Part 2 of a 3-Part Series
In part 1 of this series, I focused on the importance of rechecking the basics, and I described the first 10 of my top 30 tips for addressing CFS and fibromyalgia.
In part 2, I discuss advanced approaches for optimizing hormonal and nutritional support — while also making sure the basics are covered — and I give you my next 10 top tips for addressing CFS and fibromyalgia!
As in last week's installment, I've put an asterisk (*) next to remedies that are self-care/non-prescription. The other options require that you work with your doctor. Also, as I did in Part 1, I've listed remedies that require a blood test at the end of the article (a convenient summary in case you want to do all those tests at one time).
(Continuing the "30 top tips" numbering at 11, as numbers 1-10 are in Part 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. Many people with fibromyalgia are resistant to thyroid hormone — it's as if their body is "deaf" and has trouble "hearing" the hormone — and they need high levels to achieve normal function.
*12. Optimize your adrenals with an herbal adrenal-support supplement, Cortef, DHEA-S.
Is your adrenal functioning optimized? Probably not, if you have one or more symptoms of suboptimal adrenal functioning, which include low blood pressure, post-exertional fatigue, or becoming very irritable when hungry. You can optimize adrenal function with the an herbal adrenal-support supplement, the adrenal hormone Cortef (5 to 15 mg daily by prescription), and DHEA (if DHEA-S is suboptimal). You should also drink more water and consumer more salt (unless you have high blood pressure or heart failure).
*13. Stimulate hormone production with Pregnenolone.
Pregnenolone is the "mother hormone" — the main raw material your body uses to make other hormones, like cortisol, DHEA, estrogen, progesterone, and testosterone. We have found that pregnenolone is often low in CFS and fibromyalgia. Have your level checked — and address if you find it's suboptimal.
14. Consider growth hormone injections.
IgF is a biochemical marker for growth hormone (GH) — and we see GH deficiency over and over again in fibromyalgia. If your IgF levels are suboptimal, consider GH injections. (These are expensive, so this isn't an early choice.) In a recent study, the dose was .006 mg/kg/d of GH, adjusted based on IgF levels. The good news is that exercise, sex, and sleep also raise GH. (For more information on fibromyalgia and growth hormone, see "Growth Hormone Treatment Helpful in Fibromyalgia.")
15. Oxytocin can produce quick benefits in some cases.
Oxytocin is an important hypothalamic neurotransmitter, which is shown to be low in FMS. I suspect a deficiency is present in those with pallor and cold extremities. The typical dose (administered via intramuscular injection) is 10 units (add 0.2 cc lidocaine with epinephrine to minimize stinging). If it's going to help, the benefits will begin in 45 to 60 minutes and are clear cut. If the injection works, you can try a sublingual (under the tongue) or nasal spray, made by a compounding pharmacy, to see if there's a similar benefit — but these forms are less effective and more expensive than the injections. The injections can be used daily, or daily as needed.
16. In women, look for PCOS (Polycystic Ovary Syndrome).
Ten percent of American women have PCOS — a condition characterized by high blood levels of testosterone and DHEA associated with insulin resistance (blood sugar problems). The symptoms can include acne, increased facial hair, irregular periods, and infertility. If those symptoms are present along with an elevated testosterone and DHEA level, and a fasting insulin blood level over 10, you might have PCOS triggering your CFS/FMS. Addressing the issue consists of:
- The prescription anti-diabetes drug metformin, at 500 mg, 1 to 2 times daily. Metformin can cause vitamin B12 deficiency, so be sure to take a good multivitamin powder with it. Beyond that, it is an excellent and very safe medication.
- Cortef, at 10 to 20 mg a day, can also improve PCOS.
- Cut sweets out of your diet — sugar flares PCOS.
- Some birth control pills can help regularize the menstrual cycle.
Make sure your foundations are covered by taking a good multivitamin powder, plus ribose 5 gm 2-3x day. I also recommend zinc (sulfate or picolinate) 25 mg a day for 3-6 months for everyone with CFS/FMS. After 3-6 months, the zinc in the vitamin powder is enough to maintain zinc levels. At a few cents a day, it offers remarkable immune benefits at very low cost.
*17. Take these additional supplements for first 3-6 months.
For 3 to 6 months, add:
- Coenzyme Q10, 200 mg a day.
- Acetyl L-carnitine, 1500 mg a day.
- Iodine, 6.25 mg a day.
- A high-efficiency fish-oil supplement (for Omega-3)
- Zinc, 25 mg a day (zinc deficiency is incredibly common in CFS and FM. See Zinc Makes You Smile — Literally! to learn more about this mineral).
*18. Check for food allergies.
Food allergies can severely aggravate CFS/FMS. To see if food allergies are playing a role, go on a Multiple Food Elimination Diet. A wonderful technique to address food allergies is a specially modified form of acupressure, called NAET. (For more information, and a list of the over 10,000 practitioners worldwide, visit the NAET website.) In addition, many food allergies settle down after you provide adrenal support and address Candida.
19. Take high-potency nutritional IVs.
These are called Myers Cocktails in holistic practice. I recommend taking a set of 6. You can find the recipe for Myers Cocktails in From Fatigued to Fantastic!
20. Take iron.
Iron is critical for thyroid function, helping to convert T4 to active T3. It also helps produce dopamine, a key neurotransmitter. And it helps settle down Restless Legs Syndrome. So be sure your iron stores are optimized. Ask your doctor to check your blood ferritin (a biomarker of stored iron) level. If the level is under 60, you should take 29 mg a day of iron, plus 100 mg vitamin C (which aids absorption). Important: the so-called "normal" range for "adequate" ferritin is anything over 12, which is frankly insane.
Summary of Blood Tests
There are a number of blood tests used in the remedies discussed in this three-part series. They are summarized below for your convenience:
- Ferritin (no. 3)
- Anti-transglutaminase IgA and IgG antibody (no. 7)
- Serum ammonia level (no. 8)
- Fasting morning cortisol; DHEA-S (no. 12)
- Pregnenolone (no. 13)
- IGF-1 (no. 14)
- Free and total testosterone (no. 16)
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of four research studies on their treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.