I Have Fibromyalgia/ Chronic Fatigue Syndrome, but it Doesn't Have Me!

What is the Guaifenesin Protocol?

What is Guaifenesin?

Guaifenesin (gwy-FEN-e-sin) or “Guai” (gwy) for short, is an expectorant now available over-the-counter that thins mucus and helps to loosen phlegm.

Originally found in cough medications, Guaifenesin is quickly absorbed from the gastrointestinal tract, and is rapidly metabolized and excreted in the urine. Guaifenesin is also known to lower uric levels. No serious side effects have been reported.

What is the Guaifenesin Protocol?

The Guiafenesin Protocol is a treatment to reverse (NOT CURE) fibromyalgia. Currently, no cure exists for fibromyalgia. The Guaifenesin Protocol uses the over-the-counter medication Guaifenesin to help excrete excess calcium phosphate from the kidneys.

Who is R. Paul St. Amand, M.D.?

R.Paul St. Amand, M.D., (Endocrinologist) is a graduate of Tufts University School of Medicine. He is a fibromyalgia survivor himself, has three daughters who also have fibromyalgia, and has made finding a reversal treatment for fibromyalgia and chronic fatigue syndrome his life’s mission for fifty years.

Dr. St. Amand first began treating fibromyalgia long before it had a name. In 1995, Dr. St. Amand began to use Guaifenesin as a treatment for fibromyalgia. Currently he is a member of The City of Hope research team working on biomarkers and the genetic cause of fibromyalgia, he teaches as an Assistant Clinical Professor of Medicine at Harbor-UCLA, and is in private practice in Marina del Rey, California.

Dr. St. Amand believes that patients with fibromyalgia have a genetically defective enzyme prominent in the kidney that would cause a backup of phosphate throughout the system. Excesses of this ion in certain cell structures (mitochondria) would seriously impede the formation of energy (ATP). The resulting cellular fatigue would cause wide-spread malfunctions that would easily explain all the symptoms of fibromyalgia.(I have included his full theory below.)

What are salicylates?

Salicylic acid is a hormone produced by plants naturally as a protective agent against soil bacteria. Without salicylates plants would never get off the ground alive. Plants with high salicylate content have been used medicinally since 1500 B.C. Aspirin is now made synthetically and naturally and is therefore found in many products. Aspirin completely blocks the effectiveness of Guaifenesin at the kidney level. (St. Amand & Marek 2006, pgs. 72-.97)

YOU MUST TAKE RESPONSIBILITY FOR THE PROTOCOL. PHYSICIANS ARE NOT TRAINED TO RECOGNIZE SALICYLATE-CONTAINING INGREDIENTS.

What is mapping?

A map is a diagram of the human body that shows the size, location and hardness of a patient’s “lumps and bumps” of fibromyalgia. These lumps and bumps are nodules in the muscles that are characteristic of the syndrome. In addition to the lumps in muscles, tendons and ligaments can swell. Such swellings are also mapped.

Mapping is a tool to determine whether a person has reached his or her cycling dose. Maps are also done to monitor progress on the protocol and to detect blocking.

The mapper feels for the contracted portions of muscles, tendons and ligaments and draws them onto a blank map. Dr. St. Amand uses darker markings to indicate hard lumps, and lighter markings to indicate those that are softer.

A video or DVD that teaches how to map can be ordered from:

Fibromyalgia Treatment Center, Books, Tapes, and CDs

What is a symptom journal?

A symptom journal is a way to track your progress. It does not have to be elaborate. I use a planner (calendar) and write down my top five symptoms in capital letters each day. For example: MIGRAINE, INSOMNIA, HEART BURN, NECK, AND SHOULDERS. The less prominent symptoms I record in lowercase letters. For example: arms, hands, wrists, bladder, and feet. This way I can look back and see the areas of my body that were cycling out the calcium phosphates and compare over time.

How will I feel when I start the Guaifenesin Protocol?
When you start guaifenesin there are several things you may experience. Some people actually feel better for 24-48 hours. This is not a common reaction, but it happens because the guaifenesin begins to help the body excrete phosphate right away, if it isn't blocked. You may feel nothing at all. Remember that you won't feel differently until you get to your therapeutic dose. This means that the majority of people won't feel anything for the first week on guaifenesin simply because a dose of 300 mg twice a day (the recommended dose for the first week) isn't high enough to begin reversal.

Once you've hit the dose that works for you (most people will experience this at 600 mg. twice a day, and ninety percent will feel it by 1800 mg. of guaifenesin a day) your symptoms should exacerbate. You'll be more tired, more achey -- as if you are coming down with a flu. You may be more emotional, your irritable bowel may flare, you may be absolutely exhausted. Your symptoms, any and/or all of them can get distinctly worse. When this happens you'll know you're at the correct dose.

Some people do reverse without a distinct worsening. Their symptoms might get only slightly worse for a short period. But their maps will show clearing. These people feel as if they have a straight line of clearing instead of the up and down cycling. These people are in the minority, but if a mapping confirms you're making progress, even though you haven't felt much worse, you may be one of the lucky ones. www.fibromyalgiatreatment.com/FAQ_protocol.html

Here is a copy of Dr. St. Amand’s theory of fibromyalgia, how he maps his patients, uses Guaifenesin, and avoids salicylates to reverse the illness. Below is an example of a typical fibromyalgia map with its marked tender points.

The Guaifenesin Protocol for the Treatment of Fibromyalgia
by R. Paul St. Amand, M.D.

(Reproducedfrom www.fibromyalgiatreatment.com (The only Official Web site of the Guaifenesin Protocol.)

Fifty years ago, a man taking a gout medication noticed he could peel calculus (a calcium phosphate compound) off his teeth with his fingernail. This mundane observation raised the possibility that tartar was a reflection of an unrecognized systemic problem expressed in saliva. I postulated a genetically defective enzyme prominent in the kidney that would cause a backup of phosphate throughout the system. Excesses of this ion in certain cell structures (mitochondria) would seriously impede the formation of energy (ATP). The resulting cellular fatigue would cause wide-spread malfunctions that would easily explain all the symptoms of fibromyalgia. Our paper for interested professionals defends that theory.

We treat fibromyalgia using guaifenesin. It increases urinary excretion of phosphate, gradually extracts abnormal body-wide accumulations, and thus reverses the illness. Guaifenesin is devoid of significant side effects and totally safe for children. It has been marketed for over fifty years for loosening and increasing the flow of mucus. Manufacturing processes seem to determine its potency, effectiveness and duration of action. We monitor and recommend the brands that have proven adequate for our purposes. Excessively short-acting tablets lack twenty-four hour action. Combination long-short formulations may fail due to insufficient contents of either component. We determine what works for individuals by sequential physical examinations (next paragraph). Treatment is begun using reliable products at 300 mg twice daily for the first week. The drug has no significant side effects so that worsening symptoms suggests that is the correct dosage for reversal, an amount that works for only 20% of patients. If there are no significant changes that first week, we raise the dosage to 600 mg. twice daily and hold there until the next examination. The response rate at this amount is 80%. Obviously, 20% of patients will need further adjustments. We repeat the muscle examination monthly (see below) until sufficient areas disappear to confirm the adequacy of dosage. Symptoms frequently intensify during the clearing process and new ones may surface due to increased intensity. This confirms that purging is underway because guaifenesin has no side effects. Better hours eventually cluster into days and finally weeks. During this process, lesions objectively soften upon examination, sometimes split, and gradually vanish. Recovery is rapid compared to the time it took to develop the illness. Even the slowest responders clear at least one year’s accumulated debris every two months. The earliest lesions are the last to clear.

The original description of fibromyalgia as “rheumatism with hard and tender places” has been forgotten. The often-recommended tender-point exam seeks subjective patient pain sensations from eighteen predetermined areas. It is of limited value compared to objective, sequential body examinations (mapping) that help establish the dosage and document disease reversal. We examine musculoskeletal tissues using the pads of our fingers to feel muscles, tendons, and ligaments. With practice, multiple swollen places become obvious. We sketch their location, size and degree of hardness on a caricature that becomes our baseline for future comparisons (figure 1). Hands should move as if to iron out wrinkles in the underlying tissues. Expressions of tenderness do not influence findings. The most important site for confirming the diagnosis and establishing the dosage is the left thigh. The outside of the quadriceps muscle (Vastus lateralis) and the front part (Rectus femoris) are involved in 100% of adults; they clear within the first month of proper treatment.

To ignore the following guarantees failure: aspirin and other sources of salicylate block the action of guaifenesin at the same kidney level as they do other uricosuric medications. A person’s genetic makeup determines susceptibility to blocking. Nevertheless to assure success, everyone should adhere to the protocol and make no modifications. Salicylates are present in many pain medications such as aspirin and those for some forms of colitis. Salicylate is absorbed through intact skin as well as the thin membranes of the mouth and intestine. Products used topically or as medications should be inspected for ingredients including all synthetic forms such as octisalate in sunscreens and wintergreen in gum. Almost all plant species have substantial levels of the natural chemical. Quantities vary from crop to crop and are stored to fend off infections and to help heal injuries. For this reason herbal medications block guaifenesin as do plant extracts and oils including camphor.

The following is an incomplete guide to sources of natural and synthetic salicylates:

MEDICATIONS: (1.) Pain relievers containing salicylate or salicylic acid, for example, aspirin, Salflex, Anacin, Excedrin, Disalcid. (2.) Herbal medications such as St. John’s Wort, gingko biloba, saw palmetto, evening primrose oil, Echinacea. Vitamins with rose hips, bioflavonoids (quercetin, hesperiden or rutin) or plant extracts such as alfalfa. (3.) Some wart or callus removers, acne products and dandruff shampoos contain salicylic acid. (4.) Topical pain creams such as Tiger Balm, Ben Gay, Myoflex.(5.) Medications such as Pepto Bismol, Asacol, Alka Seltzer and Urised.

COSMETIC AND TOPICAL PRODUCTS (1.) Skin cleansers (exfoliants) that use salicylic acid or witch hazel. (2.) Hair products with plant extracts such as balsam or bisabol. (3.) Bubble baths with essential oils such as lavender. (4.) Watch for the letters ‘SAL’ in sunscreens: octisalate, homosalate, or the name meradimate or mexoryl. (5.) Lip balms containing camphor or menthol. (6.) Lipsticks, glosses and deodorants should be checked for castor oil. (7.) When gardening wear waterproof gloves, avoid barefoot contact with freshly cut grass. (8.) Avoid tissue or wipes containing aloe. (9.) Shaving creams with aloe or menthol will block. (10.) Do not use razors with aloe strips (Vitamin E, lanolin, and baby Oil are acceptable.) (11.) Moisturizers with oils such as almond, extracts such as green tea, or gels such as arnica.

ORAL AGENTS: (1.) Most mouth washes contain mint, wintergreen or salicylate (Listerine). (2.) Toothpastes contain salicylates, as well as fresh or synthetic mint, often unlisted. Use non mint toothpastes made by Tom’s of Maine, Cleure (Grace FibroSmile) or Personal Basics. Baking soda and/or peroxide also provide good cleansing and whitening. The non-mint pre-brushing rinses are acceptable as are the Cleure mouthwashes; (3.) Avoid lozenges, floss, breath fresheners or chewing gum with mint flavor (menthol, wintergreen, peppermint or spearmint). (Strong fruit and/Cinnamon flavors may mask unlisted mint)

YOU MUST TAKE RESPONSIBILITY FOR THE PROTOCOL. PHYSICIANS ARE NOT TRAINED TO RECOGNIZE SALICYLATE-CONTAINING INGREDIENTS.

If you fail, you will convince your doctor guaifenesin does not work and the opportunity to help other fibromyalgics will be lost. Dictionaries can help you identify ingredients. Get the full list of contents when you phone manufacturers because customer service employees will not know that plants make salicylates.

Our website www.fibromyalgiatreatment.com connects you with a knowledgeable support group that will help you with questions.

No diet is required for fibromyalgia because the liver has a certain but limited capacity to counter food salicylates. However, it cannot override excesses from plant concentrates obtained from juicing or in herbal medications. Teas are high in salicylate and should be avoided.

Decongestants and cough medicines have side effects and should not be used as sources for guaifenesin. Pure guaifenesin has no side effects (rarely transient nausea) and no known drug interactions. Pain medications such as acetaminophen (Tylenol), Ultram, Darvocet-N, Imitrex, and non-steroidal drugs such as Advil and Aleve, do not block guaifenesin. Especially when dealing with chronic illness, we chose not to prescribe narcotics such as codeine, hydrocodone (Vicodin), oxycontin, morphine or methadone even though they are not blockers. They are too liberally prescribed for pain control at the price of eventual addiction. When our mapping indicates it is time to discontinue them, intense withdrawal effects usually occur. All too many patients fail in the attempt since, as the drug wears off they feel worse.