Guaifenesin protocol
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Guaifenesin protocol is a popular, experimental, alternative treatment for fibromyalgia proposed in the 1990s by R. Paul St. Amand, MD. The treatment involves three parts: titrating to the proper guaifenesin dosage, avoiding salicylates, and following a low carbohydrate diet if the patient is hypoglycemic. Guaifenesin has not been approved by the FDA for the treatment of fibromyalgia, and the protocol has not been shown to be effective in clinical trials as of 2005. It has been adopted by many due to anecdotal evidence of success.
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Treatment Details
Guaifenesin Dosage
The dosage is individually determined by slowly titrating the dosage up until a worsening of symptoms is noticed and there is a decrease of the lesions that can be palpated in the muscles. Patients begin with 300 mg twice a day and increase from there. The guaifenesin should be pure guaifenesin and not a preparation including other medications.
Avoiding Salicylic Acid
Salicylic acid in even tiny amounts blocks guaifenesin from binding in the kidneys. It is present in many drugs such as aspirin, Salsalate, Disalcid, Anacin, and Excedrin. Plants produce salicylic acid, so herbal medications must be avoided as well as plant oils, gels and extracts in cosmetics and any product that touches the skin. These ingredients include aloe, castor oil, camphor, and mint. Any plants can be eaten, however, because the small amount of salicylic acid present in food is broken down in the digestive system and tagged with glycine by the liver before reaching the kidneys.
Treating Hypoglycemia
Many symptoms of hypoglycemia (or perhaps more aptly titled Carbohydrate Intolerance) are similar to fibromyalgia, and while leaving hypoglycemia untreated will not hinder the reversal of the disorder with guaifenesin, the symptoms will continue to plague the patient. The only treatment is a life-long avoidance of simple sugars, caffeine, starchy foods, and any other foods that cause insulin spikes.
Theory of Fibromyalgia Cause
This theory involves phosphate accumulation in cells that eventually reach a level to impede the ATP process, possibly caused by a kidney dysfunction or missing enzyme that prevents the removal of excess phosphates from the blood stream. This theory posits that fibromyalgia is an inherited disorder, and that phosphate build up in cells is gradual (but can be accelerated by trauma or illness). Calcium is required to buffer the excess phosphate when it enters the cells. The additional phosphate slows down the ATP process; however the excess calcium prods the cell to action. The causative mechanism in the kidneys is unknown.
The phosphate build-up theory explains the myriad symptoms present in fibromyalgia and provides an underlying cause, but remains strictly theoretical. There is no conclusive evidence that the phosphate build-up theory is correct, or that Guaifenesin protocol is effective. No clinical trials involving the treatment in its entirety have been conducted as of 2004.
History
This theory arose when R. Paul St. Amand MD noticed that patients with fibromyalgia symptoms had an increase of tartar on the teeth in the form of calcium phosphate. Crystals are also often found on urinalysis which further points to calcium phosphate, and muscle biopsies show an increase of phosphate in the cytosol. Lesions of muscles, tendons, and ligaments can be felt by a method of palpation called mapping developed by Dr. St. Amand. These lesions are thought to contracted cells forming a spastic area caused by an excess of calcium in the cytosol of the cells.
The treatment was discovered serendipitously when the physician found that uricosuric drugs for treating gout also coincided with relief of fibromyalgia symptoms. Since guaifenesin is mildly uricosuric but has fewer side effects than standard uricosuric drugs, Dr. Armand began to study whether guafenesin might relieve the symptoms of fibromyalgia.
External links
- Guaifenesin Protocol Main Page (http://www.fibromyalgiatreatment.com/index.htm)
- Protocol Details (http://www.fibromyalgiatreatment.com/GuaiProtocol.htm)
- Hypoglycemia Details (http://www.fibromyalgiatreatment.com/hypoglycemia.htm)