Dr. Teitelbaum has been studying and treating Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia since he came down with ME/CFS over thirty years ago. The author of the best selling ME/CFS treatment book, “From Fatigued to Fantastic’, Dr. Teitelbaum talked for 48 minutes on his basic approach talk to ME/CFS and FM at the American Board of Integrative Holistic Medicine conference.
This is a basic overview of ME/CFS and FM treatment. It’s interesting while watching the video or reading the overview.to contemplate the differences between ME/CFS experts in this field One group of ME/CFS/FM experts (Teitelbaum, Holtorf, Garabedian) appears to place a strong focus on hormones, another group (Peterson, Lerner, Chia, Klimas, Dantini) focuses more on immunological issues and pathogens. Dr. Bateman and Dr. Natelson appear to take a more conservative approach than either group and it’s not clear, at least to me, what group Dr. Lapp, who is well acquainted with Ampligen falls into.
Anyway – here’s a short introduction to Chronic Fatigue Syndrome and Fibromyalgia treatment from Dr. Teitelbaum.
He started off by stating that most people with ME/CFS and FM can get well (!), and then showed a study indicating that 91% of patients treated with a ‘integrated treatment approach’ experienced moderate to significant improvement in their symptoms. The average increase in quality of life was 75%.
That’s not the same as ‘getting well’, but it’s certainly significant and it does track with many ME/CFS practitioners statements that ME/CFS is generally treatable.
He noted a very interesting pattern where improving one system leads to improvement for awhile but ultimately can put stress on another system that causes the patient to crash.
Besides fatigue Dr. Teitelbaum picked out insomnia, muscle and joint aches, sensitivities to many substances, brain fog, spastic colon, leaky gut, decreased sex drive and an interesting one not often associated with ME/CFS – chronic sinusitis. Most people with ME/CFS/FM he said, had chronic sinusitis and post-nasal drip.
He recommended NAET very highly for treating allergies and sensitivities.
He believes, like Dr. Cheney, that ME/CFS is caused by a body-wide energy crisis except that Teitelbaum targets the hypothalamus instead of the heart. Infections, hormonal deficiencies, poor sleep, etc. can all cause the body to ‘blow a fuse’. Dr. Teitelbaum believes the hypothalamus, which controls sleep, hormones, temperature and autonomic functioning puts the body in a kind of hibernation to protect it.
“When your muscles get exhausted they go tight – and they hurt”.
Of course, the muscles require a lot of energy as well. When they run out of energy he noted that they get locked in a shortened position. (We’ve seen evidence of muscles in shortened, contracted position in our Fibromyalgia blogs). In a Rowe overview we’ll see evidence that the nerves associated with the muscles aren’t able to elongate as they should in ME/CFS: i.e., they remain ‘tight’). Those painful muscles then set the stage for central sensitization (increased pain sensitivity).
(It’s interesting that at the heart of it, it’s all about energy production for Dr. Cheney, Dr. Teitelbaum and probably Dr. Myhill.)
People with gradual onset often have more problems with low thyroid or other hormonal problems, yeast, autoimmune and sleep disorders and severe stress. (Autoimmune disorders often trigger a ‘secondary fibromyalgia’ that rheumatologists miss.)
Rapid onset, on the other hand, suggests to Dr. Teitelbaum, infection, injury and pregnancy or rather problems after pregnancy, when the body has trouble adapting to a new hormonal environment.
Dr. Teitelbaum at the American Board of Integrative Holistic Medicine Conference in 2013
(Also find the video here)
Then Teitelbaum talked about the psychospiritual side of ME/CFS and ‘doing what feels good’. This side of medicine has people determine what feels good and keep doing those things.
Efficiency Matters – A Standardized Approach
He uses standardized questionnaires to assess how patients are doing, noting that they can enable a doctor to accomplish in five minutes what would take an hour. He gives them out to physicians for free (firstname.lastname@example.org).
ME/CFS and Fibromyalgia Practitioner Network
Noting that there’s no way that anyone can know all or even half the things that might be helpful in this field, Teitelbaum has also set up a free Fatigue and Fibromyalgia Practitioners network to allow practitioners from different fields to share their insights (www.vitality101.com/FFPN/
Some tidbits from the nutrition section. Use powders instead of pills. Stay away from sugar (except for chocolate – a health food), add salt, high protein-low carb diet, and consider a mitochondrial enhancer (D-Ribose, others).
He’s found significant success with D-Ribose (5 grams 3x’s a day for three weeks) in two studies, one of them quite large. After three weeks he drops it down to twice a day. He gives a B-complex vitamin with it.
He noted that the energy recipe (D-Ribose, COQ10, magnesium, etc.) is amazingly like you treat heart failure – another energy production crisis.
He asserted that if anyone answers yes, to the question “Can you get a good nights sleep?” they don’t have Fibromyalgia or Chronic Fatigue Syndrome.
After noting that there are many different types of sleep aids (and describing some of them) Dr. Teitelbaum’s described his favorite ‘high tech’ recipe for sleep: two cups of Epsom salts in a warm bath, a little red wine, some chocolate and candles an hour before bed. (Being relaxed before sleep has been shown to result in deeper sleep.)
He prefers a natural approach but particularly with Fibromyalgia he mixes and matches a variety of drugs (Trazodone, Flexeril, Neurontin and sometimes Ambien) to get patients the eight hours of sleep they need to improve.
Dr. Teitelbaum believes that even mild hormone deficiencies can cause widespread problems and he has little faith in the ‘normal’ ranges that most doctors use to determine if deficits are present. He believes that most people who need thyroid test in the ‘normal range’ and he determines thyroid deficiency by symptoms. He said his thyroid talk takes an hour, but, in general to adjusts the dose to how the patient is feeling and check their free T4.
Adrenal dysfunction can simply be indicated if all of a sudden a person with ME/CFS feels they MUST eat something.
Many infections have been associated with ME/CFS, but there’s one that every doctor should look for – Candida. Sinusitis and spastic colon are dead giveaways. He prescribes low sugar diets, probiotics, anti-fungals (Diflucan), and looks for a host of other infections, but the key infection to treat is in his opinion … candida.
Pain and Small Fiber Neuropathy
About half of people with Fibromyalgia have small fiber neuropathy, most of whom also have IgG subclass deficiencies and dysautonomia (problems standing). IVIG can be helpful (and very expensive at $50K for 6 months treatment). He uses it in the sickest 15% who don’t respond to anything else.
Being driven himself Dr. Teitelbaum is well acquainted with the role the mind/body interaction can play. If you’re an overachiever, if you try to be all things to all people, if you have trouble saying no – you’re setting up for problems with this disorder. Learn how to say “No!” Teitelbaum emphasized.
He ended by talking about other alternative treatments. He singled out human chorionic gonadotropin (HCG) for chronic pain.