Question: Do you have vitamin suggestions for chronic fatigue syndrome or fibromyalgia? I was taking doxycycline but my MD doesn’t want me to take any medications for it.
Answer: The book, “From Fatigue to Fantastic” by Dr. Jacob Teitelbaum, specifically addresses fibromyalgia and multiple related issues. Levels of brain neurotransmitters such as dopamine, serotonin or norepinephrine are often at lower than normal levels. These are important brain chemicals that help modulate your experience of pain and help to deepen sleep and improve just the quality of your mood and energy. You can improve your neurotransmitter balance with amino acids like 5-Hydroxy Tryptophan and L- Theanine, EPA-DHA, Tyrosine, vitamin B6. Lumina is a supplement by Metagenics that modulates metabolism of dopamine, GABA & norepinephrine; Symphora is a supplement by Metagenics that promotes a positive mood and mental well-being by beneficially modulating cerebral metabolism of cortisol. www.DrJeffreyTucker.meta-ehealth.com,
Hormonal issues are very important. Not enough DHEA, or testosterone in both men and women, and in women the levels of progesterone and estrogen affect this. Levels of magnesium are very important but it’s hard to get magnesium glycinate by taking it in oral form. Sometimes alternative MD’s use an intravenous treatment called a Myers’ cocktail in fibromyalgia patients to significantly boost magnesium and help reduce muscle tightness and muscle aching that may happen when the muscles get tired and need help to properly relax.
Other supplements that I recommend are Fibroplex Plus by Metagenics. this product really helps muscle tenderness, energy metabolism and neuromuscular function. Other helpful supplements are COQ10 and carnitine. Helping people sleep better is important. So reestablishing sleep with either supplements like kava, melatonin, or valerian root is useful. This helps bring about a healing process in fibromyalgia and chronic fatigue. www.DrJeffreyTucker.meta-ehealth.com,
Some patients inexplicably have low levels of B12, and they may respond to oral B12 or B12 shots. Always check for low levels of vitamin D. Vitamin D is a very important part of the pain picture in fibromyalgia because when you have low levels of vitamin D, your bones demineralize and they actually may ache.
People say, “I’ve got that deep achy feeling in my bones.” That may really be what’s happening — the bones are aching due to demineralization with inadequate levels of vitamin D. So using vitamin D as a pain medication can be helpful if we find the vitamin D levels low. You can see that there is a whole checklist of issues that can make a difference for FMS & chronic fatigue.
The warm laser has been one of the best treatments I have seen for fibromyalgia. The deep heat really seems to help aching joints and muscles. please read my posts on the warm laser.
Do some research on your own and you may seek guidance from a nutritionally-oriented chiropractor or health care practitioner who can guide you through a protocol of proper support for this condition. www.DrJeffreyTucker.meta-ehealth.com,
PAD is a painful condition caused by reduced blood flow to the legs due to narrowed arteries. Diabetics and smokers are at highest risk of developing PAD. Ulcers and gangrene may develop in advanced cases of the disease. Warm laser is one of the best treatments I have seen for this condition.
Ginkgo Biloba has also been shown to help.
Ginkgo Guideline One: a daily dose of 240 mg (120 mg per day is the usual recommendation).
Ginkgo Guideline Two: Slight gastrointestinal bleeding is a potential side effect. But this is most commonly seen in ginkgo users who also take drugs (such as aspirin and warfarin) that can cause similar bleeding.
Ginkgo Guideline Three: Ginkgo contains a compound called ginkgolic acid. A safe maximum level is 5 ppm. Higher levels may prompt side effects such as headaches and skin irritations. If your ginkgo supplement doesn’t note ginkgolic acid content, consider that a red flag.
As for prevention of PAD, there are two key recommendations: 1) Stop smoking, and 2) exercise. Even though it might seem like the last thing you want to do, a daily walking regimen is an excellent way to help prevent PAD, or to minimize pain associated with PAD.
Chronic back pain can ruin your life. Dr. Tucker suggests that a targeted program of DMS, warm laser & corrective exercise training can accelerate recovery.
I hate when clients have to miss work or workout days because of low back pain. I have experienced low back pain and I understand the misery, pain and frustration it causes. Debilitating back injuries can be helped with controlled activity, movement therapy, warm laser and Deep Muscle Stimulation (DMS). First I get rid of the acute back pain and swelling with the warm laser. Then I use the DMS on the back spasms. I still use other treatments such as moist heat, therapeutic ultrasound, massage and electrical stimulation because these have positive effects too.
Part of recovery is the continuation of normal daily activities. Bed rest is only recommended when you can’t get out of bed because it hurts too much to move.
As soon as possible I like to see clients begin corrective exercise. We begin with gentle controlled movements that usually use just your bodyweight. Then we can progress to band or stability ball therapy lessons. Eventually I train my clients in kettlebell maneuvers. Kettlebell training helps with fat loss, core strength, and range of movement. If you like Pilates and yoga or wanted to learn these methods, you will love Kettlebells. Training the ‘core’ has become a popular focus in recent years, and I’m all about improving the “core” to prevent future episodes of low back pain.
June 8, 2010 (Baltimore, Maryland) — New data presented at the American College of Sports Medicine 57th Annual Meeting suggest that the application of class 4 infrared light lasers to fibromyalgia trigger points improves upper body flexibility. This finding is important because fibromyalgia is often difficult to treat with pharmacologic agents, and patients seek alternative regimens to ease their discomfort.
39 women (52 ± 11 years of age) were randomly assigned to receive 8 minutes of laser therapy or sham heat therapy twice per week for 4 weeks. Treatment consisted of the application of laser therapy or sham heat therapy to 8 standardized points located across the neck, shoulders, and low back.
The impact of laser therapy on upper body flexibility in patients treated with laser therapy was significant, compared with those treated with sham heat therapy. However, there was no improvement in functionality or pain score between the 2 groups. There was an increase in the amount of time between bouts of severe pain in laser-treated patients, compared with sham-treated patients.
Laser therapy gives consistent clinical results, with changes that are noticeable in just a few office visits. Laser effects the tissues to produce positive results such as faster wound healing and pain reduction. It is one of the best modalities to help relieve acute and chronic pain and repair injured/damaged tissue.
Just as photosynthesis creates energy for plants, the absorption of the laser light photons by cells in your body causes increased production of cellular energy to improve the rate and quality of healing.
Some of the effects include increased levels of endorphins and anti-inflammatory benefits.
Applicable conditions of laser therapy
1. Low back pain
2. Wound healing
3. Dermatological conditions
4. Temporo-mandibular Joint Dysfunction
5. Frontal and maxillary sinus inflammation
6. Rotator Cuff injuries (shoulder pain)
7. Epicondylitis (elbow pain)
8. Small joints of the hands
9. Trigeminal Neuralgia
10. Bell’s Palsy
11. Neck pain
I often hear my clients say “I don’t know what to call you: a Physical Therapist, a Chiropractor, a nutritionist?” because I don’t just perform traditional Chiropractic manipulation. I also often get asked “What is my approach called?” First and foremost I see myself as a teacher. I teach procedures and methods to help my clients get out of pain, I teach corrective exercise plans, and nutrition and diet plans. I love using my skills in manual therapy, rehabilitation exercise, and nutrition to focus on solving my clients health issues and concerns. I see the full value in mixing all of the traditional health approaches and alternative health approaches into intelligent health methods.
My approach to each client is not a cookbook. I focus on finding the source of each client’s pain – evaluating posture, the joints, the muscles, the fascia, and diet. My evaluation is individualized and personalized, but not a cookbook. I systematically examine my clients for 1) muscle trigger points (tender points within muscles that can cause pain); 2) joints that have too little motion and joints that have too much motion and 3) nutritional deficiencies. This takes time and patience on my part and my client’s part. My first office examination takes about one hour and follow up visits are 30 minutes. I need to test what we are finding, and treat the key under- or overactive muscle. One visit we may concentrate on your breathing to see how well your diaphragm is moving; another visit may find us concentrating on an upper neck dysfunction; another session may find us teaching you how to activate a core muscle deficit; or another session we may learn exercises for a low back instability.
Most importantly, you will learn to participate in your own recovery. This is the basis of my rehabilitation approach! I will be checking your soft tissues and probably using the Deep Muscle Stimulator (DMS) or warm laser as part of my treatments; I will check your core; your feet; and even your TMJ (jaw).
I have had some amazing mentors and teachers and I will blend what I have learned over being in practice for 27 years to guide our treatment. This is what separates me from what most others do. I don’t just focus on the site of symptoms, I look at the whole body.
When you are ready I can teach you how to use the foam roll on your dense and tight muscles; strength training with kettlebells, & flexibility and stretching exercises. If you need weight loss, I am happy to help you reach your goals. Please feel free to send this information to your friends.
I am a patient of Dr. S (chiropractor) and have had chronic
achilles tendonitis for at least 10 yrs. Recently icing and stretching
has not been effective to decrease inflamation in the L foot in
particular. I have been going to PT for the past month receiving
iontophoresis with dexamethasone treatments. I do get some burning on the skin and it has taken about 6 treatments to see and feel about a 60% improvement. However , as soon as I do even mild use of the left foot with weight bearing, it flares up to previous levels.
I am curious as to whether hot or cold laser therapy would help this
condition. Do you think laser therapy would help and what type…hot
or cold? Any advise, information, opinions are welcome from you.
THANK YOU very much for your time.
RESPONSE FROM DR. TUCKER
It is a challenge managing chronic Achilles tendon injuries. The warm laser can help heal the in-growth of new nerves and blood vessels which are known to be sensitive to pain chemicals. As part of my rehab protocol for Achilles problems I use the following:
•Alfredson’s heel-drop exercise
In 1998 a Swedish orthopaedic surgeon published excellent results for a group of patients with Achilles tendinosis who undertook a specific 12-week eccentric calf loading rehabilitation program. The subjects all experienced a dramatic reduction in pain, a significant increase in calf strength and returned to full running.
The client stands on the bottom step of a staircase, facing inwards, hands lightly supporting at either side. The forefoot of the affected leg is placed on the edge of the step. The client lowers their body down by dropping the heel of the affected leg over the edge, with control; then places the foot of the non-affected leg on the step to raise the body back up to the starting point. If this proves too difficult, or if both Achilles are affected, it is possible to raise back up on two legs (thereby sharing the concentric load) and coming down on a single leg (this is the “2 up, 1 down” concept).
•Perform 3 x 15 eccentric heel drops with the knee straight and 3 x 15 repetitions with the knee bent, repeated twice daily.
More recent studies have found that eccentric loading increases collagen deposition in tendinotic tendons, suggesting a healing response. Perhaps of greater significance is the apparent disappearance of the vascular in-growth in people who respond favourably to loading and it is possible that the effectiveness of the program is due to the direct effect on pain rather than tendon healing or an increase in calf muscle strength.
Balance training programs are essential as part of the rehab for Achilles.
Regarding the warm laser, I think it would be very helpful & effective.
I am not in favor of expensive, ineffective and potentially dangerous “treatments” for chronic pain while ignoring causes and prevention of chronic pain. I devote my time spent with clients on examining the causes and most importantly, focusing on how we can prevent acute pain from becoming chronic pain.
I find out what my clients vitamin D levels are. If they are low, they must be elevated to within normal levels. I recommend omega 3 fish oils to all my chronic pain patients. I figure out what exercises clients will do consistently. Diet & supplement recommendations are vitally important. I also recommend my clients eat a low-glycemic diet.
Chronic low back pain or neck pain is a disease we often give to ourselves. Poor posture and a lack of variety of movement are two of the most common causes I see in most cases.
In Most Cases, Chronic Pain is Preventable…
In the absence of trauma or other known disease, most pain that I treat is caused by lifestyle and environmental factors. That means that pain can be improved by eliminating these factors. Some of the risk factors for low back pain are possible to avoid. Maintain good sitting posture, avoid slumping over while sitting, and use proper mechanics while lifting.
In just about every degenerative disease the cause is from the poor choices we make and the habits we develop over a lifetime.
Let’s talk about how you can improve your quality of life.
I had a question from a Doctor about what nutritional recommendations I use for patients with Osteoarthritis. Here is my response.
Make sure they are consistent for at least 3 months on an Anti-inflammatory diet. Depending on the client I use either the Mediterranean Diet or Paleo Diet.
The following are supplements from my Metagenics site (www.meta-ehealth.com/site/office/index.jsp) that I recommend:
If it is a light to moderate case:
Kaprex — 1-2 softgel twice daily
Non-responders by day 5, move to 6 softgels daily
Time to benefit: 2 to 10 days.
Kaprex is an herbal supplement that provides natural joint relief that is easy on the gastrointestinal (GI) tract. It works by interfering with signals in the body that initiate the production of damaging compounds that cause minor pain and negatively impact cartilage and other joint tissues.
Chondro-Relief Intensive Care – 2-3 capsules twice daily
Chondro-Relief Intensive Care supports healthy joint function with Glucosamine HCI, Chondroitin Sulfate, Methyl-Sulfonyl-Methane (MSM), P. Canaliculus, Hyaluronic Acid, and Avocado/Soybean Unsaponifiables (ASU) in addition to other antioxidants that support healthy connective tissue.
EPA-DHA 6:1 Enteric Coated — 2 softgels three times daily. Omega 3 fatty acids are important for patients with chronic inflammatory conditions.
D3 5,000 — 1 tablet two times daily. Get there blood level checked & then dose up or down.
If it is a moderate to severe case:
UltraInflamX Plus 360 — 2 scoops twice daily. They make a shake in the morning & afternoon. It is a Medical food for inflammation and biotransformation.
Chondro-Relief Intensive Care – 2-4 capsules twice daily
EPA-DHA 6:1 Enteric Coated — 2 softgels three times daily. Omega 3 fatty acids providing a ratio appropriate for patients with chronic inflammatory conditions.
D3 5,000 — 1 tablet three times daily.
I have clients use Capsaicin cream and rub it on the involved area at least four times per day.
Laser therapy is effective for degenerative osteoarthritis
Stelian J, Gil I, Habot B et al. Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the knee treated with narrow-band light therapy. J Am Geriatr Soc. 1992; 40: 23-26.
In an Israeli study the effect of laser therapy in degenerative osteoarthritis (DOA) of the knee was investigated in a double blind study among 50 patients. One group received infrared (GaAlAs) and one red (HeNe) laser. Only the first group could be blinded, while the latter was open. Patients were treated twice daily, 15 minutes each time, for 10 days. The patients treated themselves after instruction. Total dose for each session was 10.3 J for red and 11.1 for infrared. Continuous mode was used for 7.5 minutes, pulsed for 7.5 minutes, rationale not stated. There was a significant pain reduction in the laser groups as compared to the placebo groups. There was no significant difference between the red and the infrared group. The Disability Index Questionnaire also revealed an improvement in the laser groups. All patients in the placebo group required analgesics within two months after laser therapy while the patients in the laser group were pain free ranging from 2 months to 1 year.