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How Guai Works on FMS
Dr R. Paul St Amand
(for the Guai-Support Network)
Guaifenesin is 100% absorbed
within about one to two hours after ingestion. Its action in fibromyalgia is merely one
that permits kidneys to rid themselves of excessively-accumulated, normal body
constituents. The drug has no listed side-effects and is marketed expressly to help the
body clear itself of mucus. The benefits to fibromyalgia are merely those we have
found.
I postulate that the offending
lesions are made that way because of an excess accumulation of phosphates. Lesser excesses
of oxalates and calcium are also on the suspect list.
Some genetic defect
causes us to
retain phosphates to a level that eventually blocks the formation of energy in cells
(ATP). The body seems to know the safest places to allow these deposits for protection of
more vital organs.
When substances rise too high
in the body, fluid pours into that site trying to dilute the offender to equal levels in
adjacent tissues. It is excess water accumulation, under pressure, that causes pain,
lumps/bumps we feel in FM. In fact, 90 to 95% of the swelling is merely water. This water
dilutes the ions to levels sufficient to permit cell survival but at the cost of normal
function.
Calcium is also drawn in to
accompany phosphate. Excess calcium, free in cellular fluid stimulates it to over-perform
pushing its normal function to excess. Unfortunately the cell cannot quit trying as long
as calcium is sitting in the wrong place, out of its storage bin. Think of all the cells
that are affected in FM; each is under the same duress.
Fibromyalgia as I see it, is
due to continuously overworking cells that deplete themselves of ATP, the currency of
energy, which is already in short supply. I think excess phosphate entering mitochondria
blocks ATP formation to begin the entire process.
During reversal, more fluid
enters the cell to finish the incompleted dilution. This causes further swelling and
temporary malfunction such as in the brain or muscle, tendon and ligament spasms yielding
pain. As a major area is being purged and this fluid draws out of cells along with the
excess phosphate, oxalates and calcium, the flow into the bloodstream is such as to exceed
the kidney's ability to purge. This allows the symptoms of reversal to last a few days
until the kidneys catch up, cleanse this batch and end the cycle.
At this point, a "rest
period" is possible allowing for better hours, days or weeks. The process with
guaifenesin reversal is probably continuing but at a subliminal level until the next,
perceptible crescendo begins. Tiny spurts of undesired accumulations become a flow and,
again, another debilitating cycle is underway. Each such cycle means one less in steps
nearer to good health.
This is but a partial and
simplistic explanation of far more complex biochemistry and ionic moves that are quite
likely occurring in cells. Most important however is to remember that fibromyalgia is
induced by an abnormality that ultimately strikes at the very heart of basic energy
formation. This explains all of the symptoms and findings.
We have merely stumbled into a
treatment. Our theory is only an attempt to explain what we see and feel.
Dr R. Paul St Amand
-----------oooooo------------
Some members feel they may
never get completely well.
Dear Guais, Dr St Amand has responded to my request
that he address you all regarding some of your concerns (which I summarized for
him)1.
"Hi Tesa. You posed some of the concerns expressed
by some members. The summation of their e-mails is helpful to simplify things
for me.
1. Some members feel they may never get
completely well.
That is possible if some damage has occurred especially to joints. We have not
seen permanent lesions elsewhere. However, many of our patients have had auto or
other accidents that have caused some soft tissue damage and tears that will
have healed with scar tissue. Under usage, such areas will continue to cause
pains.
2. "The protocol not working the way
they understood it would the cycles too long or no good days at all and yet they
are sure they are on the right dose and not blocking."
This is where the greatest errors exist despite the above statements. I see
many people from all over the Country who
make the same statement. They come in having been on guaifenesin (personal
physician wrote prescription), sometimes for several months. They continue to
show the telltale left thigh spasms that attest to either insufficient dosage or
blocking. Most often, after a session with my staff on salicylate sources, they
return home only to find they did indeed block. I have two of my own patients
who have been under treatment for a few years who reversed benefits in the past
one month. One thought that picking a few dandelions off her lawn "and a few
weeds" for only 10-15 minutes would not matter and, she added, "one facial a
week though I know it has the wrong ingredients, wouldn't matter." The other was
great she wore canvas gloves in her garden doing that type of work. However, in
preparing rose arrangements for her large home (large rose garden as well), she
pulled thorns off the roses for about 15-20 minutes barehanded twice per week.
Both were inadvertently blocked and their maps showed it.
Thus when someone says "I'm sure I'm not
blocking" I fear we remain skeptical. Another just came back from Europe three
weeks ago (saw her yesterday). She ran out of her lotions and dentifrice and,
for two months, used what was provided overseas and in her hotel rooms. She too
when into a tailspin.
3. The worse scenario is inadequate
dosage.
We have consistently urged patients to get mapped by someone with good hands.
This may add to costs but I think this is too serious an illness to pull up
short of the measures needed to confirm the adequacy of treatment. There is a
huge persistence of trying to wing this thing by themselves. We see many
patients who come in, read our book, take guaifenesin BEFORE they see us. We are
then in the position of trying to decipher what they might have been like before
treatment. Thus the dosage is not certain immediately until a subsequent visit.
All of this could be obviated by having an initial mapping.
The left thigh should clear the first
month if the dosage is correct and no blocking has taken place. we have stressed
this repeatedly as we did in the book. I would think it easy for people to have
the left outside and the front of that LEFT thigh mapped before starting
treatment and one month later.
Even this does not guarantee that the dose
will be sufficient to finish the job. The initial amount needed to clear the
thigh but may not be quite sufficient to dig deeply into tendons and ligaments
with any degree of speed. We have stressed that whenever a patient feels he or
she has leveled off in clearing, first recheck products for sources of
salicylates that have slipped in on replacement purchases. Next, increase the
dosage by one tablet. If that makes one decidedly worse, there is no blocking
and there is a choice return to the previous lower dosage if they cannot handle
that much pain or stay at the higher level and go for a speeded reversal. We
have even urged getting Robitussin (Plain) and take just one tsp. (100 mg. )
extra per day; tease up by another tsp. one week later just to find out what
precise dosage they can handle though more symptoms are precipitated. Other
patients are too high (frequent problem) for their needs and are purging too
hard for what they can stand. We have urged following the protocol exactly. Once
increased symptoms have occurred, wait a couple of months and wait for better
hours or days. Since those good days are our goal, why raise higher until well
down the line when it is easier to handle?
I don't know how anyone can be sure when
they hurt if they are reversing benefits or the disease without a map. Raising
the dosage is the only other way I know save waiting for whatever time that
allows the progressive accumulation of better days.
4. Most of my patients do not know how
long they have had the illness.
They almost invariably state such as "five years." However, when I question
closely beginning with growing pains, headaches of the teens, strange "tension
neck and headaches" etc. I can pick up the presence of the illness for many more
years. Most people focus on when they began to have steady, unrelenting albeit
cycling symptoms. Thus, one's estimate of how long FM has been present is
usually quite skewed.
5. Tendons seem the first hit
with the exception of the left side of
the neck (Sternomastoid muscle), left upper shoulder blade (before the right) in
96% of the children's maps we have just reviewed for the pediatric book. Thus
these are among the first hit and will be among the last to leave. The left
hip/thigh area was present in 75% of the kids--also a late reverser. The feet,
top, sides and botom, right deltoid tendon more than left are also late
clearers.
6. As to why pains are so intense at
times even later in treatment.
Think in terms of the size of the lesion being purged. The posterolateral hips
are the largest especially the left. When those areas "feed" the system as they
clear, huge amounts are sent to the bloodstream. The kidneys are slow in
clearing debris or I don't think we would have our disease. Thus, the substances
being cleared (we stick with phosphates), will recirculate in the bloodstream
allowing the brain to pick up new deposits. In addition the other muscles and
tissues will pcik up their fair share and produce aches and stiffness. Once the
"feeder" has stopped doing so, the new, mini deposits seem to clear rapidly. All
of this may take 2-3 weeks in any given cycle.
7. The speed of recovery is genetically
determined. Some are certainly
slower than others. I was one of those. Thus, there seems to be a fixation on
"two months reverses one year of disease." This is certainly true for the vast
majority of people. In fact, we think we are going faster now that we have
caught mint in toothpaste--something that does not block everyone. Again
however, let me stress, if anyone gets totally blocked by ANYTHING each of us,
however responsive, is partially blocked by the same item. Many people block
intermittently when they wear a different topical product one day and not the
next. They purge deposits on their clean days and redeposit on the inadvertent
dirty days. This certainly makes for prolonged and ineffective cycling.
I wish everyone including physicians would
look at these diseases (FM, hypoglycemia, obesity, diabetes) as a spectrum. At
one end are the severely affected patients but at the other end, only the very
mildly affected. The same goes for people in their responsiveness to medication.
Is it really surprising that some patients clear 90% within four or five months
but others of us take years?
8. The disease began at birth.
Bones tucked away phosphates until they cold tuck no more--genetically
determined. When did other tissues pick up deposits that remained below an
individual's pain threshold? Wimps (low pain threshold) go to doctors
sooner--they experience far more pain than the athletic person who has a high
pain tolerance. High pain threshold people accumulate more FM before they
finally experience sufficient aching and pain to go to a doctor and then go
through the waiting process, the delay to a diagnosis.
9. Without my having my hands on each
and every member of the Group, I
have no idea how each one is, how much disease lurks in the depths of their
bodies (many we cannot get our hands on), how responsive is each one and how
"clean" are they with all products?
Additionally, how active do they become
when better days come? How persistent are they in continuing all their
activities, exercise and work when they are still in the full throes of the
illness? All of these things determine the usage of their faulty energy
production. Activity uses energy--what we lack in FM. Each person afflicted with
the illness continues to perform at some level--totally different from others.
People who are inactive have many fewer
mitochondria per cell than active people. Remember, these are our power stations
that make ATP, the currency of energy. Athletes may have as many as four times
more of these than sedentary people. Are Group members rtying to walk as long as
possible or do moderate exercise to their limited capacity? More power stations
means more rapid clearing. Most people do not realize that one muscle fiber may
have as many as 1000 mitochondria--there are many more than one per cell all
over the body. How inactive has a person been all of their adult lives? All
variables that do not allow generalizations.
Guaifenesin causes no damage. The deposits
within cartilage many years ago may lead to osteoarthritis, cartilage erosions
and tendon malfunction even after treatment with guaifenesin. The process was
initiated too late to ward off the progression to tissue destruction.
Do not think in black and white. Each of
us has had the illness for variable times and to various degrees. Each of us
responds differently at our own genetic pace. Lacking a blood or other test, we
are working in the abstract and each time I see a posting by a member, I am
limited by these facts. I NEVER have a complete picture of that person's disease
no matter how well they try to describe their personal condition. I am also
terribly limited as you will be, Tesa, to read between the lines of posted
material from untrained patients. Each one of the Group is doing his or her best
to describe conditions. However, the vast majority are not trained medical
personnel. They do not know the nerve distributions and the radiation of pain
from an affected source. Each person has read material that is simply not true
but is often added to their interpretation of their own situation.
Is all of this frustrating? Of course it
is. We know we are not going to get everyone well because of misdiagnosis, poor
compliance, poor monitoring etc. However, those whom we see here do well to what
is certainly above a 95% level if they persist in their mappings, following our
instructions and not simply quitting even when several months or a few years are
required. Persistent improvement in the mapping however gradual is our key to
success.
My parting thought if you are getting even
somewhat better, seeing more good days off and on even in the face of some
intense cycles (not all cycles are created equal), what choice do you have? Is
there another treatment that works? You must persist however slow you respond,
continue checking for salicylate sources, exercise as much as possible, do not
allow hypoglycemia (even a mild carbohydrate intolerance) to persist, lose the
weight you must by whatever means and control any other illness that has crept
in.
I wish I could see all the slow responders
and suspected non-responders. Failures are usually from within the physician or
the patient. I can't make it planer than that."
R. Paul St. Amand, M.D.
1Subject:
DOC: Understanding Fibromyalgia
Guai-Support Archives, October 16, 2000
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