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Letters From Our Readers – Q & A Session 9-12-07

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Tramadol vs. Lyrica?

Q: I take tramadol for pain for my Fibromyalgia, but have been hearing a lot about LyricaR. Is Lyrica something you would take every day to prevent pain or just when pain occurs? Is it more effective than tramadol? Thanks. I need to see my physician about this but I’d like to have some information before I do so. I need to be prepared when I talk to her. – SM

A: Tramadol is a narcotic-like pain reliever. It binds to opioid receptors and somewhat inhibits serotonin/norepinephrine reuptake, which produces an analgesic or pain-relieving effect. Lyrica reduces the release of neurotransmitters, which lessens the transmission of pain from nerve damage. It is also an anticonvulsant.

The dosing recommendations for Lyrica, when used to treat FM, require slowly increasing the dosage over a seven-day period when starting it and slowly decreasing over the same time period when discontinuing it. Therefore, it appears that Lyrica is intended to be taken on a daily basis; however, it would be up to your doctor to determine the best dosing schedule for you.

The answer to whether or not Lyrica is more effective than tramadol will vary from patient to patient. No drug has yet been found that works for every FM patient. In clinical trials, approximately half of the FM patients taking Lyrica reported some degree of improvement. Anecdotally, we’ve heard from people who loved it, those who hated it, and everything in between. Ultimately, you and your doctor will have to decide if it’s something you want to try or not.

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Salicylate-free Supplements?

Q: I am taking guaifenesin for fibro. Am I able to use supplements that you carry? I am just not sure when I buy the guai from you if you only carry supplements without salicylates. – Karen

A: ProHealth’s info on guaifenesin products includes a “Salicylate-free Product List” featuring a lengthy alphabetized list of products you might be interested in.

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Does Guaifenesin Help?

Q: Recently I read that guaifenesin does not help FM. Is this so, and why do I read that it is good to take? – Linda

A: The Guaifenesin Protocol was developed by Dr. R. Paul St. Amand. To date research has not been able to duplicate the positive results he reports. However, Dr. St. Amand points out that previous research did not prohibit the use of products containing salicylates, which negate the effects of the guaifenesin. As with every FM treatment program, some people find it helpful and others do not. In the end, only you and your doctor can decide whether guaifenesin, or any other treatment protocol, is something you should try.

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Dr. Lowe’s Research on Hypothyroidism

Q: I live in Australia and read your site every week. I was wondering if any of your team has heard about the work being done in the USA by a Dr. John C. Lowe. His work, in a nutshell, states that FM is due to either hypothyroidism or partial cellular resistance to thyroid hormone. He has written a huge book, some 700 pages on the subject, and another simpler book. I was wondering if anyone has looked into his work and what feedback you may have on this. – Greg

A: Yes, we are very aware of Dr. Lowe’s work. As research progresses, it appears that there may be a number of subsets or causes for Fibromyalgia. It is very likely that hypothyroidism is one of those possible causes. Although Dr. Lowe has been saying it for several years, the medical community as a whole has just recently acknowledged that the thyroid tests being done were missing a significant number of people who are hypothyroid. As a result, the “normal” range on the Thyroid Stimulating Hormone (TSH) tests was lowered.

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Magnesium for FM?

Q: I have Fibromyalgia and Irritable Bowel Syndrome. I noticed in some of Dr. Podell’s information he mentions magnesium loss being an important factor in pain. [“Reversing Eight Vicious Cycles that Block FM and CFS Healing”] My rheumatologist has recommended supplementing my magnesium. However; because of my IBS, my gastroenterologist suggests I take Milk of Magnesia (in varying doses based on my daily symptoms), which of course contains magnesium.

My question is – is there a specific daily amount of magnesium that a Fibromyalgia patient should be getting? If I have a target of so many milligrams/day, I can then figure out how much supplemental magnesium to take daily based on how much MOM I have already taken. Also, is there an upper limit that I should not exceed and what symptoms would I look for if I did exceed it?

A: An article in the ImmuneSupport archives provides a good overview of the importance of magnesium for FM: “Magnesium in the Treatment of Fibromyalgia.” In clinical trials, the effective dosages of magnesium ranged from 300 to 600mg per day. It’s important to note that when using magnesium for FM, it should usually be taken with malic acid. In the clinical trials mentioned, patients also took 1200 to 2400mg of malic acid with the magnesium. Symptoms of magnesium overdose include: nausea, vomiting, severely lowered blood pressure, slowed heart rate, drowsiness, decreased reflexes, weakness, and coma. Also note, because magnesium competes with calcium for absorption, make sure you are getting enough calcium to prevent a calcium deficiency.

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FM and Face Sweating?

Q: Does anyone who has Fibromyalgia ever experience excessive sweating from the face?

A: Yes, it’s not at all unusual for people with Fibromyalgia to be extremely sensitive to both heat and cold. They may experience sudden changes in body temperature and sweat abundantly. Sometimes this sweating shows up first and most noticeably in the face.

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Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat, or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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9 thoughts on “Letters From Our Readers – Q & A Session 9-12-07”

  1. rcain03 says:

    I am a 32yr. old female who was diagnosed 2yrs ago with FM. My mother who is 50yr. old also, was diagnosed with FM about 8 yrs. ago. Neither of us ever really perspired much. Within the last year I have begun to sweat perfusely from my face with minimal activity and with minimal heat even while my skin feels cool to the touch. It was interesting to find that you also have experienced this. Is this normal with FM? I also feel as though there is definitely a genetic link. My mother and I both having FM and I also see my 13 yr. old daughter and 11 yr. old son experiencing many of our same symptoms. Has there been any research regarding a genetic link?

  2. andrewclark55 says:

    >Q: Recently I read that guaifenesin does not help FM. Is this >so, and why do I read that it is good to take? – Linda

    I can only speak from my own experience. I started using Dr St Amand’s protocol last year (unsupervised – doctors in the UK are not overly helpful) after reading about it on this site. I expected it to take some time to have effect and started on 600mg twice daily. To my surprise my fibro pain reduced within 3 days to about 10 – 20% of what it had been. It’s not meant to work that way.

    I kept on it for about 8 months, with excellent results. However I have now stopped taking it as my doctor has now prescribed Amitriptylene 10mg taken at night, and this has also reduced my pain significantly. I didn’t want to take both, and muddy the waters on effectiveness.

    Hope this helps. At least the Guai has no significant side effects, unlike the Amitriptylene which reduces Libido!

    1. guaima says:

      I started taking Guaifenesin a few years ago and stayed on the protocol for a year. The only difference I noticed was that those lumps in the thighs and other places disappeared, but I didn’t feel any different, and the protocol is hard to follow.
      I had hoped it would help me but didn’t. I take hydrocodone 750mg in the mornings and if I’m really hurting I can take morphine XL (extended release). I sleep very well on Trazodone and Fexeril. Frist get a Dr. who believes in you and lets you try different things. Good Luck.

  3. maria4454 says:

    I have been diagnosed with F.M. 8 years ago, shortly after eing diagnosed I started sweating on my face. It is very uncomfortable and there is no other sweating anywhere else, just my forehead and back of my neck! Sometimes it seems to get better only to flare back up again. When I read this i couldn’t beleive that the two could be related! This makes my life very difficult as whenever I do activity I start sweating. I have had hormone levels done and they are in normal ranges. I do have iron deficiecy anemia. I don’t understand the relatioship between FM and excessive facial sweating. I now know I am not alone.

  4. holly49 says:

    I have noticed this summer that I have been sweating more all over, especially in the face. I cannot stay out in the hot summer weather taking to air conditioning in my house and/or car. I see from a previous answer to this same question that this is another, wonderful symptom chalked up to fibro. I am glad to know, at least, why I have been feeling this way. Thanks for all the great info!

  5. guaima says:

    I first noticed my sweating only after eating some kind of sugar or product with sugar in it. I have recently started on Prempro and have been almost free of sweating but still have sugar sensitivity.Of course as the weather changes so does my temperature. This is the first summer I have been able to get out and enjoy it.

  6. sandy10m says:

    I am a believer in Dr. Lowe’s theory, and I have followed the thyroid protocol in the past. You can easily be hypothyroid even though all your blood tests come back “normal.” My waking temperature was 95.5, which is below the mercury thermometer minimum reading of 96.0. After about 15 months on Spectra dessicated thyroid (which does not require a prescription), I no longer need to take it, and my FM/CMPS symptoms are greatly reduced. I no longer take the dessicated thyroid, and my waking temperature is 98.2 or better.

    One other thing I have tried recently is the caveman or Paleolithic diet. I noticed that wheat/gluten was causing bad symptoms in my diet, so I tried eliminating ALL grains and dairy per the caveman diet. I started feeling better after only 1 week of doing this. My IBS symptoms disappeared. If I can get relief without medications (which only cause more problems over time), then I count myself lucky.

    I hope this info helps other people.

  7. ona1deb says:

    My face and head sweats so bad that people stare at me and ask me, “What’s wrong with you”, “Are you OK?”. I never ran across anyone else that had this problem. But it drives me crazy. I am a nurse and when I am leaning over patients to take vital signs, etc. I just drip sweat all over them. It is really embarassing.

  8. melansell says:

    I am so suprised to hear this! I, too have had FM (Diagnosed 3 years)and experienced the heavy facial sweating. I can hardly get dressed, even in air conditioning!!
    I am so glad to see someone else has had that problem. Sometimes I feel like I am crazy when all of the blood/hormone/thyroid tests come back normal!

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