RAY D. STRAND, M.D.

Specialist in Nutritional Medicine

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Specific Recommendations

Fibromyalgia
or Chronic Fatigue

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Fibromyalgia/chronic fatigue is a disease of exclusion. In other words, these patients have an array of symptoms and complaints, which mimic many illnesses. Physicians usually do very extensive workups only to find that everything appears pretty much normal.

This disease used to be called "psychosomatic rheumatism." I fear that many physicians still believe this disease is simply in the patient's head. More and more doctors, however, are beginning to realize the seriousness of this disease and its tremendous effect on patients' lives. Statistics estimate there are over 8 million people in the United States alone suffering with this disease. Eight out of nine are women.

Fibromyalgia and chronic fatigue are considered by many to be different expressions of the same disease. All of these patients suffer from overwhelming and usually disabling fatigue. Fibromyalgia patients experience total body pain, unrestful sleep, mental confusion, and a myriad of other symptoms. Patients with chronic fatigue, on the other hand, have more swollen glands, recurrent fevers, and frequent infections.

Fibromyalgia is diagnosed by excluding other possible diseases and then by doing tender point testing. By eliciting tenderness in at least 11 of 18 predetermined spots, a physician is able to diagnose the disease. Essentially all laboratory tests, X-rays, biopsies, and MRI's will come out negative.

Chronic fatigue patients are diagnosed by eliminating all other possible causes of fatigue. Anyone who has suffered for more than six months with disabling fatigue essentially has chronic fatigue. The sad truth is that it usually takes approximately 6 to 8 years for these patients to finally be diagnosed by their physician with one of these diseases.

Traditional medicine has no specific treatment for these diseases. With fibromyalgia, physicians typically place patients on a non-steroidal anti-inflammatory for pain, amitriptyline for sleep, perhaps a muscle relaxant, and anti-depressant and then they tell the patient to find a support group and learn to live with it. What is even more concerning is the frequency with which these patients are being treated with narcotic pain medication. Now, they not only have a horrible disease but are also hooked on narcotic pain medication.

My wife has suffered with fibromyalgia for the past 18 years. During the first 12 years of our marriage she needed to be in bed before 8 P.M. She never had a restful night's sleep and would get up just as tired as when she went to bed. Living with this illness for the past 17 years has totally changed my perception on the seriousness of this disease. Early morning stiffness, mental fog, muscle spasms (my massage technique has certainly improved), fatigue, and pain were daily encounters with which she had to learn to live.

My wife has always joked that she thought marrying a physician would allow her to improve her health. But I'm afraid I was not the answer. The frustration felt by a physician when he or she is unable to do anything for a patient cannot be overstated. And I now realize, first-handedly, the frustration patients with fibromyalgia and chronic fatigue have with their doctors.

When my wife was struggling with the most difficult fatigue, she asked if she could try some nutritional supplements given to her by a friend. For 23 years, I would do most anything to get my patients off any kind of supplements. However, my response to her shocked even me. I told her she could certainly try since I had not been able to find anything to help her through traditional medicine.

Within weeks she saw marked improvement and within months she was back to her normal self and off all medications. Over the next year she not only totally recovered, but felt more energetic than she had in years. She has added three to four hours to each of her days. She has significantly less pain and fewer muscle spasms, and her energy level has now surpassed mine.

Obviously this caught my attention. Her recovery challenged me to try to understand what had happened. This was the beginning of my newly found interest in nutritional supplements.

Shortly after this experience, I read a book by Kenneth Cooper, M.D., called "The Antioxidant Revolution." I have always admired Dr. Cooper, who started the exercise revolution back in the early 1970s. I became so intrigued with his book I researched his research. One part of the book especially caught my attention: at his aerobics clinic in Dallas, Dr. Cooper evaluated several athletes suffering from over-training syndrome. His theory was that oxidative stress was the cause.

When people exercise mildly to moderately the body is able to handle the amount of free radicals produced. However, in cases of excessive exercise as in the training of professional athletes, the amount of free radicals goes up exponentially. It struck me that these athletes with over-training syndrome had the same symptoms as patients with fibromyalgia and chronic fatigue syndrome. I was baffled and wondered, Could it be possible that the root cause of fibromyalgia /chronic fatigue is oxidative stress?

As we learn more and more about how oxidative stress can cause degenerative diseases, one has to wonder if this is the cause of the fibromyalgia/chronic fatigue syndromes. These syndromes are not high on the totem pole for research dollars. I have been unable to find any significant studies that have considered this as a possibility. I am hopeful more funds will be allocated toward these disabling diseases in the future.

For the past ten years, I have been evaluating and treating a group of patients with the belief that the underlying cause is oxidative stress. Since these diseases are able to mimic many other diseases, I must first rule all other possibilities out. I then place these patients on a complete and balanced nutritional supplement program, which I have recommended below. 

I also recommend that my fibromyalgia patients exercise carefully every other day.  Now when these patients exercise, they must be careful.  Even mild or moderate exercise can set off an exacerbation of their illness.  Therefore, I explain that they must exercise very carefully and be sure not to exercise two days in a row.  Now it may simply be walking for 5 minutes and trying to slowly build up to walking 20 to 30 minutes every other day.  Mild weight resistant training can also help; however, again this should not be done two days in a row.

I have also noted that many of my fibromyalgia patients are very sensitive to sugar.  They tend to eat sugar and what I refer to as high-glycemic carbohydrates and set off a roller coaster ride for their blood sugars.  Now they may feel better for 10 to 15 minutes; however, their blood sugars will drop almost as fast as they went up and they drop into that hypoglycemic or low blood sugar range.  Since we think on blood sugar, their mental confusion becomes worse and these low blood sugars stimulate the release of stress hormones, which set off what I refer to as a "Carbohydrate Addiction."  I encourage all my chronic fatigue/fibromyalgia patients to become members of my behavioral modification web site located at www.healthyforlifeprogram.com.  Even if you do not need to lose weight, learning how to eat in such a way as to NOT spike your blood sugar can go a long way in improving your fatigue especially when you combine these healthy lifestyles with nutritional supplementation and a mild exercise program.



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