Transcript Finally - Effective Treatment for Fatigue, Pain, CFS, and

Chronic Fatigue Syndrome
and
Fibromyalgia
2009 “State of the Union”
May 12, 2009
Jacob Teitelbaum MD
Statistics
Approximately 6 - 12 million Americans(2-4-%)
have severe Chronic Fatigue Syndrome (CFS)
and/or Fibromyalgia (FMS) and another 6-12
million have a less severe form (intermediate
Fibromyalgia)
Only 15% of these have been given the correct
diagnosis
Prevalence has more than DOUBLED in the last
10 years!
Our “Gold-Standard” Research Shows:
Most people with pain and/or
CFS/FMS can reclaim their vitality and
be
PAIN FREE!
Even Very Severely Ill People
Tired
Achy
Brain fog
Can’t sleep?
Think CFS and Fibromyalgia
which are now very treatable!
Pathophysiology of CFS/FM
• CFS/FM represent a mix of many different
processes with a common endpoint
• Each problem may trigger other problems
• Like “blowing a fuse”, these syndromes
reflect an energy crisis in your body, and
can be triggered by anything that causes
severe stress or prevents energy
production
Causes of CFS & Fibromyalgia
• When ENERGY DEMAND is greater than
ENERGY SUPPLY
• Multiple causes and subsets—not the
same disease from person to person
Hypothalamus
• This circuit controls:
–
–
–
–
Sleep
Hormonal function
Temperature
Autonomic function (B/P, pulse, sweats, etc.)
• It requires an enormous amount of energy to
do all this• which is why it acts as a circuit breaker protecting the person from further injury
Pain
Your muscles also need a lot of energy
When you run out, they get stuck in the
shortened, rigid position and hurt –
including by the joints where they attach
(think about rigor mortis).
Chronic pain results in increased brain
sensitivity to pain (Central Sensitization)
Why You “Blew Your Fuse”
• Sudden Onset – think:
– Viral, parasitic or antibiotic sensitive infections
– Injury
– pregnancy
• Gradual Onset – think:
–
–
–
–
–
Hormonal or nutritional deficiencies
Yeast/Candida infections
Auto-immune diseases
Sleep disorders
Severe stress
Causes &Triggers-Current research
• May be caused by over a dozen different
infections
• Multiple hormonal deficiencies
(hypothalamic/pituitary)
• Excessive stress
• Sleep disorders
• Nutritional deficiencies
• Multiple neurotransmitter and cytokine
abnormalities
Clinical Research
Earlier research examined the efficacy of an
integrated treatment plan for the treatment of
CFS/FMS compared to placebo.
91 percent of the CFS and fibromyalgia patients
receiving active treatment experienced moderate
to marked improvement in their symptoms of pain
and fatigue compared to the placebo group.
Effective Treatment Of Chronic Fatigue Syndrome (CFIDS) & Fibromyalgia (FMS) - A
Randomized, Double-Blind, Placebo- Controlled, Intent To Treat Study. Journal Of Chronic
Fatigue Syndrome Volume 8, Issue 2 - 2001
Study Design
• Randomized Double-Blind
• Placebo-Controlled
• Intent to Treat Analysis
Results
(p<.0001)
Much
Better Same Worse
Better
Much
Worse
Active
16
13
2
0
1
Placebo
3
9
11
6
3
Well Being (Analog) Index Score Average • (By Group) – Per Visit
Active
350
330
310
290
270
250
230
210
190
170
150
Average Analog Score per
group by visit number
1. (p=.95)
2. (p=.0051)
3. (p=.0063)
4. (p=.0053)
Final (p=.0002)
Placebo
(*p<.0001 adjusted for baseline score)
Long Term Effectiveness
• A 2-year follow up showed that patients
continued to improve despite being able
to wean off most treatments
• They went from an average ~ 75%
improvement in quality of life at 99 days
to an average ~90% increase
New Research Data
• Follow up of ~ 15,000 CFS/Fibromyalgia
patients treated at the Fibromyalgia and
Fatigue Centers clinics is being readied
for publication
• ~85% of patients using the “SHINE
Protocol” improved. “SHINE” restores
both energy production and hypothalamic
function—while markedly decreasing or
eliminating pain
I had CFS/FMS in 1975
Since then, I’ve dedicated myself
to creating effective treatment for everyone
You “blew a fuse” (the hypothalamus)!
To turn it back on and make your
fatigue and pain go away,
5 main areas need to be treated…
Think “SHINE”
Sleep
Hormonal deficiencies
Infections
Nutritional deficiencies
Exercise as able
Avoid Writer’s Cramp
www.Vitality101.com
Do the Free Online Program to tailor a
treatment protocol to your case (and sign
up for a free e-mail newsletter to keep you
up to date)
Good Quality Sleep
Getting A Good Night’s Sleep
To eliminate pain and restore energy
production, it is critical to get eight to
nine hours of deep sleep each night.
However, because of sleep center
malfunction and pain, patients with
CFS/FMS do not stay in deep stages of
sleep.
Disordered Sleep in CFS & Fibromyalgia
• Studies have demonstrated that CFS/FMS
patients are at risk for many sleep disorders (in
addition to severe insomnia):
• Restless Leg Syndrome—Treating the iron
deficiency may be more effective than Requip
• Sleep apnea
• UARS- Upper Airway Resistance Syndrome
Healthy Sleep: Natural Support
• Passionflower and Wild lettuce help to calm and
induce and maintain sleep
• Jamaican dogwood promotes muscle relaxation
• Valerian and Hops - shown in clinical studies to both
help people fall asleep AND stay asleep
• L-theanine (an amino acid found in green tea) helps
create a relaxed feeling, and also has muscle relaxing
properties – while inducing deep sleep
• These herbs help the body relax and move through all
sleep stages - wake up calm and refreshed instead of
groggy and tired
Revitalizing Sleep Formula
• Contains all 6 of these herbs
• The BEST natural sleep aid available
• Take 1 – 4 caps as needed (1 hour
before bed time)
• Excellent for anyone with insomnia,
muscle pain and anxiety (even during
the day)
Some Prescription Sleep Aids
• Ambien
• Desyrel
• Klonopin
• Neurontin
• Lyrica
• Doxepin
HORMONES
Your body’s communication
and
control system
Hormone Production
• Hormones are produced by glands,which
are controlled by the hypothalamus.
Multiple studies are showing
Hypothalamic-Pituitary axis dysfunction
• Thyroid – your body’s gas pedal
• Adrenal (cortisol & DHEA) – the stress
handler
• Ovaries (estrogens and progesterone)
and testes (testosterone)
Hormonal Deficiencies
• Even mild under-production of hormones
(deficiency) can be associated with many
health problems, and leave you sick, tired,
“brain-fogged” and in pain!
• Hormonal deficiencies are common –
despite normal blood tests
• Treat with natural hormones
Low Thyroid Hormone
• Thyroid (the body’s gas pedal)
• Symptoms of low thyroid include:
– Fatigue
– Weight gain
– Joint/muscle pain (aches)
– Cold intolerance
– Thinning of lateral eyebrows
– Poor memory and depression
• Treat – Compounded or Armour Thyroid
(Rx) and nutritional support
Weight Gain
• The average weight gain in CFS is 32
pounds (in 2 studies in our research
center)!
• Can help promote weight loss by:
Addressing thyroid and adrenal
hormone deficiency
Taking acetyl-l-carnitine 1000 mg/day
Treating fungal overgrowth
Getting 8 hours sleep a night
Adrenal Burnout
• Too much time spent in a state of high
stress can exhaust the adrenal gland.
New research suggests “Adrenaline
Overdrive” and exhaustion
• Adrenal exhaustion is common and not
recognized yet by traditional medicine
• Symptoms:
 low blood pressure
 hypoglycemia
 crashing with stress
Natural Support of the Adrenal Gland
ADRENAL STRESS-END
• Glandular adrenal extract contains supportive
nutrients
• Vitamin C and pantothenic acid (Vitamin B5)
are critical to support adrenal gland function
• Licorice - supports cortisol and acts as an
antiviral
Also consider:
• DHEA if level is low and natural cortisol (cortef)
in ultra low dosing
Infections
• Most important is yeast/fungal overgrowth
• Suspect in all CFS/FMS patients. Markers
include sinusitis and spastic colon
• Rx – Acidophilus Pearls, low sugar (use
stevia), antifungals (e.g.-Anti-yeast), Diflucan
(Rx)
• New research shows both increase in bowel
yeast during flares of CFS and clinical
improvement with probiotics
Chronic Infections in CFS/FM
• Dozens of Chronic Infections in CFS
documented (several new ones this year)
– Viral
– Antibiotic sensitive
– Yeast (Candida and others)
– Parasites
Shows that the immune suppression is
primary, with the body picking up many
infectious “hitch hikers”.
Nutritional Deficiencies-New Research
• Research showing multiple Amino Acid
(protein) deficiencies
• Low tyrosine-Can contribute to low
dopamine, adrenaline and thyroid.
• May be caused by autonomic dysfunction
with adrenaline/sympathetic nervous
system overdrive
• Multiple other amino acid deficiencies are
also critical to treat (for glutathione,
neurotransmitters, etc)
Nutritional Deficiencies-New Research
• Multiple nutritional deficiencies are likely
• Which vitamin/mineral do you need? ALL
OF THEM!
• New research shows:
Vitamin D Deficiency (controversial)
Iron helpful for RLS (Restless Legs)
Iodine deficiency recurring in the USA
The Energy Revitalization System Makes It Easy
1 good tasting drink and 1 capsule
Replaces 35 supplement tablets a day!
Contains 50 key nutrients!
Supplies optimal nutritional support for everyone
easily and affordably
100% of my royalties go to charity
as a teacher, to avoid a conflict of interest, I refuse to take money
from any company whose products I recommend
Mitochondrial and Genetic Research
• 2 new studies documented defects in
genetic energy production
• Multiple studies showed a host of genetic
predispositions to CFS.
• Polymorphisms were found to correlate
with gene expression and were strong
predictors of CFS
D-Ribose-CORvalen
• This is an incredibly promising new nutrient for
pain and fatigue patients
• Ribose availability is a rate limiting issue in
energy production-especially in people having
an energy crisis
I consider it to be the most
important nutritional discovery of
the decade!
D-Ribose-CORvalen
• ATP is composed of Ribose, adenine and
phosphate groups
• FAD is ribose plus riboflavin and adenine
• Acetyl CoA is ribose plus pantothenic acid and
adenine
• DNA and RNA have ribose as a key
component
• Ribose deficiency in energy deficient states
can be a critical piece of the puzzle
CORvalen Study
• 36 CFS/Fibromyalgia patients
• 65.7% improved significantly(~20%
dramatically)
• Significant improvements were found in:
– energy levels (+45%),
– sleep patterns (+25%),
– mental clarity (+16%),
– pain (-14%), and the
– patient’s overall state of well being (+30%)
Mind Body Connection
• There is no longer a question whether
CFS is real and physical. It clearly is.
• All illnesses (e.g..-cancer, MS, heart
attacks) have a psychodynamic
• As with any illness, counseling should be
used to support the patient if needed—
not to invalidate the illness
• Cognitive Behavioral Therapy (CBT) not
effective by itself (75% drop out rate—
more patients got worse than improved)
Medications
• 3 new medications approved by FDA for
Fibromyalgia pain (Lyrica, Cymbalta, and
Savella)
• Though helpful, best to also treat the
underlying causes of the pain with
“SHINE”
From Fatigued To Fantastic!
The best-selling book on effective
CFS/Fibromyalgia therapies
It can teach you how to get your life back!
CFS & Fibromyalgia are
treatable!
Remember SHINE!
“Teitelbaum’s treatment approach is an excellent and
highly effective part of the standard of practice for
treating Fibromyalgia and MPS”
Editorial in the journal of the American Academy of Pain
Management
Getting Well Now
• Do the free patented online program at
www .Vitality101.com
It will analyze your symptoms (and labs if
available), determine the underlying
causes of your CFS & Fibromyalgia, and
tailor a treatment protocol to your case
Fibromyalgia and
Fatigue Centers
Physicians throughout the US who know how to
effectively treat CFS & Fibromyalgia.
New-International program now available
www.FibroAndFatigue.com
Finally….
Chronic Fatigue Syndrome
Pain And
Fibromyalgia
Are Now
Treatable!