Part 3

What Your Doctor May Not Tell You About Fibromyalgia : The Revolutionary Treatment That Can Reverse The Disease
By R. Paul St. Amand, M.D., Claudia Craig Marek, M.A.

(Page 4 of 4)

To make bad matters even worse, long-term disability insurance companies have now entered the fibromyalgia fray and help to confound progress. It is to their advantage to insist that the disease and all of its variations stem from psychiatric disorders. They often have no difficulty in finding a psychiatrist who will agree. Since the vast majority of insurance policies do not cover mental disability beyond a specified time, there is a great deal of money at stake. Fibromyalgia cases have reached near epidemic proportions in the form of U.S. Social Security disability claims, workers' compensations, and accident litigation. As many as twenty-five percent of American fibromyalgia patients have received some form of disability or injury compensation. We are first to agree that the country can ill afford to swell these ranks. But we cannot turn our back on very real suffering, either.

Although there is no consensus as to the source of the disease, I postulate throughout this book, hopefully in simple enough terms, that it is caused by an abnormality in phosphate excretion. As I have already suggested, this inherited problem appears to me to be due to a genetic defect. Retention of phosphates eventually interferes with energy formation in affected cells. Patients describe their lack of energy, and cellular metabolism confirms it. If there is insufficient energy, “nothing works right” - the very complaint of the fibromyalgic. Pick a cell, any cell, from a system that bothers you, strip it of its energy, and you won't find it hard to explain why the brain, muscles, tendons, ligaments, intestine, urinary tract, and skin have joined in an act of biochemical vandalism.

Fibromyalgia is a nearly total, systemwide illness in most patients. The seemingly unconnected shifts in complaints confuses physicians, who respond by referring patients to another doctor who knows more about the “new” symptom. In the process, patients often receive a sort of medical education as they move from specialist to specialist.

Physicians are well intentioned, dedicated, and skillfully trained in trying to find ways to help their patients. I assure you that they are frequently frustrated and stymied by the difficulties fibromyalgia presents. And then, the consensus among most of my colleagues is that fibromyalgia is incurable. This makes it acceptable to relieve symptoms by reliance on medications such as NSAIDs (nonsteroidal anti-inflammatory drugs), narcotics, analgesics, and mood-altering drugs. This polypharmacy often complicates the patient's condition by further depressing the central nervous system, causing more fatigue and mental confusion. The result is that patients are even less able to control their lives than they were before treatment.

In my years as an internist and endocrinologist, I have devoted much of my career to the diagnosis and treatment of this disease. I have found that there is an effective, safe treatment for fibromyalgia, and I have used it myself. Fibromyalgia entered my own life when I was in the service in 1945. I was hospitalized with the diagnosis of “possible rheumatic fever.” All my tests were normal, though, and after six weeks my swollen muscles and joints cleared. Cycles of these symptoms were sporadic for years after that, until I was in my early thirties and they returned in earnest. Since I had no idea what was bothering me and I knew of no disease that would cause such ridiculous symptoms, I assumed I was not geared for the tribulations of having a private medical practice. I tried to pace myself and relax as best I could. It was only after I began treating patients with the disease that was later to be called fibromyalgia that I realized that I shared their misery, and began to treat myself.

Over the years I have explored the many facets of this illness mainly through observation and the compilation of data from my patient-teachers. They willingly joined me in our trial-and-error approach that lacked any other scientific credentials. It has taken many years for me to reasonably grasp the full extent of this illness and to comprehend just how insidious it can be.

I have used several different drugs to treat fibromyalgia. In the past I used exclusively gout medications and, though effective, each had certain side effects which left in limbo a small group of patients who could not tolerate them. In 1992, the continuing search led me to guaifenesin, a widely available medication. It has no known side effects, is well tolerated, and has no remaining patent and is therefore inexpensive.

I have used guaifenesin to develop a treatment protocol that addresses the actual disturbance caused by our defective genes, not merely its symptoms. This book is the culmination of nearly four decades of research. I have treated thousands of patients who have traveled from all over the world seeking relief from this enervating disease. With treatment, the symptoms and pain reverse and disappear completely in most patients. Other patients resume normal lives with minimal residual problems. This is not to say that recovery occurs immediately. Not only is it necessary to find the effective dosage of guaifenesin, there are also other crucial factors that influence the outcome of my treatment.

Briefly, in order for guaifenesin to work, it must have unrestricted access to receptors in the kidneys, the little garages where the medication must park if it is going to work. Many ingredients in the products we use every day - lipsticks, muscle balms, nutritional and herbal supplements, cosmetics, toothpastes, and sunscreens - are chemicals known as “salicylates.” These totally block the guaifenesin's access to the renal receptors where it works. When this access is blocked, none of the drugs we use are of any benefit whatsoever. Thus salicylates must be carefully avoided.

It also must be understood that approximately forty percent of female fibromyalgics have hypoglycemia, or low blood sugar, and symptoms overlap those of fibromyalgia. To be successful, treatment must address both conditions simultaneously. If this connection is overlooked and the patient fails to make the necessary dietary adjustments, the symptoms of hypoglycemia remain.

For these reasons, my protocol, as laid out in this book, should be followed very carefully in order to achieve positive results. Despite the need to watch carefully for blockers, there is no treatment currently available that is as safe or has enjoyed such a high level of success.

In succeeding chapters of this book, I will discuss all of the important factors a patient must address to successfully treat fibromyalgia, as well as share my knowledge of the disease itself. Guaifenesin is so safe that it is an ingredient in many over-the-counter cold and allergy medicines. It should be taken daily and in an appropriate dosage. Patients of any age can follow the protocol, which is designed to reverse fibromyalgia in less time than it took to develop. This book will also discuss some coping strategies. There is no question that the unrelenting nature of the disease, the cognitive losses, the fatigue, and the pains are certainly reason enough to induce depression and even suicidal thoughts. To cope with this horrible disease, patients do need more than a pill and the instructions about how to take it.

The guaifenesin approach to fibromyalgia is not well known or currently widely accepted. Since we have been unable to publish in medical journals, its fame derives entirely from grassroots support and the militancy of the patients it has helped. The list of physicians all over the country who use and support our protocol has grown to about two hundred. Many more are allowing patients to use the drug, as we constantly learn from our e-mail postings and letters from all over the world. We have spoken to hundreds of doctors who have called our office. Many more have written for information. My coauthor and I have spoken to groups in many parts of the country and have delivered our message about the success of guaifenesin to anyone who will listen. This book is, to us, merely a means to help many more people than we could ever hope to do in person. There is no doubt whatsoever that guaifenesin is highly effective as long as users exercise care in following our instructions.

To the guai army: this treatment will go forth into the world as long as we keep standing our ground. Guai works! Each time a doctor becomes convinced of the effectiveness of guaifenesin, he will spread the word to his other patients and their families. We began as a small voice crying in the night. Each day we are getting louder through the strength of our numbers. Our family grows and the world is a better place.

- Kathy Shuller, Florida

We also know that each patient must take charge of his or her own illness. Physicians will continue having difficulty coping with the many hidden sources of salicylates. It is hardly their job to walk around cosmetic counters reading labels with a magnifying glass as we have done. That task will continue to be the patient's problem. It is also the patient's responsibility to adhere to the hypoglycemia diet, if that is necessary. Cheating on the diet will harm not only you, but also affects the assessment of the doctor who is watching you for positive results - and all the other patients who rely on his or her knowledge.

The fact that you are reading this book says a lot. You are still motivated to try. You have already overpaid your dues, and we aim to help you restore your health.

I began noticeable symptoms of fibromyalgia in July 1990. . . . My symptoms began as burning on the bottoms of my feet and then within months progressed to my ankles, legs, hips, and lower back. I began to get such symptoms as headaches, muscle spasms, fatigue, and others. After seeing about twenty different doctors, no help was found, and it was said that the pain was all in my head. I was harassed into leaving my job because I had not been coming to work off and on for a year and a half. . . . Then, in July of 1993 . . . I began taking guaifenesin. . . . In the first week or two, I had had some terribly painful days. But gradually they got less and less painful and I began seeing a good day here and there. My “good” days became more and more frequent. I am currently about ninety-percent improved from using the guaifenesin treatment for four years.

- Nancy Medeiros, Escondido, CA

I invite all fibromyalgia sufferers to embark upon a journey to improved health. Let us be your tour directors. We are passionate about providing you with the information you need to regain your vitality. Realize up front that this journey is not for the faint of heart. For most of you, the road back to good health will seem long, with days of pain and discomfort. In the beginning, this may be more severe than what you have suffered to date.

Guaifenesin treatment flushes metabolic debris out of the body, and while this occurs, your pain will probably increase. Gradually you will notice that the days of pain and fatigue diminish, and good hours will eventually be followed by great days. You will bounce back again with energy after an illness, injury, or hard work, as you once did. You will be delighted that you can participate in activities with a strength that has eluded you for years. By following my treatment regimen to the letter, along with your doctor's advice, this is within your reach, and you can once again live life to its fullest. My ultimate goal is to ease the suffering and pain associated with this illness and, through this book, I hope to reach as many of you as possible with a viable and effective treatment solution. The best definition of happiness I have ever heard was: “Happiness is freedom from pain.” Wipe out mental anguish as well as physical pain, and life is a joy.

© 1999 by R. Paul St. Armand, M.D. and Claudia Craig Marek

About the Author

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 forty-three years. He is currently an assistant clinical professor at the UCLA School of Medicine. Dr. St. Amand discovered guaifenesins use as a treatment for fibromyalgia, and his work is cited wherever the substance is mentioned.

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 medical papers with Dr. St. Amand and has counseled fibromyalgia patients on the use of guaifenesin for the past seven years. She, too, is a former fibromyalgia patient, and is a leading patient advocate.