Fibromyalgia is a very common disease that affects 2-6% of the World’s population with 90% represented by women between the ages of 20-501. This number is very modest and is based on the definition by the World Health Organization and American College of Rheumatologist:
- Widespread symmetrical pains of the upper, lower and axial skeletal fibrous tissues and muscles
- Symptoms for more than 3 months
- 11 of 18 tender points
My previous post, “DR. ST. AMAND PART I: FIBROMYALGIA NODULES” explains Dr. St. Amand’s diagnostic criteria of Fibromyalgia with his body map and corresponding systemic symptoms.
Dr. St. Amand and Claudia Marek co-wrote the book, What Your Dr May Not Tell You About Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease of St. Amand, R. Paul, Craig Marek, Claudia 3 Rev Upd Edition on 26 July 2012, which goes into great detail about the Guaifenesin Protocol and lifestyle changes as a treatment for Fibromyalgia.
While in Los Angeles, I had the pleasure of observing Dr. St. Amand and his clinic. I learned a great deal from him about his specific physical exam for Fibromyalgia and the Guaifenesin Protocol. I was very humbled by his generosity to me and his patients whom he has been treating for over 50 years.
Please note that the information in this post represents Dr. St. Amand’s theories and I may not agree completely with them. As health practitioners and patients interested in learning about optimal health, the best we can do is gather as much information as needed to make educated decisions and choices about treatments to pursue. As a thank you to all my teachers and patients whom I have learned so much from, I will continue to post any education that I receive about treatments for Fibromyalgia and share resources that I obtain.
Dr. St. Amand’s journey to treating patients with Fibromyalgia started with himself. He lives with Fibromyalgia and has used many different medications and supplements in the past. His greatest revelation was when a patient on Gout medication noticed that he could “scrape tartar off of his teeth”. This led Dr. St. Amand to inquire about the composition of tartar: Calcium Phosphate.
Dr. St. Amand has had muscle nodules biopsied to identify what they are composed of and he found similar results to the tartar: Calcium Phosphate. These revelations lead to his hypothesis of the inability of the proximal tubules of the kidneys to excrete phosphates in a person with Fibromyalgia.
With the build up of phosphates in the blood and the regulation of Calcium by the parathyroid glands, there is minimal places for the body to dump excess phosphate so that they don’t injure vital organs (ie. heart, brain, liver, etc). The muscles, tendons and ligaments are the safest spots to deposit phosphate. There is then a roller-coaster type effect of phosphates building up in the blood and depositing into the muscles that accounts for the muscle pain and nodules.
The cyclical pattern of phosphate is what Dr. St. Amand attributes to the experience of ‘good days and bad days’. The baseline levels of phosphates in the body at birth and a person’s pain threshold varies. Once the phosphate levels in the body surpass this relative threshold, the person experiences pain, and often it is constant.
This relative pain threshold is the reason why Dr. St. Amand does not use the 18 Tender Points as a diagnostic for Fibromyalgia and prefers mapping the nodules of the body. Many people attribute the onset of their pain and Fibromyalgic symptoms to stress, infection, surgery or trauma, yet Dr. St. Amand believes there is a history of signs and symptoms even prior to those events (ie. painful growth spurts or growing pains).
Excess phosphates (H2PO4–) requires energy (ATP made by the cell’s mitochondria broken down to ADP + inorganic phosphate) to buffer its deleterious effects on the body and can help to explain the chronic exhaustion and muscle contraction in individuals with Fibromyalgia.
Excess phosphates in the blood can also attribute to the systemic affects of Fibromyalgia on the body:
- Irritable bowel syndrome
- Brain fog
- Changes in mood
- Salt/ sugar cravings
- Interstitial cystitis
- Neurological dysfunction, etc.
This theory helps to support the, often frustrating, negative findings in laboratory workups and lack of inflammatory markers. The proposed mechanisms of action are much more in depth and if you wish to obtain a copy of Dr. St. Amands research please contact me (info@DrAlisonChen.com) or purchase his book.
SO WHAT IS GUAIFENESIN AND HOW DOES IT WORK?
In the past, Dr. St. Amand has used urocosuric agents (gout medication) to help remove phosphates from the body and they were moderately effective but had many deleterious side effects. He then came across an over-the-counter supplement, GUAIFENESIN.
Classically, Guaifenesin is used as an expectorant to thin and loosen mucous to aid with chest congestion. It works as an anti-histamine, decongestant and cough suppressor to clear the lung airways and improve your capacity to breath. Guaifenesin is now also found to help treat asthma, gout, infertility and Fibromyalgia.
In terms of Fibromyalgia, Guaifenesin works to support the proximal tubule of the kidneys to allow phosphates to be excreted and begin the reversal of phosphates out of the blood and muscle ‘nodules’. The excretion of phosphates happens 6x faster than it is absorbed and can attribute to a sense of worsening in symptoms as the body needs to dilute the Calcium Phosphate nodules, temporarily causing swelling before their reduction.
Dr. St. Amand reports no side effects with Guaifenesin and sees no issues with taking most medications at the same time. Sounds like a miracle drug, right? It’s over-the-counter, safe, reverses Fibromyalgia symptoms without changing your lifestyle and is immediate in its action!
Well, there is one part of the protocol that I have not mentioned. There is one substance that blocks the actions of Guaifenesin and it is Salicylic acid or salicylates, which is another name for Aspirin. I know what you’re thinking, Aspirin, well that’s easy to take out. But it’s not that simple.
Salicylates are found in most plant materials and topical skin products. This means that there can be a significant change to your daily product routine and dietary habits. For more information on products/ ingredients to avoid while on the Guaifenesin Protocol please visit the Fibromyalgia Treatment Center website.
I’ve had the honor of learning from various health care practitioners who specialize in treating Fibromyalgia while traveling and being on the Fibromyalgia and Chronic Fatigue Syndrome Focus Shift at the Robert Schad Naturopathic Clinic.
All of these doctors have different perspectives which can be confusing and difficult for patients to decide what works for them. However, I find comfort in the variations of successful treatments because no two patients living with Fibromyalgia are exactly alike and this means that the individualized care given by your Naturopathic Doctor will help them to identify the most appropriate treatments.
There are so many different possible mechanisms of action for patients with Fibromyalgia and the underlying cause to the disease is what I am most interested in investigating to help heal a suffering patient instead of only curing their symptoms.
Again, I remind you that the information in this post represents Dr. St. Amand’s theories and I may not agree completely with them. As health practitioners and patients interested in learning about optimal health, the best we can do is gather as much information as needed to make educated decisions and choices about treatments to pursue.
These experiences only help to further support my journey as a Naturopathic doctor, so if you have any clinical pearls or recommendations I would love to hear about them at info@DrAlisonChen.com.
Missed Part I? Read it here: DR. ST. AMAND PART I: FIBROMYALGIA NODULES
Also, make sure you keep up-to-date on the latest research for Fibromyalgia and Chronic Fatigue Syndrome by reading other related topics:
- Fatigue: What is FM and CFS?
- FM and Cognitive Behavioral Therapy
- How much sleep do I need?
- Fibromyalgia and CFS References
- Toronto Star FM Case Study: Sandy Bolyki
- Guaifenesin Protocol with Dr. St. Amand (Part I)
1. Bested, A. C. MD, Logan, A. C. ND, Howe, R (2008). Hope and Help for Chronic Fatigue Syndrome and Fibromyalgia, 2e.CumberlandHouse.Illinois,USA.
2. St. Amand, R. P. MD and Marek, C (2012). What Your Dr May Not Tell You About Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease of St. Amand, R. Paul, Craig Marek, Claudia 3 Rev Upd Edition on 26 July 2012, 3rd edition. Grand Central Life & Style.New York,USA.