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Fibromyalgia or Chronic Fatigue
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Related Case Studies Fibromyalgia/chronic
fatigue is a disease of exclusion. In other words, these
patients have an array of symptoms and complaints, which mimic
many illnesses. Physicians usually do very extensive workups
only to find that everything appears pretty much normal.
This disease used to be called "psychosomatic
rheumatism." I fear that many physicians still believe this
disease is simply in the patient's head. More and more
doctors, however, are beginning to realize the seriousness of
this disease and its tremendous affect on patients’ lives.
Statistics estimate there are over 8 million people in the
United States alone suffering with this disease. Eight out of
nine are women. Fibromyalgia and chronic fatigue are
considered by many to be different expressions of the same
disease. All of these patients suffer from overwhelming and
usually disabling fatigue. Fibromyalgia patients experience
total body pain, unrestful sleep, and a myriad of other
symptoms. Patients with chronic fatigue, on the other hand,
have more swollen glands, recurrent fevers, and frequent
infections.
Fibromyalgia is diagnosed by excluding
other possible diseases and then by doing tender point
testing. By eliciting tenderness in at least 11 of 18
predetermined spots, a physician is able to diagnose the
disease. Essentially all laboratory tests, X-rays, biopsies,
and MRI's will come out negative.
Chronic fatigue
patients are diagnosed by eliminating all other possible
causes of fatigue. Anyone who has suffered for more than six
months with disabling fatigue essentially has chronic fatigue.
The sad truth is that it usually takes approximately 6 to 8
years for these patients to finally be diagnosed by their
physician with one of these diseases.
Traditional
medicine has no specific treatment for these diseases. With
fibromyalgia, physicians typically place patients on a
non-steroidal anti-inflammatory for pain, amitriptyline for
sleep, perhaps a muscle relaxant and anti-depressant and then
they tell the patient to find a support group and learn to
live with it. What is even more concerning is the frequency
with which these patients are being treated with narcotic pain
medication. Now, they not only have a horrible disease but are
also hooked on narcotic pain medication.
My wife has
suffered with fibromyalgia for the past 18 years. During the
first 12 years of our marriage she needed to be in bed before
8 P.M. She never had a restful night's sleep and would get up
just as tired as when she went to bed. Living with this
illness for the past 17 years has totally changed my
perception on the seriousness of this disease. Early morning
stiffness, mental fog, muscle spasms (my massage technique has
certainly improved), fatigue, and pain were daily encounters
with which she had to learn to live.
My wife has
always joked that she thought marrying a physician would allow
her to improve her health. But I’m afraid I was not the
answer. The frustration felt by a physician when he or she is
unable to do anything for a patient cannot be overstated. And
I now realize, first-handedly, the frustration patients with
fibromyalgia and chronic fatigue have with their doctors.
When my wife was struggling with the most difficult
fatigue, she asked if she could try some nutritional
supplements given to her by a friend. For 23 years, I would do
most anything to get my patients off any kind of supplements.
However, my response to her shocked even me. I told her she
could certainly try since I had not been able to find anything
to help her through traditional medicine.
Within a week
she saw marked improvement and within three weeks she was back
to her normal self and off all medications. Over the next year
she not only totally recovered, but felt more energetic than
she had in years. She has added three to four hours to each of
her days. She has significantly less pain and fewer muscle
spasms, and her energy level has now surpassed mine.
Obviously this caught my attention. Her recovery
challenged me to try to understand what had happened. This was
the beginning of my newly found interest in nutritional
supplements.
Shortly after this experience, I read a
book by Kenneth Cooper, M.D., called "The Antioxidant
Revolution." I have always admired Dr. Cooper, who started the
exercise revolution back in the early 1970s. I became so
intrigued with his book I researched his research. One part of
the book especially caught my attention: at his aerobics
clinic in Dallas, Dr. Cooper evaluated several athletes
suffering from over-training syndrome. His theory was that
oxidative stress was the cause.
When people exercise
moderately the body is able to handle the amount of free
radicals produced. However, in cases of excessive exercise as
in the training of professional athletes, the amount of free
radicals goes up exponentially. It struck me that these
athletes with over-training syndrome had the same symptoms as
patients with fibromyalgia and chronic fatigue syndrome. I was
baffled and wondered, Could it be possible that the root
cause of fibromyalgia /chronic fatigue is oxidative
stress?
As we learn more and more about how
oxidative stress can cause degenerative diseases, one has to
wonder if this is the cause of the fibromyalgia/chronic
fatigue syndromes. These syndromes are not high on the totem
pole for research dollars. I have been unable to find any
significant studies that have considered this as a
possibility. I am hopeful more funds will be allocated toward
these disabling diseases in the future.
For the past
six years, I have been evaluating and treating a group of
patients with the belief that the underlying cause is
oxidative stress. Since these diseases are able to mimic many
other diseases, I must first rule all other possibilities out.
I then place these patients on a complete and balanced
nutritional supplement program.
I have observed a
fairly consistent pattern of improvement in my patients. The
most common response I get at the two-month follow-up exam is
their thinking and focus is significantly improved. They feel
they have come out of a mental fog. At the four-month exam,
they are usually sleeping better and noticing some improvement
in their energy level. The last things to improve are the
pain, fever, and frequent infections. The decrease of
infections and fevers is evidence that one’s immune system is
definitely improving. Many of my patients comment, “I actually
have my life back!”
I have now been involved with over
500 patients with fibromyalgia and chronic fatigue and have
been able to achieve good to excellent results in over 70 to
75% of these patients. By bringing oxidative stress back under
control, their disease has been captured.
The majority
will have significant improvement while using high-quality,
complete and balanced nutritional supplements along with
necessary optimizers. I have found that the optimizers must be
varied or increased depending on the initial response of the
patient or the severity of one’s disease. It often takes six
months for these patients to be convinced of their improvement
and they may still not be fully recovered at that point—but
they know they are on the right track.
Once I see a
significant clinical response, I keep my patients at that
level of optimizer (in this case, Grape Seed Extract) for
another two to three months. I then slowly start to back off
the level of grape seed extract until the patient reaches what
I call a maintenance level. If she becomes worse for any
reason while pulling back the amount, I move her to a higher
level again until she begins improving. Economically, it’s
best to use the least amount of grape seed extract necessary
in maintaining the patient's improvement. Patients usually
continue to improve even at lower levels once oxidative stress
has been brought back under control.
Patients with
fibromyalgia /chronic fatigue have flare-ups and remissions.
Therefore, I advise my patients who have had a great response
and are now on a maintenance nutritional program that they
will have flare-ups and some difficult days. When this
happens, I simply have them increase the amount of
antioxidants and grape seed extract they are taking. They may
need to stay at this increased level of antioxidants for 10 to
14 days or until they are feeling better, and then they slowly
drop back to the maintenance level again.
Everyone
needs to review the web page on "Oxidative
Stress" to learn what factors increase the amount of free
radicals produced by the body. Patients do best who’ve learned
to anticipate situations that cause more oxidative stress.
This may include a highly stressful situation, a vigorous work
out, or even exposure to an increased amount of toxins which
otherwise cannot be avoided. By increasing the amount of
antioxidants before a potential setback, it allows the patient
a jumpstart and the possibility of even avoid the setback
altogether.
Nutritional Supplement Recommendations
I recommend that all my patients take the basic nutritional
support I refer to as cellular
nutrition. This foundational regime provides all the
necessary micronutrients to the cell at ideal levels (not RDA
levels) for significant health benefits as documented in the
medical literature. When the cell is given maximum support, it
can then determine what it does and does not need. Over a
six-month period each cell is able to not only overcome
nutritional deficiencies but also to optimize
ALL the nutrients, which are needed to combat oxidative
stress.
The synergistic affect of providing all the nutrients
needed by one’s body at the most advantageous levels results
in optimizing and rebuilding the body’s natural immune system,
antioxidant, and repair systems back to their fullest fighting
potential against disease.
Minimal support for Cellular
Nutrition:
My minimal recommendation for creating cellular
nutrition is to simply take Usana’s Mega Antioxidant and
Chelated Minerals, called "The Essentials" at their
recommended doses (3 of each daily). The Essentials offers the
cell ALL of the antioxidants, B-cofactors, and antioxidant
minerals needed by the cell at ideal levels. In order to
achieve the best results, I recommend taking 1 Mega
Antioxidant and 1 Chelated Mineral with each meal.
Nutritionals should always be taken with food because of
better absorption and better tolerance. However, as a
physician, I realize that compliance with taking supplements
three times a day is a major issue. Therefore, if you tend to
frequently forget the lunchtime dose, I suggest taking the
supplements twice daily: taking 2 Mega Antioxidants and 1
Chelated Mineral in the morning with breakfast and 1 Mega
Antioxidant and 2 Chelated Minerals in the evening with the
evening meal.
Optimal support for Cellular
Nutrition:
For the most favorable results for basic cellular
nutrition, I also recommend adding to the Usana Essentials
either OptOmega (2 tsps daily) or BiOmega-3 (4 capsules
daily), which provides the essential fats and Fibergy, which
assures the individual is receiving the additional fiber his
or her body needs. I also recommend adding Active Calcium (4
tablets daily) to provide additional calcium, magnesium, and
vitamin D that our bodies need. These recommendations provide
all the nutrients at their ideal levels creating the cellular
nutrition I recommend in my book, What Your Doctor Doesn’t
Know About Nutritional Medicine May Be Killing You.
Optimizers
It is critical that you know the necessity of adding
optimizers to your foundational cellular nutrition for optimal
results. Patients who are suffering from a chronic
degenerative disease or illness are under more oxidative
stress than the average healthy individual. Therefore, adding
potent Optimizers to the basic cellular nutrition offers you
the best chance to bring this oxidative stress back under
control. The synergy and increased potency created by this
approach to nutritional medicine is why I’m able to get such
consistent results in my patients.
However, to suit each individual’s unique needs, I always
offer both an optimal and a minimal plan for cellular
nutrition and for adding Optimizers. Obviously, one’s
improvement will be quicker and more consistent with the
optimal recommendations; however, a minimal regime can still
produce significant clinical results. Recommended
Optimizers: Optimal:
- Proflavanol 90*--3 tablets daily
- Coquinone 30—2 capsules daily
Minimal:
- Proflavanol 90*--2 tablets daily
*Proflavanol 90 is equal to 3 Proflavanol C
Optimal Recommendations
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Active
Calcium |
1 |
1 |
2 |
| Proflavanol
90 |
1 |
1 |
1 |
| Coquinone
30 |
1 |
|
1 |
| Optomega |
2
tsps |
|
|
| Biomega-3 (an
option instead of Optomega) |
1 |
1 |
2 |
*Adding at least one serving of
Fibergy daily will enhance these
recommendations.
Minimal Recommendation
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Proflavanol
90 |
1 |
|
1 |
If you are frequently going to miss taking your lunchtime
dose, it is better to simply take your nutritionals twice
daily. I recommend taking 2 Mega Antioxidants, 1 Chelated
Mineral in the morning with breakfast and then taking 1 Mega
Antioxidant, 2 Chelated Minerals in the evening. You should
try to divide up your Active Calcium, essential fats, and
Optimizers equally as possible between the AM and PM
dose.
Consider a Power Shake
USANA has a fantastic line of nutritionally balanced drinks
that many of my patients consume as a meal substitute. In
fact, I personally start every morning with 2 scoops of
Fibergy, 2 scoops of Soyomax, and 2 teaspoonfuls of OptOmega.
This provides me with a perfect, balanced, unpolluted meal to
start my day. It allows me the opportunity to supplement my
diet with soy protein; extra needed fiber, and essential fat.
This meal is also a low-glycemic meal, which will not spike my
blood sugar. Likewise, many USANA associates are using their
imaginations to create exceptionally tasting meals with
Fibergy and OptOmega. By blending in frozen, whole fruit for
added flavor they are creating a variety of great tasting
drinks.
Isn’t it remarkable that by simply taking USANA Essentials,
Active Calcium and a power drink (remember, to consider this
part of your food budget, since it is replacing an entire
meal), the body is supplied with complete, and balanced cellular
nutrition for every cell in the body? The synergy that is
created, especially when adding needed Optimizers is
phenomenal. Remember, the underlying problem is oxidative
stress NOT a nutritional deficiency.
Why I recommend USANA Products
USANA strictly follows pharmaceutical-grade Good
Manufacturing Practices (GMP). This means they not only
purchase pharmaceutical-grade raw products, but also
manufacture the products according to tough
pharmaceutical-quality guidelines. In addition, USANA Health
Sciences follows USP guidelines for potency, uniformity, and
dissolution of the tablet. In a nutshell, USANA manufactures
their products to the strict standards of over-the-counter
drugs even though not required to do so—assuring all of their
customers and associates that what is on the label is actually
in the tablet.
Usana's essentials are complete and balanced and provides
the cellular nutrition that I strongly recommend in my book,
What Your Doctor Doesn't Know About Nutritional Medicine May
Be Killing You. This improves compliance and makes taking
these advanced levels of nutritional supplements
easier.
Starting Your USANA Nutritional Program
Over eighty percent of my patients are able to start the
USANA Nutritional Program with absolutely no set backs while
beginning to experience the health benefits of high-quality
nutritional supplements immediately. Please keep in mind these
supplements are extremely potent and optimal levels of
nutrients are being provided that the body has never had
before. The body is therefore able to finally rid itself of
toxins, which have been accumulating for years (called
detoxification). This is especially true in those who are
suffering from a serious illness and are taking a significant
amount of medication. It is important to understand the
possible signs and symptoms of detoxification so that you can
deal with them confidently and properly.
Detoxification:
The most common detoxification reaction is muscle aches
and/or mild headache. These symptoms will usually pass within
a few weeks. If the discomfort is not unbearable, I simply
have my patients continue their program as I have prescribed.
However, occasionally there is a more severe reaction. The
patient is not in danger, rather, the amounts of nutrients are
just too much too fast. In this case, I have my patients quit
their supplements for a few days until the reaction subsides.
I will then have them start back on their program but
initially at lower doses (approximately one third of the
recommended dose). Once they are tolerating this amount of
supplementation, I suggest slowly building up to the
recommended doses.
Some of my patients actually develop a "detox" skin rash
somewhere on their body. As you know, the skin is an important
route for ridding the body’s toxins. This rash is a dry, red
rash that looks almost like a mild sunburn. Some people
confuse this with an allergic reaction to the supplements.
This is not typically so. I have never seen an allergic
reaction to the USANA Essentials and can only recall a couple
of patients who reacted to Proflavanol because they were
actually allergic to grapes.
Patients may also experience some aspect of loose stools or
even diarrhea. This again is a common "detox" reaction because
the GI tract is another prime route for eliminating toxins
from the body. This symptom will usually diminish within a
couple of weeks. It is an important part of the detoxification
and healing process. Therefore, I usually encourage my
patients to continue the supplements as recommended unless
their bottom gets too sore. I will then again recommend lower
doses of the supplements until they feel better and then begin
adding the supplements back more slowly until the recommended
doses are reached. Diarrhea can be the result of the magnesium
in the Active Calcium or by the Proflavanol. Again, this is
usually a mild reaction and will improve over the first week
or two. However, some of my patients need to discontinue the
Active Calcium and/or the Proflavanol until this settles down.
I then have them slowly add back the Proflavanol and
eventually the Active Calcium.
Increasing dietary fiber may also increase the amount of
intestinal gas and the frequency of bowel movements. This will
improve with time as the body adjusts to the higher intake of
fiber, but is an important aspect of getting rid of the
toxins, which have accumulated in the body.
Natural Relaxation Response:
A small percentage of patients develop a natural relaxation
response when minerals are absorbed into their body. This is
of great concern to those patients who have just been told
that nutritional supplementation will help improve their
energy level. They take the supplements as recommended only to
find themselves more fatigued and dragging themselves through
their day. If you experience this response, I recommend that
you take all of your minerals (including the Active Calcium)
with a light bedtime snack. This allows you to take advantage
of your body’s response while getting a good night’s
sleep.
Stomach Upset:
A small percentage of patients have difficulty tolerating
vitamin C. It can cause an upset stomach that will usually
become evident a couple days after starting their nutritional
program. With USANA’s specially combined vitamin C into Poly
C, I have seen many of people who could not previously
tolerate any nutritional supplements do very well with USANA’s
Mega Antioxidant. However, if nausea is experienced, I suggest
taking one Mega Antioxidant with the largest meal. Once this
level of supplementation is better tolerated, I suggest slowly
adding another Mega Antioxidant to the next largest meal. I
anticipate building them up to the recommended level of
supplementation, but sometimes this is just not possible. For
those extremely sensitive, I advise using Body Rox (the
teenage dose of Antioxidants and Minerals) as the best
alternative option.
Taking Your Supplements with Your Medication
I am often asked, "Can I take my nutritionals with my
medication?" To this I respond with this question, "Can you
eat?" I hope my point is made gently but clearly—nutritional
supplements simply contain nutrients we should be getting from
our foods, but at levels we can no longer obtain from our
foods. If you can eat anything, you can also take nutritional
supplements. The only exception to this is for those taking
the medication, Coumadin (Warfarin), which blocks vitamin K in
the body as a way of thinning the blood. If a patient is on
Coumadin, I recommend he or she take the Canadian Essentials
and Canadian Active Calcium because they contain no vitamin K.
Also, patients who are on thyroid medication should take their
medication on an empty stomach at least 1 hour prior to meals
or prior to taking supplements. Thyroid medication should not
be taken with food or with supplements because calcium can
block the absorption of the medication.
Disclaimer
Every effort has been made to make this web site as
accurate as possible. The purpose of this site is to educate
and inform. As such it is based on scientific evidence and my
clinical training and experience. No individual should at any
time use the information found on this web site for
self-diagnosis, treatment, or justification in accepting or
declining any medical therapy for any health problems or
diseases. Any application of the advice herein is at the
reader’s own discretion and risk. Therefore, any individual
who has a specific health problem or is taking medications
must first seek advice from his or her personal physician or
healthcare provider before starting a nutritional supplement
program. Dr. Strand shall have neither liability nor
responsibility to any person or entity with respect to loss,
damage, or injury caused or alleged to be caused directly or
indirectly by the information contained in this web site. We
assume no responsibility for errors, inaccuracies, omissions,
or any inconsistency herein. Any slights of people, places, or
organizations are unintentional.
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© 1999, 2000, 2001,
2002, 2003, 2004 Ray D Strand, M.D. P.C.
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