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There are many theories about what causes fibromyalgia /chronic fatigue. There is a doctor who thinks it is caused by a deficiency of vitamin D and one who thinks it is caused by too much vitamin D. There is one who thinks it is caused by a thyroid deficiency and some who think it is triggered by infection. Some suggest that it is just an over-sensitivity to pain signals in the brain. Others blame flouride, inflammatory foods or toxins in the environment or stress hormones or lack of deep sleep. There may be merit in these theories, and they are not all mutually exclusive.

Most of the conventional treatments for FMS/CF just deal with symptoms, and not very effectively at that. They have no effect on the cause and no possibility of correcting the problem or preventing its progression. Dr. St. Amand has dedicated his career to the study and treatment of this misunderstood disease. He believes that all the symptoms of FMS result from one genetic defect which, if untreated, eventually leads to osteoarthritis.

I don’t pretend to be an expert; I just plan to see what works for me and report on my experience.

Dr. St. Amand’s guaifenesin protocol has three main parts:

1. You must discover your correct dose. You start low and increase the amount in timed increments until it starts to work. When you start to feel dramatically worse, you know you have reached the proper dosage to start reversal. Dr. St. Amand’s warns that the treatment is not easy. Some liken it to having a bad case of the flu. The time it takes to get through the reversal process depends on how long you have had the condition. It may take as long as two months for every year that you have had symptoms. That works out to a formidable 22 months for me, but I’m hoping that since that estimate is a worse case scenario, it won’t really take that long. Good days are supposed to be interspersed with the bad ones until the bad days diminish and disappear.

2. Another important part of the system is that you must avoid any topical substance that contains salicylates. We are most familiar with salicylates in aspirin, but all plants contain them. Salicylates preferentially bind to the same receptors as guaifenesin and block its absorption, so all products that list plant oils, gels, or extracts (except for wheat, oats, rice, soy, and corn) must be eliminated. There is no problem with eating salicylate-containing plants; it is only products that will stay in contact with the skin that block quaifenesin. It is better to be safe and eliminate them all than to risk negating the treatment. Herbal supplements must also be avoided, since they are taken in greater quantities than what is naturally found in food. Rather than learn all the chemical names and scrutinize every label, I just bought the minimum daily necessities from a store that specializes in salicylate-free products. It may actually save me a lot of money in the long run since I stopped using some expensive cosmetics, lotions, and creams and replaced them with much simpler products.

Some critics of the protocol say that it is too difficult to follow and that no one could possibly do it correctly. I’m baffled by this complaint—how could anyone believe eliminating some toiletries and giving up herbal supplements could be worse than living with fibromyalgia and chronic fatigue? I can only think that perhaps fibro fog has addled their brains and affected their judgment.

3. The third layer of the protocol is diet, although this part does not apply to everyone, only to those who have hypoglycemia (estimated to be 40%). Dr. St. Amand tells his patients that if they have hypoglycemia, they must deal with it or they will not get better. He has two diets; both are low carb, one strict and one liberal. In my opinion, reducing sugar and starch is something we all need to do anyway and it is not really difficult. You just have to decide to do it and make the effort to find good food that you enjoy so you don’t feel deprived. I’ve been eating a diet similar to the strict one for eight years and it has become second nature.

If, as some allege, it is the low-carb diet that is responsible for Dr. St. Amand’s success—I’ve been there; done that. It changed my life for the better, and I will never go back to my old sugar-junkie habits—but I still have FMS. I’ve also tried a lot of other things; some of you probably have as well. If I were susceptible to the placebo effect, surely some of them would have worked.

I started the guaifenesin protocol about 6 weeks ago. I progressed from a dose of 600 mgs per day to 1200 and then increased up to 1800 with no results. I will stay at 1800 for two months and then go up to 2400 if nothing changes. It is a strange situation to be hoping to wake up in misery in order to know that the system is going to work. I’m not looking forward to being more tired or in more pain, but if there is a chance that this will work, there is no way I’m not going to try it. The choice is to do nothing and continue to suffer or to suffer with a purpose and with the hope of getting better. That is an easy decision.

R. Paul St. Amand, M.D., is a graduate of Tufts University School of Medicine. He has been on the teaching staff at the Los Angeles Harbor/UCLA Hospital, Department of Endocrinology for over fifty years. He is currently an assistant clinical professor at the UCLA School of Medicine.

Claudia Craig Marek, M.A., is a medical researcher tutored, trained, and taught on the job as Dr. St. Amand’s assistant. She has co-written three books with Dr. St. Amand and one of her own.

Dr. St. Amand’s and Claudia Marek’s books are available from the Fibromyalgia Treatment Center at http://www.fibromyalgiatreatment.com/ or from Amazon.com at the links below:
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