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Chapter 4
Conventional Medical Therapies
“Today’s standard, AMA-approved medicine is rooted in treating symptoms, rather than causes. Its dependence on drugs and surgery is ruinously expensive to patients, insurance companies, “Why I Left Orthodox Medicine” Conventional medical treatments for FMS and CFS is a controversial topic. Consider the following statements from The American College of Rheumatology:1 “Conventional medical therapies are ineffective and no better than a sugar pill for the treatment of Fibromyalgia.” “On tricyclic medications Amitriptyline (Elavil): Four controlled trials have evaluated the efficacy of Amitriptyline in Fibromyalgia…the longest trial showed no benefit when compared to placebo. Furthermore, the overall degree of benefit was found to be relatively small in relevant outcomes such as improvement in pain, fatigue, and sleep.” Of note, 95% of Amitriptyline (Elavil)-treated patients experienced “Furthermore, use of anti-anxiety medications Benzodiazepines (Klonopin, Xanax etc.), corticosteroids (medrol dose packs, pred- nisone, etc.), and nonsteroidal anti-inflammatory agents (Mobic, Celebrex, Vioxx, Bextra, etc.), and pain medications have been shown to be ineffective and should be generally avoided.” Most doctors continue to rely on prescription medications to treat fibromyalgia, even though their own studies show they are ineffec- tive and can cause unwanted side-effects.
“And our best therapies Amitriptyline (Elavil) and Cyclobenzaprine (Flexeril) could not be distinguished from place- bo after three months of therapy. Long-term, follow-up observa- tions indicated that clinical findings for patients with FMS did not change appreciably after 15 years.” The ACR has, like many physicians, thrown up their hands and admitted they have little if anything to offer for those suffering fibromyalgia. Yet, many are quick to ridicule nutritional therapies that consistently have been shown to be effective in treating fibromyalgia. The usual reply is that “there are no controlled stud- ies.” Or how about this one: “Nutritional supplements aren’t Chapter 4: Conventional Medical Therapies Traditional medical treatments of FMS and CFS focus on control- ling the various symptoms. Physicians generally rely on several different prescription medications, including pain medications of various sorts, muscle relaxers and tranquilizers, antidepressants, and nonsteroidal anti-inflammatory medicines.
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) Vioxx, Celebrex, Bextra, EtcNSAIDs can be helpful especially when used for inflammation that comes from traumatic injuries (sprains, strains, accidents, etc.).
They can be effective in relieving pain and inflammation associat- ed with chronic pain syndromes, including all forms of arthritis and some symptoms of FMS. However, long term use of these medications can cause a host of unwanted side effects. None of these medications actually correct the cause of pain. In fact they can accelerate joint destruction and cause intestinal permeability Nonsteroidal anti-inflammatories (NSAIDs) such as Bextra, Mobic, Ibuprofen, Daypro, Naprosyn, Celebrex, and Vioxx can cause intestinal permeability. They cover up the symptoms but do not address the cause, and they can actually cause further joint Vioxx is Removed from MarketMerck has pulled the drug Vioxx off the market because a long- term clinical trial showed that some patients, after taking the drug for 18 months, developed serious heart problems. The data that ultimately persuaded the company to withdraw the drug indicated 15 cases of heart attack, stroke, or blood clots per thousand people each year over three years compared with 7.5 such events per thousand patients taking a placebo.
Internal memos show disagreement within the FDA over a study by one of its own scientists, Dr. David Graham, who estimated Vioxx had been associated with more than 27,000 heart attacks or Studies show that Vioxx users have twice the number of heart attacks as those taking Naproxen. These new drugs which block COX–2 enzymes may promote excessive blood clot formation. It appears that COX–2 enzymes counteract some of the effects of COX–1 enzyme which narrows the blood vessels. This narrowing then causes blood to be more likely to clot.4 Controversy has shrouded Vioxx almost since its introduction in 1999. The drug was among the first of the COX–2 inhibitors, which were developed to reduce pain and inflammation without the risk of ulcers and other gastrointestinal side effects posed by aspirin and other over-the-counter medications. Thousands of Americans die every year from internal bleeding caused by the NSAIDs causes 10,000 to 20,000 Deaths a YearA person taking NSAIDS is seven times more likely to be hospital- ized for gastrointestinal adverse effects. The FDA estimates that 200,000 cases of gastric bleeding occur annually which leads to Chapter 4: Conventional Medical Therapies Pfizer’s Celebrex and Bextra Don’t Protect the StomachStudies show that only Vioxx is less damaging to the stomach.
Celebrex and Bextra are not. This is one of the dirty little secrets that never got out about Pfizer’s two block-buster drugs; they’re no safer than older nonsteroidal anti-inflammatory drugs.
New COX–2 NSAIDs Are No Better Than Older MedicationsStudies also show that neither drug (Celebrex or Bextra) alleviated pain any better than the older medicines. And the drugs cost close to $3 a pill. Over-the-counter pain relievers, in contrast, cost Other COX–2 drugs including Celebrex and Bextra are being linked to an increased risk of heart attack and stroke. It may be a matter of time before all COX–2 drugs are pulled from the market.
For a more detailed description of COX–2 hormones, please see chapter 9, Chronic Pain and Inflammation.
High Blood PressureNSAIDs can cause high blood pressure. In one study, 41% of those who had recently started on medication to lower their blood pressure were also taking NSAIDs. NSAIDs more than double a person’s risk of developing high blood pressure.6 Ultram, Hydrocone, Loritab, Darvacet, Duragesic Patches, EtcPain medications can be very helpful in relieving acute and chronic pain. Unfortunately, pain medications eventually lose their effectiveness. This is especially true in the case of FMS. If pain medications worked (long term), I’d be out on the streets buying them for my patients. However, people taking pain medica- tions find they have to take an ever increasing dose to get any relief. Before they know it, they’re addicted to a potentially life threatening drug. Eventually, the drug stops providing any pain relief. Another drug or an additional drug is tried, and the process continues until the person becomes zapped of their vitality, living hour to hour in accordance with their medication schedule. Ambien, Elavil, Flexeril, Trazadone, Restoril, Klonopin,Ambien (zolpidem) is a short-acting drug that usually lasts
for four–six hours. If a patient takes a half dose before bed, then he can take an additional half dose if needed four–six hours later. Even though the literature on Ambien suggests patients don't build up a tolerance, many do. Some patient's do well on Ambien; some build up a tolerance over a period of time needing higher and higher doses until the medicine no longer works. This medication does promote deep, restora- Chapter 4: Conventional Medical Therapies Some side effects are short term memory loss, fuzzy thinking, sedation or next day hang over, mood disorders (anxiety and depression), flu-like symptoms, muscle aches, and This drug, like most drugs, is processed by the liver, so those with sluggish liver function should use this medication with caution. Most common side effects include dizziness and diarrhea. Some patients complain of loss of coordination or concentration. Ambien has caused amnesia (short-term memory loss), but this happens mostly at doses exceeding 10 mg Patients are cautioned against abruptly stopping the medicine, since withdrawal symptoms commonly occur.
Ambien may cause fatigue, headache, anxiety, difficulty sleeping, and memory loss. Long-term use can result in back pain, flu-like symptoms, depression, constipation, upset stomach, joint pain, URI, sore throat, urinary infection, and • Trazadone (desyrel) is an antidepressant that increases a
person’s ability to hang on to serotonin. It reduces anxiety, and promotes deep sleep. I’ve found this drug to be quite helpful when 5HTP or melatonin doesn’t work. It can cause early morning hangover. This medication does promote deep Common side effects include upset stomach, constipation, bad taste in the mouth, heartburn, diarrhea, rash, rapid heartbeat, mental confusion, hostility, swelling in the arms or legs, dizziness, nightmares, drowsiness, and fatigue. • Soma (carisprodol) is a tranquilizer that acts on the central
nervous system to relax muscles. It’s used as a sleep aid and muscle relaxer. The most common complaint is its sedating nature. It can be helpful, especially if there is a great deal of muscle guarding or chronic unrelenting tightness. This med- ication does not promote deep, restorative sleep.
Soma and other muscle relaxants have an assortment of unwanted side effects including fatigue, rapid heartbeat, dizziness, depression, breathing difficulties, chest tightness, • Elavil (amitriptyline) is an antidepressant that has become
synonymous with treating FMS. It was one of the first drugs to be studied in the treatment of FMS. It can be very helpful in reducing the pain associated with FMS, but it has several potential side effects. It is also prone to lose its effectiveness over time. This medication does promote Elavil may cause weight gain, early morning hangover, neu- rally mediated hypotension (low blood pressure), depression, poor sleep, anxiety, and irregular heartbeat.
Flexeril (cyclobenzaprine) is a muscle relaxant chemically
similar to the antidepressant Elavil. It is sometimes used as a sleep aid. Unlike many of the prescription medications for sleep, Flexeril does allow the patient to go into deep stage four (restorative) sleep. It is quite sedating. This medication does promote deep, restorative sleep.
Chapter 4: Conventional Medical Therapies Side effects, including gastritis and a feeling of being hung- over or “out of touch,” prevent most patients from remaining • Baclofen (lioresal) is a muscle relaxant similar to the natural
neurotransmitter GABA. This medication does not promote Side effects include fatigue, drowsiness, low blood pressure, weakness, dizziness, nausea, headache, depression, weight • Sonata (zaleplon) is designed to last for only four hours. This
helps prevent morning hangover. I’ve not found it to be very effective, though, since most of my patients have trouble sleeping through the night, not just with getting to sleep. Side effects include drowsiness, amnesia, tingling in hands and/feet, abnormal vision, mood disorders, and perversion of • Zanaflex (tizanidine) is a muscle relaxant that has gained
some popularity among physicians treating FMS. It is sedat- ing and, like other muscle relaxers, can help with insomnia.
This medication does not produce deep, restorative (delta- wave) sleep. It does not help increase serotonin levels; it only tranquilizes the nervous system. For this reason alone it Zanaflex is associated with numerous side effects including liver failure (at least three individuals have died from taking this medication), asthenia (weakness), somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), dizziness, UTI (urinary tract infection), con- stipation, liver injury, elevated liver enzymes, vomiting, speech disorder, blurred vision, nervousness, hypotension, psychosis/hallucinations, bradycardia (slow heart action), pharyngitis (sore throat), and dykiensia (defect in voluntary • Anti-anxiety medication or Benzodiazepines:
Xanax, Klonopin, Ativan, Restoril, Busbar, Tranxene,
Serax, Librium,Tegretol, Valium, Trileptal, Seraquel,
Risperdal, Symbax
These medications are usually used as anti-anxiety medica- tion. They’re addictive, and patients build up a tolerance so that the drug eventually loses it effectiveness as a sleep aid.
These medications have many side effects that contribute to poor health and should be (slowly over a 4 week period) No one has an anti-anxiety drug deficiency. Increasing low serotonin levels with 5HTP and, if needed, using gamma- amino-butyric-acid (GABA) helps prevent anxiety rather Remember: you should work with a medical doctor and slowly wean (over a 4 week period) off these medications. There are numerous withdrawal symptoms associated with these drugs, Chapter 4: Conventional Medical Therapies The big problem with these medications is that they are loaded with side effects that cause further health problems (depression, fatigue, memory loss, “fibro fog’” etc.) yet don’t Side effects associated with these medications include sleep disturbances (poor sleep), seizures, neuropsychiatric distur- bances (mania, depression, suicide, etc.) tinnitus (ringing in the ears), transient memory loss (amnesia), dizziness, agita- tion (anxiety), disorientation, hypotension (low blood pres- sure), nausea, edema (fluid retention), ataxia (muscular in- coordination), tremors, sexual dysfunction (decreased desire and performance), asthenia (weakness), somnolence (pro- longed drowsiness or a trance-like condition that may contin- ue for a number of days), and headaches.
Neurontin and Gabitril
GABA inhibitors such as Gabitril (tiagabine) and Neurontin (gabapentin) are anticonvulsant medications originally used to control seizures. They are now being used to block nerve- related pain (neuralgia) including pain caused by herpes zoster. These medications are also being prescribed for chron- ic headaches (with some success). I’ve not found them to be helpful for the diffuse extremity pains associated with FMS.
They don’t promote deep, restorative sleep and can cause many of the same symptoms associated with CFS and FMS.
Most patients can wean off these medications with no prob- There are several side effects associated with their use, including somnolence (prolonged drowsiness or a trance-like condition that may continue for a number of days), dizziness, weakness, fatigue, double vision, edema (fluid retention), ataxia (muscular in-coordination), thought disorder, possible long-term ophthalmic problems (abnormal eyeball movements and disorders), tremors, weight gain, back pain, constipation, muscle aches, memory loss, asthenia (weakness), depression, abnormal thinking, itching, involuntary muscle twitching, Don’t these side effects sound like some of the symptoms Interestingly, the pharmaceutical giant Pfizer recently plead guilty to marketing Neurontin for uses unapproved by the federal government. They were fined $430 million, including a $240 million criminal fine, the second-largest in a health-care fraud prosecution. Of course, Pfizer’s 2003 revenue was $45.1 billion. The company admitted to marketing Neurontin to treat bipolar disorder, attention deficit disorder, Lou Gehrig's disease, drug and alcohol withdrawal seizures, migraine headaches, and restless leg syndrome, even through a scien- tific study showed a placebo worked as well as or better than Neurontin for bipolar disorder. Marketing tactics included paying doctors to attend presentations in lavish vacation • Topamax (topiramate) is used primarily for adjunctive
therapy for tonic-clonic seizures. It is also used for anxiety Chapter 4: Conventional Medical Therapies The side effects associated with this drug, especially the fatigue and low blood pressure, prevent patients from having Note this excerpt from a letter from the manufacturers of Topamax (Ortho-McNeil Pharmaceutical, Inc.) to doctors: “Topamax: drug used to control epilepsy, off-label drug for anxiety or insomnia—may cause serious eye damage and/or blindness. As of August 17, 2001, there have been 23 report- ed cases: 22 in adults and one in pediatric patients. It is gen- erally recognized that post-marketing data are subject to sub- • Beta Blockers:
Inderal, Lorpressor, Tenormin, Torprol, Etc
Beta blockers, such as Inderal (propanol), Lorpressor (metopr- lol), Tenormin (atenolol), and Torprol (metoprolol), are used for long-term management of angina (chest pain), mitral valve prolapse (MVP), heart arrythmias (irregular heart beats), and hypertension (high blood pressure). These medications have some very serious side effects and should be avoided at all costs. I’m always amazed at how many of my patients are taking these drugs for MVP. The best way to stop the symp- toms associated with heart irregularities, including MVP, is to correct magnesium deficiency. Magnesium is certainly a lot safer than these drugs (should be taking 500 to 700 mg of Beta-blockers slow the heart rate, which reduces cardiac out- put. This leads to low blood pressure and fatigue. The brain and muscles aren’t getting enough blood and oxygen. This can lead to fuzzy thinking, poor memory, depression, anxiety, According to Mark Houston, MD, associate clinical professor of medicine at Vanderbilt School of Medicine, side effects associated with beta-blockers include congestive heart failure (CHF), reduced cardiac output, fatigue, heart block, dizziness, depression, bradycardia (decreased heart beat and function), cold extremities, parathesia (a feeling of “pins and needles”), dyspnea (shortness of breath), drowsiness, lethargy, insom- nia, headaches, poor memory, nausea, diarrhea, constipation, colitis, wheezing, bronchospasm, Raynaud’s Syndrome (burn- ing, tingling, pain, numbness, or poor circulation in the hands and feet), claudication, hyperkalemia (muscle cramps), muscle fatigue, lowered libido, impotence, postural hypoten- sion, raised triglycerides, lowered HDL, raised LDL, and hyperglycemia. Dr. Houston recommends Hawthorne berry as a natural beta-blocker alternative. Hawthorne berry is an ACE inhibitor; it works by inhibiting (blocking) the angiotensin-converting enzyme. This enzyme is what causes the constriction of arteries (raises blood pressure and heart contraction/rate). Recommended dose of Hawthorne berry is 160–900 mg of standardized extract daily.
I have found that most people can wean off beta-blockers and other high blood-pressure medications by increasing their Omega-3 (fish oil) and magnesium (700 mg a day or up to bowel tolerance). Some individuals will also need niacin (B3) Chapter 4: Conventional Medical Therapies For more information about lowering cholesterol, blood pressure, or blood fats (triglycerides), please visit my website, www.DrRodger.com, or call 1-888-884-9577 to order a special report booklet on Beating Heart Disease, MVP, High Cholesterol, • Stimulants:
Adderall, Concerta, Cylert, Etc
Stimulants such as Adderall (amphetamine), Concerta (methylphenidate), Cylert (pemoline), Dexedrine (dextroam- phetamine sulfate), Focalin (dexmethylphenidate HCL), Metadate (methylphenidate), and Ritalin (methylphenidate) They can be very helpful in increasing a person’s energy. But you may remember the saying “speed kills.” With the excep- tion of Provigil, these medications are nothing more than various forms of amphetamines (“speed”). These drugs are incredibly hard on the adrenal glands. Long-term use can cause adrenal burnout at least and full blown Addison’s • Provigil, the narcolepsy drug, is being recommend for fatigue
associated with FMS and CFS. This medication is designed to keep a person from going to sleep. Yes, it can help wake you up in the morning and make you more alert. However, the reason you’re tired is because you’re not going into deep, restorative sleep each night. However, this medication will interfere with your normal circadian rhythm (sleep wake cycle). The worse thing you can do is take a medication that interferes with your circadian rhythm. Anything that may disrupt your ability to go into deep sleep each night, should Side effects include: insomnia (big problem), Tourette’s syn- drome (movement disorder consisting of grimaces, ticks, and involuntary outbursts), nervousness, unstable mood (anxiety, mania, depression, irritability, aggression, etc) tachycardia (rapid heartbeat), hypertension (high blood pressure), tics (abnormal muscle movements), psychosis (abnormal behav- ior), headaches, seizures, visual disturbances, anorexia (unwanted weight loss), aplastic anemia (arrested develop- ment of bone marrow), liver dysfunction, and blood Note: If you’re consistently sleeping through the night, then it is
probably best to wait on weaning off these medications. If natural sleep recommendations (5HTP, melatonin, etc.) aren’t working, then you need to wean off the amphetamines sooner.
When people do wean off these stimulants, they will feel very lethargic and even depressed for awhile (wean off these medica- tions slowly; over 4 week period). You can counter this by using the amino acid L-phenylalanine at 4,000–10,000 mg twice daily on an empty stomach (but not later than 4 p.m.). You should increase your adrenal cortex glandular dose to 1,000 mg twice daily. Or you can use S-adenolsyl-methionine (SAMe), 600 mg–1,000 mg daily, taken on an empty stomach. SAMe is a serotonin and norepinephrine reuptakeinhibitor. It quickly increases adrenaline levels and results in more mental and Chapter 4: Conventional Medical Therapies physical energy (without all the side effects associated with • Cholesterol Lowering Medications:
Lipitor, Zocor, Crestor, Etc
Cholesterol-lowering HMG-CoA reductase inhibitors (statin drugs) such as Lipitor (atorvastatin), Lescol (fluvastatin), Altocor (lovastatin), Mevacor (lovastatin), Pravachol (pravas- tatin), Zocor (simvastatin), and Crestor (rosuvastatin) can cause diffuse muscle pain similar to that seen in FMS and CFS. Also, consider this quote from JAMA: “Drugs that lower fats (lipids) and cholesterol have been shown to increase the Potential side effects of these drugs are myalgia (muscle pain), rhabdomyolysis (a destructive muscle disorder that usually causes temporary paralysis or weakness of the affect- ed muscle), myopathy (muscle inflammation), renal dysfunc- tion (kidney failure), dizziness, headaches, GI upset, arthalgia (joint pain), flu-like symptoms, elevated liver enzymes, and Again, these sound like a lot of the symptoms associated with Cholesterol is an Essential and Important FatContrary to popular medical fiction, cholesterol is an important part of overall health and doesn't cause (in and of itself) arte- riosclerosis. Cholesterol is essential in maintaining proper hor- mone production. Testosterone, dehydroepiandrosterone (DHEA), progesterone, estradiol, and cortisol are all made from cholesterol.
Cholesterol plays a major role in brain cell function. Furthermore, low cholesterol (130 and below) has been linked to certain mood disorders including depression and anxiety, as well as increased Cholesterol and fats are the very building blocks that make up each and every cell. Cholesterol is an important fat that helps keep cell membranes permeable. This permeability allows the good nutrients to get into the cell and toxic waste products to get out of Over 8% of the brain’s solid matter is made up of cholesterol.
Lipids (fat) make up 70% of the brain. This fat insulates brain cells and allows neurotransmitters to communicate with one Cholesterol is essential for proper brain function and normalized neurotransmitters (remember serotonin)! A deficiency in choles- terol can result in mood disorders including depression, anxiety, Cholesterol is also involved in the production of such essential hormones as DHEA, testosterone, estradiol, progesterone, and cortisol. Because it is essential to our very survival, the body manufactures cholesterol on a daily basis. Eliminating cholesterol from our diet only triggers the body to make more! Cholesterol is not the villain it has been made out to be. Rather, a deficiency in essential fatty acids and a diet high in trans-fatty acids provides the ammunition for cardiovascular Chapter 4: Conventional Medical Therapies There are receptor sites on the membranes at which point the happy hormones (serotonin and others) attach themselves. Trans-fatty acids block the cellular membrane receptor sites. A blocked or hardened cellular membrane prevents nutrients from entering and exiting the cell. The neurotransmitters are then unable to attach themselves to the cell’s membrane. This can lead to depression, insomnia, anxiety, fatigue, ADD, or any disorder that involves the brain hormones (serotonin, epinephrine, I don’t recommend patients stay on cholesterol-lowering medica- tions unless they have total cholesterol levels above 300. Even so, they should be using nutritional therapies to help reduce their Start with 400–500 mg of timed release niacin (vitamin B3). Make sure it is timed or sustained release form of niacin. This will pre- vent the flushing that occurs with high doses of regular niacin.
Some very sensitive individuals (especially if have a sluggish liver, hepatitis, fatty liver, etc.) will need to take a special form of niacin called “No Flush” niacin (inositolhexaniacinate).
Regardless, you’ll need to begin with 400–500 mg a day for 3 days.
Then increase to 400–500 mg twice a day for thee days. Then double the dose 800–1,000 mg twice a day.
You should also add policosanol (a derivative of sugar cane wax) and increase your fish oil intake (there is 2,000 mg in the CFS/Fibro Formula) to a total of 3,000–6,000 mg a day.
Policosanol has been shown in more than 15 double-blind controlled clinical trials to correct levels of total, HDL, and LDL For more information about lowering cholesterol, blood pressure, or blood fats (tryglycerides), please visit my website, www.DrRodger.com or call 1-888-884-9577 for information about ordering a special report booklet on Beating Heart Disease, High Cholesterol, and High Blood Pressure.
Antidepressants:
Prozac, Zoloft, Celexa, Paxil, Etc
Selective Serotonin Reuptake Inhibitors (SSRIs) SSRIs work by increasing the brain’s use of the neurotrans- mitter serotonin. Serotonin deficiency is linked to depression, lowered pain tolerance, poor sleep, and mental fatigue.
All SSRIs are partially or wholly broken down in the liver.
This can create liver dysfunction in some patients, so patients with a sluggish liver should be cautious in taking these med- Common side effects include headache, muscle pain, chest pain, anxiety, nervousness, sleeplessness, drowsiness, weak- ness, changes in sex drive, tremors, dry mouth, irritated stomach, loss of appetite, dizziness, nausea, rash, itching, weight gain, diarrhea, impotence, hair loss, dry skin, chest pain, bronchitis, abnormal heart beat, twitching, anemia, low blood sugar, and low thyroid. Examples of SSRIs include Zoloft (sertraline), Paxil (paroxetine HCL), Celexa (citalopram), Prozac (fluoxetine), Luvox (fluvoxamine), etc.
Chapter 4: Conventional Medical Therapies Other Side Effects Noted for AntidepressantsHarvard Medical School's Dr. Joseph Glenmullen recently reported on the many dreadful side effects associated with conventional anti-depressant medications. These include neurological disorders, sexual dysfunction (in up to 60% of users), debilitating withdrawal symptoms (including hallucinations, electric shock–like sensa- tions, dizziness, nausea, and anxiety), and decreased effectiveness Increased Link to Suicide Another frightening “side effect” is a suspected link between SSRI use and suicide in teenagers and children. Drug regulators have recommended that Paxil not be newly prescribed to anyone under age 18. Some regulators believe the risk extends to adult patients, No Better than a Sugar Pill?An article that appeared in the American Psychology Association’s journal reveals that SSRIs are not much better than placebo.
Although antidepressant medication is widely regarded as effec- tive, a recent meta-analysis of published clinical trials indicates that 75 percent of the response to antidepressants is duplicated by placebo. In other words these antidepressants were only 25 percent more effective than a sugar pill.10 • Wellbutrin (bupropion HCL) is usually reserved for major
depression. It increases the neurotransmitters serotonin, Side effects include seizures, dry mouth, rapid heartbeat, headache (including migraines), sleeplessness, loss of concen- • Effexor (venlafaxine) is chemically different from other anti-
depressants. It helps the brain hold onto serotonin, epineph- Effexor (venlafaxine) and Cymbalta (duloxetine) are known as serotonin and norepinephrine reuptake inhibitors (SNRIS) Side effects include blurred vision, fatigue, dry mouth, sleep- lessness, nervousness, tremors, weakness, nausea, constipa- tion, loss of appetite, and vomiting, pain, insomnia, (always take this medication in the morning), chest pain, fever, neck pain, migraine, increased appetite, weight gain, swelling or fluid retention, amnesia, confusion, vertigo, cough, itching, abnormal periods, increased risk of prostitis (inflammation of prostrate), problems with urination, vaginal inflammation, and dozens of less common side effects including the ones • Cymbalta has received a great deal of fanfare from its suppli-
er, Lilly. However, it is not really any different than Effexor, a drug that has been around for quite some time. The January 2005 issue of Best Pills Worst Pills News reports that this serotonin and norepinephrine reuptake inhibitor (SNRI) has been shown to cause liver toxicity. This medication can also cause high blood pressure. Cymbalta has been marketed has an antidepressant that also helps block pain. The Medical Chapter 4: Conventional Medical Therapies Letter on Drugs and Therapeutics found that Cymbalta was “nothing special” and concluded their October 11, 2004 report by saying: Whether duloxetine offers any advantage over venlafaxine (Effexor) or an SSRI (selective serotonin reuptake inhibitor) like fluoxentine (Prozac and others) remains to be established. The manufacturer’s claim that duloxetine is the antidepressant for painful symptoms associ- ated with depression is unsupported; no comparative trials Tricyclic Antidepressants: Elavil, Pamelor, Doxepin, EtcTricyclic antidepressants block the hormones serotonin and nor- epinephrine. This produces a sedative effect. They also reduce the effects of the hormone acetylcholine. Like other antidepressant medications, these drugs are processed by the liver and can cause Common side effects include sedation, confusion, blurred vision, muscle spasms or tremors, dry mouth, convulsions, constipation, difficulty in urinating, and sensitivity to light. Examples of tricyclic antidepressants include Pamelor (nortriptyline) and Elavil • Elavil (amitriptyline) is an antidepressant now synonymous
with treating FMS. It was one of the first drugs to be studied in the treatment of FMS. It can be very helpful in reducing pain, but it has several potential unwanted side effects: weight gain, early morning hangover, neurally mediated hypotension (low blood pressure), and irregular heartbeat.
Consult your doctor before discontinuing any medications.
I don’t recommend you stop taking your prescription medications until after you start feeling better on my program. Stopping med- ications can trigger a host of withdrawal symptoms. Start taking the supplements I recommend, build your stress coping system up, and allow your body to start healing itself. After you start feel- ing stronger (it may be a few months) then with the help of your doctor, slowly start weaning off the medications. Most of the med- ications can be weaned off and never missed. Some medications will have to be re-started until you become stronger or find other The medications listed below have potential side effects that will prevent you from beating FMS and CFS, and you should focus on weaning off of these medications (with the help of your medical doctor) first. These medications should be weaned off, one at a time, with the help of your doctor as soon as possible after start- ing the supplements listed in this manual.
• Zanaflex. This medication doesn’t promote deep sleep and can cause all sorts of symptoms including muscle aches, depres- sion, mental fatigue and all the other usual things associated • All the Anti-anxiety medication or Benzodiazepines:
Xanax, Klonopin, Ativan, Restoril, Busbar, Etc
These medications can cause depression, fatigue, and mental Chapter 4: Conventional Medical Therapies • Cholesterol Lowering Medications:
Lipitor, Zocor, Crestor, Etc
All cholesterol lowering medications, especially the statins, should be suspected as a cause of muscle aches, depres- sion, and lethargy. You should attempt to wean off these drugs and see if it has been a source of muscle pain. If it makes no difference, then no problem. Statins reduce CoQ10, and this is the cause of muscle pain. If you must stay on these medications (especially if total cholesterol is above 300), then I recommend you start taking 100–200mg • Stimulants:
Adderall, Concerta, Cylert, Etc
These medications bankrupt your stress coping account. They rob Peter to pay Paul. They interfere with your sleep/wake cycle and make sleep disorders even worse.
Beta Blockers:
Inderal, Lorpressor, Tenormin, Torprol, Etc
These medications prevent you from ever having any get up • Topamax – same as above.
Neurontin and Gabitril don’t seem to help with the pain
associated with FMS or CFS and are loaded with potential side effects that are a mirror images of those associated with The Emperor Has No ClothesDrugs can be helpful, but longterm use by those with chronic ill- nesses can lead to dependence and further complications. Short- term use to mask unwanted symptoms is certainly justified and appreciated by both the patient and the doctor. But FMS and CFS don’t develop from a deficiency of pain medicine. They are caused by a body’s inability to maintain homeostasis (a healthy balance).
Prescriptions can be invaluable, but most drugs have unwanted side effects. So sometimes the cure can be worse than the disease.
Studies now show that complications from prescription medica- tions kill over 100,000 people a year. These complications are the fourth leading cause of death in the United States! Only heart dis- ease, cancer, and accidents claim more lives each year.
In addition, many of the side effects of these drugs are similar or identical to the symptoms of FMS and CFS. These similarities can cause confusion when trying to determine the effectiveness of I believe prescription medications serve a valuable role in today’s health care. Not everyone can be drug free, and most of my patients are on at least one prescription medication. However, I also feel it’s best to use drugs judiciously. Drug therapy in and of itself will not correct all the symptoms of FMS and CFS. If it did, everyone would get well, and there would be no reason to be read- Prescription Medications Offer Little HopeA study conducted by the Mayo Foundation for Medical Education and Research demonstrates the need for FMS and CFS treatment beyond drug therapy. Thirty-nine patients with FMS were inter- Chapter 4: Conventional Medical Therapies viewed about their symptoms. Twenty-nine were interviewed again 10 years later. Of these 29 (mean age 55 at second interview), all had persistence of the same FMS symptoms. Moderate to severe pain or stiffness was reported in 55% of patients, moderate to a great deal of sleep difficulty was noted in 48%, and moderate to extreme fatigue was noted in 59%. These symptoms showed little change from earlier surveys. The surprising finding was that 79% of the patients were still taking medications to control symptoms.
We can conclude that the medications weren’t making a significant Medications Can Cause Nutritional DeficienciesAspirin depletes folic acid, iron, potassium, sodium and
Beta-blockers deplete coenzyme Q10 (co-Q10), an important
nutrient for liver function and for cardiovascular and overall health. This can lead to heart disease, fatigue and muscle • Amitriptyline (Elavil) depletes co-Q10 and vitamin B2. This
can cause headaches, anxiety, depression, heart disease, • Carbamazepine (Tegratol) depletes biotin, folic acid, and
vitamin D. This can cause pain, fatigue, and depression.
Celecoxib (Celebrex) depletes folic acid.
Corticosteroids (cortisone, dexamethasone, hydrocortisone,
prednisone) depletes calcium, folic acid, magnesium, potassi- um, selenium, vitamin C, vitamin D, and zinc. This can cause depression, fatigue, pain, heart disease, and other illnesses.
Digoxin (Lanoxin) depletes calcium, magnesium, phosphorus,
Estrogens (Estrace, Estratab, Estrostep, Menest, Premarin)
deplete magnesium, omega-3 fatty acids, vitamin B6, zinc, and Omega-3 fatty acids. This can cause pain, depression, poor immune function, and other illnesses.
Famotidine (Pepcid and Pepcid AC) depletes calcium, folic
acid, iron, vitamin B12, vitamin D, and zinc. May lead poor immune function, fatigue, depression, and pain.
Hydrochlorothiazide (Esidrix, Ezide, Dyazide, DydroDIURIL,
Hydro-Par, Maxide, Microzide, Oretic) depletes co-Q10, mag- nesium, potassium, vitamin B6 and zinc. This could cause pain, fatigue, depression, restless leg syndrome, irritable bowel syndrome, spastic colon, and other illnesses.
Nonsteroidal Anti-inflammatory Drugs (fenoprofen, ibupro-
fen, neproxen, Aleve, Anaprox, Advil, Excedrin, Motrin, Naprosyn, Nuprin, Orudis, and Pamprin) deplete folic acid.
This can cause anxiety and depression.
Omeprazole (Prilosec) depletes vitamin B12. This can lead to
Oral contraceptives deplete vitamin C, vitamin B2, folic
acid, magnesium, vitamin B6, vitamin B12 and zinc. This could lead to poor immune function, anxiety, depression, • Prevastatin (Pravachol) depletes co-Q10. This could lead to
heart disease, fatigue, and muscle pain.
Ranitidine Hydrochloride (Zantac) depletes calcium, folic
acid, iron, vitamin B12, vitamin D, and zinc. This could cause poor immune function, fatigue, depression, anxiety, restless • Triamterine (Dyrenium) depletes calcium, folic acid, and
zinc. This could cause fatigue, depression, anxiety, and poor • Valproic acid (Depacote) depletes carnitine and folic acid.12
Chapter 4: Conventional Medical Therapies This could contribute to diabetes, depression, and fatigue.
Lipitor, Crestor, Zocor, etc., or statin drugs block
production of co-Q10. This action can lead to muscle The System is Clearly BrokenThe Centers for Medicare and Medicaid stated in a recent report that the nation spent $140.6 billion in the year 2000 on prescrip- It is estimated that over one billion prescriptions were written last year. But though the US spends more money per capita than any country in the world, the World Health Organization ranks the overall health of the US as 15th among the 25 industrialized Our current AMA-dominated paradigm is based around controlling symptoms. Conventional medicine has made very little progress (if any) in correcting the causes associated with most of today’s chronic illnesses: heart disease, cancer, arthritis, diabetes, and The Office of Technology Assessment, under the authority of the Library of Congress, published a year-long study entitled “Assessing the Efficacy and Safety of Medical Technology.” The study showed that only 10–20% of all present-day medical prac- tice has been shown to be beneficial by scientific controlled clini- cal trials. The study concluded that the vast majority of medical procedures now being utilized routinely by physicians are The Myth of Health in AmericaDeath from medical errors is now the third leading cause of death in the US, behind heart disease and cancer. As reported in JAMA, over 250,000 Americans die each year from medical therapies, including at least 113,000 from the negative effects of prescription For instance, calcium channel blockers, used to treat high blood pressure and heart disease, actually increase the risk of stroke and of heart attack five times, according to Dr. Kurt Ferver, Wake Propulsid, a drug used for GERD and gastro paresis (delayed emp- tying of the stomach usually found in diabetics), caused severe heart rhythm abnormalities. In June 1998, the FDA issued a statement reporting 38 deaths in the United States from people taking Propulsid: “Due to reports of serious heart arrhythmias and deaths in people taking Propulsid (Cisapride), the label had been • 30 million Americans suffer from serious arthritis.
• 13 million Americans suffer from diabetes.
• 80 million Americans suffer from serious allergies.
• 64% of the population is overweight.
• More than 10 million suffer from psoriasis.
• More than 10 million have asthma.
• Each year, Americans consume 5 billion sleeping pills.
• Each year, 15,000 Americans die from sleeping pills.
• 13 billion barbiturates and amphetamines are consumed • 36,000 tons of aspirin are consumed each year.
Chapter 4: Conventional Medical Therapies • Life expectancy for a 1-year-old is no longer now than it was • The life expectancy of an American man ranks 20th in the • The life expectancy of an American woman ranks 15th in the • In 1987, 33,592,000 Americans were admitted to hospitals.
• That same year, we had 300,960,000 outpatient visits in • 5 million are hospitalized each year for side effects to pre- • 50% of Americans die of heart disease.
• 1,000 Americans die each day from cigarettes.
• 461,563 Americans died from cancer in 1985. 469,376 died • From March 1990 to March 1991 alone, 508,210 people died • 86% of our children can’t pass a minimum physical fitness Recommended ReadingWhat Doctors Don’t Tell You by L ynne McTaggart, Avon Books.
The Truth About the Drug Companies by Marcia Angell, MD, former editor of The New England Journal of Medicine.
Why I left Orthodox Medicine by Derrick Lonsdale, MD, Hampton • What Your Doctor Didn’t Learn In Medical School by Stuart Berger, MD, William Morrow and Company.
The Pill Book, 10th edition by Harold M. Silverman; 2002.
1. Robert W. Simms, MD: Associate Professor of Medicine, Clinical Director, Rheumatology Section, Boston University Arthritis Center, Boston, Massachusetts.
2. Shield MJ. Anti-inflammatory drugs and their effects on cartilage synthesis and renal function. Eur J Rheumatol Inflam 1993; 13:7–16.
3. NSAIDs actually increase the acceleration of osteoarthritis and increased joint Brooks PM, Potter SR, Buchanana WW. NSAID and osteoarthritis help or hinderence. 5. Drs. Peter M. Brooks and Richard O. Day, New England Journal of Medicine, 1991; 6. Archives of Internal Medicine. Oct 28, 2002; 162: 2204–8.
7. Carcinogenicity of Lipid-Lowering Drugs. JAMA, January, 1996.
8. Natural Health and Science, Inc. Website. Drug Induced Nutrient Deficiencies by 9. FDA Talk Paper T04-31 August 20, 2004.
11. Farrell, Greg. “Pfizer settles fraud case for $430 million” USA TODAY.
12. Kirsch, Irving (University of Connecticut), Moore, Thomas J. (The George Washington University School of Public Health and Health Services), and Scoboria, Alan and Nicholls, Sarah S. (University of Connecticut). “The Emperor's New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration.” Prevention & Treatment, Volume 5, Article 23, posted July 15, 2002. American Psychology Association.
14. Journal of the American Medical Association, September 14, 1994.
15. Drs. Peter M. Brooks and Richard O. Day, New Eng J of Med, 1991;324(24):

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