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GUAIFENESIN - From "The Fibromyalgia Advocate"
I will consider changing my medications, my physical therapies, and my exercise routines, but I will not
consider going without guaifenesin, nor will I take anything that might block its effect. It's too important to
my well-being. I must still practice sound nutrition, bodywork, mindwork and the other lifestyle
modifications important to the FMS/MPS Complex patient, but I feel that guai has made a decided
difference in my quality of life, and allowed me to do much more than I could have done otherwise. I want
others to know that there are options.
Guaifenesin therapy was developed by Dr. R. Paul St. Amand. It is experimental. We don't know how it
works. The one study done on guaifenesin and FMS was flawed, through no fault of those who ran it (St.
Amand R. P. and C. Potter 1997). We simply didn't know all the variables at the time the study took place,
including the importance of diet for reactive hypoglycemia.
WHAT IS GUAIFENESIN AND WHERE DO I FIND IT?
Guaifenesin is a common over-the-counter expectorant. It has been around for about seventy years, first
as guaiacum and then as guaiacolate, and for about twenty years as guaifenesin. Guaifenesin is not a cure
for FMS. It does seems to allow the kidneys to eliminate something harmful that has been stored in the
body. Dr. St. Amand feels that at least part of what is eliminated is phosphates, and I agree. Oxalates may
also be part of this package of unwanted stored matter that is released by guaifenesin. Excess oxalates
seem to be responsible for some of the vulvitis and vulvodynia experienced by female FMS patients.
St. Amand found that with guaifenesin therapy, there was an increased excretion of 60 percent
phosphates, 30 percent oxalates and 30 percent calcium. Although you lose excess calcium, none of his
patients has exhibited any sign of osteoporosis or calcium loss. Emphysema patients on guaifenesin
often take 2400 mg a day for many years without any side effects.
Guaifenesin is safe and even available in pediatric dosages. It is also sold in as a prescription medication
available in 600 mg caplets or capsules. It is important to ensure that there are no other medications
mixed in with the guaifenesin, as there often are in cough and cold formulations. You can buy guaifenesin
from Hyrex Pharmaceuticals as 200 mg pills by phone at 800-238-5282, or Star Pharmaceuticals at
800-274-6400.
HOW DO I KNOW IT'S WORKING?
St. Amand feels that FMS develops in a cyclical process. At first, there are times when we experience
symptoms interspersed with periods where we feel ok. Sometimes we are unaware of what is happening
at this stage. The periods without symptoms get shorter, the symptomatic episodes become more
frequent and the symptoms worsen. This is what St. Amand calls "cycling". He believes that guai therapy
reverses this process.
Your urine and sweat may become dark and smelly as guai takes effect. I believe that this indicates a
release of wastes, excess acids and, I believe, toxins, as well as substances such as quinolinic acid, the
nerve toxin produced by the kynurenine pathway of tryptophan metabolism ( see Alternative Tryptophan
Pathway, Chapter 5). This release into the bloodstream is manifested by muscle aches, headaches, and
often overwhelming fatigue. This includes physical problems as well as psychological ones, including
feeling depressed at times during the cycle. With the release of the wastes into the blood stream, your
body can begin to process these unwanted substances, and get rid of them through the urine, feces, and
sweat. Your feces may become irritating, and you may experience anal itch or soreness. This can be
eased by Bag Balm, anesthetic ointment, or cortisone ointment. You may also experience burning on
urination, caused by the excess acid (see first book).
After the initial flush of wastes, you will begin to go through a reverse of the cyclical process. Every once
in a while you will have a period where your symptoms ease. You may then begin to experience whole
days where you feel well. It is important not to overdo on these days. Your body is in a struggle to regain
balance. Don't overtax it.
When you get to the point where there are clusters of good days, the contrast can be remarkable.
Knowing what is happening helps you to deal with the reversal symptoms. The bad days are still bad, but
you know why, and you know you are on a path to better health.
GUAIFENESIN THERAPY
Before you begin guaifenesin therapy, use the body chart to map your areas of pain. This will allow you to
record any progress.
The typical regimen is to start with 300 mg twice a day. I have seen some people start gentle guai therapy
on 200 mg a day. Children should use pediatric form. It is important that you consult with your pediatrician,
as the dosage is weight dependant. It is important to find the dosage that works for you. This varies from
patient to patient. If, after one week, no obvious change occurs, increase the dose to 600 mg twice a day
for about a month. Check your creature map. The break up of pain areas in spite of an increase in
symptoms means the stored waste matter is leaving your body.
I have sat with many patients, agonizing over the decision to take guaifenesin. I have held hands, rubbed
backs, soothed heads, and encouraged those going through the first cycles toward healing, as the wastes
and toxins (another area in which the good doctor and I disagree) came out of their hiding places and
flooded the body, producing the aggravation of symptoms. I have also rejoiced with many who were able
to return to their lives and, often, their jobs. I have seen the magic of guaifenesin work, both in my life and
in the lives of others. I respect and love Dr. St. Amand, who has given so much to so many, receiving with
nothing in return but the knowledge that he has been able to help people.
GUAIFENESIN AND DIET
There is no "guaifenesin" or "fibromyalgia" diet. It is important those of you with co-existing reactive
hypoglycemia to follow a low carbohydrate diet if you want to feel better during guaifenesin therapy. I have
found the Zone diet helpful (see Reactive Hypoglycemia). A strict low carbohydrate diet is a must for
those who are overweight as well as hypoglycemic
SALICYLATE BLOCKING EFFECT
The effect of guaifenesin therapy may is blocked by salicylates. Dr. St. Amand explains what happens in
this way: "All cells have little garages called "receptors." They are each unique for certain chemicals and
hormones. To work, any medication must have the ability to enter and park in the garage in order to signal
the cell to do a certain job.
Guaifenesin parks in receptors to get the kidney cells to do the work you need done.. Unfortunately,
salicylates are a much better fit for that garage and the valet will park salicylates in preference to anything
else. When guaifenesin arrives in the parking lot, there are no available garage spaces. Thus no signal is
given for our desired effect."
The effects of a guaifenesin blocking agent may last about 24 hours. Salicylates are found in some
medications and topical creams, for example some muscle rub products and sunscreens. It is also
present and often hidden in a great array of cosmetics, some ultrasound gels, mouthwashes and herbal
preparations. Everyone on guaifenesin should avoid obvious sources of salicylates such as aspirin and
other blatant salicylates (Diflunsal, Methyl salicylate, Trisalicylate), plant extracts (aloe, licorice,
pycnogenol, St. John's Wort, ginko, quercetin etc).
Each person seems to have a different sensitivity to the guai blocking effect of certain salicylates, If
you've found your proper dosage and suddenly the cycling stops and your symptoms worsen, check out
secondary sources such as camphor, almond oil, coconut oil, lauric acid, etc. I've seen this happen to me
and to others, and we've always been able to track down the offending salicylate and eliminate it, with a
subsequent return to improvement. These setbacks and subsequent resolutions are yet another indication
to me that we are on the right track with guai.
Only phosphate is known to decrease ATP formation when it accumulates in the mitochondrial matrix
[COMMON KNOWLEDGE]. The mitochondria are the body's energy factories, and ours are polluting
badly. Low ATP has been found in people with FMS (NEW REF: Park J. H., P. Phothimat, C. T. Oates, M.
Hernanz-Schulman and n. J. Olsen. 1998. "Use of P-31 magnetic resonance spectroscopy to detect
metabolic abnormalities in muscles of patients with fibromyalgia." Arth Rheum 41(3):406-413; Eisinger,
Plantamura and Ayavou 1994). ATP essential to almost all cellular functions.
Both Dr. St. Amand and I suspect a lowered pH is at least part of the FMS problem. The pH is a measure
of the acid/base balance of the body. Low pH indicates acid. Dr. St. Amand used his observational skills
and deductive logic to theorize what is happening in our cells. Sherlock Holmes would have been proud.
At 300 mg guaifenesin twice a day, Dr. St. Amand found that about 20% of his patients reverse--and this
reversal is often swift and strong. About 70% patients reverse at 600 mg twice a day. The rest of us need
a stronger dosage. Once your symptoms are made distinctly worse by a given dose, that is probably the
proper dose for you. Just remember, your body has a limited capacity for clearing out the debris. Give it
the time it needs, and bee gentle with yourself when you begin guaifenesin therapy.
If your symptoms have been relieved, it may be time to see if you can do without your other medications,
one at a time. Talk to your doctor about this. Once this has been done, and if your symptoms don't return,
you may want to try to drop the guaifenesin dosage. Do this gradually. According to Dr. St. Amand, some
people cut back a half pill at a time and wait about three months or so before they cut back another half
pill. People are reluctant to jeopardize their hard-won health. You have cut down too far when the
symptoms return, so just resume what dosage you were on when you had no symptoms. This is your
maintenance dose.
INTERNET GUAIFENESIN SUPPORT
To join the guaifenesin support group in the Internet, send an email to the following address:
LISTSERV@MAELSTROM.STJOHNS.EDU
with the message: SUB GUAI-SUPPORT Your full name changes in your protocol or condition.
Your doctor may contact Dr. St. Amand at the following:
R. Paul St. Amand M. D.
4560 Admiralty Way, Suite 355
Marina del Rey, CA 90292
310-577-7510
CONCLUSION
Guaifenesin hasn't taken away all of my symptoms. I have an exceedingly long-standing and severe case
of FMS/MPS Complex, with many perpetuating factors, and I have also been pushing my body and mind
to the edge. The first book led to the video and website, which were followed immediately by work on this
book. Overwork is my main perpetuating factors. My priority as soon as I finish this book is to work on all
my perpetuating factors, including greatly scaling down my workload. I would not have been able to
attempt these projects without guaifenesin. I strongly believe that in ten years, a lot of doctors will be
jumping on the guaifenesin bandwagon. I intend to use those ten years undergoing guaifenesin therapy,
and becoming healthier. Devin J. Starlanyl
In Reply to: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by DEVIN STARLANYL on March 17, 1999 at 05:42:41:
I have been thinking about guaifenesin lately and wondering how Dr. Stoll feels about it. I am particularly interested in it because I have taken vocal lessons and the singing teacher mentioned guafenesin as an absolutely "safe" solution, according to his doctor, for lubricating the vocal cords (its effect is supposed to thin the mucous), especially in the dry climate of Colorado where it is hard to sing for long without straining one's throat. In fact, the singing teacher's referal for it was that it is so safe that you could literally "take it like candy". Is there truth to this?
In Reply to: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by DEVIN STARLANYL on March 17, 1999 at 05:42:41:
Dear Doc Devin,
I have no doubt that guaifensin is very helpful in fibromyositis. I am not yet convinced that fibromyositis is caused by a guaifensin deficiency (grin).
I have seen too many people get rid of fibromyositis by practicing SR regularly (while many of their other health complaints improved at the same time) to not know that total-body bracing is a major causitive factor in its etiology.
I will be interested in seeing how many people, who ONLY do guaifensin, are still clear of symptoms 5 years after getting their relief.
If I had this problem I would take guaifensin while I was practicing an effective SR at least twice a day for 20 minutes. THEN, when all my symptoms had been gone for about a year I would see if I had recurrence when I stopped the guaifensin. If so, I would get back on it.
I know of few people who would stop effective SR once they had done it for a year.
I REALLY appreciate your information since I have no experience using guaifensin for fibromyositis. It is exciting to me to know that there are other options for relieving symptoms of this condition.
Thanks for sharing this information on the BB.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Jason on March 17, 1999 at 20:31:15:
Hi, Jason.
See my note to Doc Devin today.
THEN, if you still have questions, write again.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" (ARCHIVE) posted by Walt Stoll on March 18, 1999 at 11:23:40:
The pharmacologically trained will always tend to see things from the outside-in rather than the inside-out.
Just as GERD isn't a result of a ginger deficiency, FMS won't be solved by Guaifenesin. However, it's great for people to have options like this since most are still of the mindset that there is a potion to fix everything. And are reluctant to do something about the cause. I'm glad to see Devin has the knowledge that there is a mind-body connection for FMS. Most don't.
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" (ARCHIVE) posted by David Ferguson, D.C. on March 18, 1999 at 13:12:03:
Thanks, Doc Dave!
You got THAT right!
Namaste` Walt
In Reply to: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by DEVIN STARLANYL on March 17, 1999 at 05:42:41:
Dr Strarlanyl
I want to thank you for posting on Dr Stoll's BB and also for writing your book on FMS. It was a very important tool in my journey towards wellness. I'm not there 100%, but since I started reading this BB, I've made remarkable gains. I consider myself rid of FMS, due to SR, Chiropractic care, mostly Hunter-Gatherer diet, and supplements. Yoga and moderate exercise are also included, but I fall short of where I should be there. I've read all the books Dr Stoll recommends and believe that the total body bracing is at the root of all the FMS symptoms because when I let my body tense up for a few days without properly discharging the stress through SR, my muscles start to knot up. Then I have to spend 1-2 hours or more a day for a few days to get rid of that.
My quai question is this: If it is the most important aspect of FMS treatment, why do you (and others) have to keep on taking it? Do you believe this treatment will be necessary for the rest of your life? Do you do SR as Dr Stoll recommneds (twice a day, 20 min. each in alph/theta brain waves)?
Please continue to contribute to this board. You have much to share!
Nancy
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Nancy on March 19, 1999 at 19:48:02:
I think the reason people continue to do the guai is that
they still remain in the "state" of FMS and can keep
flushing out the phosphates that way, and many of them were
in terrible pain without the help of it.
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by PHANTOM JN on March 19, 1999 at 21:27:47:
have been on guai treatment for 9 weeks now and have felt much relief until a flare-up of four days after a move to a new home. Was expecting it though after all the hard work. Would have been bedridden after one day of packing prior to starting the treatment. Would like to hear of other successes and need more information on what to expect as I continue treatment. Does long term relief set in and how long before this occurs? Am really encouraged so far
and am looking forward to adding back activities in my life that had been given up over the last several years.
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by sabuk on May 12, 1999 at 19:09:20:
Thanks, Sabuk.
I am hoping for many more "testimonials" (pro & con) about this relationship.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Nancy on March 19, 1999 at 19:48:02:
What is SR and can anyone recommend a good yoga tape for fms or mps sufferers? Thanks
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Margaret on May 23, 1999 at 15:28:52:
Margaret
SR stands for Skilled Relaxation, a technique that is considered to be essential in dispelling stored stress in the hypothalymus and eliminating "bracing" which causes all the aches and pains associated with FMS and other chronic conditions. Along with proper diet (for your matabolic type) and exercise, which are also discussed at length on this board, you can decrease and even eliminate all the symptoms of FMS. Yoga can fit into both SR and exercise. I, personally, think that it's a good idea to take some instruction in Yoga before trying any tapes. An instructor can point out the correct way to breathe and position your body, while stressing the importance of gentle stretching, rather than overdoing. The instructor can also recommend good tapes. If no one else on the board suggests a tape, I can ask my instructor for a couple. Just email me or post a new question on the board. This time, use "Yoga" in the question.
As a result of studying this BB and practicing the methods discussed here, I have eliminated my FMS. It took only a few months. Go to the homepage, and read as much as you can, read the suggested books, and ask lots of questions! Good luck!
Nancy
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Nancy on May 23, 1999 at 16:54:09:
Thanks, Nancy, for the help & the testimonial.
As you know, testimonials do more to change peoples' minds than anything I can say.
Walt
In Reply to: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by DEVIN STARLANYL on March 17, 1999 at 05:42:41:
I have just begun the journey into understanding fibromyalgia . My 64 year old mother was diagnosed 8 years ago with parkinsons disease. She has been in excruciating pain and we have watched her quality of living deteriorate to being practically bedridden with pain. She has been hospitalized 3 times in a psychhiatric unit. She has been to neurologists, and a myriad of other healthcare professionals including the Mayo Clinic since this pain began. With no pain asssociated with parkinsons, the general consensus is that it is an emotional problem.
In reviewing her medical records recently, there were 2 doctors in 8 years that wrote possible fibromyalgia down as a diagnosis. Obviously they did not feel that they were qualified to address it with our family, so they left it out of their discussions with us. After doing some research on the disease, there is no question in my mind that she has been afflicted with fibromyalgia for many years and has suffered incredibly.
Our next step is to find a physician who knows the ropes and get a plan for treatment in action. I just wanted to say I am happy to have found your information and I am using much of it prepare the family and healthcare professionals now involved for her ruture trreatment.
Lisa Cowan
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Jason on March 17, 1999 at 20:31:15:
Jason, I've been taking guaifenesin for FMS about 4 mos. and have seen good results, as are many others who are taking it. It's not an over night cure, but slowly and steadily reverses the symptoms. I have a way to go, but am presently in much less pain than I was. I continue to 'cycle' and believe I will improve more and more each month. If you or a family member has FMS, I urge beginning guaifenesin NOW. The sooner the better. Check out the guafenesin support site.
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Lisa Cowan on June 06, 1999 at 09:24:56:
Hi, Lisa.
Good Luck in your attempts at trying to educate the (usually) uneducatable conventional docs (whose monopoly is threatened by this kind of thinking). If I knew what part of the country she was from, I might be able to direct her to docs who know more about this in her area. If her present docs are open to learning, stick with them.
Fortunately, many of the same things you could do to help the fibromyositis would also reduce the symptoms of the parkinsonism.
Your best resource of information about how to help the Parklinson's would be to call (800) 843-9660 or go to their website at www.healthcomm.com and get a listing of the world publications in this area for the past 5+ years.
If you have not read the archives for fibromyositis, you might take a look at that. Just Rolfing would help her a lot while you both are learning of her other options.
Let us know what you learn.
Walt
In Reply to: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by DEVIN STARLANYL on March 17, 1999 at 05:42:41:
Is the guai treatment for the FLULIKE pain of fibromyalgia or the muscle pain...or does it actually treat the hardened muscles of MPS by releasing the hardened myofascia crystals?? I have had horrible pain in the shoulder for years with extremely tight muscles...and also after delivering a baby 6 months ago..I now have pain and hard muscles from the pelvis to buttocks to thighs..and this is causing vascular problems and pain as my blood flow is being restricted. Would the guai therapy be useful to me?? Thanks!
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Abbye on June 21, 1999 at 16:11:20:
Hi, Abbye.
Even if the guaifensin DOES help your symptoms, it will not resolve the problem. NO ONE thinks that fibromyalgia is due to a "guaifensin deficiency". "The resolution of any chronic condition will NEVER be something you TAKE but something you DO."
The same thing causes fibromyalgia that causes arthritis. Look at the link below & start understanding WHY you have this & do something about the causes.
THEN, if you still have questions, write again.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Jason on March 17, 1999 at 20:31:15:
Where, and how do we acquire pure guaifenesin? Unable to find it here in MI. Thank you FMN
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Frieda Nellis on June 27, 1999 at 02:22:32:
Call (800) 238-5282 for information.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" (ARCHIVE) posted by David Ferguson, D.C. on March 18, 1999 at 13:12:03:
Dear Mr. Stoll
I had heard that guaifenesin will X out other vitamins and herbs if you take them together. Can you please give me some input on this.
Thanks for your help,
Russ Newman
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" (ARCHIVE) posted by Russ Newman on September 25, 1999 at 22:26:51:
Hi, Russ.
I have had no experience using guaifenesin for fibromyhalgia. I am as interested as you are in learning if this really works.
I have not heard of this concern and would be very interested in any research you may have that shows this poroblem. From what I know of biochemistry and nutrition, I would be very surprised if this could happen.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Walt Stoll on June 28, 1999 at 07:44:09:
Please Send info on Guaifenesin as used in Fibromyalgia. I have had this disorder for 28 years and am constantly trying new medications as I am alergic to most such as Elavil and all derivatives. Am now on Oxycontin and Effexor. Came across Guaifenesin in an article off the net.
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Jacqueline Lima on October 04, 1999 at 17:26:20:
Hi, Jacqueline.
Since I have never used it, I will have to wait for another BB participant to respond and we can both learn at the same time.
Let us know your experience and we will all benefit.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by Nancy on May 23, 1999 at 16:54:09:
Need more information.
In Reply to: more information posted by Kethleen on October 26, 1999 at 00:58:31:
Hi, Kethleen.
Although Guaifenesin may well help the symptoms of fibromyalgia for a while it is subject to the "Stoll Rule": "Chronic problems will never be resolved by something you TAKE but by something you DO."
When you are ready to understand the condition and get rid of the causes, go to the glossary and the homepage articles. THEN, if that makes sense to you, spend a few hours on the link to the archives I have prepared for you below.
THEN, if you still have questions, write again.
Walt
In Reply to: Re: GUAIFENESIN - From "The Fibromyalgia Advocate" posted by PHANTOM JN on March 19, 1999 at 21:27:47:
Do you know an Alberta, Canada source of this product?
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