammation resulting in severe repeated diarrhea.
The yeast is not its cause (if the diagnosis was made by biopsy) nor is SIBO, but either or both can aggravate the colitis. I would clearly take the Diflucan for 6 weeks (at least).
A recent study (rare to find because your process is rare) showed that the herb Boswellia (frankincense) was very helpful for collagenous colitis. You can get Boswellia separately, and find a form standardized to 70-80% Boswellic acids. Another way to get the Boswellia is with the End Pain Formula product at my website. I would double the dose of Boswellia used in the study, taking 2 tabs 3x day for 6-8 weeks till symptoms improve, and then the dose can drop to 3-4 tabs a day as needed. This contains the boswellia in the optimal form, potency and dose as well as willow bark, an herb helpful as well for colitis. I would also add Pepto Bismol and Probiotics, and read my article on ulcerative colitis.
Love & Blessings,
Dr. T
What does low cholesterol mean?
Mary asks:
Hi Dr. Teitelbaum, What does it infer if your cholesterol is abnormally low? My husband's level is 114,and he is 60 lbs. overweight and has high blood pressure. His CRP (c-reactive protein) is 12 times the normal range and fibrinogen is high too.
I remember you talking about a too low cholesterol. Will you expound on it again?
Thanks,
Mary
ANSWER
Dear Mary,
If the cause is not clear once liver and overactive thyroid issues are ruled out, then it may simply be genetic. I have seen low cholesterol (at 64—lower than here) be associated with severe recurrent intestinal bleeding (we were able to stop it).
Beyond this, if he feels fine I would ignore it.
If fatigued, check a pregnenolone level. If under 40, I would add 100-200 mg of pregnenolone at bedtime. Low cholesterol problems may arise because cholesterol is the main building block of many hormones—being the source of pregnenolone. If pregnenolone is OK, no problem. If low, the cholesterol being low can cause hormonal deficiencies for lack of pregnenolone—so we give the pregnenolone 100-200 mg at bedtime as a supplement.
Love & Blessings,
Dr. T
Help for Ankylosing Spondylitis (AS).
Deb asks:
My 55 year old brother has ankylosing spondylitis w/morphine daily for pain. Doctors have different surgical options. He is very hesitant—to the point of needing anxiety meds. He is in constant pain, stiffens up if inactive, and cannot sleep more than a few hours. Has just started omega 3 capsules, cats claw, and probiotics as suggested by friend w/Enzymatic Therapy Co. Can you recommend a doctor or clinic and nutritional advice? Every doctor wants major surgery (cutting or removing vertebrae). With ankylosing spondylitis, any such invasion might worsen his condition. Family history of general Arthritis.
Thank you.
Sincerely,
Deb
ANSWER
Dear Deb,
Ankylosing Spondylitis (AS) can be a very difficult process to treat. There is a genetic component, but it is important to also take into account the effect of environmental factors interacting with the genetics. This interaction is seen for example in people with a specific genetic (also HLA) who respond especially poorly after having Lyme infections. Most doctors ignore how autoimmune processes similar to AS are markedly impacted by the environment. The good news though is that this gives us several avenues of treatment that can be helpful.
If I were your brother I would consider the following treatments:
| 1. | A therapeutic trial with the antibiotics doxycycline and or Biaxin for at least six months. A number of studies have implicated a variety of infections as been implicated in flaring AS in those that are genetically predisposed. |
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| 2. | The chemical load on the immune system. For more information on this I refer you to a book called The Auto Immune Epidemic by Don Jackson Nakazawa. Click here to read an interview I did with her. |
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| 3. | I would use the Pain Formula herbal mix that is available on my website at two tablets three times a day. Give it at least three months because of the severity of his condition. In addition, I would recommend fish oil at a dose of at least one to two teaspoons a day or at least three servings of salmon and/or tuna weekly. Fish oil is an excellent anti-inflammatory. |
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| 4. | Several studies have suggested that using anti-osteoporosis medications can be helpful in AS, especially if given intravenously and should be looked into. I would also recommend using the natural treatments that I discuss on my website (see Osteoporosis and Osteopenia—Loss of Bone Density). |
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| 5. | To find a pain specialist more open to using alternative therapies, visit the American Academy of Pain Management website. |
I hope this is helpful for your brother.
Love & Blessings,
Dr. T
What do you recommend for lupus?
Dear Dr. T,
What should a patient should do when they have systemic lupus and fibromyalgia? I do take prednisone for my lupus flareups on occasions due to inflammation around my lungs and heart. However, the stress of those symptoms can cause problems with fibromyalgia.
Sincerely,
Jerri
ANSWER
Dear Jerri,
Lupus is very often associated with a secondary fibromyalgia and is one of many triggers. The treatment for the fibromyalgia is the same in cases of lupus, except that several studies show that DHEA at a dose of 200 mg daily significantly improves how people with lupus do. The main problem with this high a dose of DHEA is that it can increase testosterone and results in acne or darkening a facial hair in some women (although in the studies it was not a major problem), so I prefer to begin with smaller dosing and work up. In addition, because of the inflammation seen in lupus, I am quicker to recommend the use of ultra-low-dose Cortef (up to 20 mg daily every day instead of only during flares), fish oil, and the Pain Formula herbal mix on my website, as all of these help to settle down the inflammation.
Many of the symptoms however, which are attributed to your lupus, are likely coming from your fibromyalgia and will respond to the rest of the SHINE Protocol.
Love & Blessings,
Dr. T
Should I do steroid shots for my arthritis and bone spurs?
Dear Dr. Teitelbaum,
I was diagnosed with bone spurs on my back and bone on bone in my knees. My bone doctors want to give me steroid shots, but I am afraid of the side effects. But I am in such pain all the time and don't know if I should get them. Is there any other thing I can do to help get rid of some of my pain?
Thank you.
Melva sitting in pain from Texas (~_*)
ANSWER
Dear Melva,
I think it is reasonable to occasionally do the steroid shots to see if they give you some relief from the pain while doing other treatments to help heal the arthritis. It is important to know that many people who have bone on bone or bone spurs have absolutely no pain at all—and this has been shown in research studies and is the experience of many pain specialists. So you can get relief regardless.
I would go ahead and begin the steroid shots, but meanwhile also begin the arthritis remedies discussed in my article ( see the link below). Or you may simply prefer to give the natural remedies time to work first. Give those six weeks to start working, although they likely will start to kick in earlier. I think you'll find when you have done this your arthritis pain will be markedly decreased. There are many other treatments that can be helpful as well, but these are usually enough to get most people very comfortable. For more information, I invite you to read my book Pain-Free 1-2-3 which you can find in most bookstores or on my website. Start, however, my reading my article Arthritis—A 6 Week Program to Help Heal Your Achy Joints and following the guidance in it.
Let me know how things work for you!
Love & Blessings,
Dr. T
She felt worse after taking vitamin D.
Merrijean asks:
My doctor tested my vitamin D blood level and it was in the hypovitaminosis range so she supplied me with a supplement—2,000 IU per drop. She thought it would help with many of my symptoms. So with optimism I took the first drop and soon felt so somnolent. I thought, boy these doctor visits are hard on me... The next drop added symptoms of weakness, loss of appetite, unusual thirst, palpitations and a general malaise. I stopped the vitamin D. Several days later, I developed a stiff neck and then low back spasm—symptoms I have not had for years. It took me over a month before I was feeling "normal" again. Have you ever run into this kind of reaction and do you have any idea what caused it?
Also, you mentioned the use of topical pain-relief cream over the jaw muscle for hot/cold tooth sensitivity. Is there a specific one you recommend?
I appreciate so much your medical ministry and your newsletter. I am blessed by the light... and also by the warmth. Thanks.
ANSWER
Dear Merrijean,
Although it was a good idea for your physician to give you the vitamin D, it sounds like what you had was a die off reaction to an infection that was being killed off by your body when you took the vitamin D. Vitamin D is a powerful immune modulator, and is critical for proper function. I would recommend that your physician check a 1,25 hydroxy vitamin D level( 1,25 OHD) in addition to the 25 hydroxy vitamin D level (25 OHD) which was checked. If the 1,25 level is more than twice the 25 vitamin D level, it suggests that you have an underlying infection (usually antibiotic sensitive), which can also cause CFS/fibromyalgia. Anything that kills off the infection (such as antibiotics and immune stimulants—like vitamin D) can cause a "die off" reaction (also known as a Herxheimer reaction medically), suggested by the symptoms that you had.
I presume that your physician also made sure that your calcium blood level was normal. If not, that would offer an alternative explanation.
I recommend that you read the chapter in my book From Fatigued to Fantastic! on treating infections, and have your physician add the antibiotics in very slowly to make sure that you do not repeat the die off reaction. Sometimes people have to go through the reaction, but keep it mild enough that it is not too uncomfortable.
Dr. Trevor Marshall, who proposed what is called the "Marshall Protocol" recommends avoiding vitamin D in fibromyalgia. Unfortunately, his protocol is very difficult to follow (because sunshine must be strictly avoided) and the large majority of my patients did not benefit from it (only one did), so I no longer use it. Nonetheless, his theories also may help explain your reaction and can be found online.
Love & Blessings,
Dr. T
Fibro is much better with “SHINE” but now has thigh pain and high iron.
Paula asks:
Several years ago I used your labs and internet program and went from coming close to not wanting to live to following all your advice and living a great life in SPITE of fibro! I have even caddied for my husband in some of his Champions Tour qualifiers! Thank you so much Doc!
My question is one that puzzles both me and my doctor. Recently I began getting a "sharp burning" in my right thigh. Started in back and now on side and front of thigh. I have woke my husband screaming. It has ONLY happened when I am lying down... any ideas? We are stumped. (I don't know if this is relevant but my Epstien-Barr is active and over 2,000.) Other than that my only abnormal blood test is that my blood ferritin level is always high... this puzzles doctors too.
Thank you.
ANSWER
Dear Paula,
Without doing an exam (and possibly even with an exam because of the pain's intermittent nature), I can only speculate.
The nature of the pain suggests that it is a pinched nerve causing the pain. Being intermittent, it is most likely a muscle or ligament pitching on the nerve, but again I recommend your physician do a physical examination (and also a pelvic CAT scan) to rule out other causes.
If the examination and CAT scan x-rays are negative, I would then look for spasm in the muscles of the right lower back. When you get to pain, I would also feel around to see if there are any areas where pushing on them affects the pain. If so, those areas may be causing the pain. I would also recommend that you sit in a cross legged position (like when you see people meditate or do yoga on TV) for 10-15 minutes to see if this brings on the pain. If so, look up a condition called Meralgia Paresthetica. This condition, however, usually affects the side of the thigh and not the front or back (it also causes decreased hair growth on the side of the thigh). It can be treated with an injection to the pinched nerve.
Although a number of medications can be helpful, it sounds like the problem is intermittent enough to not make medications worthwhile. I would begin with massage, chiropractic or other therapies to release the muscles and ligaments in the low back and pelvis as well as in the thigh.
Sorry that I cannot be more specific without being able to do an exam, but hopefully this will give you a start.
Regarding the elevated ferritin (iron) level, if your iron percent saturation is also elevated you should see a liver specialist to rule out a genetic disease called hemochromatosis. This is easy to treat if caught early and can disable you if ignored too long. If the iron percent saturation is under 40%, I would check three blood tests looking for inflammation:
| 1. | ESR |
| | |
| 2. | CRP |
| | |
| 3. | ANA (anti nuclear antibody; OK if 1;160 or lower) |
Ferritin blood tests go up with inflammation as well as with a high iron, but the iron percentage saturation does not. If one of the above tests is positive for inflammation, it could also add clues to your thigh pain. If you are no longer of childbearing age, take a vitamin A 25,000 units a day for three months as vitamin A deficiency can also cause a high ferritin and normal percent saturation. Do not take the vitamin A if you may get pregnant, as more than 8 thousand units of vitamin A a day can cause birth defects.
Love & Blessings,
Dr. T
A chiropractic treatment flared her CFS.
Joanne asks:
Hello Dr. T,
How are you? I am a former patient of yours. I saw you in 2006. You saved me! Although I have yet to FULLY recover, I will say that I recovered about 75%. Which I'll gladly take! I'm just a little scared. I developed some back problems, which I wouldn't associate with my CFS, but more from having a 2 year-old son. I began massage therapy, and my therapist recommended I see a chiropractor because of the abnormal spacing of my shoulders. I had one spinal manipulation about three days ago, and now I feel I am having a CFS flair (brain fog, nausea, disorientation)! What are your thoughts on this?
ANSWER
Dear Joanne,
It will pass.
Sometimes spinal manipulation (especially in the neck) can flare autonomic dysfunction because of spinal cord stimulation if the space in the spinal cord is tight. I suspect the muscle tightness you were being treated for reflected that the CFS was beginning to act up again as well just a little—even before the manipulation.
This is not a big deal and simply requires a tune up. Begin with taking (or continuing) the Energy Revitalization System vitamin powder and Ribose (Corvalen) and add natural remedies or medications (Ambien, Desyrel, Klonopin) as needed to get your eight hours sleep a night. Ask your doctor to increase your thyroid dose to see if it helps and if spastic colon or nasal congestion symptoms are present, re-treat for candida. Add in vitamin B6 at 200 mg a day for 6-12 weeks as it can help recovery from the chiropractic manipulation.
Usually chiropractic can be very helpful—especially when combined with SHINE to treat the metabolic issues (discussed in my book). In your case though, I would hold off and treat with SHINE instead. Also, ask your therapist or chiropractor to check to see if your hip heights are even. If not, a $15 heel lift can do wonders (if it is the right size heel lift, you'll feel better and more balanced immediately when you use it. If not, it is not the right size).
Love & Blessings,
Dr. T
Is it OK to not be “superwoman?”
Cindy asks:
You spent 4 and 1/2 hours with us tonight on the teleconference and I am simply blown away. Doctors do not do this sort of thing. I have no questions, only gratitude. One comment you made during the teleconference was especially helpful. Fibro is the gift our bodies gave us so we can finally put ourselves first. In the seventies we were told we could "Bring home the bacon, fry it up in a pan, and never let you forget you're a man." So we did.
We built our careers, demanded equal pay. And when we divorced we raised the kids alone and made the house payments alone. We treated our body like our servant. We blew a fuse. Now you tell me my body won't heal to the point that I can go back to cleaning the house at night while every one else is asleep.
Thank you. You are in my prayers.
ANSWER
Dear Cindy,
You're very welcome ;-)
I am glad you feel you have permission to listen to your body when it tells you that you are overdoing—instead of to media hype and images that are nuts!
Wishing you a life you love.
Love & Blessings,
Dr. T
Hi Dr. T.
I started DHEA 20 mg for 10 days, 10 mg/day for 1 week and now I am taking 5 mg/day. I feel cured of the CFS symptoms. I have a ton of energy but my breasts are tender. I have no history of breast or ovarian cancer in my family. I also have increased abdominal fat since I started it, but I don't want to harm myself. I am getting a level checked on Tuesday. My last level was 50 before starting it. I know to keep my DHEA-S level 150-180 mcg/dl. Is the breast tenderness bilaterally anything to worry about? How long would you advise to stay on DHEA. I read Christian Northrup's book and she said to wean off when levels reach normal but I wanted to see what you thought.
Thanks!
Mary
ANSWER
Dear Mary,
If it is helping your CFS that much, and the 5 mg works as well, I would stay on it if the blood levels are OK. For breast tenderness, have a breast exam and mammogram as a precaution (likely fine—it is very rare for bilateral breast tenderness without overt masses to be a cancer—but best on the safe side). I would add iodine for the breast tenderness (Iodoral 1 tab a day for 1 bottle, then 1 a week—available on my web site). I would continue the low dose DHEA long term to keep levels ~ 150 mcg/dl (I take it every day myself—likely will the rest of my life—I think it promotes health.)
If the breast tenderness continues as a problem despite 6 weeks on iodoral and being checked by your physician, goes away when you stop the low dose DHEA and recurs when you restart it, you may be getting increased estrogen conversion. This is usually fine, but if it causes persistent breast tenderness (which persists despite also stopping caffeine for 6 weeks) and is otherwise very helpful, the problem may be helped by adding the medication Arimidex 1 mg 1/3 tab 3x week to block its conversion to estrogen.
L&B,
Dr. T
Dear Dr. T,
Is there help for Polymyalgia Rheumatica and Temporal arteritis?
Bernadette
ANSWER
Dear Bernadette,
This inflammatory illness of the muscles and blood vessels (Giant Cell Arteritis or Polymyalgia Rheumatica—PMR) will very often trigger a secondary fibromyalgia/Chronic Fatigue Syndrome (CFS)—which then may cause most of the symptoms. The doctor may then attribute the fibromyalgia symptoms to the PMR and raises your dose of Prednisone, which can then cause toxicity. If you are having trouble sleeping at night, you likely have a secondary fibromyalgia—which most physicians are not familiar with and will miss.
We find that treating with the SHINE protocol (which we discuss in From Fatigued to Fantastic!) will often eliminate many of the symptoms of PMR. People can be kept on cortef 20 mg (equivalent to ~ 4 mg of prednisone but safer and more effective) forever without the toxicity seen with prednisone (it is in fact quite safe at this low dose as discussed in From Fatigued to Fantastic!) along with the other treatments we discuss, so there is not this constant pressure to need to wean down the prednisone (so you can avoid the flares). When feeling better, people find it easier to lower the cortef dose—simply because it is not needed. For an excellent but technical report of the safety and use of Cortef in CFS (which overlaps fibromyalgia ) which your physician may find helpful, click here.
In addition to standard SHINE protocol approaches to treat the secondary fibromyalgia/CFS caused by the PMR, some find the PMR is caused by a wheat allergy, and in severe or refractory cases I will do a wheat/gluten elimination trial (but this is a difficult diet, and usually not needed). I will optimize DHEA hormone levels (getting the DHEA-S blood test to 150-200 mcg/dl in women and 450 in men) as this tends to lower the toxicity of the prednisone and allow a lower dose, and add natural anti-inflammatory nutrients such as fish oil, and Boswellia and willow bark combos (both are in the herbal "Pain Formula" on my website; use 2 tabs 3x day for 6 weeks or pain is controlled as comes first, then take as needed—it can be taken with the prednisone).
L&B,
Dr. T
M asks:
Dear Dr. T,
This is sort of embarrassing to bring up, but bring it up I must. I've had CFS for two years, and throughout the illness I've had dark green, extremely malodorous stools that I'm quite certain are not caused by the supplements and medications I'm taking. I also have gas and bloating. My doc had me on nystatin, but it did nothing for me. I've now just started taking Diflucan. My doctor thinks yeast overgrowth is the cause of my problem, but I'm wondering if it might be something else. I've not been tested for parasites or SIBO. What do you think?
Thank you,
M
ANSWER
Dear M,
Though the yeast can cause all kinds of bowel problems, green smelly stools are usually bacterial or parasites. Green stools are usually bacterial (though rarely they can reflect yeast) and though yeast cause a lot of gas, it is usually not smelly like the gas caused by bacteria or parasites. If your doctor does by mail stool tests for bacterial cultures and parasite testing at a specialty lab like Genova Labs or DiagnosTechs (standard labs are useless for this), I would obtain the stool samples first to see if a specific bacteria or parasite can be isolated. If not convenient to do this testing (or it comes back negative) I would still treat without the tests. I would begin treatment as soon as the stool samples are obtained (with Cipro 500 mg 2x day for 7-10 days or if allergic or under 18 years old I would substitute Septra DS [a sulfa] 1 twice a day for 7-10 days) and not wait for the stool test results as these take 3-4 weeks (the results are used to guide future treatments if needed). I would probably stop the Diflucan till after the antibiotic is completed, and then take the Diflucan for 6 weeks after the antibiotic is done—so you may want to discuss this with your physician.
L&B,
Dr. T
Dear Jacob,
It was great seeing you on British television last week. You said lots of thing that badly needed saying—thank you so much.
I have a quick question for you though. I understand that the upper reference value for TSH in the UK has recently been increased to 10. If a reference range is to include 95% of the population (2 standard deviations), how can such alterations to reference ranges be justified? Either they are arbitrary or they are two standard deviations, but they can't be both. What is going on here? Also, given that different labs have different reference ranges anyway, how can you just say that the upper reference value will be 10 for all the UK? Is this just endocrinologists being illogical and unscientific again?
Best wishes,
Peter Warmingham,
Thyroid UK
ANSWER
Dear Peter,
If the TSH test normal range is being raised to 10 for the upper limit of normal, the best justifiable defense would be insanity.
Though labs set the reference range, and usually do so based on 2 standard deviations, specialty groups can write normal ranges that override this (e.g., cholesterol levels which may define most people as being abnormal—helps sell a lot of unneeded cholesterol medication).
I have attached an old press release showing that the AACE lowered the upper limit of TSH to 3 in 2002. If you look at my newsletter archives at my website you'll see many recent studies suggesting that if anything this is high.
Love and blessings,
Dr. T
Dear Dr. T,
I am currently pleased to have a Family Practitioner who is willing to work with me using MOST of your protocols, after having been diagnosed with a mitochondrial dysfunction. My doctor was impressed with Dr. T's SHINE protocol and we have begun following it. My doctor is willing to prescribe most everything EXCEPT Diflucan—he says he will not as it is too rough on my liver. He has prescribed Nystatin for one week—QID—or until the bottle runs out. Question: What then will help treat the Infection part if he won't give me Nystatin? My doctor is very willing to work with me. What can be suggested that he use instead?
I greatly appreciate your help as I try to get my "fantastic" back! Thank you very much!
Debra
ANSWER
Dear Debra,
In our experience with thousands of patients the Diflucan is much easier on the liver than Tylenol, but as your doctor has worked with you otherwise, I wouldn't push it. Though not absorbed into the system like Diflucan, using the herbal mix "Anti-Yeast" 2 twice a day along with the probiotic pearls 2 twice a day (both for 5 months) has been pretty helpful.
If you also have sinusitis/nasal congestion maybe the doctor would call in the "Sinusitis nose spray" from ITC pharmacy (888-349-5453 ) which will kill the yeast in the nose (use 2 sprays in each nostril 2x day for 1 bottle).
L&B,
Dr. T
Dear Dr. Teitelbaum,
I needed to express my appreciation of your free newsletter. It is first rate, and always contains valuable information. It is the most comprehensive information on FMS I have ever seen and the fact that you share this information for free is remarkable. Your heart is truly in the right place. I have had active FMS for 9 years, and am now a patient at FFC. You, however, remain my "guru" on FMS. From the bottom of my heart, I thank you.
Joyce
ANSWER
Dear Joyce,
You're welcome ;-)
It is very much a labor of love (not sacrifice) and gives me a lot of joy.
Love and blessings,
Dr. T
Keith asks:
Hi Dr. T,
A saliva test that was performed about a year ago indicated that my cortisol levels were at the very low end of normal throughout the day (sometimes a little below normal). I took low doses of Isocort, about 15 mg/day for a while, but never noticed any noticeable improvement. I started the SHINE protocol about a month ago, including the Energy Revitalization System, Ribose and the Adrenal Stress End Formula and seem to be feeling a little better already (YES!!). I was considering trying the Isocort again to see if any additional improvement might be gained now that the other supplements seem to be helping.
I'm a little confused about the Adrenal Stress End Formula which contains 33 mg of Adrenal Cortex Extract. The Bezwecken IsoCort I have contains 2.5 mg of freeze-dried Adrenal Cortex in each pellet. In reading From Fatigued to Fantastic!, my understanding was that recommended dosage would be less than 20 mg/day. If I'm taking the stress end formula, I'm already taking 33 mg/day, so should I avoid taking the Isocort? Or am I confused and these are two different things and it's ok to take 15 mg/day of Isocort in addition to the Adrenal Stress End Formula?
Thanks a lot for your help.
Keith
ANSWER
Dear Keith,
I know it seems confusing, and I am happy to clarify.
A few helpful points:
| 1. | Though I have reservations about saliva hormone testing, it may be reliable UNTIL one is on hormone supplementation. When on the hormones, I consider saliva testing to be quite unreliable. |
| | |
| 2. | I think taking up to 20 mg a day of cortisol (hydrocortisone or cortef), a key adrenal hormone, is often helpful in CFS/FMS. More than that runs the risk of toxicity. Do not confuse cortisol with adrenal glandulars though. The Adrenal Stress End, though it has the high level of adrenal glandular, has NO significant levels of cortisol. It simply supplies your body what it needs to heal so it can make its own. Therefore, the amount of glandular in it does not count toward the 20 mg daily maximum of hydrocortisone. |
| | |
| 3. | Although Isocort is a glandular, they have NOT removed the cortisol from the glandular (as most products do). This means it can add the extra benefits and risks of cortisol. The current GUESS is that it has 2.5 mg of cortisol per pellet, but the actual amount is uncertain and can vary from pill to pill. Because of this, for safety and efficacy, I prefer prescription cortisol (cortef) so we know the exact amount, COMBINED with adrenal glandulars that do NOT contain cortisol (e.g., Adrenal Stress End). Unfortunately, most physicians are not familiar with the CFS/FMS research and will not prescribe cortef (cortisol), so the public has been left with little choice but to self medicate with Isocort. As there are now Fibromyalgia and Fatigue Centers throughout the USA (and they see people from all over the world) and they know how to prescribe cortisol safely and effectively, this offers a better option. |
| | |
| 4. | It is ok to add the Adrenal Stress End to the Cortef or Isocort. I would add the adrenal support back in, now that you've addressed other issues—it may now be more helpful. |
| | |
| 5. | I recommend that Isocort be limited to 6 pellets a day. If also on cortef/hydrocortisone, decrease the 6 pellet maximum by 2 pellets for each 5 mg of cortef/cortisone you are taking. If on prednisone over 4 mg, only use Isocort with your doctors approval (other adrenal glandulars are ok). |
Love and blessings,
Dr. T
Dear Dr. Teitelbaum,
I'm sure you have received many of this kind of email since your appearance on ITVs "This Morning" (the equivalent of Good Morning America in England/UK), but I had to email and thank you.
I was off work with fatigue, pain and all the associated symptoms for the whole of 2007. (I also suffer with endometriosis and have done so for 5 years). I gradually started back to work, one day at a time, and now work 3 days a week, and even do floor exercises as well as my usual housework routine!
In order to recover, I built in plenty of rest periods, had 9 hours sleep a night, avoided sugar and yeast, took supplements (the very ones you have recommended) and practiced a conscious relaxation process. Obviously, I got a similar reaction at my GP as other people, and had no help with infection or hormones and was told "There's no point. Just deal with the symptoms." The local ME team, a dietician and occupational therapist, were very helpful even though constrained by NHS guidelines.
And now to my point, finally! I saw you on "This Morning" and cried. It was such a relief to have someone talk about all the things I have had to deal with in such a concise way, without any sense of being "scoffed"' at.
I have now bought your book, but wanted to say Thank You so much. I hope that many people will see your media appearances and will thus understand the condition and its recovery and make it a little easier on us all!
Your's thankfully,
Sandra
ANSWER
Dear Sandra,
You are very welcome!
Teaching people how to get well is very much a happy task for me and a labor of love. As you noted, just knowing what is happening and that they are not crazy helps people begin the healing process.
You can get your life back (likely even much more than you have). You may want to do the free online questionnaire as it will analyze your symptoms (and labs if you have them) to determine what you need to do to get well.
As you get well, use your energy for things that feel good to you (instead of "making up for lost time" doing things you hate). This way you are less likely to blow a fuse again ;-)
Love and blessings,
Dr. T
P.S.—The word is getting out to people. My book was the #7 best selling book on Amazon UK last week!
Hi Jacob,
This article is good but there is one serious problem: the example you use comparing brain fog (forget where I left my keys) and Alzheimer's (forget HOW to use the keys). This example is a problem because people with CFS-ME and MCS forget what things are for.
For instance: I have CFS and, of course, I forget where I have left everything, including my bank book. But I also forget, once I get to the bank, what the bank book is for and what the bank is (one could make poetic/political comments on this... but I'll skip it for now). I know of people with MCS who do not remember what a chair is for.
I use to work in Alzheimer's in a major Montreal, Canada hospital and when I would take patients to the bathroom, they would often now know what each object in the bathroom was for (sink, toilet, bathtub, etc). Well, imagine my surprise when, just last week I went to my bathroom and it took me 5 minutes to figure out what each object was for.
Over the past few years I have been noticing amongst fellow CFSers that the cognitive problems we have, some of them are very similar to Alzheimer's (except they do not seem to progress, or so we think/hope... no one is doing a long term study).
I suppose that the prevention/treatment you suggest could be useful for all cognitive problems, along with all the other CFS treatments (biochemical, immune, antiviral, etc).
Just thought I would share this with you.
All the best,
Clara
Barcelona, Spain
ANSWER
Dear Clara,
It is good to hear from you, and please give my regards to the CFS/FMS support group in Barcelona.
You have raised an interesting point in your email, and I would like to add some background that I think those with CFS/FMS will find helpful.
Although short term memory is the more common issue, there are times when people will have the kind of issue you note. The key though is that it is short term (minutes) and not long term. These episodes often are similar to the periods of episodic disorientation discussed in today's newsletter article on brain fog, and can also occur during episodes of low blood sugar, low blood pressure, and decreased blood flow, though other mechanisms also contribute. Fortunately, this usually improves markedly with treatment with the SHINE Protocol. For those who have this problem persisting for days to weeks instead of minutes (not knowing how to use the keys or recognizing common objects) without coming and going, this would be most unusual for CFS alone and other causes for the memory deficits should be sought.
L&B,
Jacob
Diane asks:
So far in my reading of your book Pain Free 1-2-3 you mention estrogen playing a role in fibro but I don't see anything about progesterone. In my searching and trial usage I am experiencing benefits from using a pure form of progesterone cream (Endau). Along with that I am following your supplement program and D-Ribose along with fish oil and coenzyme Q10. From my other searching they say most women these days are estrogen dominate, which is why I am confused that you suggested taking more estrogen but don't mention progesterone.
Thanks,
Diane
ANSWER
Dear Diane,
This is an area of controversy. We have the one camp promoting Estrogen (e.g., Elizabeth Vliet) and another camp promoting progesterone (the late John Lee).
I take a stand in the middle recommending and recognizing that as the body makes both hormones, it likely needs both hormones. This is why even though I speak more about the estrogen component, I recommend that women also get progesterone—even if they have had a hysterectomy. I do recognize that some woman do better with either estrogen alone or progesterone alone as there is a lot of biological individuality.
Of course, it is important that the Bioidentical hormones only be used, as these do appear to decrease the risk of heart disease and also decrease the risk of breast cancer as opposed to synthetics.
The reason this area was not discussed in more length in the Pain Free 1-2-3 book is because the publishers required that we shorten the book. Because of this, the discussion on both estrogen and progesterone is largely moved to the Book Notes section of my website. Click here to visit this section and read an excellent article by my friend and colleague, Dr. Kent Holtorf.
I hope this is helpful.
Love and blessings,
Dr. T
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