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Letters From Our Readers – Q&A Session 6-06-07

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What About Drug Interactions?

Q: I am currently taking about 14 medications (for FM, Myositis, Sjogren's, IBS & Pernicious Anemia). I am concerned about possible drug interactions; should I be concerned? – Flo

A: You are wise to be concerned about possible drug interactions. Following are some suggestions to help you evaluate what you are currently taking and to prevent future interaction problems.

n Make sure all doctors who treat you have a complete list of everything you take, including: prescription medications, over-the-counter medications, supplements, and topical treatments (such as progesterone cream).

n If possible, get all your prescriptions from the same pharmacy. If you have to use more than one pharmacy, make sure each pharmacist has the same complete list you give your doctor. The computer programs pharmacists use are set up to alert them of possible drug interactions. If you have any questions about possible interactions, a knowledgeable pharmacist is probably the best person to ask.

n Some Web sites offer tools that allow you to check for possible drug interactions yourself. One is an Express Scripts site called DrugDigest You can choose all of the medications and supplements you take, then click “check interactions” and it will give you a description of all possible interactions. (The list of drugs is significantly more comprehensive than the list of supplements.) You can check on individual herbs or supplements to learn how they may interact with certain drugs at HealthLynx.

n Some support groups invite experts (such as pharmacists, clinical nutritionists, or nutrition-oriented physicians) to “brown bag” sessions where members bring their medications, supplements and questions. If your local support group doesn’t do this, you might suggest it as a possible program idea.



How to Choose Between Multiple Supplements?

Q: (Flo also asked) I want to try some of your supplement products…but sometimes there are multiple products stating to [provide support for] the same symptoms. How can I know which one is the right one?

A: Often, there are multiple supplement products that may assist the body in addressing the same symptoms. Every individual is different and different bodily systems may be involved in the same symptoms. While one product might support the best result for one person, a different product may work best for another. It’s wise to use a trial and error process to determine which is best for you: Try just one at a time. If you try several things at once and feel a benefit, you won’t know which one is responsible.



Is There a Printed Newsletter?

Q: I love the information that is in this newsletter, but it's just too much to read while on the computer. Do you publish something like this I can get mailed to me?…The articles here are wonderful and so informative. – Dianne

A: You can order our free catalog, which always contains several articles about FM and CFS. However, we don’t offer a printed version of the newsletter. If you have a printer, each article has a printer-friendly version. (Scroll to the bottom, where you can click on “Print Page,” “Discuss,” or “E-mail article.”) If you don’t have a printer, perhaps you could ask a friend to print the articles for you.



What’s the Difference Between MS and CFS?

Q: Could you tell me the difference between MS and CFS? – DS

A: While there are several similarities between MS (multiple sclerosis) and CFS, there are also some significant differences. One of the biggest differences lies in the onset of the illness. When MS begins, the symptom flare ups occur at least a month apart. In fact, that is an important aspect of the MS diagnostic criteria. However, one of the distinguishing characteristics of CFS is that the fatigue and other symptoms do not go away. A key feature of the CFS diagnostic criteria is that the fatigue must have persisted for at least six months.

Another significant difference is that MS results in the destruction of the fatty tissue called myelin, which surrounds and protects the nerve fibers of the central nervous system. There is no evidence that the myelin is damaged with CFS. You can learn more about MS at the National Multiple Sclerosis Society’s website http://www.nationalmssociety.org.



Will My CFS Turn Into FM?

Q: (DS also asked) Will CFS turn into FM later on?

A: Answering whether CFS will "turn into" FM or vice versa is a bit like answering which came first, the chicken or the egg. A significant percentage of people who have one also have the other, but because the two have so many similarities, it’s often difficult to determine which actually came first.

The fact is that most people with either CFS or FM also have one or more additional conditions. Whether one illness weakens our system, leaving us susceptible to other illnesses – or we have a genetic predisposition to any number of central sensitivity syndromes – is something we just don’t know yet.



What’s the Difference Between CFS and FM?

Q: CFS and FM – What’s the difference? Are the treatments the same? – Connie

A: An overly simplified explanation of the difference between CFS and FM is that pain is the most predominant symptom of FM, while fatigue is the most predominant symptom of CFS. FM is identified by 18 distinct tender points. CFS is distinguished by post-exertional malaise (a deep fatigue and exhaustion that follows physical exertion and lasts more than 24 hours).

Additional differences include:

n Substance P (a neurotransmitter that sends pain signals) is elevated in FM but not in CFS.

n RNaseL (a cellular antiviral enzyme) is frequently elevated in CFS but not in FM.

n CFS is often triggered by an infectious or flu-like illness, while FM is more often triggered by a severe physical or emotional trauma (i.e., injury, illness, surgery, prolonged stress).

n CFS patients frequently have chronic sore throats and tender lymph glands, but they are not commonly considered to be FM symptoms.

Treatments for CFS and FM have some overlaps and some differences. Both are often prescribed antidepressants and/or anti-anxiety medications. And both are encouraged to try cognitive behavioral therapy. But there are also several differences:

n Mild to moderate exercise is an essential component of FM treatment, however, CFS patients have to be extremely careful, as even mild exercise can sometimes make them worse.

n Since the primary aim of most FM treatments is to reduce pain, a number of different pain relievers may be tried, both narcotic and non-narcotic.

n CFS patients are often prescribed anticonvulsants, antifungals, antihistamines, anti-inflammatories, antivirals, central nervous system depressants, corticosteroids, expectorants, and/or immunoglobulins.

Note: The information provided here has not been evaluated by the FDA. It 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 regimen without researching and discussing it in collaboration with your professional healthcare team.

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One thought on “Letters From Our Readers – Q&A Session 6-06-07”

  1. BlueRoseMK says:

    This is the most concise explanation of the differences between CFS and FM that I’ve encountered and something even my family and friends will understand. Thank you.

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