THE MOST COMMONLY ASKED QUESTIONS

THE MOST COMMONLY ASKED QUESTIONS

 

 
 
 
 
○ When should I start the treatment?
The sooner the better. Why wait? The natural course of fibromyalgia is to grow worse. Patients of any age can follow the protocol, which is designed to reverse fibromyalgia in less time than it took to develop. The reward is freedom from pain, and improved well-being.
 
○ How long should I continue to take GUAIFENESIN after getting well?
It is a life time treatment, as is the treatment for diabetes or hypertension. GUAIFENESIN works only when you are taking it. The genetic defect that caused your symptoms is unchanged. When you stop taking GUAIFENESIN, the disease will eventually return. Your effective dose will be yours for ever.
 
○ How long should I be on diet?
Only 40% of women , and 20% of men need a diet low in carbohydrates. Hypoglycemia must be treated concurrently or the patient will not totally recover despite reversal of fibromyalgia. There is no compromise. The goal of the diet is simple: avoid repeated insulin release from the pancreas which promotes the reabsorbtion of phosphates. After two months, if you have followed the diet rigorously, you will have accrued most of the benefits. Once you discover the beneficial effects of the diet, it is your responsibility to stay on it. The diet requires to become a way of life. The diet, together with GUAIFENESIN, is designed to help you recover.
 
○ Should I continue my other medications when I start GUAIFENESIN?
You will be allowed to continue all other medications except those that contain aspirin. It will be discussed with your family doctor how to replace aspirin. When you start GUAIFENESIN it may be useful to keep taking your symptomatic medications. With the time, on the effective dose of GUAIFENESIN, once you will feel a great improvement, some drugs or supplements will be optional and we will decide which one may be withdrawn.
 
○ If I take anti-depressor drugs, what should I do? 
There is no question that the unrelenting nature of the disease, the cognitive losses, the fatigue, and pain resistant to all forms of therapy, are certainly reason enough to induce depression. Depression, at various degrees, is often one of the symptoms of fibromyalgia itself. An antidepressant drug is the usual approach of fibromyalgia treatment whether there is depression or not. The reason for using these drugs is that they raise the level of serotonin, usually low in fibromyalgics. The antidepressants elevate the pain threshold, decreasing pain perception, sleep patterns may be helped or restored, depression eased. No doubt that they do help many fibromyalgics, and what helps in some means or other has to be maintained. But antidepressant drugs, in addition to some side effects, have often no lasting benefits or insufficient benefits for fibromyalgia, although initially some pain is masked and depression may lessen.
Low serotonin is one among a lot of laboratory findings. To other patients the antidepressant drugs may have no effect at all - not all fibromyalgics have a low serotonin level.
GUAIFENESIN treating the underlying cause of fibromyalgia helps, with the time, most patients to withdraw their antidepressant drug, the withdraw is always done cautiously and progressively. To most patients, depression begins to lift as their other fibromyalgic symptoms begin resolving. 
 
○ Can I exercise and do sport while taking GUAIFENESIN?
Most doctors recommend exercising to one's physical limit, or advise strenuous aerobic exercises as an important part of the established treatment plan for fibromyalgia. Many probably get worry that their patients may develop stiffness all over the body. What is obvious is that most patients cannot perform such physical exercises, or cannot tolerate them without paying a heavy price later. We have to keep in mind that fibromyalgia produces pain at rest. Each effort is painful and debilitates the patient. The pain cycle is self-sustaining. In addition, there is also the problem of fatigue after physical exercise.
 
Exercise is said to make patients feel better, but first they should feel well enough to exercise, that means well enough in their metabolic condition. The rule is simple: keep muscular workouts light and within a tolerable discomfort zone, and treat the underlying disease. As patients improve, they can gradually tolerate more exercise, and eventually more exercise will increase well-being. It is important to start out modestly. Ambitious starts are the most common cause of defeat. You can begin by walking around the block.
 
Yoga, tai chi, and other disciplines are as individual as everything else in fibromyalgia is. You may keep trying until you find an exercise program you like, but do not overdo it.
I do not recommend massage at the start of the treatment, as deep-tissue work will increase the pain. After a month or two will be allowed a gentle massage to ease the pain in your muscles, but only from a massage therapist who understands fibromyalgia and does not use cream or oil containing salicylates.
A bodywork technique I have seen to benefit patients is known as the Feldenkrais Method. The Alexander Technique may also be helpful.
Acupuncture may relieve pain for some patients, while others experience no benefit.
Hydrotherapy is the best I would recommend.
Patients should always remember that these therapies will, at best, only make them feel more comfortable while the GUAIFENESIN does the work.
 
○ Is GUAIFENESIN safe to take if I get pregnant?
Yes. Two institutes of teratology in Israel, one in Jerusalem, and the second in Haifa, studying effects of medicines over embryo and fœtus, allow the use of GUAIFENESIN from the very first day up to the last day of pregnancy. All my patients who have been on GUAIFENESIN during their pregnancy have given birth to lovely and healthy babies. GUAIFENESIN is OK as well during lactation.
 
○ Can GUAIFENESIN cause kidney stones, or produce damage to the kidneys?
No. GUAIFENESIN has been used extensively over the past twenty years and it has never been shown in medical literature to produce kidney stones or any renal problem. No side effects have ever been reported after using GUAIFENESIN in numerous preparations against cold or allergy during decades. There is no connection between kidney stones and GUAIFENESIN, neither between kidney stones and fibromyalgia, therefore the presence of kidney stones is not a counter-indication of using GUAIFENESIN.
 
What effect has GUAIFENESIN on osteoarthritis?
Fibromyalgia is described as a non-articular disease. However, the duration of the disease determines articular involvement. According to Doctor R. St. Amand, on a study based on thousands of fibromyalgics over four decades, fibromyalgia that progresses for years will eventually lead to joint damage, contrary to current teaching. I have confirmed this observation in my own practice. The damaged cartilage and the bony spurs of osteoarthritis cannot be changed. This is a compelling reason to begin treatment with GUAIFENESIN as soon as the diagnosis of FMS is made.
 
Has GUAIFENESIN any influence on associated diseases with fibromyalgia like rheumatoid arthritis or lupus disease?
Cytokines, inflammatory substances, are elevated in rheumatoid arthritis, lupus, and other autoimmune diseases sometimes associated with fibromyalgia. Since it has been shown that GUAIFENESIN normalize most of the cytokines, it helps these coexistent conditions as well.
 
○ What about salicylates contained in food?
The small amounts of salicylates contained in food and spices do not block GUAIFENESIN because of glycination process of salicylates in the liver. All food, as well as herbs, when used as seasoning in cooking, are OK. Herbal supplement and most teas that claim to have medicinal value have high enough concentration of salicylates to block. Black tea is fine, but not green tea or mint tea. Vitamins that contain herbs should be discontinued.
Notice that since plants contain salicylates on their exterior surface, gardening bare hands will block GUAIFENESIN, wear gloves (not needed for cooking). As well is not allowed to walk on grass bare footed, wear shoes.
 
○ Tell me about thyroid/fibromyalgia connection
Researches have found higher incidence of thyroid disease among fibromyalgia and CFS (Chronic Fatigue Syndrome) patients – I have confirmed this observation in my own practice. Dr. John C. Lowe, one of the pioneers in fibromyalgia research in the States, has, in a 1997 research study reported in the Clinical Bulletin of Myofascial Therapy, that he found clear relationships between thyroid function and fibromyalgia, and believes that some form of hypometabolism, including thyroid dysfunction, may in part explain fibromyalgia. The results of his analysis suggest that approximately 64% of fibromyalgia patients have thyroid hormone deficiencies. 
Symptoms of underactive thyroid usually include fatigue or depression, anxiety or panic attacks and a host of other complaints such as muscle and joint pain, excessive weight gain, or persistent difficulty losing weight in spite of adequate exercise and reasonable caloric restrictions, hair loss, breaking nails, dry and coarse skin, coldness and cold intolerance, constipation, decreased memory and concentration, low libido, menstrual irregularities, infertility and recurrent miscarriage, low blood pressure, high cholesterol, and others. Since these symptoms are very similar to fibromyalgia, there is a risk of misdiagnosis of thyroid disorder.
Thyroid hormone deficiency (hypothyroidism) associated with fibromyalgia or CFS can be seen with the presence or the absence of thyroid antibodies. If you have been tested positive for "thyroid antibodies", it indicates that your thyroid is in the process of autoimmune failure – in that case the disease is called Hashimoto's Autoimmune Thyroiditis (HAIT), which is about 25 times more common in females than males. 
While HAIT is known to be an autoimmune illness, researches are beginning to believe that there is a strong autoimmune component to fibromyalgia and CFS as well. Ultimately, the three diseases may, in fact, be found to be varying manifestations of the same underlying autoimmune problems.
 
What is the reason of misdiagnosis of hypothyroidism? Because the current lab standard of TSH (Thyroid Stimulating Hormone) (click for more) what is called the "normal" range (established in 1973), is too wide, obsolete, inadequate, unreliable. According to the American Association of Clinical Endocrinologists, the new target TSH level is much narrow.  Unfortunately, what is considered by doctors "normal range" of TSH leaves a huge number of patients with symptoms and no treatment.
Within the "normal range", too many hypothyroid patients remain undiagnosed for years before the number of TSH raises high enough to reveal the condition - and many wasted years untreated. "Help! My TSH is "normal" but I am hypothyroid."
 
Let me point out that there are women (with or without fibromyalgia/CFS) that will find it hard to get and/or maintain a pregnancy purely and simply because of a TSH level considered totally "normal" at their lab, but with evidence of hypothyroidism undiagnosed and untreated.   
 
○ Tell me about estrogen/fibromyalgia connection?
Hormonal relationships may explain the higher incidence of fibromyalgia in women.
Hormone imbalances can begin as early as the 20's, and sometimes before. Fibromyalgia can start around puberty. To most women, fibromyalgia symptoms increase before menstruation. Due to estrogen dominance, premenopause and menopause are critical periods of life to start fibromyalgia or to get a significant involvement.  
 
Hormonal health doesn't get the level of attention that it needs and deserves. The hormonal system relies on a delicate interplay of balance among its different sub-systems. If one area experiences imbalance, it can lead to a domino effect. For example, a cortisol deficiency, from an adrenal gland weakness, makes it difficult for thyroid hormones to get into the cells and do their metabolic job.
A progesterone deficiency may cause sleeping disorders, migraines, symptoms met in fibromyalgia. Migraines may be related to liberation of substance P, a neurotransmitter involved in the process of pain, and elevated in fibromyalgics. Studies have shown that progesterone therapy can reduce substance P levels in the blood. Progesterone therapy can as well ease pain by acting on the NMD neuronic receptors involved in perception of pain.
Low levels of testosterone may play a role in chronic pain, and a certain number of fibromyalgics, men and women, have low levels of testosterone. One study has shown that a low testosterone causes reduced levels of ATP in muscles. Reduced levels of ATP are found in fibromyalgic muscles.
 
This is why I find it important to recognize to people suffering from fibromyalgia symptoms of imbalances, mainly thyroid conditions, adrenal conditions, and sexual hormone imbalance, and to act, if needed, to bring a return to equilibrium. That is what is done in my clinic, as routine approach of the disease.
 
○ What is known about enteroviral infections/fibromyalgia connection?
The non-profit Enterovirus Foundation, created in November 2008 and led by top researchers in the field, is dedicated to funding research to detect, understand, and treat the stealthy enterovirus (EV) infections suspected of trigger/persisting in at least 26 different syndromes of unknown cause, including fibromyalgia and CFS.
Many conditions are known to have some association with enteroviral infection, such as fibromyalgia/CFS, various cardiac conditions, diadetes type 1, ADHD, Guillain-Barre Syndrome, pancreatitis, and hepatitis, to name just a few.
Enteroviruses are small, very contagious viruses made of ribonucleic acid (RNA) and proteins. The unsetting fact about enteroviruses is that they can spread to various organs and persist in the body for years – potentially causing disease long after the initial infection. Though researchers have not yet discovered why, and there is so far no approved treatment for eradicating them.
 
○ Is GUAIFENESIN in cough syrups or in pills form appropriate?
No. GUAIFENESIN that is combined with other active ingredients is not considered appropriate for our purposes. However, one has to take in account the dosage added of GUAIFENESIN.
norkurld@zahav.net.il
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