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What Your Doctor May Not Tell You about Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease

What Your Doctor May Not Tell You about Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease

4.4 21
by R. Paul St. Amand, Claudia Craig Marek

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Patients suffering from fibromyalgia experience a variety of painful and debilitating symptoms, including chronic fatigue, joint and muscle pain, chronic bladder and vaginal infections, depression, insomnia, and disorientation.


Recognized as a disease by the World Health Organization



Patients suffering from fibromyalgia experience a variety of painful and debilitating symptoms, including chronic fatigue, joint and muscle pain, chronic bladder and vaginal infections, depression, insomnia, and disorientation.


Recognized as a disease by the World Health Organization in 1993, fibromyalgia has been treated in the past with medications to relieve symptoms, including antidepressants, analgesics, and narcotics. These remedies have not worked for everyone.


Guaifenesin is an inexpensive medication used in over-the-counter products for nasal congestion. But in his studies, Dr. St. Amand discovered that this drug, taken in the proper dosage, is the first effective treatment for reversing fibromyalgia(with no known side effects.


Dr. St. Amand is the country's foremost expert on this subject and is himself a past sufferer of the disease. Drawing on Dr. St. Amand's firsthand experience and filled with the latest research on the subject, this book also offers complete appendices that include Internet user groups and dozens of support organizations for people with fibromyalgia and for those using guaifenesin.

In this groundbreaking book, Dr. St. Amand, an experienced endocrinologist and UCLA assistant clinical professor, presents his amazing discovery, the result of forty years of research based on his own experience with fibromyalgia and that of hundreds of his patients. This book offers the first effective protocol for reversing this disease: a program that uses guaifenesin, an inexpensive, safe medication available from your doctor. The authors have seen symptoms eliminated and normal living restored in an astonishing 90 percent of the fibromyalgia sufferers they properly treated with guaifenesin. Now you too can discover:

  • Why fibromyalgia is often misdiagnosed
  • How you can cope with symptoms before guaifenesin takes full effect
  • The link between fibromyalgia and hypoglycemia(and a plan for controlling your hypoglycemia through diet
  • How, if you are one of the millions who have any of the syndromes listed above, myofascial pain syndrome, vulvar pain syndrome, or chronic interstitial cystitis, this treatment can help you too
  • Guidelines to determine the proper dose of guaifenesin for you and the medications and substances to avoid while you take guaifenesin-and much more.

About the Authors:

R. Paul St. Amand, M.D., is a graduate of Tufts University School of Medicine. He has been on the teaching staff at the Los Angeles Harbor/UCLA Hospital, Department of Endocrinology for over forty-three years. He is currently an assistant clinical professor at the UCLA School of Medicine. Dr. St. Amand discovered guaifenesin's use as a treatment for fibromyalgia, and his work is cited wherever the substance is mentioned.

Claudia Craig Marek, M.A., is a medical assistant tutored, trained, and taught on the job by Dr. St. Amand. She has co-written medical papers with Dr. St. Amand and has counseled fibromyalgia patients on the use of guaifenesin for the past seven years.

Product Details

Grand Central Publishing
Publication date:
What Your Doctor May Not Tell You about Series
Product dimensions:
5.25(w) x 8.00(h) x 1.25(d)

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What Your Doctor May Not Tell You About Fibromyalgia

By R. Paul St. Amand Claudia Craig Marek

Warner Books

Copyright © 1999 R. Paul St. Armand, M.D. and Claudia Craig Marek
All right reserved.

ISBN: 0-446-67512-1

Chapter One

An Invitation to Join Us and Find Your Way Back to Health

Having fibromyalgia means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about (this illness) and its effects, and of those that think they know, many are actually misinformed. -J. M., Texas

It can start off quite subtly: a bit of muscle pain, along with some generalized aches and stiffness. Then there are periods when concentration is impossible, a day or two of overwhelming fatigue, and maybe a little dizziness, cramps, and diarrhea. Symptoms come and go at first, and it's easy to chalk them up to a mild case of flu that never quite localizes, to overexertion and too much stress in your life.

Then, one day, you realize it hasn't gone away-it never goes away anymore. One part or another of your body always hurts. You feel stressed and irritable all of the time. You wake up tired every morning. In short, you haven't felt "right" in a long time. The symptoms begin to worsen, and you notice new ones. Perhaps depression, numbness and tingling of the hands, leg cramps, stiffness, headaches, or bladder infections. Often you can no longer sleep through the night. Sometimes it's pain that keeps you awake; sometimes you don't know what it is that keeps you from falling asleep. When you do sleep, you wake up tired and unrefreshed. You crave sugar or other carbohydrates, and if you give in to this craving, you tend to gain weight and feel even worse. Then, before you know it, bad days outweigh the good ones, and eventually there are no good days, just ones that range from bad to worse.

It feels like coming down with the flu, yet it never manifests fully. It's like being fluish, achy and tired, and embarrassed and discouraged about it because you don't know why or what you can do to make it better or what you did to make it worse. Everyone gives advice but they don't have a clue as to what it's really like. Having people tell you to eat differently and exercise more and not focus on your health makes you just want to isolate yourself because you've already experimented with every possible food plan, supplement, and idea. -Miki K., Hawaii

You become increasingly immobile. Gradually and without realizing it at first, you stop making plans because you never know how you will feel, and you become mostly housebound or bedridden. The simple task of going to the supermarket can be an impossible chore. By now you have visited doctors of various specialties in the hope that one of them will be able to tell you what's wrong and set things right. When the pain is bad, you seek out chiropractors and massage therapists, and maybe you try acupuncture and alternative treatments like herbs or homeopathy. You have had many diagnostic tests run, costing hundreds, perhaps even thousands of dollars. Your friends have offered you a lot of advice about vitamins and nutritional supplements that have helped them or someone they know. But you are already taking a regimen of vitamins, minerals, and enzymes, and you do not feel much better. You may have heard the word "fibromyalgia," and maybe you know whether or not you have it. No one has told you how to treat your disease, although they have many ideas about how to ease your symptoms.

Your life has entered a downward spiral of pain, depression, and fatigue. You have a great deal of guilt about not being the person you used to be. Unless you are blessed with an exceptional companion, your personal relationships have suffered or completely fallen apart. You worry about your ability to care for your children. You may even contemplate suicide.

It feels like everyone around me is normal and happy and having a good time and I'm so different. I want to have a few normal days. I don't fit in anywhere because no one understands. People laugh and say "You look fine" but I'm dying inside and I can't explain it to them. I'm so tired of pretending I'm okay when I want to scream. I have kept a positive attitude for so long but it's exhausting and I just can't do it anymore. I wish I could just go away somewhere and hide. -Susie

This is an oversimplified picture of what it's like to have fibromyalgia. Those of you who have it know that it is far more involved than this. I know what you're going through. I am intimately familiar with the personal struggles that each and every one of you has experienced with this illness either as sufferers or as their supporters. I have lived with your pain, your fatigue, and your despair.

I have spent my entire medical career treating patients with symptoms such as these and more. Headaches, jaw and facial pain, abdominal discomfort, dizziness, memory lapses, vulvar and bladder pain, itching and rashes, all plague fibromyalgics. Until recently, doctors told patients like you that your illness was due to "nerves." And, to underscore this diagnosis, patients were reminded that the pages and pages of tests run on them had shown "nothing wrong."

Fibromyalgia is prevalent in all ethnic groups in all parts of the world. In North America, it is estimated that about five percent of the adult population suffers from this disease, although I believe the actual rate is higher. Conservatively then, some twenty million Americans suffer from fibromyalgia and its related disorders-most are women, with the ratio of women to men at about five to one. There is some evidence, mostly anecdotal, that this statistic may be skewed due to the fact that men are often either misdiagnosed or less likely to visit a doctor. Rheumatologists say fibromyalgia is the most common disorder they see.

Another twenty-five million people suffer from chronic fatigue syndrome, which I (and most other physicians) believe is the same disease. I have good reasons to conclude through my work that today's fibromyalgia is the prelude to tomorrow's osteoarthritis that afflicts another thirty-five million people. Adding these numbers would suggest that one third of our population will suffer with some of the symptoms of fibromyalgia at some point in their lives. And this does not include those who have been diagnosed with other "syndromes," such as myofascial pain, chronic candidiasis, vulvar pain, irritable bowel and irritable bladder, and so on-who in all probability have fibromyalgia as well.

My rheumatologist told me I was too old to have FMS. At that time I was fifty-four, never mind the fact I had had symptoms most of my life. The disease had become "full blown" when I was about fifty-one.... After another year of suffering, I diagnosed myself via the Net. My DO (Doctor of Osteopathy) sent me back to the same rheumatologist because he is the only board-certified one in our area. At that time he told me I was too old to have FMS but even if I did there was nothing that could be done.... I have since been diagnosed with FMS by three other doctors, all of whom have told me the only thing they could do was treat my symptoms. I was as good as I would ever be and would get much worse. -Betty, Texas

"Rheumatism with painful hard places" which can be felt in various locations on the body is considered the first description of fibromyalgia in modern medical texts, by a doctor named Froriep in 1843. Sir William Gowers of University College Hospital in London, who began by studying his own lumbago, initially dubbed this disease "fibrositis" in 1904. Dr. Gowers observed that his patients were also exhausted and that the disease was "so painful it would make a strong man cry out." He tried everything he could think of in an attempt to relieve this pain, including injecting cocaine into the tender points (it didn't work very well) and having patients take a newly discovered drug called aspirin that, he observed, didn't work very well either. "Fibromyalgia," a Greek word meaning pain in the muscles, has now all but erased fibrositis and rheumatism as the name of this disease.

On New Year's Day 1993, fibromyalgia was officially declared a syndrome by the World Health Organization (WHO) in the Copenhagen Declaration. It was declared the most common cause of widespread chronic muscle pain. As a new entry in the ICD code (International Statistical Classification of Diseases and Related Health Problems) it became an official diagnosis that, among other things, a doctor could use to bill insurance companies and to label a patient disabled. The WHO decided to incorporate into the definition of the disease the American College of Rheumatology's 1990 definition penned by Drs. Muhammed Yunus, Hugh Smythe, and Frederick Wolfe. This had carefully detailed the location of eighteen tender points symmetrically located around the human body. The presence of at least eleven out of eighteen of these was considered the gold standard for diagnosis, along with muscle pain.

But the World Health Organization went a little farther. The Copenhagen Declaration added: "Fibromyalgia is part of a wider syndrome encompassing headaches, irritable bladder, dysmenorrhea, cold sensitivity, Reynaud's phenomenon, restless legs, atypical patterns of numbness and tingling, exercise intolerance, and complaints of weakness." It also recognized that patients are often depressed.

Today, thousands of medical articles later, fibromyalgia is almost universally recognized as a distinct illness. Sadly, there remain a few doctors who still try to tell patients it is simply a catchall name for a collection of symptoms shared by a group of neurotic women, but luckily they are increasingly rare. Despite so many articles and so much speculation, much of fibromyalgia remains poorly understood. It is a complex and chronic disease that causes widespread pain and profound fatigue-accompanied by a range of symptoms that make simple, everyday tasks daunting, difficult, and sometimes even impossible.

Once upon a time, a lifetime ago, I was a gymnast, played in tennis leagues, golfed, played on a softball team, and panned for gold in the Colorado mountains.... Now I am lucky if I can walk to my mailbox-usually I have to drive. If I can make the stairs, I go down to check on the laundry situation, or go upstairs to see if the dust has carried away the entire floor. -Gloria

Symptoms affect widely disparate parts of the body. Doctors don't always realize that tenderness in the neck area, frequent bladder infections, and brittle nails, for example, are symptoms of the same illness. Patients, often young women, look "well" and many have learned to put up a facade in the workplace or with friends. A growing number of people have now heard of fibromyalgia and know someone who has it. Lists are available that detail the multiple symptoms of the disease, but it remains a phantom illness that has few concrete findings to the casual examiner. It still lacks a laboratory test to confirm its existence, and no scans or X rays can detect it. For these reasons, fibromyalgia is often described as an "invisible disability."

Yet a well-conducted history will unveil the chronology of the cyclic symptoms that point to a diagnosis. This is easily confirmed by the many abnormalities in muscles, tendons, and ligaments revealed by a detailed examination. Some doctors enjoy semantics and argue whether this is a syndrome or a true disease. "Disease" is exactly that: lack of ease, and fibromyalgics are certainly qualified to wear that name. Symptoms and findings that regularly appear together in a number of patients are grouped as a "syndrome." Congratulations! Fibromyalgia is that, too.

The painful areas of tenderness are often superimposed at the sites of previous injuries or surgery, so some believe that it is caused by trauma. We believe that there are good scientific reasons why this should be, but we also believe the disease-syndrome is inherited. Since eighty-five percent of fibromyalgia patients are women, at least one gene is undoubtedly on the X chromosome. But there must be more than one gene involved, since we have seen the illness begin as early as the age of four and as late as the age of seventy-four. That spread would be impossible to explain with only one defective gene. There is no doubt in my mind that there is a genetic predisposition to FMS. My eighty-six-year-old father has had it since my teen years. My mother recently told me when I asked about his leg pain that the doctor said years ago that there were lumps in his legs. -M. Bush, Alabama

Although fibromyalgia is not a terminal illness, it is a demoralizing and debilitating one. The symptoms can be unbearable-so unbearable that the so-called "Suicide Doctor," Dr. Kevorkian, has helped several fibromyalgia patients end their suffering. In 1997, one of these fibromyalgics was forty-year-old Janis Murphy. After her death, her father spoke out about his daughter's condition. "Over the years, I've seen my daughter experience intractable and unrelenting pain." He hated losing his only child, but "there are things in this world worse than death."

The currently accepted method for helping fibromyalgics is to recommend exercise (knowing the patient can't do it) and to employ a war chest full of chemical Band-Aids used simply to palliate the lengthening litany of symptoms. Medical professionals unwittingly promote increasing disability when they prescribe ever-stronger medications that, sooner or later, deplete energy even further and deepen the mental haze. Along with the failure of exercise programs, massage, and physiotherapy, patients accept their lot and become victims of their disease.

To make bad matters even worse, long-term disability insurance companies have now entered the fibromyalgia fray and help to confound progress. It is to their advantage to insist that the disease and all of its variations stem from psychiatric disorders. They often have no difficulty in finding a psychiatrist who will agree. Since the vast majority of insurance policies do not cover mental disability beyond a specified time, there is a great deal of money at stake. Fibromyalgia cases have reached near epidemic proportions in the form of U.S. Social Security disability claims, workers' compensations, and accident litigation. As many as twenty-five percent of American fibromyalgia patients have received some form of disability or injury compensation. We are first to agree that the country can ill afford to swell these ranks. But we cannot turn our back on very real suffering, either.

Although there is no consensus as to the source of the disease, I postulate throughout this book, hopefully in simple enough terms, that it is caused by an abnormality in phosphate excretion. As I have already suggested, this inherited problem appears to me to be due to a genetic defect.


Excerpted from What Your Doctor May Not Tell You About Fibromyalgia by R. Paul St. Amand Claudia Craig Marek Copyright © 1999 by R. Paul St. Armand, M.D. and Claudia Craig Marek . Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

What People are Saying About This

Kendall Gerdes
Offers a clear road map out of the wilderness of fibromyalgia pain and fatigue.
— (Kendall Gerdes, M.D., former president, American Academy of Environmental Medicine)
Devin Starlanyl
I have seen the magic of guaifenesin and the program in What Your Doctor May Not Tell You about Fybromyalgia work.
— (Devin Starlanyl, author of The Fybromyalgia Advocate)
C. Ronald McBride
I've been using guaifenesin and the protocol in this book in my practice for seven years. The results have been amazing! If you have fibromyalgia I strongly recommend you buy this book and begin treatment immediately.
— (C. Ronald McBride, M.D., assistant clinical professor of medicine, UCLA Medical Group)
Miryam Ehrlich Williamson
Dr. St. Amand's unique approach to fibromyalgia gives patients who have run out of treatment options a new hope....A revelation to fibromyalgics.
— (Miryam Ehrlich Williamson, author of Fibromyalgia: A Comprehensive Approach and The Fibromyalgia Relief Book)

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What Your Doctor May Not Tell You about Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease 4.4 out of 5 based on 0 ratings. 21 reviews.
Guest More than 1 year ago
I am a nurse and have suffered from fibromyalgia syndrome for nearly 60 years with many progressing subtle and not so subtle distressing and debilitating symptoms. After reading Dr St Amand's book, I gave it a try with all I had, fibrofog and all. With great care to eliminating salicylates, bioflavonoids, etc... as prescribed in the book, and starting on the 'protocol', I find myself cycling and improving with each passing month. I feel that for me, this is the most helpful, critical regimen and protocol to recover from fibromyalgia. It is IMPERATIVE to be COMPLIANT as to avoiding the offending culprits, otherwise the protocol 'and over the counter medication' won't work at all. The website offered in the book is a great help with the regimen. This book and the author's website in the book, are a must.
1952shirl More than 1 year ago
I found this book to be just what I was looking for to make me more aware of the condition I was being tested for. Very easy to read and good information. It made me feel much more comfortable being able to pin symptoms down that I was having.
Guest More than 1 year ago
I came across this book in the library and decided to take a look at it. I thought it was probably another scam, but once I started the book I found it extremely interesting. I must have finished it in 3 or 4 days. It explains so much about the various symptoms of fibromyalgia and offers hope for a legitimate, if unproven treatment. Through joining the online protocol support group, I have found numerous people who have had success on this protocol. I hightly recommend this for sufferers or family members of people who have fibro.
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Thought the book was full of useful information. Also to the point.
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thayley More than 1 year ago
I've been on the protocol for a year and a half. I just had a check up with Dr. St. Amand last week and I've improved so much on the protocol that he said if I were to just walk in off the street and ask to be evaluated he would not be able to give me a definitive diagnosis of fibromyalgia. When I first started with him I had 63 trigger points and I'm down to 27! While I still experience the cycling/symptoms they are much better than before. My children have it also and are on the protocol and they are improving. Some people think this is nonsense but there is no doubt in my mind it's working because I'm seeing and feeling the results. Those that aren't willing to try this don't realize the quality of life they are missing out on.
Guest More than 1 year ago
Having suffered many years with this illness, I was looking for something that made sense and explained why my muscles hurt so much. Now I know! It was a good read with explanations a lay person could understand. I started the treatment plan and have seen some slow but real improvements. I would recommend it to any sufferer. The authors also have an online support group to answer the many questions that pop up.
Guest More than 1 year ago
Worth a look for any person that is struggling with this terrible condition. If you have back pain too, I can recommend "The Multifidus Back Pain Solution." It's based on research and treatment consist of a simple exercise you do at home for your multifidus muscle.
Guest More than 1 year ago
I saw 22 doctors and an entire team at Mayo Clinic. No one could help me. They said my problems were due to 'being a woman, having 4 children, or menopause'. When finally diagnosed with fibromyalgia, they still couldn't help me, I should just learn to live with the pain. I KNEW there had to be something that I could do to get well. The answer is here, in this book by Dr. Paul St. Amand. I am now on guaifenesin (it's not herbal, it's an ingredient found in Robitussen, and is safe & approved by the FDA). I knew I was getting well when my 8 year old said 'mom, this is how you used to be'! It works, try it.
Guest More than 1 year ago
If you have FM, you have to read this book. I bought this book, read it and within a couple of weeks I was sitting in Dr. St. Amand's office. I've been following the protocol he outlines in this book for 2 months now and already do MORE than I could do a year ago. Thank you Dr. St. Amand, Nurse Claudia & my fellow guai'ers for giving me my hope, health and life back!!!
Guest More than 1 year ago
I bought this book on a Saturday night and I was seeing a Dr. and getting the recommended treatment by the following Saturday. It is a great book with a great premise. The protocol involves a very simple medication called guaifenesin and there is a support group on the internet who will help you every step of the way. If you are like others with fibromyalgia you are discouraged, sick, and at the end of your rope. This book will give you hope. I promise.
Guest More than 1 year ago
Most of the books I have read offer advice on how to manage the symptoms of FMS, but no real insight into the cause or possible treatment. This book is a real breath of fresh air. The description of the symptoms and cause are clear and easily understood, the guaifenisen treatment protocol is explicit enough that the committed individual can get help with minimal reliance on their care provider. I used this book to help obtain a guai rx from my doctor and followed Dr. St. Amand's protocol. Nine months later, I can honestly say I have my life back. My doctor is so impressed with my progress that he is now recommending the book to his other FMS patients! Thank you, Dr. St. Amand and Claudia!
Guest More than 1 year ago
This is very informative book for anyone that has been diagnosed or suspects the diagnosis of fibromyalgia. I gained a lot of knowledge even though I have been using the subscribed treatment protocol for many years. THIS PROTOCOL WORKS! Please check out this information and don't let anyone tell you that you have to suffer with bandaid cures if you have this disease.
Guest More than 1 year ago
This is the miracle book of all books. This book is well written, easy to understand and the answer to Fibromylgia recovery by utilizing Guaifenesin. You will see that you are not crazy, you are not a hypochondriac and that you do have a legitimate illness despite all tests that were negative. You will feel vindicated after all your many trips to many doctors who could not tell you why you ached, felt tired, were dizzy, had headaches, IBS symptoms, cognative problems and a myriad of symptoms that you have had over many months or years or a lifetime. I have been on Guaifenesin for 26 months and am enjoying a wonderful life on my journey to recovery. A miracle indeed considering I was bedridden for most of 1998 before Guaifenesin. I have had Fibromylgia all my life.
Guest More than 1 year ago
This book is an absolute must for anyone with fibromyalgia. It includes a detailed accounting of how you can actually reverse the disease, not cover it up with drugs or other treatments. The medication has no side effects and is very inexpensive. Included in the book is detailed information on diet recommendations, products to avoid and internet links to a support group which is very active and supportive to anyone wishing to find out more information on this protocol. The authors regularly read the email and answer pertinent questions. You can't get any better help than from the book and the mailing list support group.