Note from Nancy:  My approach to healing is integrative in nature, where mind-body-spirit intersect in such an intertwined way that true transformation and healing cannot really be realized without attending to all levels. In that context, I offer other experts’ experience and skills in areas which address those that are outside my own expertise.

The article below is written by Dr. Jacob Teitelbaum, a board certified internist who has been in the forefront of treating fibromalygia and CFS for over 40 years. What is unique and so valuable about Dr.Teitelbaum is that he himself has walked this path of chronic illness, and like me, has combined his personal journey with his professional expertise. Dr. T offers us an invaluable perspective and directions on how to deal with the physical level of healing.

I’m delighted to share this article written by Dr. T, and hope you find it a useful and complimentary path to my approach. I have incorporated his suggestions into my own physical management and can vouch for its’ effectiveness!

Effective Treatment For Chronic Fatigue, Fibromyalgia and Muscle Pain

By Jacob Teitelbaum M.D. (Guest Contributor)

Ready to Get Well?

Our study titled "Effective Treatment of CFS and Fibromyalgia"(Journal of CFS-see full text at www.endfatigue.com) showed that over 90 percent of patients improved with treatment (p<. 0001 vs. placebo), with an average improvement in quality of life of 90 percent. Many patients no longer even qualified for the diagnosis of CFS or fibromyalgia after treatment! In support of our work, an editorial in the Journal of the American Academy of Pain Management (the largest multidisciplinary society of pain specialists in United States) noted " the comprehensive and aggressive metabolic approach to treatment detailed in the Teitelbaum study are all highly successful approaches and make fibromyalgia a very treatment responsive disorder.  The study by Dr. Teitelbaum et al. and years of clinical experience make 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”. These same principles work wonderfully for optimizing energy in those with day to day fatigue. Dr. Oz has also repeatedly invited us to present our work on Oprah and Friends.

What is causing these syndromes?

CFS/FMS acts as a “circuit breaker”, with the hypothalamus decreasing its function to protect the individual in the face of what is perceived to be an overwhelming stress (just like blowing a fuse/circuit breaker in a house). This center controls sleep, hormones, temperature, and blood flow / blood pressure/sweating. In addition, if your muscles do not have enough energy, they will get stuck in the shortened position and you’ll be in pain (think rigor mortis).  This “Energy Crisis” can be caused by any of a number of infections, stresses, or injuries.
 
Five main categories of problems need to be treated- Think “SHINE”!

These are the 5 key areas that need to be treated for your ‘circuit breaker to turn back on’ and for fatigue and pain to resolve:

1. Sleep. Because the hypothalamic “circuit breaker” that is offline controls sleep, most patients need a mix of natural and prescription sleep treatments.  For you to get well and pain free it is critical that you take enough of the correct natural & prescription sleep treatments to get 8 to 9 hours sleep at night!  I prefer to start with natural therapies.  An excellent one (which I developed –‘Revitalizing Sleep Formula’ by Enzymatic Therapy -- 100 percent of my royalties for all products I develop are donated to charity) includes theanine, Jamaican Dogwood, wild lettuce, valerian, passionflower, and hops. Take 1-4 capsules 1 hour before bedtime. Another excellent verbal mix is called Terrific ZZZZ by EuroPharma). Ambien, trazodone, and other specific sleep aids that improve deep sleep can also help.

2. Hormonal deficiencies.  The hypothalamus is the main control center, via the pituitary, for most of the glands in the 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 to treat with natural thyroid, adrenal (e.g.-glandulars such as Adrenal Stress End or Adrenaplex & DHEA), and bioidentical ovarian and testicular hormones -- despite normal blood tests!  These hormones have been found to be reasonably safe when used in low doses. 

Low thyroid, which reflects as fatigue, weight gain, cold intolerance and even unexplained infertility is especially common, and the majority of those who benefit from thyroid have NORMAL lab tests, so a treatment trial should be given (using natural thyroid hormones) if symptoms are suggestive.

3. Infections.  Many studies have shown immune system dysfunction in FMS/CFS, which can result in many unusual infections. These include viral infections, parasites and other bowel infections, antibiotic sensitive infections and, most importantly fungal/Candida infections. 

4. Nutritional supplementation.  Widespread nutritional deficiencies are common, and require dozens of nutrients. As people are tired of being part of the “Handful Club” (taking handfuls of supplement tablets each day), I developed a product that contains 50 key nutrients in 1 capsule and ½-1 scoop of powder taken daily (as a good tasting drink). Called the “Energy Revitalization System” by Enzymatic Therapy, it replaces well over 35 supplement tablets with 1 drink. Add Ribose (SHINE ribose on www.endfatigue.com this) 5 gm (1 scoop) 3-x day for 3 weeks, then twice a day to powerfully jump-start your energy. In two of our published studies, ribose increased energy and average of 61% after three weeks.

5. Exercise as able. Do not push to the point of crashing the next day. Start by walking as long as you comfortably can (even if that is only 2 minutes). After 10 weeks on treatment, start to increase your walks by up to 1 minute more each day as able. When you are up to an hour of walking, you can increase intensity.

Another important factor to address, especially in the most severe cases, is orthostatic intolerance. This is when your blood rushes to your legs when you stand up, and stays there. It is often associated with some of the most severe cases of fibromyalgia, and is a major treatable contributor to the illness.

You don’t need to do a $2000 tilt table test to see if this is an issue. A simple one-minute quiz from the Mayo Clinic Journal can tell you whether NMH, POTS, or other forms of orthostatic intolerance are present. If you would like a copy of this quiz, email me at FatigueDoc@gmail.com . The quiz I will send you also has a link to a detailed article on treating this.

When this is present, simple treatments such as increasing salt and water intake, and wearing thigh-high medium pressure (20 – 30 mm) compression stockings when up and about can dramatically improve function – along with a half-dozen other treatments for orthostatic intolerance
     
We wish you all of God’s blessings and our best wishes in your healing!

Jacob E Teitelbaum MD

Resources:

1. To find a holistic physician who it is more likely to know how to get you well: www.ABIHM.org  . We also consult (often by phone) with people worldwide. For information, email Sarah at appointments@EndFatigue.com
2. for numerous articles on fibromyalgia, see www.EndFatigue.com
3. the free Energy Analysis Program can analyze your symptoms and even pertinent lab tests to determine what is contributing to your energy crisis and how to effectively treat it. It applies the SHINE protocol principles discussed above (www.energyanalysisprogram.com )

Dr. Teitelbaum is a board certified internist.  Having suffered with and overcome these illnesses in 1975, he spent the next 40 years creating, researching, and teaching about effective therapies for fatigue and pain. His goal is simple. Make effective treatment available for everyone with fibromyalgia.

He is the senior author of the landmark studies "Effective Treatment of Chronic Fatigue Syndrome and Fibromyalgia -- a Placebo-controlled Study" & “Effective Treatment of CFS & Fibromyalgia with D-Ribose”.
 
He lectures internationally.  He is also the author of the best-selling book” From Fatigued to Fantastic!” which is like a medical textbook on the illness, the “Fatigue and Fibromyalgia Solution” (Easy Reading), the popular Free Smart Phone App “ Cures A-Z” and “Pain Free 1-2-3- A Proven Program to Get YOU Pain Free! “(McGraw Hill 2006)  His web site can be found at:www.EndFatigue.com.