From Fatigued to Fantastic!

by Jacob Teitelbaum

  18. Adrenal Stress-End (from Integrative Therapeutics or www.vitality101.com): Take one to two capsules each morning (or one to two in the morning and one at noon). Take less or take with food if it upsets your stomach.

  19. Isocort (adrenal glandular): Contains approximately 2.5 milligrams cortisol (Cortef) per pellet (do not give more than six a day). Order from 800-743-2256.

  20.*DHEA: 5 to 25 milligrams each morning or twice daily (lower the dose if acne or darkening of facial hair occurs). Some experts recommend that the entire dose be taken in the morning. Keep DHEA levels between 140 and 180 micrograms/dL for females and 300 and 500 micrograms/dL for males. If the patient has breast cancer, do not use DHEA. See information sheet for dosing.

  21. Increase your salt and water intake substantially. If your mouth and lips are dry (and you’re not on Elavil), you’re dehydrated; drink more water (or herbal tea or lemonade sweetened with stevia—not sodas or coffee). Celtic sea salt is an excellent form to use (800-867-7258).

  OTHER HORMONES

  22. Biest, 2.5 milligrams, plus 30 to 100 milligrams progesterone, plus 2 to 5 milligrams testosterone, all in 1 gram of cream. Apply 1 gram of cream to your abdomen at bedtime. (I recommend ITC Pharmacy for my compounded medications; 303-663-4224.)

  23. Testosterone: Males Testim 1 percent 25 to 100 milligrams daily. Consider checking total estrogen and DHT levels when you check the testosterone blood levels. If the DHT goes too high it can cause hair loss—which can be prevented by Proscar or saw palmetto, 160 milligrams two times a day. If estrogen goes too high, this can be blocked by Arimidex, 1 milligram every other day. If taking thyroid tablets, be aware that adding testosterone can increase thyroid blood levels. If the patient gets moody or anxious, or has a racing heart, check a blood level for thyroid and consider lowering the dose.

  INFECTIONS

  ANTI-YEAST TREATMENTS

  24. **Avoid sweets—this includes sucrose, glucose, fructose, corn syrup, and any other sweets until the doctor says that it is okay to include them in your diet again. Avoid fruit juices, which are naturally sweet. Having one to two fruits a day (the whole fruit as opposed to the juice) is okay. Stevia is a great sugar substitute. Inositol (helps anxiety and depression) and xylitol (helps osteoporosis) are also excellent and healthy sugar substitutes that look and taste just like sugar.

  25. Stevia is a wonderful herbal sweetener. A great-tasting one is by Body Ecology; 800-478-3842. Use all you want.

  26. *Acidophilus milk bacteria: Use the Probiotic Pearls form (by ITI). Take two twice a day for five months. Then consider one a day to help maintain a healthy bowel.

  27. *Anti-Yeast (Ultraceuticals) is an excellent natural antifungal mix. Take for three to five months.

  28. Citricidal: 100 milligrams (use the tablets) two twice a day.

  29. Nystatin: 500,000 units, two tablets two to four times a day. Begin with one a day and increase by one tablet a day until you are up to the total dose. Symptoms may initially flare as the yeast die off.

  30. **Diflucan (fluconazole): 200 milligrams a day for six to twelve weeks. Begin taking the Diflucan four weeks after starting Phytostan or nystatin.

  IMMUNE STIMULANT

  31. Thymic Protein (Pro Boost): Dissolve the contents of one packet under your tongue—any that is swallowed is destroyed. Take it three times a day for twelve weeks, then once a day for six weeks. Also take it three times a day at the first sign of any infection until the infection resolves (it is approximately two dollars a packet). Available from www.vitality101.com or wholesale from Klabin Marketing (800-933-9440). Works in the first twenty-four hours for acute infections but takes two to three months to work for chronic infections.

  CHRONIC AND ACUTE SINUSITIS

  32. **Sinusitis Nose Spray: By prescription from ITC Pharmacy (303-663-4224). Contains Sporanox, xylitol, Bactroban, and Beclamethasone. Use one to two sprays in each nostril twice a day for six to twelve weeks. If it irritates the nose, dilute with nasal saline spray.

  OTHER TREATMENTS

  FOOD AND OTHER SENSITIVITIES

  35. **NAET: Wonderful for elimination of sensitivities/allergies (see www.naet.com for more information).

  36. Food Allergy Elimination Diet (instruction sheet is available at www.vitality101.com).

  IV NUTRITIONAL SUPPORT

  37. **Myers cocktail—IV nutritional therapies (very helpful). See further information on contents on page 364.

  *DETOXIFICATION

  There are several simple things that you can do that can be helpful:

  38. Sweating can remove toxins—especially if you shower immediately after—and can be beneficial for health. Many of the newer saunas are what are called “far infrared,” and a half hour three to seven times a week can help detoxification. I use the one from High Tech Health (800-794-5355).

  PAIN TREATMENTS

  NATURAL PAIN THERAPIES

  Dozens more are discussed at length in Pain Free 1–2–3.

  39. Rolfing, Trager, myofascial release, chiropractic, other bodywork and manipulation modalities, and/or acupuncture.

  40.**Pain Formula: Contains willow bark, Boswellia, and cherry. Take two to four tablets three times a day. It takes two to six weeks to see the full effect. At that time, you can often lower the dose to one tablet three times a day or two tablets twice a day. From ITI (Integrative Therapeutics).

  PHARMACOLOGIC PAIN TREATMENTS

  See my book Pain Free 1–2–3 for dozens more options and details for use.

  41. **Ultram (Rx: tramadol): 50 milligrams, one to two tablets up to four times a day as needed for pain. Fewer side effects are seen with four or fewer tablets a day. May cause nausea/vomiting. Caution: May very rarely cause seizures or raise serotonin too high when combined with antidepressants.

  TOPICAL PAIN TREATMENTS

  42. **Topical Pain Formula cream or lotion (Rx): Contains a mix of prescription pain medications. Rub a pea-size amount onto painful areas three times a day as needed. Available by prescription from ITC Pharmacy (303-663-4224). You can use this on up to three or four silver-dollar-size areas at a time.

  43. *Lidoderm Patches (Rx; lidoderm): Can be cut into pieces to put over different areas. Leave the patch on for twelve to eighteen hours, then off the rest of the day. It can help localized pain (i. e., it helps pain that is right under the patch). Up to four patches can be used at a time each day. It can take two to three weeks to see if it works.

  GABA AGONISTS

  44. Neurontin (gabapentin): 300 to 900 milligrams one to four times a day (to a maximum of 3,600 milligrams a day). Cut back and increase by 100 milligrams a day every four to five days if it causes any uncomfortable or unusual neurologic symptoms or excessive sedation. Begin with 100 to 300 milligrams at night, then slowly increase to 300 to 900 milligrams three times a day as is comfortable. In some, pain relief is immediate; in others, it can take a minimum of 1,200 milligrams a day.

  45. Lyrica (pregabalin): 50 to 150 milligrams three times a day. The main side effects are sedation and weight gain.

  MUSCLE RELAXANTS

  46. Flexeril (cyclobenzaprine): 10 milligrams, half to two at bedtime. Muscle relaxant; can cause dry mouth.

  47. *Skelaxin (Rx; metaxolone): 800 milligrams, 1 tablet four times a day as needed for pain. This is usually nonsedating.

  ANXIETY

  48. Calming Balance: One to three capsules three times a day as needed. A unique mix of eleven herbs and nutrients. Some effect is immediate and the rest builds over two weeks (available retail at www.vitality101.com and wholesale from Health Freedom Nutrition at 800-980-8780).

  DEPRESSION

  49. Happiness 1–2–3: One to two capsules three times a day. A unique mix of twelve herbs and nutrients that may help depression. The effect builds over six weeks (available retail at www.vitality101.com and wholesale from Health Freedom Nutrition at 800-980-8780).

  Wholesale Sources

  The following companies can provide some of the more important supplements use
d in the protocol (most can be obtained retail at www.vitality101.com). As an aside, I note that I take NO money from any company whose products I recommend, and 100 percent of the royalties for my products go to charity.

  Integrative Therapeutics Inc. (ITI). This is the company that I respect most in the natural supplements industry. It actually voluntarily registered with the FDA as a pharmaceutical company, and therefore has to go through all the quality-control testing done by drug companies. It did this so that customers can be assured of both the purity and potency of its products. As would be expected, the science the goes into making its products is also outstanding. ITI carries the Energy Revitalization System vitamin powder and B complex, Revitalizing Sleep Formula, Adrenal Stress-End, Pain Formula, Probiotic Pearls, Vitaline coenzyme Q10, and Eskimo-3 fish oils. For ordering and product information, I recommend that you call Cathy Leet at 920-737-8828 or call 800-931-1709.

  Bioenergy Life Sciences, Inc. For D-ribose (CORvalen); 866-267-8253; www.corvalen.com Klabin Marketing. Carries the wonderful immune stimulant Pro Boost (800-933-9440).

  Health Freedom Nutrition. Makes Happiness 1–2–3! supplement for depression and Calming Balance for anxiety (800-980-8780).

  Body Ecology brand of stevia (1-800-4-STEVIA). Many brands of stevia are bitter but this brand is excellent-tasting and well accepted by patients as a sugar substitute.

  ITC Pharmacy. An excellent source for bioidentical hormones, concentrated injectable B12, pain creams, and the sinusitis nose spray; ships worldwide (303-663-4224).

  www.vitality101.com. This is my Web site, and I invite you and your patients to sign up for my free e-mail newsletters. In addition, copies of all my books (From Fatigued to Fantastic!, Three Steps to Happiness: Healing Through Joy, and Pain Free 1–2–3) and information on getting our two-and three-day conference CDs are available. Our computerized online program is a resource that will make treatment of these patients much easier. Patients can do the online program at www.vitality101.com. The online program will analyze their labs and symptoms to create a complete medical record of their case. This will create a complete H&P with assessment and recommendations for your chart. Another option that many doctors prefer is to have patients go to a data-collecting site that looks like your site and enter their symptoms. Only the doctor’s office can enter the labs (which are optional) and get a printout. A short form that creates only the assessment and recommendations is also available. For more information on these www.medicalwebrecord.com options, e-mail us at the Q&A section at www.vitality101.com.

  Myers Cocktail

  For further information about sources of the products and services mentioned in this section, see Appendix E: Resources.

  1. The following are instructions for making and administering the slow IV Myers Push (MP).

  Items 1 through 3 and 6 through 12 can be ordered (among other sources) from Harvard Drug Company (800-783-7103). Item 4 is available from compounding pharmacies, including Pathways and Wellness and Health Pharmaceuticals. Item 5 may be purchased from G. Y. and N. Most of the above items are also available from McGuff.

  To make the Myers Push (MP), draw up each ingredient using a separate syringe/needle and squirt it into the mouth of a 20-cc to 25-cc syringe. Attach the 25-gauge butterfly to the large syringe, pushing fluid through the butterfly tubing until the entire tubing and needle are filled. Now the mixture is ready for venipuncture and a slow IV push. The glutathione should be kept in the initial syringe (not mixed with other nutrients) and pushed in over one to ten minutes (1 cc every one to two minutes).

  The dose of MgSO4 typically begins at 2 cc. If the patient feels comfortable, without dizziness, nausea, or hypotension (warmth in the neck, face, chest, abdomen, groin, and/or extremities is normal, and is a sign of physiological action of the magnesium as a vasodilator), I usually increase the MgSO4 to 4 cc and give it over ten to forty minutes. Alternately, all these nutrients can be added in an IV bag and allowed to drip in over thirty to sixty minutes.

  The desired result is to inject at a rate at which the patient feels comfortable warmth without excessive flushing or feeling ill—that is, dizziness, nausea, and headache, symptoms that are rare.

  Prior to the injection, it is important for the patient to be instructed to give frequent feedback about any developing warm feeling early on, so that the injection may be slowed down, or even temporarily stopped, before excessive, uncomfortable flushing occurs. Likewise, feedback by the patient needs to be given when the warm feeling has mostly subsided so that the injection may be resumed at a reduced rate. Eventually, the infusion will find the “happy medium” rate of injection, which maintains the “comfortable warmth” (see above).

  Also, prior to the first few MP injections, explain that a taste of B vitamins usually appears during the infusion, often early in the push.

  The physician needs to consider one major option, which has become routine in many quarters—the possible addition of calcium gluconate, 10 percent injectable. Some of the major reasons for deciding to include calcium are:

  If the patient feels consistently unwell for any reason after the MP (weakness, fatigue, sleepiness, palpitations—all rare and mild, if present).

  If the patient has a history, or laboratory evidence, of calcium deficit.

  If the physician’s clinical judgment dictates it for any reason.

  The dose of calcium gluconate 10 percent injectable varies from 4 cc to 10 cc, depending on the clinician’s judgment. The key is to maintain balance without diluting the magnesium’s positive effects.

  A final caveat is that one needs to keep in mind the third of the troika—oral potassium. Over a period of time, IV magnesium may deplete potassium; the danger is that one may be tempted to increase the dose of magnesium, only to aggravate the low potassium picture. Always keep in mind that a potassium deficit may prevent magnesium repletion and vice versa.

  It is also, of course, possible to create calcium deficit by the MP. However, potassium depletion, in my experience, is clinically more frequent and more symptom provoking, and at times alarming. (If needed, give the potassium by mouth—not IV, as an IV push potassium is fatal. I use Micro K Extentabs, 10 MEQ, one to two times a day if potassium levels are under 4.0.)

  2. Intravenous Vitamin C (IVC)

  The following are instructions for making and administering the intravenous vitamin C (IVC.)

  All of the above supplies can be obtained from Harvard Drug Company.

  To make the IVC, add the ascorbic acid and the sodium bicarbonate to the IV bag. This infusion can be mixed one to two days before administration and stored in the refrigerator. It is best to bring the IV bag to room temperature before starting the infusion. This can be accomplished by taking the IV bag out of the refrigerator one to two hours ahead of time. Also, protect the IV bag from light.

  The infusion is usually given over a period of forty-five to sixty minutes. It is best to select a large vein for the IV (that is, antecubital region) because the vitamin C can irritate the vessel wall. The 3 cc of sodium bicarbonate helps with the irritation problem. If the patient experiences pain or discomfort, slow down the infusion and apply a warm heating pad to the area. Also, squeezing and releasing the fist of the infused arm helps any discomfort.

  It is rare for any patient not to tolerate the IVC. However, if discomfort continues and is unbearable, remove the needle and select a different vein. Another option is to add some IV procaine or lidocaine 2 percent to the infusion bag, starting with 3 cc (don’t give more than 5 cc of 2 percent lidocaine per hour). Always make certain the patient is not sensitive to any of the “-caine” products, that the procaine or lidacaine is for IV use, and that it does not contain epinephrine.

  Notes

  Introduction

  1. J. E. Teitelbaum and B. Bird, “Effective Treatment of Severe Chronic Fatigue: A Report of a Series of 64 Patients,” Journal of Musculoskeletal Pain 3 (4) (1995): 91–110.

  2. J. E. Teitelbaum, B. Bird, R. M. Greenfield, e
t al., “Effective Treatment of CFS and FMS: A Randomized, Double-Blind Placebo Controlled Study,” Journal of Chronic Fatigue Syndrome 8 (2) (2001).

  3. J. E. Teitelbaum, C. Johnson, and J. St. Cyr, “The use of D-ribose in chronic fatigue syndrome and fibromyalgia: A pilot study.” J Alt Comp Med 2006; 12 (9): 857–862.

  4. H. Blatman, “Effective Treatment of Fibromyalgia and Myofascial Pain Syndrome.” Editorial: American Journal of Pain Management, April 2002.

  Chapter 1. What Are Chronic Fatigue Syndrome and Fibromyalgia?

  1. G. P. Holmes, J. E. Kaplan, N. M. Gantz, et al., “Chronic Fatigue Syndrome: A Working Case Definition,” Annals of Internal Medicine 108 (1988): 387–389.

  2. R. K. Price, C. S. North, S. Wessely, et al., “Estimating the Presence of Chronic Fatigue Syndrome in the Community,” Public Health Reports 107 (September-October 1992): 514–522.

  3. R. B. Marchesani, “Critical Antiviral Pathway Deficient in Chronic Fatigue Syndrome Patients.” Infectious Disease News, August 1993, p. 4.

  4. L. A. Jason, J. A. Richman, A. W. Rademaker, et al., “A Community-Based Study of Chronic Fatigue Syndrome,” Archives of Internal Medicine 159 (18) (11 October 1999): 2129–2137.

  5. D. L. Goldenberg, “Fibromyalgia Syndrome: A Decade Later,” Journal of the American Medical Association 159 (1999): 777–785.