Director of the Fibromyalgia & Fatigue Centers, Inc. This is part 2 of a=
=20
3-part series written by Dr. Teitelbaum that he is releasing through his=20
newsletter and blogs. Part 3 will be released next week.]
30 TOP TIPS FOR TREATING CFS & FIBROMYALGIA WHEN ALL ELSE FAILS (PART 2 O=
F=20
3)
In part 1 of this series, I focused on the importance of rechecking the=20
basics, and I described the first 10 of my top 30 tips for treatment.
In part 2, I discuss advanced approaches for optimizing hormonal and=20
nutritional support =E2=80=94 while also making sure the basics are cover=
ed =E2=80=94 and I=20
give you my next 10 top tips for treatment!
RECHECK THE BASICS - AND THEN ADD ADVANCED THERAPIES (PART 2)
As in last week's installment, I've put an asterisk (*) next to treatment=
s=20
that are self-care/non-prescription. The other treatments require that yo=
u=20
work with your doctor. Also, as I did in Part 1, I've listed treatments t=
hat=20
require a blood test at the end of the article (a convenient summary in c=
ase=20
you want to do all those tests at one time).
HORMONAL SUPPORT
(Continuing the "30 top tips" numbering at 11, as numbers 1-10 are in Par=
t=20
1...)
11. Consider a trial of high-dose T3 thyroid hormone.
If it hasn't been tried, consider a trial of high-dose T3 thyroid hormone=
.=20
Many people with fibromyalgia are resistant to thyroid hormone =E2=80=94 =
it's as if=20
their body is "deaf" and has trouble "hearing" the hormone =E2=80=94 and =
they need=20
high levels to achieve normal function.
*12. Optimize your adrenal, Cortef, DHEA-S.
Is your adrenal functioning optimized? Probably not, if you have one or m=
ore=20
symptoms of suboptimal adrenal functioning, which include low blood=20
pressure, post-exertional fatigue, or becoming very irritable when hungry=
.=20
You can optimize adrenal function with an adrenal herbal mix, the adrenal=
=20
hormone Cortef (5 to 15 mg daily by prescription), and DHEA (if DHEA-S is=
=20
suboptimal). You should also drink more water and consumer more salt (unl=
ess=20
you have high blood pressure or heart failure).
*13. Stimulate hormone production with Pregnenolone.
Pregnenolone is the "mother hormone" =E2=80=94 the main raw material your=
body uses=20
to make other hormones, like cortisol, DHEA, estrogen, progesterone and=20
testosterone. We have found that pregnenolone is often low in CFS and=20
fibromyalgia. Have your level checked =E2=80=94 and treat if you find it'=
s=20
suboptimal.
14. Consider growth hormone injections.
IgF is a biochemical marker for growth hormone (GH) =E2=80=94 and we see =
GH=20
deficiency over and over again in fibromyalgia. If your IgF levels are=20
suboptimal, consider GH injections. (These are expensive, so this isn't a=
n=20
early choice for treatment.) In a recent study, the dose was .006 mg/kg/d=
of=20
GH, adjusted based on IgF levels. Good news: exercise, sex, and sleep als=
o=20
raise GH.
15. Oxytocin can produce quick benefits in some cases.
Oxytocin is an important hypothalamic neurotransmitter, which is shown to=
be=20
low in FMS. I suspect a deficiency is present in those with pallor and co=
ld=20
extremities. The typical dose (administered via intramuscular injection) =
is=20
10 units (add 0.2 cc lidocaine without epinephrine to minimize stinging).=
If=20
it's going to help, the benefits will begin in 45 to 60 minutes and are=20
clear cut. If the injection works, you can try a sublingual (under the=20
tongue) or nasal spray, made by a compounding pharmacy, to see if there's=
a=20
similar benefit =E2=80=94 but these forms are less effective and more exp=
ensive than=20
the injections. The injections can be used daily, or daily as needed.
1) The prescription anti-diabetes drug metformin, at 500 mg, 1 to 2 times=
=20
daily. (Metformin can cause vitamin B12 deficiency, so be sure to take a=20
good multivitamin or vitamin powder with it. Beyond that, it is an excell=
ent=20
and very safe medication.)
2) Cortef, at 10 to 20 mg a day, can also improve PCOS.
3) Cut sweets out of your diet =E2=80=94 sugar flares PCOS.
4) Some birth control pills can help regularize the menstrual cycle.
* NUTRITIONAL THERAPIES
Make sure your foundations are covered by taking a good multivitamin=20
powder =E2=80=94 I recommend the Energy Revitalization System from Enzyma=
tic=20
Therapy =E2=80=94 (1/2-1 scoop a day) plus ribose 5 gm 2-3x day. I=C3=82 =
also recommend=20
zinc (sulfate or picolinate) 25 mg a day for 3-6 months for everyone with=
=20
CFS/FMS. After 3-6 months, the zinc from a good vitamin powder should be=20
enough to maintain zinc levels.
*17. Take these additional supplements for first 3-6 months.
For 3 to 6 months, add:
1) Coenzyme Q10, 200 mg a day.
2) Acetyl L-carnitine, 1500 mg a day.
3) Iodine, 6.25 mg a day.
4) Fish oil (I recommend a special brand of fish oil called Vectomega by=20
EuroPharma; take 1 to 2 capsules a day).
5) Zinc, 25 mg a day (zinc deficiency is incredibly common in CFS and FM).
*18. Check for food allergies.
Food allergies can severely aggravate CFS/FMS. To see if food allergies a=
re=20
playing a role, go on a Multiple Food Elimination Diet. A wonderful=20
technique to treat food allergies is a specially modified form of=20
acupressure, called NAET. In addition, many food allergies settle down af=
ter=20
you provide adrenal support and treat Candida.
19. Take high-potency nutritional IVs.
These are called Standard IVs at the Fibromyalgia and Fatigue Centers (wh=
ich=20
use a special advanced formula) and Myers Cocktails in holistic practice.=
I=20
recommend taking a set of 6. (You can find the recipe for Myers Cocktails=
at=20
http://www.endfatigue.com/health_articles_f-n/IV-myers_cocktail.html)
20. Take iron.
Iron is critical for thyroid function, helping to convert T4 to active T3=
.=20
It also helps produce dopamine, a key neurotransmitter. And it helps sett=
le=20
down Restless Legs Syndrome. So be sure your iron stores are optimized. H=
ave=20
your blood ferritin (a biomarker of stored iron) level checked. If the le=
vel=20
is under 60, you should take 29 mg a day of iron, plus 100 mg vitamin C=20
(which aids absorption). Important: the so-called "normal" range for=20
"adequate" ferritin is anything over 12, which is frankly insane.
SUMMARY OF BLOOD TESTS
There are a number of blood tests used in the treatments discussed in thi=
s=20
three-part series. They are summarized below for your convenience:
* Ferritin (treatment no. 3)
* Anti-transglutaminase IgA and IgG antibody (treatment no. 7)
* Serum ammonia level (treatment no. 8)
* Fasting morning cortisol; DHEA-S (treatment no. 12)
* Pregnenolone (treatment no. 13)
* IGF-1 (treatment no. 14)
* Free and total testosterone (treatment no. 16)
Part 3 will be posted on September 21.
---------------------------------------------
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