These findings are consistent with a 2017 study by Dr. William Pridgen that suggested taking the anti-EBV medications Famvir and Celebrex for six months can help a subset of people with CFS and fibromyalgia. I’ve also seen this in thousands of people that I’ve treated.

Meanwhile, another recent study shows that an old diuretic called spironolactone (Aldactone) is also active against Epstein-Barr syndrome. Combining it with other antiviral treatments may enhance their effectiveness, although this must be done cautiously, as the diuretic can lower both testosterone and blood volume. And both of these are already low in people with fibromyalgia.

The price of spironolactone treatment is only $0.20 a day. For most healthy people, it’s also quite safe. However, there are concerns using it to treat CFS/FMS:

• Because it’s a diuretic, spironolactone can dehydrate people. But people with chronic fatigue syndrome and fibromyalgia already tend to be chronically dehydrated. This is because having CFS/FMS lowers your antidiuretic hormone, which leaves you “drinking like a fish and peeing like a racehorse.” Some people I’ve treated have improved with prescription antidiuretic hormone pills (DDAVP or vasopressin, the same medication used for bed wetting). In those needing spironolactone who have low blood pressure or orthostatic intolerance, it can be combined with the DDAVP.
• Spironolactone lowers testosterone levels, which are already in the lowest 30% of the population in 70% of men and women with CFS and fibromyalgia. Research by Prof. Hillary White of Dartmouth showed that treating women who had fibromyalgia with testosterone, despite normal blood levels, decreased their pain. So testosterone levels need to be monitored and optimized when using this treatment.
• Anything that kills off a chronic infection can trigger a “Herxheimer reaction,” which is a severe flare up in symptoms. Years ago, a young woman I was treating was put on spironolactone for high testosterone (called polycystic ovarian syndrome). The first dose put her in the emergency room. I assumed it was because of the diuretic effect and her orthostatic intolerance. But now I suspect it was a Herxheimer reaction. So when adding spironolactone, especially combined with other antivirals, it’s important to start with a very low dose.

Bottom Line?

Spironolactone offers another potential tool for treating people whose CFS and fibromyalgia began with an acute viral infection, have the severe form that leaves them housebound, or who have chronic flu-like symptoms. However, it needs to be used cautiously for the reasons noted above. Fortunately, simple measures can prevent these problems.

Eliminating Pain

A critical concept in pain management is that pain is not an outside invader. Rather it is part of our bodies monitoring system telling us that something needs attention. Kind of like the oil light on our car’s dashboard. The standard medical approach has been to put a Band-Aid over the oil light or cut it out.

Might it not simply make more sense to put oil in the car?

Research shows that this is so. Let’s take a look at a few types of pain as examples (there are countless more):

• Muscle Pain. This is arguably the most common type of pain. And the most underdiagnosed. The best test for it is a good exam – which almost no physicians know how to do. You can’t diagnose something if you don’t know that it exists. Although arguably an oversimplification, muscle pain comes from decreased energy in the muscles. Muscles are like a spring. They take more energy to stretch than to contract. As noted above, optimizing energy in the muscles with the SHINE protocol decreases even the most severe forms of muscle pain by at least 50% (and often completely). SHINE stands for optimizing Sleep, Hormones, Immunity/Infections, Nutrition, and Exercise. You can email me for free treatment tools that will dramatically simplify treating fibromyalgia.
  • Meanwhile, once the inadequate energy in the muscles is addressed with SHINE, then structural therapies to stretch the muscle show dramatically increased and longer lasting benefits.
• Arthritis. Natural therapies have been shown to be as or more effective than NSAIDs. For example, Curamin (by Terry Naturally) was shown to be more effective than Celebrex in two head on studies looking at osteoarthritis ⁹ and rheumatoid arthritis ¹⁰.
  • The large NIH study showed glucosamine plus chondroitin to be statistically equivalent for osteoarthritis. But as all but one of the study authors were on the payroll of the drug companies, the data was tortured and natural remedies were reported to be ineffective.
  • What the research showed was that for one measure (which was later changed to be the “primary outcome measure” after the study was done. When I checked it on clinical trials.gov , the timeframe had been changed) the p=.04 for Celebrex and .06 for glucosamine/chondroitin. If you think about it, statistically that means there is nowhere near a significant difference between Celebrex and glucosamine chondroitin. Many of the hundreds of endpoints showed the natural remedies to be much more effective. This data was ignored in the study “conclusions.”
• Migraines. Research has shown that simply taking riboflavin (vitamin B2) 300 – 400 mg daily decreases migraine frequency by about 69% after six weeks. Adding magnesium increases its effectiveness. Multiple other therapies are also effective, as is addressing the role of hormonal fluctuations in migraines that occur around ovulation and menses. Meanwhile, IV magnesium 1 g over 15 minutes was shown to eliminate 85% of acute migraines in under one hour. Making it the most effective treatment available short of decapitation.
• Central Sensitization. Most chronic pain, when severe, can trigger central sensitization (brain pain) with microglial activation. Although several expensive medications can address these, they often are ineffectual or inadequate, and certainly do not reverse the underlying problem.
  • Highly effective for central sensitization or treatment such as low dose naltrexone and Palmitoylethanolamide (PEA) 350 mg 4 times daily for 2-4 weeks, then twice a day (or 3 x day if more helpful). Higher doses of the PEA can be helpful but start with low doses and work up.

And these are just a few examples.

I would add two other options that we are seeing dramatic responses to for pain in general. I like to begin with the CuraPhen and another herbal mix called the Pain Formula (Integrative Therapeutics), giving them six weeks to see the full effect. In severe refractory pain, I am adding in:

• Hemp Oil. I like using the entire hemp oil because there are over 10 cannabinoids that have been shown to be effective against seven key components of pain. Making them very synergistic. I am very picky about the brand I use, as many do not have therapeutic amounts. I like to use the Hemp Select capsules by EuroMedica. The optimal dose is three capsules twice a day for pain and five for sleep. In many, lower doses can also be helpful.
• Kratom. This herb is becoming controversial because the FDA and DEA are both going after them. Unfortunately, as part of a sensationalized media attack, the data is again being tortured. If any of the herb is found in the patient’s blood at death, the death is being attributed to the Kratom. Even if the person drank a gallon of tequila and took 60 OxyContin. If you have a natural health practitioner familiar with its use, it is best to work with them however.
  • In real life, used at a maximum dose of about ½ to 1 teaspoon to three times a day, it has been a safe treatment. In a number of patients, it has also eliminated severe pain that was refractory to most everything. For example, I have one patient considering moving here from Japan because her pain went from 10 to a zero in one day after taking it, and she can’t get it in Japan. Use the red form of the herb. It can be found in vape shops, dispensaries and online.

• Using the entire healing arts toolkit, including structural therapies (e.g. chiropractic, osteopathic, and myofascial release) and biophysics (e.g. – Frequency Specific Microcurrent) are also remarkably helpful as part of a comprehensive treatment approach. Although this article’s focus is on pain’s biochemistry, people do best when the entire “toolkit” is optimally applied.

Virtually all pain can be effectively treated, and most often without narcotics. But in the few cases that narcotics are needed, when properly used in combination with these other treatments they can be a godsend, and be much safer than leaving the person in pain.

It’s time to end the governments war on people in pain.

 The problem is not lack of effective treatment. Rather it is lack of proper physician education, and access to natural remedies.

You no longer have to make a choice between being on narcotics or being in pain. Pain is usually optional!

To get the NSAID death calculations noted above, or the free fibromyalgia treatment information, feel free to email me and request these at FatigueDoc@gmail.com

1. https://www.cdc.gov/drugoverdose/data/prescribing.html

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

• https://www.bmj.com/content/357/bmj.j1909
• Recent considerations in nonsteroidal anti-inflammatory drug gastropathy

The American Journal of Medicine, Volume 105, Issue 1, Pages 31S-38S.Gurkirpal Singh

http://linkinghub.elsevier.com/retrieve/pii/S0002-9343%2898%2900072-2?showall=true

• https://www.ncbi.nlm.nih.gov/pubmed/28676480
• http://archneur.jamanetwork.com/article.aspx?articleid=2487379
• http://nationalpainreport.com/what-is-largest-chronic-pain-patient-survey-showing-8838943.html
• https://vitalmei.com/chronic-pain-statistics/
• https://www.tandfonline.com/doi/abs/10.1300/J092v08n02_02
• Osteoarthritis Abstract 316. Osteoarthritis Cartilage. 2011;19(S1):S145-S146.] https://pdfs.semanticscholar.org/e8d4/76ea39303de736eb353d9f31e85b43c3f183.pdf

Phytother Res. 2012 Nov;26(11):1719-25

About 20 years ago, with one quarter of Americans having chronic pain, the US government declared a war on pain. Unfortunately, it gave physicians absolutely no guidance on how to relieve pain effectively. So, with drug company encouragement, physicians turned to increasingly prescribing narcotics.

Now we have one third of Americans suffering with chronic pain, and nearly 17,000 overdose deaths per year from prescribed narcotics. 5000 of these are from people using them as directed by their physician. The rest are from diversion to street use, or from combining them with illegal opioids like heroin. These are the actual figures from research.

 The government has decided to deal with this by declaring a “War on People in Pain.” Narcotic medications are being stopped abruptly, with people given no alternatives for pain relief. Sometimes, all they are getting from their physicians is the attitude “All pain is tolerable, as long as it is somebody else’s!”

Meanwhile, the propaganda war is ratcheting up with blame being fixed, instead of the problem. Instead of the nearly 17,000 yearly deaths from prescribed narcotics being discussed, the government is lumping in all deaths from even street drugs like heroin to inflate the figures and justify their actions.

So, let’s take a step back, and get some perspective on the real numbers:

• Nearly 17,000 yearly deaths from prescribed narcotics ¹. 5000 from prescribed narcotics used as directed and not combined with other illegal drugs ^1b. The biggest culprits have been the fentanyl patch and OxyContin.
• 30,000 to 50,000 US deaths yearly (conservatively) from NSAIDs such as ibuprofen. Despite this being shown in numerous studies, including a major meta-analysis of almost 500,000 patients which showed a 35% increase in MI risk ² and as many as 16,500 bleeding ulcer deaths yearly ³, I suspect that few of you have heard about the research. Why? As one news editor put it very simply “any reporter who loses me an advertiser is fired!” I do want to stress, that the chronic pain is still far more toxic than the NSAIDs medications. It’s simply that natural options are usually more effective, and much safer, in head on studies.
• About 30,000 to 40,000 US deaths a year from PPI acid blocker medications ⁴. Ironically often given for no reason except that the person is on NSAIDs (these numbers are in addition to the NSAIDs deaths). These are also associated with a 44% higher risk of dementia ⁵. 
• In a recent survey 6.7% of people with chronic pain note they have thoughtfully reflect[ed] upon suicide:
  • 89 persons shared the story of a friend or family member who ended their life
  • Seventy percent (70%) report that their health care has either worsened or they have lost support entirely.
  • Twenty-five (25%) of individuals have lost access to a primary care provider ⁶.
• About 100 million Americans suffer from chronic pain. Chronic pain affects more Americans than diabetes, heart disease and cancer combined.⁷  

All of this suggests that the current ill-designed war on prescribed narcotics may cause far more deaths by collateral damage than it prevents. It suggests that as many as 7 million additional Americans face the risk of suicide from unabated pain, in an effort to prevent 5000 prescribed narcotic overdose deaths yearly. You can be certain that the suicides will be ignored in making public policy.

Surprisingly, increased NSAIDs use from the anti-narcotic policy may even be more toxic than the narcotics.  Meanwhile, numerous people may turn to illicit drugs for pain relief, which carry a higher risk of overdose, as they have no idea what’s in what they are taking.

The answer is not to either ignore the overdose deaths or the suffering of those with chronic pain. There is a third option, which can effectively address both, that is being largely ignored.

Treat the root causes of pain.

 Our research has shown that this can dramatically decrease pain and improve function without narcotics. Using fibromyalgia as a model, our placebo-controlled study showed that pain can be decreased doing so by 50%. A very large percent of people no longer qualified as having fibromyalgia by the end of the study ⁹.

Using the entire toolkit, including structural therapies (such as physical therapy and chiropractic) low-cost generic medications, and natural remedies, most pain can be effectively controlled, and often eliminated, without narcotics. But most physicians are simply not trained in, or even open to, these options.”

It is time to look for door number three in addressing these major problems.

Yikes! Chronic pain is indeed a global issue. Join us next week as we discuss NATURAL ways to alleviate your pain.

In OSA, the pharynx (throat) repeatedly collapses during sleep. The person with OSA fights to breathe against a blocked airway, resulting in decreased oxygen levels in the blood. Eventually, the sense of suffocation wakes the person, the throat muscles contract, the airway opens, and air rushes in under high pressure. When the airway is opened, the rushing air allows the patient to once again drift back into sleep, but creates a loud gasping sound.

People with OSA are generally not aware that this is happening, although their partners often have severely disrupted sleep from the snoring and gasping. This cycle repeats itself many times throughout the night, and this constant waking from deep sleep, as well as the loss of oxygen in the blood, can cause next-day sleepiness, brain fog, poor concentration, and mood changes. Another side effect of OSA is high blood pressure.

There is a lot of controversy about how common OSA is. There is not even an agreement about how to define it. Generally, if the throat closes off for at least ten seconds, with no air flow, it is considered to be an apneic episode. This lack of breathing for ten seconds is enough to cause the oxygen level to drop in the blood and to cause one to go from deep sleep into light sleep.

Many sleep specialists define sleep apnea as having five or more episodes of decreased breathing per hour in association with daytime sleepiness. Although some specialists estimate that OSA is present in only 3 percent of the adult population, a recent study of all patients in five general medicine doctors’ offices suggested that approximately 17 percent of adults had clinically significant sleep apnea (defined as having at least fifteen episodes an hour of non-breathing during sleep). This study shows that when a doctor looks for it, sleep apnea is very common.

Although sleep apnea is diagnosed by a positive overnight sleep study, fewer than 8 of the 10,000 patients at these practices had been referred for a sleep study in the previous year, though it would be expected that as many as 1,700 of them had sleep apnea. This is because doctors simply have not been trained to look for OSA. In fact, as noted in an editorial in a recent issue of the Annals of Internal Medicine, “The real problem is the lack of education at all levels about all sleep disorders. Physicians have been shown to receive, on average, a total of only 2.1 hours of formal education in sleep medicine during their medical school training. Sleep history is typically skipped in the general history.” When physicians did receive training about sleep apnea, the number of patients they sent for sleep apnea testing increased dramatically.

Causes of Sleep Apnea

The main reason for OSA is being overweight. If more fat deposits develop in the rest of your body, they also occur in the tissue surrounding the throat. When you get into certain positions, the placement of your head can actually cause compression of the pipe that carries air into the lungs.

The primary symptoms associated with sleep apnea are snoring and daytime sleepiness. Having a neck circumference of seventeen inches or more also predisposes one to OSA. Because we inherit certain physical characteristics of the throat, there also appears to be a genetic predisposition to sleep apnea.

There are other problems that occur besides the daytime sleepiness in sleep apnea. As noted above, high blood pressure is common. A number of studies have also shown that patients with severe sleep apnea are at a two- to seven-fold increased risk of having an automobile accident. There is also a possible risk of heart and lung damage as a result of untreated OSA. Although some doctors do not consider OSA to be significant until there are fifteen or more apneic episodes per hour of sleep, evidence suggests that even five or more episodes per hour are associated with increased risk of auto accidents and high blood pressure.

Diagnosing Sleep Apnea

Symptoms that suggest sleep apnea are snoring, being overweight, hypertension, daytime sleepiness, periods where breathing stops at night, and frequent auto accidents. If you have several of these symptoms, you should have an overnight sleep study done.

During this test, several aspects of sleep are measured. An electroencephalogram (EEG) measures the brain wave patterns that tell the depth of sleep and gives a printout of how much time is spent in the various stages of sleep. It can also tell how long it takes to fall asleep, how many times you wake during the night, and how many actual hours of sleep you get. Respiratory monitors can measure air flow and tell if the blood oxygen level is dropping, which demonstrates the apnea. The test should also be able to check for leg movements to look for restless leg syndrome (more about this below) and to monitor for snoring as well.

These tests can be very expensive, costing approximately two thousand dollars. Because of the cost, insurance companies are sometimes hesitant to pay for it. It is a good idea to have the sleep laboratory get preauthorization from your insurance company before the test is done.

Because of the high cost, it is common to have what is called a split-night study. When this is done, the technician spends the first half of the night looking for evidence of clinically important sleep apnea. If they find it, they put a mask on you that gently keeps up the pressure in your throat, which in turn keeps your airway from collapsing. This is like gently blowing into a balloon to keep the opening open. They will do a continuous positive airway pressure (C-pap) titration to determine the optimum mask pressure needed to keep your airway open.

Because of the study’s cost, it is certainly reasonable to do a split-night study all in one night, rather than coming back for a second night to do the C-pap titration, which would double the cost.

What I recommend however it is to simply videotape yourself sleeping for an hour or two. Set up the camera so it is at your feet looking towards your head. The way you can look for signs of both restless leg syndrome and sleep apnea.

If you do have snoring and periods where you stop breathing, see if this occurs predominantly when you are laying on your back. If so, simply wearing a tight pajama or T-shirt at night that has a tennis ball sewn into the area by the small of your back may be enough to keep you from laying on your back while sleeping – which may be enough to eliminate the problem.

Some sleep testing machines can be used at home. These machines are often more effective (even though they monitor fewer variables) because you are more likely to be able to have a normal night’s sleep in the familiarity of your own home.

Treating Sleep Apnea

There are several treatments for sleep apnea and they fall into three main treatment categories: behavioral, pharmacologic, and mechanical. Let us consider each in turn.

Behavioral Treatments

As noted above, being overweight is the main cause of OSA. Because of this, weight loss is one of the most effective ways to treat it. Markedly cutting back on your carbohydrate intake and increasing your protein intake can help as well. As many people with this also have severe daytime somnolence, I sometimes prescribe medications that help to treat the daytime sleepiness that also assist with weight loss, among them dextroamphetamine (Adderall, Dexedrine), thyroid hormone, and certain antidepressants.

Avoid sleeping in positions that cause you to snore and have sleep apnea, especially lying on your back. As noted above, Sleep apnea can often be decreased by taking a tennis ball, putting it into a cloth pocket and then sewing it into the mid-back of your pajama shirt. Then, when you lie on your back, the tennis ball makes it uncomfortable, forcing you to roll onto your side or stomach without waking you. Finally, avoid bedtime alcohol and other substances that can aggravate sleep apnea.

Pharmacologic Treatments

A number of drugs have been used for OSA, but with limited success. A few patients have also been helped by supplemental oxygen. This is especially helpful if you live at high altitude.

Drugs that contribute to weight loss (including the ones noted above), as well as antidepressants that help weight loss, such as Prozac, can also be useful. It is important, though, to not take these drugs later in the day if they interrupt sleep.

Mechanical Treatments

There are several mechanical devices that change the shape of the upper airway and help to prevent the throat from collapsing.

Orthodontic devices can help to keep the lower jaw and tongue forward. These are most likely to be helpful for mild cases of sleep apnea and for people who who cannot tolerate the C-pap machine. A nasal C-pap is a mask that is kept over your face while you sleep. It keeps constant pressure in your airway and, as noted above, helps to keep the airway inflated and open while sleeping.

Unfortunately, three quarters of people with sleep apnea are not able or willing to continue with the C-pap treatment because of the noise of the machine, the discomfort of wearing the mask, and the cost. Most patients find that if they can tolerate the C-pap for three to six months, the treatment becomes second nature and comfortable.

Another possibility is surgery to reshape the throat so it stays open during sleep. Removing the tonsils, nasal surgery, and surgically trimming back the soft palate and the uvula (the tiny thing that hangs down in the back of your throat) are the most common treatments performed. Although these surgeries can be very helpful for snoring, they are less likely to help the sleep apnea. A new technique, in which stick like implants or high-frequency radio waves are used to scar areas in the soft palate and tongue and thus shrink them, shows promise.

It is controversial whether using more aggressive treatments for sleep apnea are worthwhile for people who have fewer than fifteen episodes of apnea per hour.

The more conservative approaches (for example, weight loss and avoiding sleeping on your back) are a more reasonable way for those with mild apnea to begin treatment.

The only definitive test for diagnosing Alzheimer’s is a brain biopsy, which appropriately is not done. Because of this, and because most doctors do not have time to do a proper 30-60 minute evaluation for underlying causes (Medicare pays poorly for visits over ~ 5 minutes), many elderly folks get a label of Alzheimer’s slapped on them and a prescription for Aricept at first sign of confusion, and perhaps a cursory look for other causes of confusion.

In addition to the tragic personal costs, the financial cost of caring for someone with Alzheimer’s averages from $70,000 to $174,000 (over a lifetime) with global costs for care being $248 billion yearly. It is insane to not aggressively look for and treat simple reversible problems that can cause or aggravate dementia.

Let’s look at a simple medical approach to evaluating and treating people with mild to severe loss of mental function. When doing this, you may find that the person never had Alzheimer’s, and that even if they do, even modest improvements in mental function can dramatically improve the ability to function and remember names and people. We will also discuss a promising new medication for Alzheimer’s that can stop it in its tracks (well, really an old natural compound that they will try to pass off as new).

Also, for those of you with day to day “brain fog” wondering if you may have Alzheimer’s, here’s a simple rule of thumb:

Alzheimer’s is not when you keep forgetting where you left the keys—it’s when you forget how to USE the keys.

This article will focus on Alzheimer’s and dementia, as well as poor memory & mental function in general. It will also lay the foundation for next week’s newsletter on “Brain Fog in CFS & FMS.”

Are you ready to get your memory and mind back?

Where Do We Start?

Begin with the basics. These are:

1. Nutritional support. Check a vitamin B12 level. If it is under 540, get a series of at least 15 B12 shots over several months (make sure the injections have 1,000-5,000 mcg of B12 per injection). If the B12 level is under 350, I would take the shots monthly forever, and add 1 teaspoon of cider vinegar to each meal (as convenient) as low B12 is usually associated with low stomach acid and the vinegar can help digestion. The B12 shots can take 3 months to fully kick in. In addition, supply overall nutritional support with the Energy Revitalization System vitamin powder (which also has a strong B complex vitamin which can take care of the low B12 if your doctor won’t give the injections). In addition, add fish oil—3 to 4+ servings of tuna, herring, or salmon a week or a tablespoon of fish oil twice a week. The brain is made of the oil found in fish oil (DHA). This can also help treat any hidden depression which may be present (see below). Also check a blood ferritin level (for iron) and treat with iron if it is under 40.
2. Treat hormonal deficiencies—even if the blood tests are normal.
   1. I would recommend a trial of Armour Thyroid in most people with unexplained chronic confusion to see if it helps. If risk factors for heart disease are present, the doctor should start with a low dose and work up slowly. A recent study (see Thyroid Function and Alzheimer’s) showed that even a low normal thyroid hormone (TSH over 2.1 vs. a TSH of 1-2—anything under 5.4 is consider “normal” by most doctors—even if it can kill you) in women was associated with more than a doubled risk of developing dementia!
   2. In men, if the total testosterone is under 400, I would give natural testosterone cream to bring the total testosterone level to ~ 600-800. Testosterone used in the natural form and safe dosing decreases heart disease and diabetes risk as well and does NOT increase prostate cancer risk (in fact, low testosterone is associated with a higher risk).
   3. Synthetic estrogen/Premarin and Provera do not improve brain function—and are dangerous. Bioidentical hormones do seem to have heart and cancer protective effects, where the synthetics worsen these. Though I have not seen studies on Bioidentical Estrogen and Progesterone in women and brain function, the other data suggests to me that it is worth a 6 month trial in women with cognitive/memory problems.
3. Consider a trial of 1 aspirin a day. Much of what is called Alzheimer’s is really the result of multiple small mini-strokes. This is especially so if the progression of mind problems seemed to occur in discrete small steps (worsening with each small silent stroke). An aspirin a day (or willow bark found in health food stores, 120 mg of salicin a day, if aspirin bothers your stomach) can decrease the risk of further strokes and often improve function as well.
4. Get your 8 hours of sleep a day. Begin with Melatonin 3-5 mg (I usually recommend ½ mg, but use the higher dose in this setting) at bedtime. If needed, add 2-3 capsules of the Revitalizing Sleep Formula herbal mix at bedtime. Other natural sleep aids are also available (see Treating Insomnia).
5. Make sure there is no depression (which can mimic Alzheimer’s).
6. Look for and treat diabetes, liver disease, anemia, heart disease, and other medical conditions.
7. Look for and eliminate any chronic infections (e.g., silent bladder infections; yeast overgrowth reflecting as increased gas or clearing one’s throat a lot).
8. Look for medications (or excess alcohol) that could contribute to confusion, and see if the doctor will work with you to leave each medication off for 2-3 days (if able) to see if the mind clears.I would add a trial of Gingko Biloba 40-80 mg 3x day. Give it 6 weeks to work. Though a long shot, the natural supplement PhosChol 1-3 caps a day could also raise acetylcholine levels (the brain chemical raised by Alzheimer medicines), but I have not seen studies using it in Alzheimer’s and it is expensive.

How About Alzheimer Medications?

A treatment called “Rember” is twice as effective as Aricept . While the Aricept slightly slowed Alzheimer’s progression over 12 months, Rember stopped the progression entirely—even when followed over 18 months! Interestingly, Rember is simply Methylene Blue, an old time natural compound.

I remember back in Junior High I was very much the scrawny geek. If a bully came after me, there was no good way to defend myself. I was able to get my revenge though (being a science geek). A little methylene blue slipped into their colas had them peeing a pretty shade of blue—and having a great panicked look! For the really nasty ones, I could get them peeing red as well…

Methylene blue will have an interesting time getting a patent (it is older than I am), but the drug company will probably patent the delivery system. It is worth keeping an eye out for, for use with those with Alzheimer’s. Although it will be 4-5 years before the FDA process is completed, so it can be approved for Alzheimer’s and available in pharmacies, the optimal dose is 60 mg 3 x day (more is not better) and it can be prescribed by Holistic Physicians and made by compounding pharmacies. For more info on Rember, see Rember for Alzheimer’s: Methylene Blue’s Comeback. It may cause blue urine, which is normal (it is a blue dye that gets excreted in the urine).

The benefit of Aricept and other medications that raise the brain transmitter acetylcholine (cholinesterase inhibitors ) is minimal, but still reasonable to use. The effect of these drugs was not very large when measured in 13 studies. In one measure of how well the drugs worked, for instance, patients across the studies improved by an average of less than three points on a 70-point scale that tracks mental functioning.

“There is nothing to suggest the effects are less for patients with severe dementia, although there is very little evidence for other than mild to moderate dementia,” according to Cochrane review author Jacqueline Birks of the University of Oxford.

Side effects caused about 29 percent of the patients taking the Aricept family drugs to leave the studies, compared with 18 percent dropout among the patients taking a placebo. The most common side effects were nausea, vomiting and diarrhea.

Although minimally effective compared to the other treatments we discuss in this article, I would add in 5 mg a day of Aricept (not 10 mg, which simply adds costs and side effects with minimal benefit) if you have prescription insurance. I suspect the rest of the treatments discussed above are MUCH more effective, but I’d add the Aricept for now for the additional tiny benefit it adds. For severe Alzheimer’s, especially if the person also has chronic pain, a trial of the medication Namenda may have modest benefits (but may also help pain).

That your doctor is not thinking in the terms we discuss in this article simply reflects that almost all the information doctors get comes from the drug companies (e.g., “give Aricept”).

I invite you to give this article to your physician. If they are open minded and willing to try (and they can email me with questions on my web site at http://www.Vitality101.com) these approaches, great! Once they see people get better, they can help many more folks.

If your doctor won’t do the treatments and gets hostile or dismissive with you for bringing up these options, don’t argue with them (it’s a waste of time trying to force open a physician’s closed mind). Instead find a Board Certified Holistic Physician to treat you or your loved ones.

You can restore or at least improve mental function in most people. Now you know how!

In the United States, with approximately 18% of the average American diet coming from added sugar, this is becoming the rule rather than the exception. Many people eat their weight in sugar every year. And it may be why you are tired, achy, “brain fogged”, anxious, and unable to lose weight.

As most people have found, simply trying to cut out sugar usually does not work very well.

In addition, who wants to cut out things that give you pleasure? Put simply, if you live a long life because you’ve cut out everything you enjoy, why bother?

How to eliminate the causes of your sugar cravings!

There are four main types of sugar addiction. In each type, there are different forces driving your addiction. By treating the underlying causes that are active in your type of addiction, you will find that not only do your sugar cravings go away, but you also feel dramatically better overall.

Here’s more good news. Once you have broken your sugar addiction, your body will usually be able to handle sugar in moderation. This means saving sugar for dessert or snacks where it belongs, and going for quality, not quantity. Dark chocolate is especially okay. Natural sweeteners like stevia are also a healthy way to satisfy your sweet tooth, but you need to use the right brands.

The 4 Sugar Addiction Types

To beat sugar addiction, first you’ll need to figure out which type of sugar addict you are. Here are the four key types:

Type 1: Hooked on “Energy Loan Shark” drinks. Chronically exhausted and hooked on caffeine and sugar

When daily fatigue causes sugar (and caffeine) cravings, sometimes all you need is to improve nutrition, sleep, and exercise. When your energy increases, you won’t need sugar and caffeine for an energy boost. Want a healthy daily energy drink? Add 1 scoop of the supplement Ribose (e.g.-Corvalen by Bioenergy) to ½ -1 scoop of a good vitamin powder (e.g.- the Energy Revitalization System by Enzymatic Therapy). This is a healthy way to turbo charge your energy!

Type 2: Feed Me Now or I’ll Kill You. When life’s stress has exhausted your adrenal glands

For those of you who get irritable when you’re hungry and crash under stress, it is important to treat your adrenal exhaustion. Herbal Licorice, adrenal glandular, Vitamin C and Pantothenic acid will help heal your adrenal stress handler glands (can be found in combination in Adrenal Stress End)

Type 3: The Happy Twinkie Hunter. Sugar cravings caused by yeast/candida overgrowth

For those of you with chronic nasal congestion, sinusitis, spastic colon, or irritable bowel syndrome, treating yeast overgrowth is critical. This can be done with probiotics, natural antifungals, and even the medication Diflucan given for 6 weeks (you’ll need a Holistic doctor to prescribe this-see http://www.HolisticBoard.org)

Type 4: Depressed and Craving Carbs. Sugar cravings caused by your period, menopause, or andropause

Standard blood testing for hormonal deficiencies will not reveal the problems until they are very severe, sometimes leaving people deficient for decades. Bioidentical hormones can be very helpful. Raise low estrogen naturally by eating a handful of edamame each day. This is the same tasty snack served in Japanese restaurants.

Quick Quiz – See What Kind of Sugar Addict You Are!

Type 1 Sugar Addict profile.

Do you?

1. Feel tired much of the time? (20 points)
2. Need coffee to get jumpstarted in the morning? (10 points)
3. What is the average number of ounces of caffeinated coffee or soda or “energy drinks” you drink daily? (Score 2 points for each ounce.)
4. Do you repeatedly crave sweets or caffeine to give you the energy to get through the day? (25 points)
5. Are you gaining weight? Or having trouble losing weight? (Score 1 point for every two pounds gained over the past three years.)

Score

• 0-30: No problem. Skip to the next quiz.
• 31-50: You are treating your fatigue with sugar and caffeine-which are energy “Loan Sharks”.
• Over 50: You are a sugar and caffeine junkie. Learn how to restore your energy production naturally, so you can cut back on sugar and still feel great.

Use the SHINE Protocol (Sleep, Hormonal support, Infection control, Nutritional support, Exercise) to optimize your energy-naturally!

Type 2 Sugar Addicts

1. Are you very irritable when hungry? Do you get a “Feed me now or I’ll kill you” feeling? (35 points)
2. Is life a crisis to you? (15 points)
3. Do you enjoy the rush of energy you feel when you are in a crisis? (15 points)

Score

• 0-24: You are probably a type B “low-key” person with healthy adrenals.
  25-34: You are developing early stages of adrenal fatigue.
  35-65: This suggests moderate to severe adrenal exhaustion, and your body is crying out for help.

Type 3 Sugar Addicts

1. Do you have chronic nasal congestion or sinusitis? (50 points)
2. Spastic colon or irritable bowel syndrome? (gas, bloating, diarrhea or constipation)? (50 points)
3. Have you taken antibiotics for any type of infection for more than two consecutive months, or shorter courses more than three times in a twelve-month period? (20 points)
4. Have you been treated for acne with antibiotic pills for one month or longer? (50 points)
5. Have you had a fungal infection, such as jock itch, athlete’s foot, or a nail or skin infection that was difficult to treat? (20 points)
6. Do you have postnasal drip or clear your throat a lot? (20 points)
7. Do you have food allergies? (20 points)

Score

• If your total is 50 or higher, you likely have a yeast/candida overgrowth.

Type 4 – Sugar Addiction

Women

PMS? Treating sugar addiction can help decrease your PMS.

MENOPAUSE OR PERIMENOPAUSE

1. Have you had a hysterectomy or ovarian surgery ( 30 points):
2. Do you have decreased vaginal lubrication? (25 points)
3. Do you have decreased sex drive (libido)? (15 points)
4. In the week before and around your period (or in general if you no longer have periods), do you experience noticeably worse
5. Insomnia? (15 points)
6. Headaches? (15 points)
7. Fatigue? (15 points)
8. Hot flashes or sweats? (20 points)

If you scored 30 or higher you likely have symptoms from estrogen or progesterone deficiency;

Men (over 45 years of age)

1. Do you have decreased libido? (20 points)
2. Do you have erectile dysfunction or decrease in erections? (20 points)
3. Do you have hypertension? (20 points)
4. Do you have high cholesterol? (20 points)
5. Do you have diabetes? (20 points)
6. Are you overweight with a “spare tire” around your waist? (20 points)

If you scored 50 or higher, these symptoms may be the result of an inadequate testosterone level-even if your blood test is normal.

If the answer is yes, you are not alone.

The average American has 140 to 150 pounds of sugar per person of sugar added to their diets each year. Another 18 percent of our calories come from white flour (which acts a lot like sugar in our bodies). Eating almost twice our weight in sugar and white flour each year, it’s not surprising that we have become a nation of sugar addicts. Like many other addictive substances, sugar may leave you feeling a bit better for a few hours, but then wreaks havoc on your body.

In our Beat Sugar Addiction NOW! book, we describe the four main types of sugar addicts. In each type, there are different forces driving the addiction, and in all four types the excess sugar leaves people feeling much worse overall.

By treating the underlying causes that are active in your type of addiction, you will find that not only do your sugar cravings go away, but you also feel dramatically better overall.

Here’s more good news. Once you have broken your sugar addiction, your body will usually be able to handle sugar in moderation. This means saving sugar for dessert or snacks where it belongs, and going for quality, not quantity. Dark chocolate is especially okay.

We will also discuss how to “have your cake and eat it too”, and how to use natural sugar substitutes to get the pleasure– without paying the cost. It is not our goal to eliminate things you love. Our goal instead is to teach you how to get the most pleasure you can, in a way that is healthy for your body and leaves you feeling better. In medicine, we have a simple rule. Never take away something pleasurable from a person’s diet without substituting something equally pleasurable.

Why Is Sugar Addictive?

For thousands of years, humans ate sugar found naturally in their food. Sugar was not a problem; it was a treat. But now more than one-third of the calories we consume come from sugar and white flour added by food processing. Our bodies simply were not designed to handle this massive load.

Many of you have already noticed that although sugar gives you an initial high, you crash several hours later, and this leaves you wanting more sugar. In fact, sugar acts as an energy loan shark, taking away more energy than it gives. Eventually, your “credit line” runs out and you find yourself exhausted, anxious, and moody.

The Long-Term Consequences of Sugar Addiction

In addition to the immediate fatigue and emotional problems, sugar also causes many long-term health problems. For example, our consumption of high-fructose corn syrup has risen 250 percent in the past fifteen years–and our rate of diabetes has increased approximately 45 percent during the same time period.

Although the sugar industry sometimes tries to confuse the public by claiming that corn syrup is not sugar, it is a form of sugar as far as your body is concerned–and more toxic than cane sugar.

Some chronic medical problems associated with excess sugar in our diet include:

• Fatigue and pain
• Weight gain
• Chronic fatigue syndrome and fibromyalgia
• Chronic sinusitis
• Irritable bowel syndrome and spastic colon
• Cancer
• Metabolic syndrome with high cholesterol and hypertension
• Heart disease
• Hormonal problems
• Candida and yeast infections
• ADHD
• Anxiety and depression

This is the short list. The actual list could go on for pages!

Sugar is also a mood-altering substance, which is no surprise to anyone with a sweet tooth. For all these reasons, it’s likely that if sugar growers tried to win FDA approval today, they’d have a tough time getting permission to sell their product.

But the fact is that sugar is everywhere in our diet, and it is dumped into what we eat and drink during food processing. With one-third of our calories coming from sugar and white flour, and the stress of modern life increasing, we are seeing the makings of the “perfect storm” of medical problems.

Eating sugar causes blood sugar to surge, insulin to spike, and fat to get deposited throughout your body. Obesity, often accompanied by diabetes and heart disease, is just one more consequence of our high-sugar diet.

The Value of Sugar Detox

I know the value of ridding the body of excess sugar. For more than thirty years I have incorporated sugar detox into treatments for countless patients suffering from chronic health problems. I have also seen thousands of people whose chronic fatigue syndrome and fibromyalgia were aggravated by their sweet tooth.

I also understand the problem firsthand. A former sugar addict myself, I came down with chronic fatigue syndrome in 1975. Eliminating my sugar addiction was an important part of my recovery.

Sugar addiction is the canary in the coal mine. It usually points to a larger problem that is also dragging you down. We don’t have anything against sugar. We simply don’t want you feeling poorly and getting sick because of it. In fact, we want you to feel great! And most of you will when you treat the problems accompanying your sugar addiction. Ready to get off of the “sugar roller coaster”? We’re happy to guide the way.

The basics of sugar detox are, of course, diet related–the standard method used to overcome sugar addiction. But an even deeper level of treatment is necessary to produce wellness.

If you have tried the “cold turkey” approach to sugar addiction without nutritional strategies, treatment guidelines, and support, you probably found success elusive. That’s because getting rid of the sugar is but one step in an overall comprehensive approach that must address the mind, body, and spirit.

The problem with many medical self-help books is that they pick off a little corner of the problem and miss the big picture, so often you get frustrated and stop your program without getting well. My goal in writing Beat Sugar Addiction Now! is to give you an organized step-by-step approach for each type of sugar addiction, so you can effectively and easily kick sugar addiction–along with the hidden problems driving your addiction.

The Four Types of Sugar Addiction

To beat sugar addiction, first you’ll need to figure out which type of sugar addict you are. Different kinds of sugar addiction have different underlying causes and require different treatments. Here are the four key types of sugar addiction:

Type 1: The Energy Loan Shark. Chronically exhausted and hooked on quick hits of caffeine and sugar

When daily fatigue causes sugar (and caffeine) cravings, sometimes all you need is to improve nutrition, sleep, and exercise. When your energy increases, you won’t need sugar and caffeine for an energy boost. This can often be done fairly easily. Instead of “energy loan shark” drinks, optimize nutritional support with a good vitamin powder (I like the “Energy Revitalization System” vitamin powder by Enzymatic Therapy-one simple drink replaces over 35 tablets of supplements). In addition, 2 studies we have done have shown that a special energy nutrient called Ribose (ironically, a sugar-but a healthy one) increases energy by an average of 45-60% after 3 weeks. My daily regimen is to add a 5 gram scoop to the vitamin powder each morning.

Type 2: Feed Me Now or I’ll Kill You. When life’s stress has exhausted your adrenal glands

For those of you who get irritable when you’re hungry and crash under stress, it is important to treat your adrenal exhaustion.

Increasing water and salt intake (unless you have high blood pressure or heart failure), a high protein diet with frequent smaller meals (called grazing), and realizing that life is not an ongoing crisis (contrary to the impression given by some in the news media) help your adrenal stress handler glands to stabilize. Natural support with Licorice, Vitamin B5, Vitamin C and Adrenal glandulars (all present in a product called Adrenal Stress End) make recovering much easier.

Type 3: The Happy Twinkie Hunter. Sugar cravings caused by yeast/candida overgrowth

For those of you with chronic nasal congestion, sinusitis, spastic colon, or irritable bowel syndrome, treating yeast overgrowth is critical. This can be done effectively with “pearl- coated” probiotics and both prescription and natural antifungals.

Type 4: Depressed and Craving Carbs. Hormonal deficiencies-Sugar cravings caused by your period, menopause, or andropause

For women who feel worse around their menstrual cycle, or whose problems increased when they entered perimenopause in their forties, estrogen and progesterone deficiency may be driving sugar cravings. In a woman’s earlier years, this is likely to reflect as premenstrual syndrome (PMS, with associated progesterone deficiency), with severe irritability around your periods.

In your mid-forties, as estrogen deficiency begins, estrogen or progesterone deficiency often produces increased sugar cravings, fatigue, moodiness, and insomnia around your periods, as well as decreased vaginal lubrication.

For men, testosterone deficiency associated with andropause can also cause sugar craving along with other severe problems. Depression, decreased libido, decreased erectile function, high blood pressure, weight gain, diabetes, or high cholesterol can suggest testosterone deficiency. Interestingly, supplementing with bio-identical natural testosterone (by prescription) has been shown to help all of these problems.

Standard blood testing for hormonal deficiencies will not reveal the problems until they are very severe, sometimes leaving people deficient for decades. Eliminating the sugar addiction and other problems caused by low estrogen, progesterone, or testosterone can be life transforming.

Beat Sugar Addiction NOW!

To make it easy, Beat Sugar Addiction NOW! is structured as a workbook, so that when you’re done reading it you will have a treatment protocol tailored to your specific problems.

Ready to get a life you love? It’s time!

Love and blessings,

Jacob Teitelbaum, MD

After over a decade of economic special interests seeming to block the way (i.e., Nutrasweet), the FDA has finally approved the healthy herb Stevia as a natural sweetener to add to foods and sodas.

In fact, the first Stevia-sweetened soft drink, “Sprite Green” by Coca-Cola, was on its way to stores.

Pepsi said its first Stevia product, SoBe Lifewater, should hit store shelves next week, and Trop50, a Stevia-sweetened light orange juice product, is due out in January.

Dr. Pepper Snapple, the No. 3 soft drink company, said on Thursday it will market Stevia within a few weeks.

We have recommended Stevia as a safe and healthy natural sweetener for decades — even as the FDA, seemingly driven by someone heavily on the Nutrasweet payroll (though this is simply my impression, of course, without definite evidence) required the first and only book burning demanded by the U.S. government — which just happened to be books recommending Stevia. Till now, the FDA would not allow stevia to be added as a food sweetener. Instead, it could only be added as a “nutrient.”

Stevia is a safe, healthy and calorie free natural sweetener. Expect the media to jump all over bizarre stories raising questions of its safety (which will be fed to the media by publicists for the sugar, Splenda and Nutrasweet trade groups trying to protect their market share). In the middle of their trying to scare you away from this healthy sweetener and back to their toxic ones, let yourself enjoy watching an example of American marketing hype in action. And indulge your sweet tooth

One word of caution. If Stevia is not filtered, it will taste bitter and with a licorice aftertaste. I suspect the large soda companies will do proper filtering to ensure taste.

Stevia simply comes from soaking a Stevia leaf in water and using the sweet liquid.

Stevia — another great example of keeping your pleasures — while staying healthy!

Immune dysfunction (i.e., being more susceptible to infections) is a common part of both Fibromyalgia and CFS, and is becoming more common in the overall population as well. In earlier articles, we have discussed how to diagnose and treat chronic viral and antibiotic sensitive infections. The most common and important infections to treat in CFS and Fibromyalgia are yeast, fungal and Candida infections (I will treat these as a single infection for this article). Unfortunately, standard medicine does not recognize fungal infections unless they affect the nails, skin, hair or groin areas—or they are in the blood and can kill you. Because there is no test to clearly diagnose overgrowth of bowel or sinus Candida, many doctors say it doesn’t exist. Reminds me of the little boy who thinks he’s invisible because he’s covered his eyes…

That there is no blood test does not mean there is no way to tell if you need treatment. I recommend the Candida/yeast/fungal treatment for most people who have ANY of the below problems:

	1.	CFS/ Fibromyalgia—As I have discussed in lectures to thousands of health practitioners, if someone has CFS/FMS, presume the Candida is present and treat for it.
	2.	Chronic sinusitis—which is usually caused by yeast.
	3.	Spastic colon/irritable bowel syndrome.

When you treat the yeast as we’ll discuss, not only does the CFS/FMS usually improve, but the sinusitis and spastic colon will often go away as well. As fringe benefits, most of you will find (if you take the Diflucan medication part of the treatment) that your dandruff and feeling like you want to stick your finger in your ear to scratch it will also go away!

How do I Treat the Candida/Yeast?

It takes around 3-5 months to restore balance between the healthy bacteria and the yeast in your body, but most people will be feeling better at ~ 1 month into using the prescription antifungal “Diflucan.” Here is your “recipe” for treating the yeast:

	1.	Begin by avoiding sugar (I will add the magic words “except for dark chocolate,” which is a healthy food in moderation). Sugar feeds yeast, so substitute stevia, a healthy natural sweetener.
	2.	Take healthy bacteria (probiotics) to fight the yeast. I recommend Probiotic Pearls or Acidophilus Pearls 2 twice a day for 3-5 months.
	3.	At the same time, begin the herbal antifungal mix “Anti-Yeast” 2 twice a day for 3-5 months.
	4.	After 1 month on the above, add the medication Diflucan 200 mg a day for 6-12 weeks (get the generic form fluconazole. The brand name is $600 for 6 weeks. The generic is available for only $40 for 42 tablets at Consumers Discount Pharmacy, phone 323-461-3606).

For those who would like more detail on the Candida issue, it is discussed at length in my book “From Fatigued to Fantastic!“ (Avery/Penguin Oct 2007). Part of the section from the book is in the article below.

An Overview of Yeast/Candida Infections

I will use the terms yeast, fungi, and Candida interchangeably for this discussion. Fungal overgrowth may suppress the body’s immune system. It is suspected that this occurs in part because the bowel yeast infections cause what is called “leaky gut syndrome.” This means that food proteins get absorbed into the blood system before they are fully digested. Because of this, your immune system has to complete the digestion process, which often overtaxes it. Many physicians feel that yeast overgrowth causes a generalized suppression of the immune system. In other words, once the yeast gets the upper hand, it sets up a cycle that further suppresses the body’s defenses.⁷

Yeast are normal members of the body’s “zoo.” They live in balance with bacteria—some of which are helpful and healthy, and some of which are detrimental and unhealthy. The problems begin when this harmonious balance shifts and the yeast begins to overgrow.

Many things can prompt yeast to overgrow. One of the most common causes is frequent antibiotic use. Antibiotics kill off the good bacteria in the bowel along with the bad bacteria. When this happens, the yeast no longer have competition and begin to overgrow. The body is often able to rebalance itself after one or several courses of antibiotics, but after repeated or long term courses—and especially if the body has an underlying immune dysfunction—the yeast can get the upper hand.

Other factors are also important. Studies have shown that animals that are sleep-deprived and/or have increased sugar intake develop immune suppression and bowel yeast overgrowth. Many physicians feel that eating sugar stimulates yeast overgrowth in people as well. So as you prepare your meals, remember—sugar is food for yeast.

Diagnosing Yeast Overgrowth

There are no definitive tests for yeast overgrowth that will distinguish yeast overgrowth from normal yeast growth in the body. In my experience, using Dr. William Crook’s yeast questionnaire is still the most reliable way to tell if a person is at risk of yeast overgrowth. A simplified version is part of our free web program which will analyze your symptoms to determine the cause(s) of your CFS/FMS, fatigue or pain and tailor a treatment protocol to your case.

In addition, anyone with ANY of the following criteria should be treated with antifungals:

	1.	anyone with CFS or Fibromyalgia, OR
	2.	who has chronic nasal congestion or sinusitis, OR
	3.	has spastic colon (gas, bloating, diarrhea and/or constipation), OR
	4.	has been on recurrent or long term antibiotics (especially tetracycline for acne), OR
	5.	who intermittently has painful sores in the mouth (not cold sores on the outer lips) that last for about ten days at a time.

Treating Yeast Overgrowth

A number of very effective treatments can be used to eliminate a yeast problem. I find that the best approach is to combine dietary changes, natural remedies, and prescription medications.

Natural Yeast Treatments

The most important part of treating yeast overgrowth is avoiding sugar and other sweets, although I will add the three magic words, “except for chocolate.” You can also enjoy one or two pieces of fruit a day, but you should not consume concentrated sugars like fruit juices, corn syrup, jellies, pastry, candy, or honey. Stay far away from soft drinks, which have ten to twelve teaspoons of sugar in every twelve ounces. This amount of sugar has been shown to markedly suppress immune function for several hours. Be prepared to have your CFS/FMS symptoms flare for about one week when you cut sugar out of your diet.

Using stevia as a sweetener is a wonderful substitute for sugar. Despite some misconceptions, stevia is safe and natural, and you can use all you want. There are even cookbooks available for using stevia. The brand of stevia that you choose is very important, however. Most brands of stevia are not filtered and therefore are bitter. The two that won the taste test in our office are made by Body Ecology (1-800-4STEVIA) and Stevita. Ribose (Corvalen), a very effective nutrient for treating CFS, FMS and heart conditions, is not readily digestible by yeast and is usually well tolerated.

Several books have been written on the yeast controversy and offer additional dietary methods to try. One of the best is The Yeast Connection and the Woman by the late Dr. Billy Crook, a physician who advanced our understanding of CFIDS/FMS considerably.

One of those dietary methods that can help restore balance in the bowel is the intake of acidophilus—that is, milk bacteria, a healthy type of bacteria. Acidophilus is found in yogurt with live and active yogurt cultures. Indeed, eating one cup of yogurt a day can markedly diminish the frequency of recurrent vaginal yeast infections.⁹ Acidophilus is also available in supplement form, but which brand you use is important. Many brands do not actually contain the amount that the label claims or contain dead bacteria—which do not put up much of a fight against the yeast. I like to use Probiotic Pearls by Integrative Therapeutics or Acidophilus Pearls by Enzymatic Therapy. The pearl coating acts like a little tank—which protects the milk bacteria as they pass through the acidic environment of the stomach. Without this coating to protect against stomach acid, it is estimated that 99.9% of these yeast fighting bacteria will NOT survive the trip through the stomach. This means that to get the number of healthy bacteria in 1 pearl to your colon, you’d need to eat around 3 gallons of yogurt! Once the pearl hits the alkaline environment of the small intestine, it dissolves and releases the bacteria to fight the yeast. I recommend that you take 2 pearls twice a day for 5 months, after which time many people choose to continue taking one a day for prevention. Although the box claims 1 billion bacteria per pearl, the laboratory assays actually show that these pearls contain 2.4 billion bacteria. If you are on antibiotics (not antifungals), take acidophilus at least three to six hours before or after the antibiotic dose.

Many other natural antifungals can be helpful, but when used individually in a high enough dose to kill the yeast they also irritate the stomach. Because of this I like to combine multiple anti-fungal herbs. My favorite combination is Anti-Yeast by Ultraceuticals, which contains 240 mg of coconut oil powder (50% caprylic acid), 200 mg of oregano powder extract, 120 mg of uva ursi extract, 240 mg of garlic powder (deodorized), 160 mg of grapefruit seed extract, 80 mg of berberine sulfate, 200 mg of olive leaf extract, 50 mg of alpha lipoic acid, 50 mg of milk thistle extract, and 50 mg of N-Acetyl L-Cysteine.

Prescription Treatments for Yeast Overgrowth

It is critical to add a prescription anti-fungal as well, because the natural products only kill yeast in the gut and are not as strong. I recommend that almost all of my CFS/FMS patients use Diflucan (Fluconazole) 200 mg/day for 6-12 weeks. If stool cultures (which are negative in most people who need yeast treatment) show the yeast to be resistant to Diflucan, then your doctor may choose to substitute Nizoral at 200 mg/day for 6 weeks. Nizoral can lower adrenal hormone levels, so if your cortisol is low your doctor should consider adding adrenal support when prescribing Nizoral. I don’t use Sporanox because it costs over $600, and if your yeast is resistant to Diflucan, it will usually also be resistant to Sporanox but sensitive to Nizoral. The anti-fungal medication Lamisal is simply NOT effective for Candida.

Nystatin, an antifungal medication, has been helpful in the treatment of yeast overgrowth in the past. Unfortunately, more and more fungi seem to be developing resistance to nystatin. In addition, nystatin is poorly absorbed, which means that it has little impact on the yeast outside of the bowel. Because of this, I am now using the Anti-Yeast herbal mix instead.

Any effective antifungal can initially make the symptoms of yeast infection worse. In addition, Diflucan can cause liver inflammation, although this is uncommon (Tylenol is more likely to cause liver problems), and I have not seen it be a significant problem in the more than 3,000 patients I’ve treated. If you have preexisting active liver disease, you should be cautious about using Diflucan—or not use it at all. The “Anti-Yeast” herbal above also contains lipoic acid, milk thistle extract, and N-Acetyl L-Cysteine, natural supplements that helps to protect and heal the liver.

If symptoms of yeast overgrowth are caused by an allergic or sensitivity reaction to the yeast body parts, symptoms may flare up when mass quantities of the yeast are suddenly killed off. This is called a die-off (Herxheimer) reaction and can occur with the treatment of any chronic infection. To decrease the risk of this reaction, start your treatment with the acidophilus and a sugar-free diet for a few weeks, followed by the Anti-Yeast herbals for one month before beginning the Diflucan. If symptoms flare up, take just 25-100 mg of Diflucan each morning for the first three to fourteen days. If symptoms recur after you stop the Diflucan, I recommend continuing the medication for an additional six weeks at 200 mg a day. If you cannot get the Diflucan from your physician, the rest of the program will still help, but will not kill off the yeast in the sinuses as the Diflucan will.

Many books on yeast overgrowth advise readers to avoid all yeast in the diet. This advice is based on the theory that an allergic reaction to yeast is the cause of the problem. However, the yeast that is found in most foods (except beer and cheese) is not closely related to Candida, which is the predominant yeast that seems to be involved in overgrowth.

In my experience, trying to avoid all yeast in foods results in a nutritionally inadequate diet and does not substantially help most people. Although a few people do appear to have true allergies to the yeast in their food, they account for fewer than 10% of my patients with suspected yeast overgrowth. These people may benefit from the more strict diet recommended in Dr. Crook’s book. Interestingly, once adrenal insufficiency and yeast overgrowth are treated, most people find that their allergies and sensitivities to yeast and other food products seem to improve or disappear.

Nutritional deficiencies such as low zinc or low selenium may also decrease resistance to yeast overgrowth.¹⁰ A good multivitamin supplement, such as the Energy Revitalization System, should take care of these deficiencies. This is simply another example of how all the factors involved in CFS/FMS are closely interrelated.

What If the Yeast Comes Back?

It is normal for yeast symptoms to resolve after treatment. After six weeks on Diflucan, most people feel a lot better. If not, you may have Diflucan-resistant Candida, and a trial of Nizoral may be helpful. However, symptoms may sometimes also recur soon after you stop taking either antifungal. If this happens, I would continue taking Diflucan or Nizoral for another six weeks or for as long as is needed to keep the symptoms at bay. More frequently, people feel better after treatment and stay feeling fairly well. Although many people never need to be re-treated for yeast, others need to repeat a course of antifungals after six to twenty-four months, especially after eating too much sugar or taking antibiotics.

The best marker that I have found for recurrent yeast overgrowth is a return of bowel symptoms, with gas, bloating, and/or diarrhea or constipation, vaginal yeast, mouth sores, and/or recurring nasal congestion or sinusitis. If these symptoms persist for more than two weeks, especially if there is also even a mild worsening of the CFIDS/FMS symptoms, it is very reasonable to repeat treatment with six weeks of Anti-Yeast, Probiotic Pearls, and Diflucan. If a second round of treatment resolves the symptoms, you may opt to repeat this regimen as often as is needed, usually every six to twenty-four months. By using the Anti-Yeast and Probiotic Pearls, however, you may be able to avoid the need for repeated use of antifungals and the possible risk of becoming resistant to them.

Some people find that they need to stay on the antifungals for extended periods of time-years, in some cases—or the symptoms recur. As an alternative, instead of taking the antifungals every day, many people find they can get long term suppression of the yeast by taking 200 mg of Diflucan twice a day, one day each week (for example, each Sunday).

Treating the yeast is one of the most important parts of treating CFS/FMS, chronic sinusitis, or spastic colon. Though it takes 5 months to restore balance, you’ll be feeling much better after 1 month on the Diflucan anti-fungal medication. If your physician won’t prescribe it, see a Fibromyalgia and Fatigue Center physician or a Board Certified Holistic Physician. You’ll be glad you did!

This syndrome is caused by the compression of a nerve (the median nerve) as it goes through a narrow tunnel in the wrist formed by the carpal bone, hence the name carpal tunnel syndrome. According to the American Academy of Neurology, 10 percent of the population suffers from the syndrome. It also affects up to 50 percent of industrial workers. All too often the syndrome is treated by surgery. Although this can be effective, it is also expensive and can leave people with residual problems due to the formation of scar tissue that can occur after surgery.

Fortunately, unless people are continuing to stress the wrist with repetitive stress injuries (e.g. handling heavy equipment or doing large amounts of typing), carpal tunnel syndrome can almost always be relieved without surgery. In almost all of my patients, their carpal tunnel syndromes have resolved by simply using vitamin B6 (250 mg daily), Armour thyroid hormone, and a wrist splint for six weeks.

When your hand gets into funny positions while you are sleeping, it stretches and strains the nerve as it goes through your wrist. This is why you wake up in the night with numbness or tingling. The type of wrist splint to use is called a “cock up” wrist splint. It keeps your hand in the neutral position (i.e. the position your hand is in while holding a glass of water), which takes the stress off the nerve. Be sure to wear the splint for at least 6 weeks while you’re sleeping. During that period, also wear it during the day when you can.

Although the treatment above generally takes care of carpal tunnel syndrome, it is worth being aware of a new treatment as well. A portable wrist traction device combines neutral wrist position and stretching to decompress the carpal tunnel. It is used 10 minutes twice a day for 1 month, followed by 10 minutes once a day for a second month. It can be used at home or at work, making it very convenient.

At the end of a study of 30 patients, most had normalization or near normalization of the nerve function. Other conservative measures can also be effective, including acupuncture, osteopathic manipulation, chiropractic manipulation, and myofascial release.

Unfortunately, your doctor may be totally unfamiliar with these conservative therapies; in today’s medicine only expensive treatments tend to get attention. If surgery is recommended, ask your physician if you can try these conservative measures instead for 6 to 12 weeks.