by Jacob E. Teitelbaum, M.D.
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| Most patients with these illnesses find that they
are unable to get seven to eight hours of deep
sleep a night without assistance. |
 re you tired, achy, can’t sleep
and have brain fog, weight
gain and loss of libido? Then
you probably have chronic
fatigue syndrome (CFS) and/or fibromyalgia
(FMS)—two syndromes that devastate the
lives of over six million Americans. In addition,
at any given time, over 25 million
Americans are suffering from disabling
fatigue that has lasted at least one month.
These problems are so common that it is
likely that you or someone you know has for
years dreamed of the day when s/he would
see the headline “Effective Treatment
Developed for Chronic Fatigue Syndrome
and Fibromyalgia.” We are very excited to
report that that day has arrived.
The lead article in the summer 2001 issue
of the Journal of Chronic Fatigue Syndrome is
titled “Effective Treatment of Chronic
Fatigue Syndrome and Fibromyalgia—the
Results of a Randomized, Double-Blind,
Placebo-Controlled Study.” After decades of
hard work by hundreds of researchers in the
field, we have progressed to the point where
effective treatment is now available for these
illnesses. In our study, over 90 percent of
patients improved with treatment.
In the average patient, after two years of
treatment the improvement in quality of
life was 90 percent. Pain decreased by over
50 percent on average. Many patients no
longer even qualified for the diagnosis of
CFS or fibromyalgia after treatment. (The full
text of the study can be seen at www.endfatigue.com.)
In addition, in April 2002 the American
Journal of Pain Management (the official
journal of the American Academy of Pain
Management—the largest organization of
pain specialists in North America) noted
“the study by Dr. Teitelbaum, et al. confirms
what years of clinical success have
shown . . . that the comprehensive and
aggressive metabolic approach to treatment
detailed in Teitelbaum’s study are all highly successful approaches and make fibromyalgia
a very treatment responsive disorder
[and] . . . makes this approach an excellent
and powerfully effective part of the standard
of practice for treatment of people who suffer
from fibromyalgia and myofascial pain
syndrome, both of which are common and
devastating.”
That the vast majority of patients
improved significantly in the active group
while there was minimal improvement in the
placebo group proves two very important
things. The first is that these are very treatable
diseases. The second is that anyone who
now says that these illnesses are not real or
are “all in your head” are clearly both wrong
and unscientific. A new day is dawning in
how CFS/fibromyalgia will be treated. It is
important to recognize that these syndromes
can be caused and perpetuated by a large
number of different triggers. When all these
different contributing/perpetuating factors
are looked for and treated effectively,
patients improve significantly and often
become vibrantly healthy.
What is causing these illnesses?
As we noted above, CFS/FMS is not a single
illness. Our study has shown that it is a mix
of many different processes that can be
triggered by many causes. What these
processes have in common is that most of
them can suppress a major control center in
the brain called the hypothalamus. This
center controls sleep, the hormonal system,
temperature and blood flow/blood pressure.
When one doesn’t sleep deeply, the immune
system also stops working properly and the
patient will be in pain. When we realized
this, the myriad symptoms seen in
CFS/fibromyalgia suddenly made sense. It
also gave us a way to effectively treat
patients.
Problems with marketing hype
Even though the natural products industry does an incredible service in advancing our
health, the amount of marketing hype often
makes it difficult to figure out which things
are most likely to help. I have found this to
be so even as a trained physician who has
reviewed many thousands of research studies
and treated thousands of CFS/fibromyalgia
patients. Because of this, and the importance
of getting clear information about effective
treatment out to those who suffer with
CFS/fibromyalgia (and even those who
simply would like more energy), I made a
decision many years ago. I decided not to
take money from any company whose products
I recommend. This also includes the
products I have personally developed. I do
this because it makes my role as a teacher
more effective.
Four main categories of problems need to be treated.
1. Disordered sleep. Most patients with
these illnesses find that they are unable to get
seven to eight hours of deep sleep a night
without assistance. In part this occurs
because the hypothalamus contains the sleep
control center. Unfortunately, most prescription
sleep medications actually aggravate
sleep problems by decreasing the amount of
time spent in deep sleep. For one to get well,
it is critical that s/he get seven to nine hours
sleep at night. Although some medications
can be helpful (these include Ambien and
Desyrel), it is best to begin with natural
remedies that can help sleep. These include
valerian, Jamaican dogwood, L-theanine, hops, wild lettuce, kava, passion flower, lemon
balm, 5-HTP, melatonin, magnesium and calcium.
It is interesting that while most of these
natural remedies are calming and help to
deepen sleep, they are not sedating and can
also be used during the day for anxiety. For
the first six months of treatment, because of
the severity of the hypothalamic sleep center
disturbance, it is not uncommon to need to
take most if not all of these different sleep aids
simultaneously to get eight hours of sleep.
Because of this I have made a natural sleep aid
(called “Revitalizing Sleep Formula”) that
combines the first six natural remedies listed
above. It will be available in health food stores
and health practitioner offices beginning
September 2002.
2 Hormonal deficiencies. The hypothalamus
is also the main control center for most of
the glands in the body. Most of the normal
ranges for our hormonal blood tests were not
developed in the context of hypothalamic
suppression and are not valid for these
syndromes. Because of this (and for a number
of other reasons) it is usually necessary, albeit
controversial, to treat with natural thyroid,
adrenal (e.g. adrenal cortical extracts and
DHEA) and ovarian and testicular hormones—
despite normal blood tests. These hormones
have been found to be reasonably safe when
used in low doses. Growth hormone has also
been shown to be helpful in fibromyalgia. We
don’t use it because, unfortunately, it can cost
over $15,000 a year and is given by injection.
Fortunately, there may be a cheaper way to
raise one’s low growth hormone. The amino
acid arginine (2–3 grams a day—do not take
this if you have oral or genital herpes) can
stimulate growth hormone production. In
addition, colostrum (which takes five months
to work) contains IGF-1—a natural hormone
that carries out the function of growth
hormone, as well as infection fighting compounds.
In addition, most growth hormone is
made during deep sleep. This may be another
reason why getting seven to nine hours of
deep sleep a night can be critical.
3. Unusual infections. Several studies have
shown immune system dysfunction in FMS/CFS
which can result in many unusual infections.
These include viral infections (e.g.— HHV-6,
CMV and EBV), parasites, Mycoplasma, Chlamydia, Lyme disease and most importantly, fungal/
yeast infections. Although the prescriptions
nystatin and Diflucan can be very helpful in
treating yeast infections, there are natural
remedies that are very effective as well. These
include (among many others):
- . Avoid sweets. Stevia can be used instead.
- . Acidophilus or other milk bacteria (3–6 million units/bacteria daily).
- . Caprylic acid (1800–3600 mg/day with meals).
- . Garlic. One clove three times a day as tolerated.
- . Oregano oil (enteric coated). One capsule two to three times a day.
- . Olive leaf extract (500 mg). Three capsules three times a day (effective against many infections).
4. Nutritional deficiencies. Because the
Western diet has been highly processed,
nutritional deficiencies are a common problem.
In addition, bowel infections can cause
poor absorption and the illness itself can cause
increased nutritional needs. The most important
nutrients include: a) Vitamins—especially
the B vitamins, vitamin B12 and antioxidants
(e.g.—vitamin C and E). b) Minerals—especially
magnesium, iron (only if blood levels are sub
optimal) and selenium. c) Essential fatty acids
(e.g. flax seed or fish oil) and d) Amino acids
(proteins). Deficiency of a critical antioxidant,
called glutathione, may be a major problem in
these syndromes and could account for most
of the symptoms. Taking it by mouth is not
effective as it gets digested in the stomach.
It can be raised inexpensively, however, by
taking NAC 500–1000 mg/day and vitamin C
(500–1000 mg/day). There are many other
nutrients that can be very helpful also.
What makes it so complicated is that there
are over 50 different nutrients that are
commonly deficient and/or essential in
CFS/fibromyalgia. To decrease the large number
of tablets needed, I have made a powder
supplement, consisting of one tablet and one
drink daily. This replaces 25 tablets of vitamin
supplements daily. By doing this I hope to
decrease dramatically the hassle and costs of
one’s taking the necessary supplements. I
suspect, in fact, that this product (called
“Daily Energy Enfusion”) is the best single
dose nutritional supplement available for anyone who wants more energy or who
suffers from chronic pain. Now you can see
why I instructed the vitamin company to give
my entire share of the profit from making
these products to charity—otherwise I know
my eyes would start to glaze over when I read
things like this.
Determining which treatments are needed
by any given individual and then teaching
them how to use them can be very difficult
and time consuming, even for doctors who are
very skilled in treating these syndromes. (A
new patient visit in my office usually takes at
least four hours of my “one-on-one” time).
Since it is often difficult to find a health care
specialist who knows how to treat these
syndromes, I’ve created a Web site (www.endfatigue.
com) that contains many tools,
including a list of over 700 health care practitioners
who treat CFS/FMS and a sophisticated
computer program that is like a computerized
CFS/FMS specialist. This program can do a
detailed analysis of one’s medical history,
symptoms and lab tests to determine which of
over 100 underlying medical problems are
contributing to one’s CFS/fibromyalgia, create
a detailed medical record of the case for
patient and health care practitioner and determine
which of over 150 treatments are most
likely to help in each case (with detailed
instructions). Most of these treatments are
natural and can be begun on one’s own.
In the last 20 years my associates and I
have had a wonderful time in our quest to
make the possibility of effective treatment
available for everyone with CFS and FMS
related problems. Finding effective treatment,
doing the research to prove its effectiveness,
writing a book that teaches people
how to get well (and their doctors how to
treat them) and creating the Web site educational
program that can help one tailor a
treatment program for a specific situation
has fulfilled this goal. You have no idea how
joyful this has made me and my associates.
Our next job is to get the word out to the
many millions of people suffering worldwide
—these illnesses are treatable. Once a
person has effectively used our protocol (or
even before), please e-mail us on our Web
site if you would like to help us get the word
out. Your help is very much appreciated.
You now have the tools you need to
get well.
Jacob E Teitelbaum, M.D. is a board-certified internist and director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies. Having suffered with and overcome these illnesses in 1975, he spent the next 25 years creating, researching and teaching about effective therapies. He treats patients from all over the world in his office in Annapolis, Maryland (410-573-5389) and lectures internationally. He is also the author of the best-selling book
From Fatigued to Fantastic! completely revised and updated August 2001. His Web site, which contains a sophisticated computer program which can analyze and create a complete medical record of a case and determine the treatments one needs to take to get well, can be found at: www.endfatigue.com
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