A multipronged strategy
While treatment differs from patient to patient, a typical Fibromyalgia and Fatigue Center plan involves more than just one strategy. For example, Garabédian uses nutraceuticals, foods or components of foods or plants that help prevent and treat disease. However, he says, “Sometimes you need to add prescription drugs or other products to enhance the immune system and increase energy levels.” Garabédian says that 85 percent to 92 percent of his patients see significant improvement, although it takes an average of six months or longer. Also promising is a relatively new drug called Lyrica. Garabédian says the good news is not so much that Lyrica is an effective treatment for fibro (35 percent to 40 percent of patients who take it have an improved pain tolerance, he says), but rather because its presence in the market is helping to provide legitimacy to a syndrome and resources for a community of patients who need them.
Teitelbaum calls his treatment protocol SHINE, which stands for sleep, hormones, infections, nutritional supplements and exercise. Getting eight to nine hours a night of restorative sleep is recommended. To address the “H,” he typically prescribes natural thyroid and adrenal supplements. Try: End Fatigue Adrenal Stress-End ($17 for 50 capsules; endfatigue.com/store) and End Fatigue DHEA 5 mg ($5 for 60 capsules; endfatigue.com/store), as well as ovarian and testicular hormones. (Optimizing thyroid hormone is especially important during pregnancy.)
The “I” might be of particular concern for me because irritable bowel, sinusitis and C. difficile all seem to fall under the category of infection. While the immune system dysfunction associated with fibromyalgia is partly to blame, Teitelbaum says an overgrowth of a strain of yeast called Candida is also a significant problem. To eliminate Candida and restore the healthy balance in the gut, he recommends a high-quality probiotic. Try: Enzymatic Therapy’s Probiotic Pearls ($17 for 30 capsules; emersonecologics.com), or the herbal antifungal mix Anti-Yeast from Nutri Elements ($54 for 120 capsules; endfatigue.com/store). After a month on a probiotic, add the generic version of the prescription anti-fungal medication Diflucan (neither this nor the Anti-Yeast should be used during pregnancy). Cutting out most sugar except for dark chocolate is also helpful because sugar feeds yeast; Teitelbaum suggests substituting with Stevia, a natural sweetener.
As for nutritional supplements, he and Garabédian recommend magnesium and fish oil, which not only decrease fibromyalgia symptoms but also are very important during pregnancy. In addition, both doctors recommend that patients exercise as much as they comfortably can. “People with fibro often become inactive because of the pain, which adds to their deconditioning, pain and stiffness,” Teitelbaum says. “It’s a vicious cycle.” Acupuncture is another legitimate approach. According to a Mayo Clinic study, patients who underwent acupuncture for fibromyalgia reported significant improvement in symptoms, especially fatigue and anxiety.
The road ahead
When I tell Teitelbaum that I’m pregnant, he seems particularly interested to know how I’m feeling. Apparently, the hormone fluctuations during pregnancy can cause fibro patients to drastically improve or worsen, although he suggests the former is more likely. I did make it through my first two trimesters fairly unscathed, and while I’m currently struggling with back and rib pain, fitful sleep and nerve irritation, any woman who has been through the third trimester of pregnancy could claim most of those same symptoms. “During pregnancy the placenta makes high levels of corticotropin-releasing hormone, which supports the adrenal glands and increases blood volume,” Garabédian says. “That’s why people [often] feel pretty good then.” I sense a “but” coming … “But after pregnancy the hormone levels drop and you start to crash,” he says. “The good news is with proper support, you’re not going to crash.” Both doctors suggest that I wait and see if my body returns to form after I give birth. That’s my plan, but even if it doesn’t, I’m confident there are solutions out there that can help me continue to enjoy an active life. For me and for most fibro patients, that promise, along with the prospects of greater acceptance and more treatment options, would be an answer to our prayers.