Causes & Therapies
There is no one specific lab test to confirm that you have CFS or fibromyalgia. Because of this and other limitations in lab testing, diagnosis is often made by a practitioner and patient after medical evaluation and lab testing have eliminated other possible causes. An experienced practitioner can see subtle nuances in traditional blood testing that indicate CFS/FMS. Because of the need to exclude other disorders with similar symptoms, such as Lyme’s Disease, MS or depression, it can often take months of evaluation before a person realizes they have CFS/FMS.
What Causes CFS?
CFS/FMS acts as a "circuit breaker," with the hypothalamus decreasing its function to protect the individual in the face of what is perceived to be an overwhelming stress (just like blowing a fuse/circuit breaker in a house). This center controls sleep, hormones, temperature, and blood flow/blood pressure/sweating. When you don't sleep deeply, your immune system also stops working properly and you'll be in pain. In addition, if your muscles do not have enough energy, they will get stuck in the shortened position and you will be in pain (think rigor mortis). This "energy crisis" can be caused by any of a number of infections, stresses, or injuries.
Some of you had your illness caused by any of a number of infections. In this situation, you can often give the time that your illness began almost to the day. This is also the case in those of you who had an injury (sometimes very mild) that was enough to disrupt your sleep and trigger this process. In others the illness had a more gradual onset. This may have been associated with hormonal deficiencies (e.g., low thyroid, estrogen, testosterone, cortisone, etc.) despite normal blood tests. In others, it may be associated with chronic stress, antibiotic use with secondary yeast overgrowth, and/or nutritional deficiencies. Indeed, we have found well over 100 common causes of, and factors that contribute to, these syndromes.
Understanding this helps us understand the symptom complex seen in CFS/fibromyalgia. Restoring energy production so that your hypothalamic circuit breaker turns back on and eliminating what blew your fuse in the first place also gives us a way to effectively treat you!
How Do I Get Well?
A half-century of work by Dr. Janet Travell, the White House physician for Presidents Kennedy and Johnson and author of the Trigger Point Manual showed that the same problems caused by hypothalamic suppression resulted in muscles getting stuck in the shortened position. Chronic muscle shortening then causes myofascial and fibromyalgia pain. As she laid the groundwork for effective treatments these processes, our research team dedicated our published study to her memory.
To "turn your circuit breaker back on," five main areas of health have to be tended to. I summarize these as the term "S.H.I.N.E."
S.H.I.N.E. — A Holistic Approach to Optimizing Energy
In his 30 years of clinical experience treating CFS/FMS, and in his landmark published research on CFS/FMS (published in the Journal of Chronic Fatigue Syndrome), Dr. Teitelbaum has found that his S.H.I.N.E. approach is successful in the vast majority of patients. S.H.I.N.E. identifies five key areas related to the body that, when addressed in combination, provide a blueprint for promoting optimal energy. Tending to these can help you maintain healthy energy levels when you are well, and can help support recovery when dealing with CFS and fibromyalgia.
|SLEEP: Get adequate sleep, preferably eight to nine hours a night. Sleep replenishes the body's energy and heals its muscles. Inadequate sleep will leave you exhausted and in pain.|
|HORMONES: Get tested for hormone deficiency and treated if needed. Hormone deficiencies can contribute to fibromyalgia and chronic fatigue syndrome.|
|IMMUNITY: Get treatment when symptoms of infections occur. The lack of restorative sleep in CFS/FM leads to dysfunctional immune systems. Underlying viral, bacterial, bowel, sinus and yeast infections are common and can be a contributing cause or result of CFS/FM.|
|NUTRITON: To maintain normal health and optimal energy levels you need to be sure you body is getting a proper balance of nutrition, particularly as nutritional deficiencies can result from CFS/FM. Vitamin B-12, magnesium, Acetyl L-Carnitine, glutathione, as well as your basic A, B, C and D vitamins are especially vulnerable to depletion from this.|
|EXERCISE: Exercise as able. After 10 weeks on the 4 steps above, you will be able to slowly increase your exercise-without being wiped out the next day!|
Our free Energy Analysis Program can help you in your approach in following the S.H.I.N.E. protocol. It is a specially designed, patented, questionnaire (a tool) that helps you pinpoint individual lifestyle and nutritional factors that are impacting your energy and vitality and overall wellness. You can complete this simple questionnaire here at our website (takes about 20-30 minutes to complete). The program analyzes your answers using special algorithms developed by Dr. T and then suggests where you may not be receiving proper nutrition for optimal performance of body structures and functions, along with recommendation on how to optimize those areas.
What to Expect
For most of you, CFS/FMS took months to fully manifest. It can similarly take several months to get well. Following the guidelines in S.H.I.N.E. will give you the fastest path to healing (though keep in mind that total recovery can take several months to over a year). You should remain focused on these five areas until you are feeling consistently well for six months or more (with no back slides), and be aware that it takes an average of six weeks to begin to feel the benefits.
In our published research study, over 90% of patients improved with treatment, with an average improvement in quality of life of 90%. Pain decreased by over 50% on average. Many patients no longer even qualified for the diagnosis of CFS or fibromyalgia! Interestingly, many of the same principles for treating fibromyalgia also apply to myofascial pain syndrome.
That the vast majority of patients improved significantly in the active group while there was minimal improvement in the placebo group proves two very important things. The first is that these are very treatable diseases. The second is that anyone who now says that these illnesses are not real or are all in your head are clearly both wrong and unscientific.
A new day is dawning in how CFS/fibromyalgia/MPS will be treated. In support of our work, an editorial in the April, 2002 journal of a major multidisciplinary medical society for pain management in United States noted "the comprehensive and aggressive metabolic approach to treatment detailed in the Teitelbaum study are all highly successful approaches and make fibromyalgia a very treatment-responsive disorder. The study by Dr. Teitelbaum et al. and years of clinical experience make this approach an excellent and powerfully effective part of the standard of practice for treatment of people who suffer from fibromyalgia and myofascial pain syndrome."
It is important to recognize that these syndromes can be caused and aggravated by a large number of different triggers. When all these different contributing factors are looked for, and treated effectively, patients improved significantly and often get well!
The American Board of Integrative Medicine (ABIHM) includes over 1,500 board-certified holistic practitioners who can help you. Their website can also help you locate a certified holistic physician near you.
My best-selling book From Fatigued to Fantastic! (Penguin/Avery 2001) and my book Pain Free 1-2-3 (McGraw Hill 2006) can supply you and your physician with wealth of information to help understand CFS and fibromyalgia..
We also provide personal counseling to help guide you through defining a wellness plan.