fibromyalgia pain

  • Exercise: Friend or Foe in Fibromyalgia?

    10 Tips For Healthy Exercise In Fibromyalgia by Jacob Teitelbaum

    10 Tips For Healthy Exercise In Fibromyalgia

    In previous articles, we have discussed the basics of using the SHINE Protocol:

     Nutrition and
     Exercise as able

    To recover from CFS and fibromyalgia, double-blind placebo-controlled research has shown that 91 percent of people improve with an average 90 percent increase in quality of life using this approach. Today, let’s discuss the E in SHINE- Exercise This whole area has become very controversial. Not because there is uncertainty about the importance of exercise in any chronic disease. But rather, because there is still a small subset of fools who like to make believe that fibromyalgia is not a “real” disease, and who attempt to use the research showing that conditioning helps to somehow invalidate the illness.

    We have seen this before when multiple sclerosis used to be called “hysterical paralysis,” and lupus and rheumatoid arthritis were considered diseases of neurotic women. Just as some people will persist in believing that the world is flat, some will persist in believing that these illnesses, and fibromyalgia, are somehow all in people’s minds.

    Research is clear that exercise helps cancer — induced fatigue. Yet no one would dream of saying that this suggests that cancer is not a real disease. In the same way, anyone who implies that the research showing that conditioning helps fibromyalgia somehow suggests that the illness is not real is simply being a fool.

    For today, let’s ignore the fools.

    So what is occurring? Because of the energy crisis occurring in CFS/FMS/ME, people are unable to condition beyond a certain point. Instead, if they exercise beyond that point, they get postexertional fatigue, often being bedbound for a day or two. This, along with the pain, often leaves people afraid to exercise at all — leading to severe deconditioning. In this illness, the deconditioning can be devastating. In fact, it can be more devastating than the exercise.

    The answer? You want to begin a walking program so that you can condition as much as your body is able to. For some this may be 50 steps a day, and for others this may be two miles. Simply start slow, and listen to your body. If you feel good tired after and better the next day that was a good level of walking. Increase by 50 steps each day as able. A good $15 pedometer will help you to do this easily. If you get to the point where you feel wiped out the next day, simply cut back.

    The good news? After you give the SHINE protocol 10 to 12 weeks to build energy production, you’ll be able to start conditioning again, instead of simply crashing. When you feel your energy building on the protocol, continue to increase your walking by about 50 steps every day or two, as feels comfortable. It can be as simple as this, and does not need to be complicated. For many fibromyalgia patients, doable exercises include walking, yoga, and Tai Chi just to name a few. Walking is an ideal exercise.

    Here are 10 tips to get you started safely, and to make the exercise program more effective:

    1. Begin with light exercise, like walking or even warm water walking (in a heated pool) if regular walking is too difficult.
    2. Walk to the degree that you feel “good tired” after and better the next day. If you feel worse the next day, stop a few days and then cut back
    3. Walk only as much as you know you can comfortably (or start with five minutes). Then increase by one minute every other day as is comfortable. When you get to a point that leaves you feeling worse the next day, cut back a bit to a comfortable level, and continue that amount of walking each day.
    4. After 10 weeks on the “SHINE Protocol,” your energy production will usually improve considerably, and you’ll be able to continue to increase your walking by one minute every other day.
    5. When you get to one hour a day (or 5000–10,000 steps throughout the day if using a pedometer), you can increase the intensity of the exercise. Again, listen to your body, and only do what feels good to you. You’ll know the difference between how “good pain” feels versus “bad pain” or crashing. Overall, “No Pain, No Gain” is stupid. Pain is your body’s way of saying, “Don’t do that!”
    6. Do consider a pedometer. It makes it more fun to be able to see your endurance go up (set it for total steps you walk a day).
    7. When it’s cold outside wear woolen long underwear. A cold breeze can throw muscles into spasm. So can sweating during the walk if you’re overdressed. Woolen long johns will soak up any sweat and wick it away from your skin. Meanwhile, don’t forget a scarf and hat. Unless it is cold, and the cold flares your pain, I recommend you get your exercise by walking outside, so you can get sunshine your key source of vitamin D. Many people with CFS/Fibromyalgia are vitamin D deficient. Vitamin D from sunshine (or supplements) will help improve immune function and will also decrease the risk of hypertension, diabetes, and cancer (low Vitamin D is responsible for upwards of 85,000 deaths a year in the U.S.).
    8. Enjoy Your Exercise! (Or you won’t stay with it.) No pain, no gain. You’ve heard that slogan, of course. It reflects the belief that unless exercise hurts, it’s not doing its job.I have another slogan I want you to say to yourself instead. Pain is insane! Exercise should be virtually pain-free.
    9. Find An Exercise You Enjoy. Find an activity you love to do, look forward to, and that fits into your routine. This way, you will be more likely to stick with it. Whether you begin with a simple walk to the mailbox, or as you improve you find that you’re doing a dance class, going for a walk in the park, doing yoga, or even shopping, doing something you love makes it more likely that you’ll stick with it.
    10. Have A Regular Scheduled Routine. And meet with a friend to do the exercise. The obligation of meeting somebody means that you’re also more likely to show up.

    Some of you will have orthostatic intolerance (e.g.—NMH or POTS), where your symptoms get worse if you are upright for an extended period.

    We have begun with an overview of how to use SHINE to recover from fibromyalgia. To make this easier, I recommend doing the free “Energy Analysis Program” at This will analyze a series of quizzes, and can also analyze pertinent lab tests if they are available, to tailor a program to help optimize your energy production. I also recommend the free iPhone and android app “cures A – Z,” which you’ll find very helpful in addressing day-to-day problems, and my books, The Fatigue and Fibromyalgia Solution and From Fatigued to Fantastic!

  • February 2017

    Total Health Magazine February 2017

    Dear Readers,

    Welcome to the February 2017 issue of TotalHealth. February is National Heart Month, there are several articles on heart health in this issue.

    In our Studies section this month we report Kyolic Aged Garlic’s Hypertension Benefits Confirmed.

    Dallas Clouatre, PhD, in "Three Pillars Of GI-Tract Health" gives us a look inside at our GI tract. He describes the workings of the this body system, what can go wrong and how we can influence the GI-track to healthy working order. You'll be impressed with how complicated the whole operation is—even without much consideration from us.

    Elson Haas, MD, presents "Self Care And Stress Reduction." Guiding us on a tour by looking at ways to protect our body and heart from the negative effects of stress and to create better health. Beginning with a self-inventory, included is an explanation of the three major areas of stress for most of us and goes on to describe seven types of stress. You'll find this educational and healthful.

    In "Sugar Addiction and Fibromyalgia," Jacob Teitelbaum MD addresses the pitfalls of sugar and its influence on all of us, our heart health and hypertension. Included are suggestions on dealing with "sugar cravings."

    Gloria Gilbère, CDP, DAHom, PhD, shares her recipe for "Salsa Jovan—Nightshade Free." She suggests using it in place of salsa and salad dressing, using it with eggs, on burritos or to accompany chips and vegetables as a dip. It is a healthy and easy to make recipe. Gilbère includes all the health benefits of the ingredients for her natural health recipes.

    Stephen T. Sinatra, MD, FAAC, presents "For A Healthier Heart, Try the Mother Earth Rx." In this article, it's explained—"a well-established, but little known scientific fact that the surface of the Earth contains a subtle, natural, negative electric charge. You may have felt it sometime when walking along the wet sand at the beach and noticed a bit of tingling or warmth in your feet. That's it. You were getting charged up by Mother Earth." Read on for the heart benefits it offers and become familiar with the Mother Earth Rx.

    In "A Healthy Heart At Any Age," Ann Louise Gittleman, PhD, CNS, tells there are over 250 risk factors for heart disease that have been identified. However, you'll be relieved to know that a large number of these factors—including many that are especially dangerous—can be lowered with lifestyle choices and changes. Covered are effects of smoking, obesity, diabetes, and a sedentary lifestyle. Your daily choices have a significant influence on your health.

    Gene Bruno, MS, MHS, RH(AHG), in "Pros and Cons of Coffee and Caffeine" includes the sources of caffeine, how much is in each source and how it can effect various health issues. He also lists contraindications for caffeine intake and reminds those who are sensitive to caffeine to forego it.

    Charles Bens, PhD, in "Lowering Blood Pressure Naturally," defines high blood pressure, lists the causes, includes prevention using nutrition, which foods to favor and which to avoid and suggestions on exercise.

    In Pet Care, Shawn Messonnier, DVM, presents Part 2 of a four part series on cancer, many pet owners are seeking this information for their pets.

    Best in health,

    TWIP The Wellness Imperative People

    Click here to read the full February issue.

    Click here to read the full February issue.

  • Fibromyalgia—Orthostatic Intolerance Made Easy

    Fibromyalgia Orthostatic Inolerance Made Easy Jacob Teitelbaum

    Think about it this a moment. We are a big bag of water. Ever wonder why it doesn't just all flow down to our legs when we stand up?

    The answer is, that it does. Because of this, our autonomic nervous system has to direct the blood vessels in our legs to contract and send the blood back up to our brain and muscles where it is needed. Otherwise, the effect can be similar to rapidly losing several units of blood.

    When this system is not working properly, people's blood pressure can drop significantly when they are upright for an extended period. This can result in low blood pressure (Neurally Mediated Hypertension-NMH) or a compensatory rise in heart rate called Postural Orthostatic Tachycardia Syndrome (POTS). Whatever name you choose to call it, it falls under the umbrella of orthostatic intolerance. When people stay upright, they can get dizzy, exhausted, and brain fogged.

    Orthostatic intolerance is a major and very treatable part of what causes disability in CFS and fibromyalgia. And research has shown that many people diagnosed with NMH and POTS actually have CFS or fibromyalgia.

    Some Background
    Just a quick refresher. Fibromyalgia essentially represents an energy crisis in the body. When this happens, the area that uses the most energy for its size, called the hypothalamus, malfunctions. Basically, it is like tripping a circuit breaker when one has an energy crisis. Just as there are hundreds of ways to blow a fuse; there are numerous triggers for the energy crisis that precipitates fibromyalgia.

    So what does the circuit breaker that goes off-line control? The hypothalamus controls:

    1. Sleep. Which is why insomnia despite exhaustion is a hallmark of this condition
    2. Hormonal function
    3. Temperature regulation
    4. Autonomic function

    We have addressed these other components in earlier articles. To summarize, our research showed that by treating with the SHINE Protocol, 91 percent of people with fibromyalgia improved with an average 90 percent increase in quality of life (p<.0001 vs. placebo). SHINE stands for:

    • Sleep
    • Hormonal support and Hypotension (Dysautonomia)
    • Infections
    • Nutritional support
    • Exercise as able

    To make this easier, there is a free Energy Analysis Program at that can analyze your symptoms and even lab tests. I had this illness in 1975 and it left me homeless. So my goal is simple. Helping to make effective treatment for people with this illness available—to everyone.

    Orthostatic Intolerance
    So basically, autonomic dysfunction is a routine part of fibromyalgia, and contributes markedly to its symptoms. People are upright for a few minutes, the blood rushes to their le.g.s, their tissues don't get adequate blood flow, and they feel wiped out and brain fogged.

    Simple so far. It gets simpler

    How to Diagnose It
    The standard approach to diagnosis is to use a Tilt Table Test. It is unreliable, will make the person miserable, and the insurance tends to not cover it leaving them with a $2000 bill. An easier approach? A wonderful study in the Mayo Clinic Journal showed that this simple quiz could be quite reliable. It is free and takes about two minutes.

    Self Report Orthostatlc Grading Scale Mayo Clin Proc. 2005;80(3):330-334 ("Orthostatic symptoms" include worsening dizziness, fatigue, Racing heart or brain fog when standing)

    Circle 0 –4 below as best applies to you

    A. Frequency of orthostatic symptoms
    0. I never or rarely experience orthostatic symptoms when I stand up
    1. I sometimes experience orthostatic symptoms when I stand up
    2. I often experience orthostatic symptoms when I stand up
    3. I usually experience orthostatic symptoms when I stand up
    4. I always experience orthostatic symptoms when I stand up

    B. Severity of orthostatic symptoms
    0. I do not experience orthostatic symptoms when I stand up
    1. I experience mild orthostatic symptoms when I stand up
    2. I experience moderate orthostatic symptoms when I stand up and sometimes have to sit back down for relief
    3. I experience severe orthostatic symptoms when I stand up and frequently have to sit back down for relief
    4. I experience severe orthostatic symptoms when I stand up and regularly faint if I do not sit back down

    C. Conditions under which orthostatic symptoms occur
    0. I never or rarely experience orthostatic symptoms under any circumstances
    1. I sometimes experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower)
    2. I often experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower)
    3. I usually experience orthostatic symptoms under certain conditions, such as prolonged standing, a meal, exertion (e.g., walking), or when exposed to heat (e.g., hot day, hot bath, hot shower)
    4. I always experience orthostatic symptoms when I stand up; the specific conditions do not matter

    D. Activities of daily living
    0. My orthostatic symptoms do not interfere with activities of daily living (e.g., work, chores, dressing, bathing)
    1. My orthostatic symptoms mildly interfere with activities of daily living (e.g., work, chores, dressing, bathing)
    2. My orthostatic symptoms moderately interfere with activities of daily living (e.g., work, chores, dressing, bathing)
    3. My orthostatic symptoms severely interfere with activities of daily living (e.g., work, chores, dressing, bathing)
    4. My orthostatic symptoms severely interfere with activities of daily living (e.g., work, chores, dressing, bathing). I am bed or wheelchair bound because of my symptoms

    E. Standing time
    0. On most occasions, I can stand as long as necessary without experiencing orthostatic symptoms
    1. On most occasions, I can stand more than 15 minutes before experiencing orthostatic symptoms
    2. On most occasions, I can stand 5–14 minutes before experiencing orthostatic symptoms
    3. On most occasions, I can stand 1–4 minutes before experiencing orthostatic symptoms
    4. On most occasions, I can stand less than I minute before experiencing orthostatic symptoms

    _____Total Score

    Scores of 9 or higher suggest Orthostatic Intolerance In fibromyalgia, I consider a score of seven or higher to be suggestive.

    In addition, the instructions for how to do NASA 10-minute lean test checking blood pressures can be found at So whether you simply want to diagnose it by history, checking blood pressures, or both, the diagnosis can be fairly simple.


    Basically, these simple treatments can markedly improve function:

    1. Increase salt and water intake. I know. You are already "drinking like a fish." But you are also "peeing like a race horse!" This occurs because one of the hormone deficiencies is antidiuretic hormone (vasopressin—the anti-peeing hormone), which leaves you dehydrated. In addition, salt is the sponge that holds water in our body. You need to eat large amounts of salt, sometimes even licking sea salt. You can simply do this from the palms of your hands. If you notice, you will find that your body is craving salt. You will sometimes find that in an attempt to be healthy, many of you are salt restricting. That misguided advice is a good recipe to crash and burn.
    2. It is remarkable how much improvement many people will see by simply using medium pressure (20–30 mm) compression stockings. They should use ones that go at least to mid thigh, but if they can't wear those, then kneehigh ones will still be fairly helpful. You should wear them during the day when you are active (not when you are lying down for extended periods). Although low cost, these first two treatments are very helpful. Wearing something that constricts the abdomen, such as a corset or a girdle, may also be helpful.
    3. Improve adrenal function. This is a critical part of our holding onto salt and water. As discussed in earlier articles, some will benefit a prescription from low dose hydrocortisone (do not go over 20 mg daily). In addition, natural adrenal support with Adrenaplex or Adrenal Stress End is very helpful for optimizing adrenal function.
    4. Salt and water retaining hormones (prescription). Florinef .1 mg each morning can be helpful, but is most helpful in those under 20 years of age or those with more severe orthostatic intolerance. DDAVP .1 mg 1–2 tablets once or twice daily (basically vasopressin or antidiuretic hormone) can also be quite helpful. These replace the hormones that are low because of the hypothalamic dysfunction. It takes six weeks to see their effect. Rapid shifts in fluid levels can trigger headaches and migraines in some people. In these, it is best to slowly raise the dose, increasing by a quarter tablet every one to two weeks.

      For those with problematic frequent urination during sleep, giving a dose of the DDAVP at bedtime can help with this as well. This is the same medication that is given to children who bed wet.
    5. Increasing sympathetic/adrenaline tone. The medication midodrine (ProAmatine) 5–10 mg twice daily (morning and early afternoon) can be fairly helpful after six weeks of use. Do not use the medication after 5 PM, or when lying down, as it can drive blood pressure too high. Lower the dose or stop if it causes too high of a blood pressure or shakiness. I will occasionally increase the dose to a maximum of 10 mg three times daily, with the last dose at 4 PM.
    6. Medications that increase serotonin and dopamine. Prozac, Zoloft, and Dexedrine have all been shown to help autonomic dysfunction.
    7. Some people find that a gluten and milk free diet is also helpful.

    Although all of these treatments can be combined, I would begin them in the order listed as needed.

    Finding the Missing Link

    Although we have given a simplified version, you will find that it serves very well clinically. But there is much more to the story. Those of you interested in a bit more of the science can read on.

    Excellent research by Dr. Mark Sivieri in Maryland is showing that many people with fibromyalgia also are showing IgG1 and IgG 3 antibody deficiencies (deficiencies in our body's defense function) on blood testing. This expectedly contributes to the immune dysfunction, but research and clinical experience are additionally showing that these immune deficiencies are also associated with Small Fiber Neuropathy, which is common in fibromyalgia. This is one of many factors contributing to the pain, and also seems to cause a "shrinking" of the nerves involved in autonomic function.

    Studies are showing that treating with IV gamma globulin actually can result in a growing back and recovery of these nerves, helping both the small fiber neuropathy pain and autonomic dysfunction.

    So we are now finding a missing link between immune dysfunction, autonomic dysfunction, and small fiber neuropathic pain.

    We have found IV gamma globulin to be very helpful in a small subset of the most critically ill people retreat that has fibromyalgia and orthostatic intolerance. Essentially, these are people who are often housebound and bedbound. Getting insurance coverage for this expensive treatment can be difficult, and I will have my patients consult with Denise Haire to help guide them through the process of getting insurance authorization. She does an excellent job and is highly recommended. It is important to start with a low dose of gamma globulin and work up to the half-gram per kilogram IV each three weeks. Otherwise significant Herxheimer (infection die off) reactions can be seen. Treatment benefits, often dramatic, usually begin at about four months on the optimal dose.

    Addressing the autonomic dysfunction and orthostatic intolerance seen in fibromyalgia can be fairly simple using the above quiz for diagnosis, and the treatments listed above. In combination with the rest of the SHINE protocol, and even done on its own, the clinical benefits can be marked.

    Fibromyalgia can be effectively treated. And you now have one more easy and powerful tool in your toolkit!

    For a superb 27 page orthostatic intolerance information sheet written by my favorite orthostatic intolerance specialist, Dr. Peter Rowe at Johns Hopkins, see

    It's time for you to get well NOW!

  • Sierrasil, A Joint Pain Product That Works, Naturally

    Results from a clinical trial published in the international Journal of Inflammation demonstrate that SierraSil®, a powerful, uniquely balanced blend of numerous naturally occurring macro and trace minerals, is safe and effective for significantly decreasing pain and inflammation in patients with osteoarthritis.*

    Mark Miller, Ph.D., and Professor of Cardiovascular Sciences and Pediatrics at Albany Medical College (NY), supervised the study and was instrumental in the in-depth analysis of its data. “SierraSil,” said Miller, “may offer exciting new approaches to limiting the joint destruction and lack of mobility associated with arthritis.”

    The SierraSil product for this study was provided by Sierra Mountain Minerals, Inc. Michael Bentley, the company’s Executive Vice President and Chief Operating Officer, is more than pleased with this latest testament to the effectiveness of SierraSil.

    “We know from past trials, patient testimonials and reports from physicians that SierraSil improves joint mobility and flexibility,”* said Bentley. “Now, we see how important it can be as a support to those suffering from the pain of osteoarthritis.”*

    An emerging supplement in the battle against inflammation, SierraSil is found only in the high Sierra Mountains.

    The human body can make many vitamins, amino acids, fatty acids and their derivative molecules, but it cannot make a single mineral. Due to mineral depletion in soil, some doctors say people cannot rely on getting all of these necessary nutrients from food. Also, when minerals are not consumed in adequate amounts, the body will resort to stealing minerals from its fluids, soft tissues and bones.

    That’s why many health professionals advise people to use supplements rich in macro and trace minerals. SierraSil is considered an excellent mineral supplement because it is comprised of numerous naturally occurring macro- and trace minerals including calcium, potassium, magnesium, copper, iron, zinc, phosphorus, manganese, selenium, vanadium, chromium, boron and molybdenum in a form that possesses unusual health-promoting properties.

    SierraSil helped pro golfer Ken Venturi. A former US Open Champion and 1964 Sports Illustrated Sportsman of the Year, Venturi gave up playing golf due to hand injuries. Finally, after a distinguished 35-year career of broadcasting as CBS Golf Analyst, Ken is playing golf again—thanks to SierraSil. Venturi says, “I believe in this product so very much that I’m willing to endorse it. It can help you, because it helped me. And what it’s done for me most of all, it’s given me back the game of golf, which I love so much. Without it I wouldn’t be able to hit golf balls.”

    Is Ken alone in his discovery? Absolutely not! Al Stonehouse, Senior Men’s Captain at Kelowna Golf and Country Club read about Ken’s success with SierraSil and gave it a try. “I have achieved remarkable success with SierraSil,” Stonehouse said. “Normally I am very reluctant to try any form of drug or supplement but after reading about the success achieved by Ken Venturi, I decided to give it a try. Within days I noticed improved flexibility with my golf swing, increased driving distance and reduced carpal-tunnel pain in my hands. It’s great to be able to play three to four rounds a week and not have to go through the pain and suffering that I had been accustomed to for the past few years. I’m hitting the ball further than ever! I have had no hesitation in recommending SierraSil to my golfing friends. Thanks for making golf the pleasurable experience it should be.”

    SierraSil is completely natural and vegetarian. It contains no glucosamine or chondroitin and exhibits beneficial properties even in small amounts. Only two to three grams a day are needed. Unlike other well-known joint support supplements, like glucosamine and chondroitin, which reportedly take up to three months to work, many SierraSil users are reporting noticeable benefits in less than two weeks.*

    The past Vioxx recall led a number of health care professionals and consumers to take a closer look at natural approaches to joint health. Even the Arthritis Foundation, which only twelve years ago discouraged the use of supplements, is now encouraging its members to explore exercise, a healthy diet and dietary supplements. “Dietary supplements present a safe and effective long-term option, and consumers have a wide range of options when deciding which approach is right for them,” said James LaValle, R.Ph., N.D., an expert on naturopathic medicine. “The Vioxx recall should serve as a wake-up call. The truth of the matter is that in some cases there are serious side effects with prescription drugs,” Dr. LaValle said. “The good news is that there are safe and effective dietary supplements that are a better first choice for improving joint health.”

    For more information please visit

    The complete clinical trial report is available at the Journal of Inflammation's website:

  • SierraSil: A New Joint Pain Solution

    Some diseases, or health conditions, seem to be women’s issues. Arthritis and osteoporosis are in that category. Although men also struggle with joint inflammation and bone loss, the literature focuses on women. Are women at greater risk? According to the research, they are. Over 50 percent of women will suffer an osteoporotic bone break, while just one in eight men will experience an episode of fracture due to bone loss. Arthritis statistics are similar. While younger men are more likely to experience arthritis, due to accidents and injuries, the disease is three times more prevalent in women after the age of 45.

    The bones and joints are not the only parts of the body affected by inflammation. Research now correlates chronic inflammation with obesity, hypothyroidism, heart disease (yes, heart disease is a woman’s issue), diabetes, and Alzheimer’s disease. It is clear, then, that if women are to thrive through their senior years, they must develop a strategy for dealing with “the body on fire.”

    Fortunately, minerals from the rocky reaches of the Sierra Nevada mountains provide an excellent way to dampen the fires of inflammation, wherever they occur in the body. SierraSil® is a blend of over 65 naturally-occurring minerals that have been shown, in both in vitro and human studies, to “shut off the genetic switch to inflammation.”

    What Is It About Minerals?
    When we discuss chronic inflammation, we seldom mention minerals, but these essential nutrients play a vital role in bone and joint integrity, and they confer powerful anti-inflammatory benefits. The research community is just now delving into the world of minerals and beginning to understand their diverse and complex roles in the human body. They participate in the structural integrity of the body and catalyze enzymatic reactions. They help regulate the pH of the body.

    One of the most important tasks of minerals, particularly the unique blend of minerals in SierraSil, is that they help regulate the genetic expression of inflammation. To understand how this works, Sierra Mountain Minerals embarked on a series of human studies to assess both the safety and efficacy of SierraSil. One hundred twenty study participants were asked to answer the following question: Is SierraSil safe, and is SierraSil effective in reducing osteoarthritis symptoms?

    The treatment protocol lasted for eight weeks, and at the conclusion of the trial, researchers and patients found that every marker of arthritis (pain, stiffness and function) was greatly improved. Equally important, SierraSil was completely safe.

    SierraSil has been used clinically to relieve the pain of injury, fibromyalgia, colitis, and many other sources of pain. Benefits generally appear within seven to ten days, and without side effects. The recommended dose is three capsules each morning on an empty stomach.

    One medical doctor in Canada is testing C-reactive protein levels (a marker for inflammation) in his pain patients who have been using SierraSil for several years, and finds that their inflammatory markers are low, a sign that the inflammation, wherever it has lodged in the body, is abating.

    What else can women (and men) do to improve joint and bone health? Remove inflammatory foods like red meat, sugar, alcohol, and grains from the diet. Red meat contains a fatty acid called arachidonic acid, a precursor to pro-inflammatory hormones called eicosanoids. Grains, sugar and alcohol are highly acidic foods; low pH levels are associated with inflammation. Grains, particularly wheat and corn, are problematic in terms of allergies, an inflammatory process.

    An anti-inflammatory diet provides seven to eight servings of fresh vegetables per day, plenty of oils like fish, flax and olive oil, and good sources of protein like organic poultry, wild-raised seafood and lamb (preferably organic).

    Lifestyle factors can be either pro- or anti-inflammatory as well. Get plenty of sleep; it is during the dark hours of the night that the body repairs itself and the bones are built. Stress can heighten inflammation. Women often juggle two full-time jobs: employment outside the home and the care of the home and family. Since they seldom take time to rest and recover, the continual stress can cause pain.

    Restoring the integrity of the bones and resolving joint inflammation starts with diet and lifestyle, but well-chosen supplements are a vital part of the diet. Since both osteoporosis and arthritis share a common link in inflammation, as well as the other “illnesses of inflammation,” it makes sense to supplement with an anti-inflammatory mineral blend like SierraSil.

  • Simplifying Nutritional Support in CFS & Fibromyalgia

    People often ask “Which vitamin or mineral do I need?” the answer, simply put, is “All of them!”

    Fortunately, we do not have to become part of the “handful club”, where you are taking handfuls of pills each day, to get what you need. It can be done very easily with one drink and 2 to 5 pills daily.

    Let’s begin with an exploration of why high potency nutritional support is so important to optimize health in those with CFS/fibromyalgia:

    1. With half of the calories in our modern diet coming from sugar, white flour and fats, which are empty calories which have been stripped of nutrients, most Americans have lost over half of the vitamins and minerals they should be getting, before they even get out of the starting gate. In fact, this is the first time in human history where a very large percent of the population is both obese and malnourished at the same time.
    2. Fibromyalgia is associated with increased nutrient needs. This occurs for a number of reasons which we discuss below. Because of this, the RDAs (which I call the Ridiculous Dietary Allowances) are often woefully inadequate for those with CFS and fibromyalgia
    3. Because of the gut infections, poor absorption of nutrients is also a concern
    Begin with Diet
    • Increase salt and water intake! Especially with the adrenal fatigue and low blood pressure/dehydration issues routinely found, people who salt restrict in an attempt to be healthy will crash and burn. Salt is your friend, and I would especially recommend high quality sea salts such as Celtic or Hawaiian sea salt. Mediterranean sea salt can also be found at low-cost at Costco. Increase water intake as well.
    • Most people with CFS/FMS do best with a high-protein diet and frequent small meals during the day. Everyone is different though, and eat what leaves you feeling the best.
    • As much as it is convenient, add in whole unprocessed foods and cut down the junk food.
    • Consider a 1 ounce protein snack at bedtime (e.g. a hardboiled egg, some meat, cheese, or fish), as this may prevent some of the 2–4 AM drops in blood sugar that wake people up. You will know if this is helpful for you in the first three days. A carb snack may worsen sleep.
    For Key Areas Where Nutritional Support to Optimize Health Is Needed
    1. B-vitamins. These form the backbone of energy production in our body, and I recommend at least 40 mg of vitamin B1 to vitamin B6, 400 ìg of folic acid (with at least half of this being in a form that is methylation friendly, called 5 MTHF), and 500 ìg of vitamin B12 (as methyl or hydroxycobalmin, again to support methylation). These nutrients, especially vitamin B1 and B12, are also critical for having a clear mind. Research has shown that despite normal blood levels of vitamin B12, levels in the brain in CFS are very low or nondetectable. Because of this, very high levels of B12 are required to get optimal levels in the brain in this illness. Research suggests that very high levels of the other B-vitamins may also be important.
    2. Magnesium. This is another key nutrient for both energy metabolism, calming, and relief of muscle and nerve pain. The average American diet only has 275 mg per day, where a healthy unprocessed your diet has over 600 mg. It is likely that the vast majority of Americans suffer the effects of inadequate magnesium levels.
    3. Vitamin C, glutamine, glycine, and cysteine. These four nutrients are critical for making the key human antioxidant, called glutathione. It has been suspected that glutathione deficiency is one of the most important common denominators contributing to CFS/FMS. Although we hear a lot about antioxidants, it is important to realize that humans make just two antioxidants, glutathione and SOD, suggesting that these are the two that are most important for people. Having optimal levels of these antioxidants is critical for optimizing immune function.
    4. Zinc and vitamin A. These are also critical for immune function, and zinc deficiency is routinely seen in people with chronic infections or inflammation. Zinc and copper are also critical for making the other key human antioxidant, super oxide dismutase (SOD). More is not better though, and I recommend 15 mg a day. Consider taking an additional 20–25 mg a day for 3 months to “fill your tank”
    5. Vitamin D. In those with chronic pain and also those with immune dysfunction, vitamin D deficiency is routine and a significant player. Too much however can be problematic, as it can be converted to a form called calcitriol (1,25 hydroxy vitamin D) which may suppress immune function. Because of this, sometimes people have falsely low vitamin D levels on their blood testing, despite massive amounts being taken. I consider it ill-advised to chase these blood levels. Instead, I recommend that people simply take 1000 units of vitamin D daily and get sunshine.
    6. Tryptophan, tyrosine, and serine—these amino acids are critical for a number of functions including optimizing neurotransmitter levels(e.g., serotonin and dopamine) that are low in fibromyalgia
    7. Selenium. This mineral is critical for immune function, but has a very narrow optimal dosing range. For most people, I recommend 55 ìg daily, as higher doses can unnecessarily increase the risk of diabetes. For those with Hashimoto’s thyroiditis, taking the higher dose of 200 ìg a day can be helpful, with the benefits outweighing the risk of the diabetes.

    To keep it simple, all of the above, and essentially all of the other key micronutrients that should be found in an optimal diet (except for calories, essential fatty acids, iron, and enzymes) can be found in a simple vitamin powder called the Energy Revitalization System by Enzymatic Therapy. This allows you to get them in one simple low-cost drink each day, instead of requiring 35 to 50 pills. Try getting get what’s in the one drink in less than 50 pills. Most people will not be able to! I designed the powder to be excellent for optimizing nutritional support in everyone, and it has recently been redesigned to improve methylation as well. I will note that all of my royalties for this product are donated to charity.

    The other key nutrients that I recommend for everyone with CFS/FMS include:

    • Ribose. This special sugar produced by our body is the backbone of the energy molecules ATP, NADH, FADH, etc. We have now published two studies showing a dramatic average increase in energy of 60 percent after three weeks of taking 5 g three times a day. Two thirds of the people taking it were helped. After three weeks, the dose can be dropped to 5 g a day. I personally take one scoop of the Energy Revitalization System vitamin powder plus 5 g of ribose each morning. Just add water and stir with a fork. It will be the best 30 seconds for energy production you spend each day! It also was shown to decrease muscle pain, improve cognitive function, and improve sleep. I recommend the ribose and Energy Revitalization System vitamin powder for everyone. More good news? SHINE Ribose is now available. The same Bioenergy ribose used in the studies—at the lowest cost for Bioenergy ribose—anywhere!
    • Omega-3 support. Fish oil support is critical for mood, balancing inflammation, and a host of other processes. Fortunately, you no longer have to take eight big fish oil pills each day, while putting up with the “fish oil burps”. Using a pure omega-3 with phospholipids (such as Vectomega by EuroPharma), one small pill replaces eight big fish oil gels
    • Coenzyme Q10 at 200 mg daily. Take this with a meal containing some oil to optimize absorption
    • Acetyl l-carnitine 1500 mg daily for four months. Most people with CFS/FMS are carnitine deficient, but I would not bother with muscle biopsy needed to show it. Carnitine is critical for both energy production and the ability to lose weight (a topic we will discuss at length in the future). It also is helpful for helping the nerves to heal. Use the acetyl l-carnitine form, as this is better able to get into the parts of the cell where it is needed.
    • If the ferritin blood tests is under 60, I strongly recommend supplementing with iron. Take at least 50 mg of vitamin C along with the iron to support its absorption, and do not take the iron within six hours of taking thyroid hormone

    Using the above approach, nutritional support can be done very easily. Give it six weeks to see the effects. Most people find it to be very helpful!

  • Ten Tips to Simplify, Lower the Cost, and Optimize CFS and Fibromyalgia Treatment

    Ten Tips to Simplify, Lower the Cost, and Optimize CFS and Fibromyalgia Treatment Jacob Teitelbaum

    TREATING CFS AND FIBROMYALGIA (CFS/FM/ME) can be very satisfying, because with proper treatment even these severely ill people usually improve, and sometimes completely recover, given the proper treatment. They are also remarkably complex, however, and it is easy for you and your practitioners to burn out if you don’t use the proper tools to simplify care.

    We have discussed how to effectively treat these illnesses in previous articles, and more detail can be found in my books From Fatigued to Fantastic (for practitioners) and The Fatigue and Fibromyalgia Solution (an easy read for people with the illness).

    To summarize, these illnesses represent an energy crisis where the person essentially blows a fuse (called the hypothalamus). This circuit breaker can be turned back on and function restored by optimizing energy production with the SHINE Protocol (Sleep, Hormones, Infections, Nutrition, Exercise as able). In our published randomized placebo-controlled study, 91 percent of people with CFS/FMS improved with an average 90 percent increase in quality of life (p<.0001 versus placebo). So we already know these are real and very treatable conditions.

    Here are 10 more tools to simplify patient care, and to add new powerful treatments for those who do not improve or recover with SHINE:


    1. The free Energy Analysis Program at can analyze a person’s symptoms and (optional) even their key lab tests to determine what is causing their energy drain and tailor a protocol to their case to optimize energy. The person can do it themselves, or with a family member’s or friend’s help, in just 10 minutes. All of the work needed to determine what is causing YOUR energy drain, and how to fix it, is then done online for free with the click of a button.

    2. Treating the pain
    Although the pain most often begins with muscle shortening caused by inadequate energy, the chronic muscle pain then triggers “brain pain” or central sensitization. Think of pain as being like the oil light on your body’s dashboard telling you that something needs attention. If you put oil in the car, the oil light goes out. If you give the body what it needs, the pain goes away. What it needs varies by the type of pain. When the body’s need is not addressed, the brain amplifies the pain, and the pain can become self-sustaining. This occurs because of increased microglial cell activity in the brain.

    The pharmaceutical industry has focused on three modestly helpful medications that are very expensive and have significant toxicity. Three other medications, however, can also decrease microglial cell activity, which causes central sensitization and can result in significant improvement. These are:

    Treat the central sensitization (brain pain).
    A. Low dose naltrexone. This medication has been shown to help rebalance immunity and decrease central sensitization and microglial cell activity. Give 3–4.5 mg at bedtime, and give it at least two months to work. It may initially disrupt sleep, in which case starting with a lower dose and giving it in the morning instead can help the body to adapt. It is available from compounding pharmacies at about a dollar a day. If it was still patentable, I’m certain the drug companies would be charging $20,000–$120,000 per year and every physician would know about it. Have the patient read the book The LDN Solution by Linda Elsgood. I would use this treatment for most autoimmune and severe chronic pain conditions. Unfortunately, it cannot be used in patients also taking narcotics, in which case the two treatments below may help.

    B. Minocycline 100 mg 2 x day. This antibiotic medication also helps to rebalance microglial activity, even in the absence of infections. Be sure to also treat to prevent Candida overgrowth.

    C. ACE inhibitors (e.g.,—Enlapril or vasotec) 10–20 mg a day.

    3. Other tips for treating pain
    A. For those of you requiring narcotics, be aware these will routinely cause both B vitamin and testosterone deficiency, amplifying the pain. Be sure you take a high potency B complex (e.g.,—the Energy Revitalization System vitamin powder by Enzymatic Therapy) and have your doctor optimize your testosterone to keep it at least midrange normal.

    B. hCG, research by the pain specialist Dr. Forest Tennant in patients requiring very high-dose narcotics showed that giving 25 to 500 units of hCG sublingually daily decreased the narcotic dose needed by 30 to 40 percent after several months.

    C. Natural remedies can be more effective than medications for pain, and can be added to pain medications as well. The most effective? Curamin (by EuroPharma) has been a pain relief miracle. I also will add topical comfrey (Traumaplant). Although this works very quickly, give it six weeks to see the full effect. In head-on studies with Celebrex for arthritis, Curamin was shown to be more effective. Except for the LDN (which cannot be used with narcotics or Ultram), all of the above can be taken with any pain medications.

    4. The free iPhone and android app “Cures A-Z” will give a brief overview of the best way to treat each kind of pain (as well as over 100 other conditions often seen in FMS, such as pelvic pain syndromes, sinusitis, dry eyes and mouth, and many more). It is kind of like having my brain in your pocket, but much less messy.

    5. Treat mold neurotoxins
    This can be an important part of the process in a selected subset of people. This is work developed by Dr. Ritchie Shoemaker, who is brilliant, but is so smart that he can be unintelligible. I once tried to get him to “dumb down” the information by getting him drunk, but this was only slightly effective. Dr. Neil Nathan succeeded where I failed in this, and has just come out with a brilliant and very simple ‘how to’ book for treating neurotoxins, called Mold & Mycotoxins: Current Evaluation and Treatment 2016. This is available on Amazon (Kindle), can be read in under an hour, and will give you all the information you need to immediately begin effectively treating these conditions. Dr. Nathan has jokingly nicknamed it Shoemaker/neurotoxins for Dummies. I highly recommend it for both you and your physician if you suspect that mold neurotoxins may be playing a role.

    6. IV Gamma Globulin (and help with insurance and disability paperwork)
    In about 10 percent of my sickest patients who have severe refractory CFS/FMS, often leaving them bedridden, I will check antibody levels of IgG 1–4 (available from Quest or LabCorp— order “Immunoglobulin G, subclasses 1–4, serum” and “Immunoglobulin, quantitative, IgA, IgE, IgG, IgM, serum”). Work by Dr. Mark Sivieri has shown that people with CFS/FMS often have IgG 3 or IgG1 subset deficiency, and this has been my experience as well. In these cases, IV gamma globulin (– 1/2 gm/kg each 3 weeks) often results in dramatic improvement after four months of use. It is very expensive, however, so they will have to get insurance coverage— which can be difficult. I use the services of Denise Haire (office"at", who can work with people to help them get insurance coverage. She also is excellent at helping people with CFS/FMS in applying for their disability insurance, and can review the medical records to help people put together the letters needed for their insurance company or Medicare, so that people that are disabled can get disability. This can be very helpful for you, while also making your doctor’s life much simpler.

    7. Avoid getting raped by prescription prices
    If people don’t have insurance to cover the medications, they often get charged 10 to 40 times what the insurance company is paying. A simple tool? Download the free app “GoodRx” or you can go to Put in the name and dose of the medication, and print out a coupon that will often lower the price by 90+ percent (I’m not exaggerating—this is more the rule than the exception). Patients will be pleasantly shocked. For example, Ambien is eight cents a pill instead of $4.

    Another helpful tip, as even men can get raped by pharmaceutical pricing. For erectile dysfunction, the medications can cost $70 a pill. Viagra (Sildenafil) should be available in generic, but pulled a legal ploy to avoid this. But there was a loophole that you will love. Order Sildenafil 20 mg tablets (available in generic for pulmonary hypertension). Using the GoodRx app, these are available for 50 cents a pill (one percent of the cost of Viagra). Some women also find it helpful for libido, and a small percent find it also helps their CFS!

    For other medications such as fluconazole, compounding pharmacies can often make the medication at a small fraction of the regular pharmacy cost.

    8. Treat the orthostatic intolerance (NMH, POTS)
    Basically, when we stand up, gravity makes our blood rush down to our legs. If not for our autonomic nervous system telling our legs to send the blood back up to our brain and muscles, we would pass out. In most people, the autonomic system works well. This is not the case in CFS/FMS. A new medication just came out at a cost of $120,000 per year. An absurdity, and I will not even mention the medication’s name. My impression is that it is far more effective to simply have the person increase their salt intake dramatically (I like to use a tasty good quality sea salt like Celtic Sea Salts) and increase water intake. In addition, be sure to get medium pressure (20– 30 mm) thigh high compression stockings and wear them when you are walking around. People with CFS/FMS find these dramatically improve stamina. And for only $60/pair versus $120,000! Feel free to email me at EndFatigue@aol. com to ask for an excellent information sheet on treating orthostatic intolerance as well as a simple quiz that will tell you in one minute whether orthostatic intolerance is present (validated in the Mayo Clinic Journal—I find it much better than spending $1000 for a tilt table test).

    9. For anxiety
    A. Two new herbals called Anxiocalm and Maximum Stress Relief (both in the Terry Naturally line by EuroPharma) are excellent.

    B. Severe anxiety is a clue that mycotoxins may be an issue (see #5 above).

    C. check out the Buteyko Breathing Method.

    10. Going gluten free
    When people don’t respond to other treatments, I have them do a gluten and dairy free diet for three weeks to see if it helps (stay on it if it does). This is difficult to sustain long-term, so I do not begin treatment with it, as most people get well without having to avoid milk and gluten. It is not enough to simply avoid gluten and dairy, or you will become malnourished. Instead, do a consultation with a nutritionist. My favorite? The wife of Brad West ND, Chef Lauren Hoover-West has appeared and cooked on ABC Live in Chicago and Sacramento. She has cooked for four United States Presidents and is the author of No Wheat No Dairy No Problem cookbook and the blog site She can guide people via phone consultation.

    Here is one bonus tip. People don’t like being part of the “handful club,” taking handfuls of pills each day. They also won’t stick with it.

    I make this easy for everyone, and people are very happy because they see a quick response, I simply have them take a morning energy drink called the Energy Revitalization System (by Enzymatic Therapy) which replaces over 35 supplement pills with one low-cost easy drink (replacing their multivitamin and sometimes dozens of other pills). I have them add one 5 gm scoop of ribose (SHINE), which in two studies we published increased energy an average of 61 percent after three weeks. I add one Vectomega tablet, which replaces eight fish oil capsules. This is what I take each morning, and you will find that it turbocharges you and most people with healthy energy as well.

    It’s a lot of fun helping people with this illness get well, and we do three hour in person or phone consultations with people worldwide. For info on making an appointment, contact Sarah at Appointments"at"