Fibromyalgia is a syndrome in which a person has chronic, non-specific body pains in the joints, muscles, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.
When patients approach their physicians about it, they would be checked for the most obvious causes of body pain like arthritis or muscle trauma. They also may check for common causes of tiredness such as anemia or thyroid issues. These tests often come back negative and no further tests are carried out.
Being in pain and fatigued all day causes a drop in normal functioning, social interactions and outings; and leaves one with symptoms of depression. However, many doctors fail to see the real equation, and end up putting these patients on a lifetime of anti-depressants and painkillers.
FINDING THE REAL CAUSE
Fibromyalgia is a condition that I’ve come across very commonly in my practice, mostly because conventional treatments have not been able to help them at all.
Years of extensive research and practice, coupled with outstanding results has brought me to understand that the cause of FIBROMYALGIA = CHRONIC FLU + CHRONIC ADRENAL FATIGUE. It can either be one or both these conditions that cause Fibromyalgia over time.
CAN YOU RELATE TO ANY OF THESE?
- CHRONIC FLU SYMPTOMS
- Body aches and pains (can be muscle or joints)
- Low grade fevers
- Chills (which are not relieved by layering up either)
- Night sweats
- Feeling “under the weather” a lot
- History of infections or invasive procedures in the past (eg:- sinusitis, lung infections, dental infections or root canal procedure, urinary tract infections, arthritis etc)
- CHRONIC ADRENAL FATIGUE SYMPTOMS
- Morning tiredness
- Fatigue all day, especially after exercise
- Cold hands and feet
- Low blood pressure
- Low blood sugar
- Emotionally hypersensitive (cries easily , gets angry and startled easily)
- Inability to adapt to new situations or changes easily
MY APPROACH TO TREATING YOU
This depends on which symptoms you relate to the most. Accordingly, various tests would be carried out to confirm the diagnosis. Following this, I would sketch out a detailed treatment protocol for you.
If you feel like you relate more to the symptoms of:
- Chronic Flu / Underlying infection
- Chronic infections and my approach to its treatment is dealt in detail below.
- Chronic Adrenal Fatigue
- A summary of my approach to this issue can be found below.
- A detailed article explaining my approach and treatment options may also be given to you.
- General Tiredness
- An article that I have composed covering the various aspects to why you could be tired, and how to treat the underlying issue will be given to you.
- MY APPROACH TO CHRONIC FLU / INFECTION
- Symptoms like achiness, chills and rigors, low-grade fevers, night sweats or a chronic “under the weather” feeling, according to me, are signs of a chronic ongoing infection that you are unable to get rid of.
- It could be bacterial, viral, fungal or even parasitic. Nothing else in the world will give you chills other than infections.
- Several patients are able to go back in time, and find that the onset of the above symptoms coincides with an infection or invasive procedure they had in the past.
- Several examples are:
- Gynaecological infection/procedure (Caesarean section/endometriosis/biopsy etc)
- Urinary tract infections/ Colitis, amoebiasis, parasites and other GI tract infections
- History of root canal/ tender gums/ hypersensitivity/ other dental procedures
- History of sinusitis/ pneumonia/ any chronic infections
- History of arthritis/ other joint diseases.
- These infections gradually enter the blood stream and spread to other organs. There, they multiply and silently form pockets of infection in different parts of the body including the joints.
- Areas like the joint spaces are inaccessible to the white blood cells (our germ fighting squad) because of the tough, impenetrable capsule around the entire joint. This causes the immune system to attack the area around it in an effort to reach the target, and this explains the joint aches and pains.
- Tracing the culprit – Depending upon the suspected source of infection, tests can be carried out.
- Urine culture and microscopy
- Sputum culture / stool culture
- Throat swab / vaginal swab
- Stool and saliva test (to check for several parasites and yeast)
The above tests only check for bacteria, and therefore, are not comprehensive enough.
- DNA test This test can find organisms that are not traceable by any OHIP- covered test. It can detect virus, fungi and semi-viruses too. This is because this test does not rely on actually “seeing” the organism, but it tests for the presence of its DNA! Examples include chlamydia spp, mycoplasma etc.
- Treating the infection
- Antibiotics or antifungals (as required)
- IV H2O2 treatments
- H2O2 is a well-known killer of germs –Its action is against viruses, bacteria, fungi and semi bacteria. It mostly works by creating a high oxygen environment in which the germs can’t survive.
- I had good clinical success using this treatment, but now, I have a more powerful treatment that does not irritate the veins which is High dose Ozone therapy. I prefer this approach.
- High dose (10 pass) Ozone therapy
- It delivers more ozone in a shorter amount of time and better saturation of red blood cells with oxygen without damaging it.
- The 10-Pass method describes an ozone therapy treatment during which 200 ml to 220 ml of a patient’s blood are drawn under negative pressure. The blood is then mixed under positive pressure with 200 ml of ozone at a concentration of 70 ug/ml, and then re-infused into the patient’s vein, also under positive pressure. This is repeated 10 times and can be administered 1-2x/week for 10 sessions initially.
The 1st 5 treatments:
The patient may develop flu-ish symptoms (die-off effect) because the Ozone would initially break down and flush out the infectious agents and toxins into the blood stream.
6th to 10th treatment:
This effect will gradually subside and will not require additional treatments. You can use symptoms like chills, low grade fever, achiness as a yardstick of improvement.
After 10 treatments:
A follow up consultation needs to be booked with me, so I can analyse your progress and revise your treatment plan if necessary.
MY APPROACH TO CHRONIC ADRENAL FATIGUE
Adrenal glands are responsible for the production of various vital hormones like:
- Glucocorticoids (cortisol) which is responsible for glucose metabolism and energy production.
- Mineralocorticoids (aldosterone) which deals with salt and water retention in the body.
- Sex corticoids– like DHEA, which in turn, converts to testosterone and estrogen.
- They also produce adrenaline and noradrenaline which play a vital role in dealing with stress and emergencies.
Due to the vital actions of these various hormones, the adrenals play a very important part in our lives by preparing us to face all the stresses in life, and by creating an overall mineral and hormonal balance in our bodies.
The cause of adrenal fatigue:
Overworking the adrenals for a prolonged period can cause exhaustion of the glands.
This can be caused by excessive exercise, overworking, job stress, sleep deprivation, fear, anger, depression, guilt, anxiety, surgery, chronic pain/infection/ inflammation, chronic allergies/illnesses etc.
Diagnosing Chronic Adrenal Fatigue
- Cortisol levels in the body can be determined by a simple saliva cortisol test which measures your body’s cortisol levels at 4 different times of the day.
- For example, the production of cortisol by adrenals glands is highest in the morning upon waking up – around 6 am to 8 am. A drop in your levels around this time can explain your lack in morning energy.
- The saliva samples will be sent to the USA and the results received by us in approx. 3 weeks. This will then be interpreted by me- and on the basis of your levels and symptoms, the severity of your condition will be assessed. Accordingly, a treatment plan will be drawn out for you.
Treating Adrenal Fatigue
- LICORICE DROPS
- This is a way to top up your cortisone levels without actually taking any medication.
- The brand I usually prescribe is Francis whole licorice drops – 30 drops in the morning, noon and late afternoon. This is available in most health food stores.
- Licorice works by slowing down the breakdown of the cortisone molecule. In this way, the number of molecules in circulation at any given time is increased, thereby increasing cortisone levels in blood without any external supplementation.
- HORMONAL REPLACEMENT / TOP-UP METHODS
CORTEF (GENERIC NAME: HYDROCORTISONE)
This is a higher level of Glucocorticoid (Cortisone) top-up that I use in patients that have severe symptoms, and when quick intervention is needed.
Cortef is a bio-identical, less potent, very low dose form of cortisone. This is a ‘supplemental dose’ as opposed to the ‘suppressive dose’ that comes with using prednisone. This allows you to get the benefit from cortisone, without actually suppressing or permanently affecting the secretive function of your glands.
Also, for patients who have been advised to take this drug for a longer duration, the book “Safe use of Hydrocortisone” by William Jefferies (available through Amazon) gives all the details you need on every aspect of cortisol.
The usual dosage I prescribe is
- 10mg in the morning on waking up,
- 5 mg at noon
- 5 mg at 5pm
Hydrocortisone molecule has a short half life, and does not last > 4hrs in our bodies, and this is why more frequent dosing is required.
B) FLORINEF (GENERIC NAME: FLUDROCORTISONE)
- Florinef is the low-dose ‘top-up’ medication that I prescribe for patients who are significantly low in
- As mentioned in detail earlier, aldosterone is the water and mineral retention hormone produced by the adrenal glands.
- Deficiency of this hormone may result in low blood volume, low blood pressure, light headedness, increased urination, bony face and sunken facial features.
- The dosage I usually prescribe is 1 mg a day. You may be advised to start with HALF a pill (0.05mg) a day, and increase it up to one pill (0.1mg) a day until your systolic blood pressure crosses 100 mmHg.
- As explained earlier, DHEA is a sex hormone produced by the adrenal glands. In patients with CAF, it’s very likely that they would be low on this hormone as well.
- Your DHEA levels can easily be determined by a simple blood test (OHIP-covered).
- DHEA is a precursor for other hormones like Testosterone and Oestrogen and hence the lack of which can cause low libido, vitality, menopausal symptoms, erectile dysfunction, low energy etc.
- The dosage I prescribe is usually 25mg a day, to be taken early in the morning before breakfast. The dosage may vary depending on how low your levels are.
V ADRENAL DRIP
- The adrenal drip you are prescribed contains Adrenal support injection. This fools the pituitary to believe that the adrenals are back on track, and therefore it stops the ACTH production. (ACTH is a hormone which acts as the whip that forces the adrenals to work overtime)So, this drip finally gives the adrenals a much deserved chance to rest and regenerate.
- Your drip also contains a mix of several minerals and vitamins like Calcium, Magnesium, Zinc, Chromium, Selenium, Manganese, Potassium, Copper, Vit B5, B6, Bcomplex, B12, Vit C etc. These minerals and vitamins serve as the raw materials that help to rebuild the gland.
- The usual recommendation is two infusions per week for the first 5 weeks, each around 90 mins each.
- This is followed by an assessment of your progress and accordingly, you will be advised to either continue or gradually stop and go on a maintenance dose.
Chronic Adrenal Fatigue – the symptoms, the diagnosis, the treatment options and the risks& benefits of the treatment are dealt in detail in another article by me called CHRONIC ADRENAL FATIGUE. The information given above is only a summary, and the detailed article will be given to you if this is a suspected cause in your case.
MY APPROACH TO FATIGUE/ TIREDNESS
Dr. Jacob Tietelbaum, author of the bestseller “From Fatigued to Fantastic” has a comprehensive approach towards diagnosing and treating fatigue, and its called the “SHINE” protocol. A slightly modified version has been adopted by me. The SHINE protocol rules out the most common causes and lesser known causes, and also allows one to address multiple issues at the same time, because they are often linked to one another.
The SHINE protocol stands for:
S – SLEEP
H – HORMONE
I – INFECTION
N – NUTRITION
E – EMOTIONS
A good sleep releases endorphins, which is endogenous morphine, also called the “Feel- Good Hormone”. Poor sleep is one of the simplest but common reasons for tiredness, decreased concentration etc.
An article explaining my approach to improving your sleep in detail will be given to you.
This is our body’s natural sleep hormone. As we age, our melatonin levels drop. For those patients whose melatonin baseline levels are low, its supplementation would improve the depth and quality of sleep.
Melatonin is a non-addictive, natural sleeping pill. There is no lingering effect/ daytime drowsiness. Melatonin also has anti-oxidant, anti-aging and immune system boosting
Start with a 3mg pill on Night 1 ——->2 pills on Night 2 ——-> 3 pills on Night 3 and gradually increase the dosage until you discover the right dosage for your body. You can take a maximum of 10 pills a night (30mg).
USE AN EYE COVER – In order to increase the effectiveness of this hormone, ensure complete darkness over the eyelids because light deactivates the action of melatonin.
This is another natural supplement for sleep that is composed of herbal ingredients like Valarian root extract, passionflower extract, lemon balm extract and griffonia seed. It also contains 5-HTP, melatonin and GABA, which are known to relax the body and mind. Dosage: 2 caps/ night.
Deficiency of certain hormones can also bring about the associated symptoms and hence I would first need to rule out such deficiencies.
- TSH, Free T3 and Free T4 – A routine blood work only checks for TSH but I take a more detailed look into your thyroid function by checking your Free T3 and Free T4 as well.
- Having decreased thyroid function can cause low energy, sluggishness, increased sleep, weight gain etc.
- Low Temperature – If the basal body temperature is <1°C than normal, the thyroid or adrenal hormone production may be low. [Normal temp. = 37°C or 98.6°F]
- Desiccated thyroid – Depending on how low you may be, you would be prescribed desiccated thyroid, which is better than synthetic alternatives like eltroxin and synthroid. Desiccated thyroid is actual dried and powdered porcine thyroid glands.
- This is dealt in detail under the heading CHRONIC ADRENAL FATIGUE
- SEX HORMONES
- DHEA is a hormone produced by the adrenal glands that converts into other hormones like Testosterone and Estrogen. The deficiency of these hormones may cause tiredness, low libido, menopausal symptoms, erectile dysfunction etc.
- It is good to top up these levels in order to bring down your biological age.
- Most of these tests are OHIP-covered, and based on the results, you may be supplemented with:
- DHEA 25 mg daily
- Testosterone cream
- Triple hormone cream (This cream is prescribed mostly for menopausal patients. It contains estrogen, progesterone and a hint of testosterone)
- Progesterone cream (This cream is mainly prescribed for patients who also currently have heavy periods and PMS symptoms. The dose is 0.1cc twice a day, to be applied from Day 15 to Day 28 of the menstrual cycle. This dose may be increased up to 0.2cc if hot flashes are not controlled)
- These bio identical hormone creams are specially compounded as per my prescription and are available at all my clinics.
Dealt with in detail under MY APPROACH TO CHRONIC FLU/ INFECTIONS
- DEFICIENCY OF NUTRIENTS
- Deficiency of certain nutrients can also cause tiredness and aches.
- In order to rule out such nutritional deficiencies, I may test the following levels:
- Vitamin D
- Vitamin B12
- Serum iron
- Serum folic acid
- The conventional recommended daily dosage of Vit. D is 1000IU/day. This is far from being adequate. The dosage I usually advice is 5000IU/day.
- Vitamin B12 levels above 600 is ideal in my opinion. In order to keep it at such a high level, sometimes oral supplementation will suffice. For others, a subcutaneous injection of 1cc Vit B12 may be prescribed.
- TOXIC NUTRITION (HEAVY METAL INTAKE)
- Over many years, everyone tends to accumulate heavy metals in their bodies.
- The source – The heavy metals may have entered your body through various sources like Cadmium (from cigarettes), Lead (from old water pipes) and Mercury (from seafood and dental fillings). High mercury levels due to amalgam fillings are one of the most common cases I come across. Other heavy metals include Aluminum, Cesium and Gadolinium.
- The accumulation – These metals don’t have an escape plan in our body. They don’t get broken down or flushed out. They accumulate in our cells and circulation and over time, causes toxicity. This consequently produces symptoms like brain fogging, tiredness, circulatory issues etc.
- Heavy Metal Challenge Test – For patients who have had long-term exposure to heavy metals, I strongly recommend this test. It’s a 2-hour IV treatment with EDTA and DMPS (which are chelating agents), following which a urine sample will be collected and sent away to the US for analysis.
- Depending on the results, I can recommend chelation treatments like:
- DMPS treatment – To chelate mercury. Must have amalgam fillings removed prior to starting treatments. Can be done once in 2 weeks only.
- EDTA treatment – To chelate lead, cadmium, aluminum etc. Max: thrice a week.
- Most patients struggle with some sort of food allergy on a daily basis – and most are unaware of it. The allergy can be mild, moderate or severe.
- Severe allergies are the obvious ones – where one can swell up and have extreme difficulty in breathing, or have rashes and itching.
- Mild-moderate allergies – these are the ones that just give you gas, reflux, bloating, belching, heartburn, abdominal cramps, diarrhea or constipation.
- What many people don’t understand is that food allergies harm you over time. Every time you eat something you are allergic to, your body needs to produce antibodies against it.
- Your body therefore, is constantly in fight mode as the ”enemies” keep pouring in – this weakens the immune system and distracts the body from the real issues like a possible underlying infection. This, in turn, causes or aggravates most of the symptoms.
- Food Allergy Test
- If you have any of the above mentioned symptoms, then I would strongly recommend a food allergy test.
- This is a simple test that uses 3 drops of blood to identify IgG antibodies against 96 different foods. It covers all food groups like dairy, poultry, seafood, meats, fruits, vegetables, legumes, wheat etc.
- The results even tell you what degree of reaction you have towards that food – ranging from “No reaction” to “Severe”. It also comes with a diet booklet that guides you through the allergy elimination process.
- For patients who have food allergies, I also recommend taking digestive enzymes to aid the digestive process. This natural supplement contains bromolein, chymotrypsin, amylase, lipase, trypsin, papain, lysozyme etc.
- Neurotransmitter imbalance. Biochemical imbalances of Serotonin, GABA and Dopamine can be helped by natural supplements such as St. John’s Wort, 5-HTP, or SAMe. Since it is hard to accurately determine which neurotransmitter is deficient, offering an intravenous buffet of neurotransmitter precursors allows the body to utilize what it needs. In my practice, I recommend Intravenous amino acid. I had observed amazing results on restorative balancing of patient’s mood such as anxiety or depression.
- Emotional trauma. These are events or situations that overwhelm the individual’s ability to cope, and eventually feel emotionally, cognitively, and physically overwhelmed. I do recommend patients to undergo Emotional freedom technique(EFT)which utilizes light tapping technique combined with verbalizing the identified problem followed by a general affirmation phrase. This balances the energy system and appears to relieve psychological stress and physiological pain.
- Work Overload is one of the commonest reasons for tiredness in modern society: taking on more than one can handle; taking on a bigger mortgage than one can comfortably afford; being a working mother with not enough resting time, etc. No amount of medicine can erase the fatigue until a person does some fundamental lifestyle changes.
- If one can learn meditation technique, it would be extremely wonderful for recharging and rebalancing the body. Here is a link http://marc.ucla.edu/mindful-meditations that can help you start meditation.
* Dr. Shiela Torabi provides top internal medicine care to the following communities: Seven Oaks, Grapevine, Visalia, Tulare, Shafted, Dela, Alame, Lamo, Edison.
* For up to a 1.5 hour visit, Dr. Sheila Torabi charges $525 per visit and she accepts Medicare and some private insurances. Please bring your previous labs to your appointment.