Disordered sleep:
Most patients with these illnesses find that they are unable to get 7-8 hours of deep sleep a night without taking medications. In part, this occurs because hypothalamic function is critical to deep sleep. Unfortunately, many of the most common sleep medications actually aggravate the sleep problems by decreasing the amount of time spent in deep sleep. For patients to get well, it is critical that they take enough of the correct sleep medications to get 8 to 9 hours sleep at night! These medications include Ambien, Desyrel, Klonopin, Xanax, Soma and, if you don't have Restless Leg Syndrome, Flexeril and/or Elavil. In addition, natural remedies can help sleep. An excellent one, Revitalizing Sleep Formula by Enzymatic Therapy includes SunTheanine, Jamaican Dogwood, wild lettuce, valerian, passionflower, and hops. Other natural sleep aids include Krebs Calcium Magnesium Chelates (1-5 at bedtime), 5-HTP (100-300mg), Kava (125-375mg-do not use if you have liver disease), and melatonin (3/10-1mg). Some patients find that over-the-counter antihistamines such as doxylamine (Unisom for sleep) or Benadryl can also help. In the first six months of treatment, it is not uncommon to sometimes need to take even six to eight different products simultaneously to get 8 hours of sleep at night. After 6-18 months of feeling well, most people can come off of most sleep (and other) medications.
Hormonal deficiencies:
The hypothalamus is the main control center for most of the glands in your body. Most of the normal ranges for our blood tests were not developed in the context of hypothalamic suppression or these syndromes. Because of this (and for a number of other reasons) it is usually necessary, albeit controversial, to treat with thyroid, adrenal (very low dose cortef; 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. Unfortunately, it can cost over $4,000 a year and is given by injection. Fortunately, there may be a cheaper way to raise your low growth hormone. Most growth hormone is made during deep sleep. This may be another reason why getting 8 to 9 hours of deep-sleep a night can be critical!
Unusual infections:
Many studies have shown immune system dysfunction in FMS/CFS. Although there are many causes of this, I suspect that poor sleep is a major contributor. The immune dysfunction can result in many unusual infections. These include viral infections (e.g. HHV-6, CMV, and EBV), parasites and other bowel infections, infections sensitive to long-term treatment with the antibiotics Cipro and Doxycycline (e.g. mycoplasma, chlamydia, Lyme’s, etc) and, most importantly, fungal/Candida infections. Although the latter is controversial, both our study and another recent placebo-controlled study found treating with an antifungal to be very helpful with the symptoms seen in these syndromes. Avoiding sweets (stevia is OK) and taking Acidophilus Pearls (healthy milk bacteria 2 pearls twice a day for 5 months) can be very helpful. We often also add prescription antifungals as well.
Nutritional supplementation:
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 (most at 25-50 mg/day), vitamin B12 (50-3000mcg/day), antioxidants (e.g. -- vitamin C and E). b) Minerals -- especially magnesium, zinc, and selenium and c) amino acids (proteins). To replace the 25 - 35 tablets that people needed to take, a good tasting product was developed that contains 50 key nutrients in 1 capsule and 1 scoop of a good tasting powder taken daily. It is called "Energy Revitalization System" by Enzymatic Therapy, and is available at health food stores .
Ribose (Corvalen)-An Exciting New Discovery!
Corvalen (D-Ribose by Valen Labs) is an outstanding new nutrient (a special sugar-even OK for those who need to avoid sugar!) for those of you who want a powerful energy boost! In addition to its role in making DNA and RNA, those of you familiar with biochemistry remember Ribose as the key building block for making energy. In fact, the main energy molecules (like "Energy dollars") in your body (ATP, FADH, etc.) are made of ribose plus B vitamins/phosphate. That makes these energy molecules similar to the paper that money is printed on- kind of like being able to print your own energy currency!
Corvalen has many uses, including treating heart muscle weakness (Congestive Heart Failure). One study reported that two thirds of CFS/Fibromyalgia patients improved, with an average increase in quality of life of ~ 25% outstanding for a single nutrient! Take 1 scoop 3 times a day for 2 weeks, then decrease to a scoop twice a day, but lower the dose or take it with food if you get hyper from being too energized. The use of Ribose (Corvalen) is a major step forward in treating fatigue with the average CFS/FMS patient in the study having a 45% improvement in energy after 2-3 weeks. In one study, pain, sleep, and "brain fog" also improved.
So can I make my pain go away?
Fibromyalgia and Myofascial Pain and associated nerve entrapments are now very responsive to treatment! In many cases, they usually will improve dramatically and often even go away if you simply get the eight hours of sleep a night I discuss above, take the vitamin powder, take thyroid hormone, and treat the underlying yeast infections. Other patients require the more thorough evaluation and treatment. Localized myofascial pain also requires an evaluation for structural causes.
Aspirin family medications (including ibuprofen) are not very effective for most Fibromyalgia and Myofascial Pain patients. I avoid Tylenol because it can markedly deplete a critical antioxidant (glutathione). Helpful natural treatments include the "Revitalizing Sleep Formula" herbal discussed above which can be used during the day for muscle pain and/or anxiety and the "End Pain" formula, an herbal remedy for inflammation and arthritis that includes Boswellia, Willow bark, and cherry. This combination can be more effective than Celebrex and Motrin and are much safer. I recommend 1-4 tablets three times a day for both herbal formulas. Although some effect can be seen immediately, improvement continues to build over six weeks. At that time, the dose can be lowered. The medications I find to be most helpful for myofascial pain include Celebrex (celecoxib) and Skelaxin (which are not sedating) and Ultram, Neurontin, and Zanaflex which can be sedating. Lidocaine patches (Lidoderm) and creams creating a mixture of medications can also be highly effective for local areas of pain without significant side effects. There are many other medications and other effective ways to treat pain as well. These can be used to help keep you comfortable while we go after the pain’s underlying causes.
