A half-century of work by Professor Janet Travell, the White House physician for Presidents Kennedy and Johnson, and author of the Trigger Point Manual showed that the same problems causing hypothalamic suppression resulted in muscles getting stuck in the shortened position. Chronic muscle shortening then causes myofascial and fibromyalgia pain. As Professor Travell laid the groundwork for effective treatments of these processes, our research team has dedicated our published study to her memory.
To effectively resolve CFS and fibromyalgia, five main areas of health have to be tended to. I summarize these with the acronym "S.H.I.N.E.®," which stands for Sleep, Hormones, Immunity/Infections, Nutrition and Exercise as able.
In my 40 years of clinical experience treating CFS/FMS, and in our landmark published research on CFS/FMS (published in the Journal of Chronic Fatigue Syndrome), I have found that the S.H.I.N.E.® approach is successful in the vast majority of patients. S.H.I.N.E.® identifies five key areas related to the body that, when addressed in combination, provide a blueprint for promoting optimal energy. Tending to these can help you maintain healthy energy levels when you are well, and can help support recovery when dealing with CFS and fibromyalgia.
Sleep: Get adequate sleep, preferably eight to nine hours a night. Sleep replenishes your body's energy and helps heal your muscles. Inadequate sleep will leave you exhausted and in pain. Because your sleep center isn't working in CFS/FMS, aggressive sleep support is necessary.
Hormones: Hormone deficiencies can contribute to fibromyalgia and chronic fatigue syndrome. Unfortunately blood testing misses the large majority of people with hormonal deficiencies in these illnesses. The large majority of people with fibromyalgia should do a treatment trial with thyroid. In addition, if you get irritable when hungry, adrenal support is needed. Most men with CFS/FMS find that their testosterone level is in the lowest 30% of the population. If a woman's fibromyalgia symptoms are worse around her menses, estrogen and progesterone support may be helpful. Low blood pressure (hypotension) is also a major contributor to CFS/FMS. Called orthostatic intolerance, this occurs when gravity causes your blood to pool in your legs when you stand up, leaving you easily exhausted and brain fogged. Download this simple quiz to find out if you have orthostatic intolerance.
Immunity/Infections: Underlying viral, bacterial, bowel, sinus and yeast infections are common and can be contributing causes of CFS/FMS, or even the result of it.
Nutrition: To maintain normal health and optimal energy levels you need to make sure you get an optimal balance of nutrients, particularly as nutritional deficiencies can result from CFS/FMS. Vitamin B-12, magnesium, acetyl L-carnitine, glutathione, as well as your basic A, B, C and D vitamins are especially vulnerable to depletion.
Exercise: Exercise as able. After 10 weeks on the first four steps above, you should be able to slowly increase your amount of exercise without being wiped out the next day. Don't overdo it trying to follow "normal" exercise recommendations, as doing too much can result in Post Exertional Malaise, a condition that can last for days that leaves you feeling as though you were hit by a truck. But by following the S.H.I.N.E.® protocol, you should gradually begin to condition.
Watch the below video of Dr. T's presentation on S.H.I.N.E.® (approximately 50 minutes).
What to Expect
In our study over 90% of patients improved using the full S.H.I.N.E.® protocol, with an average of 75% improvement in quality of life at just three months! At two years quality of life increased to an average 90%. By then most people were able to wean off of most of the treatments. The treatments were basically like crutches that helped them recover. When well enough that the treatments are no longer needed, you can simply discard them.
In our published research, after treatment many patients no longer even qualified for the diagnosis of CFS or fibromyalgia! Interestingly, many of the same principles for treating fibromyalgia also apply to myofascial pain syndrome (MPS), as our study showed that pain decreased by an average of over 50%.
That the vast majority of patients improved significantly in the active group while there was minimal improvement in the placebo group proves two very important things. The first is that these are very treatable diseases. The second is that anyone who now says that these illnesses are not real or are all in your head are clearly both wrong and unscientific.
A new day is dawning in how CFS and fibromyalgia (and MPS) will be treated. In support of our work, an editorial in the journal of a major multidisciplinary medical society for pain management noted the following:
- The comprehensive and aggressive metabolic approach to treatment detailed in the Teitelbaum study are all highly successful approaches and make fibromyalgia a very treatment-responsive disorder. The study by Dr. Teitelbaum et al. and years of clinical experience make this approach an excellent and powerfully effective part of the standard of practice for treatment of people who suffer from fibromyalgia and myofascial pain syndrome."
It's important to recognize that these syndromes can be caused and aggravated by a large number of different triggers. When all of these different contributing factors are looked for and treated effectively, patients improve significantly and often get completely well!
Energy Analysis Program
Our free Energy Analysis Program can help you in your approach to following the S.H.I.N.E.® protocol. This online tool is a specially designed, patented, questionnaire that uses algorithms developed by Dr. T to pinpoint individual factors that may be impacting your energy, vitality and overall wellness. It takes only 10-15 minutes to complete and recommends steps based on S.H.I.N.E.® principles that you can take to optimize your energy.
Finding a Practitioner
Expecting most physicians to be able to treat fibromyalgia is like expecting your chiropractor to be able to do heart bypass surgery. That they have no idea how to do this doesn't make them bad practitioners. It simply means that they aren't trained in these areas. In fact most health practitioners have no idea how to help people with fibromyalgia.
To help this situation, we provide the CFS/Fibromyalgia Practitioner Referral List. This is a searchable database you can use to locate CFS/FMS-trained health practitioners who may be available near you.
Also, holistic physicians are more likely to be familiar with treating CFS and fibromyalgia. Although their expertise varies considerably from physician to physician, they are more likely to be able to help you. The Academy of Integrative Health & Medicine (AIHM) includes over 2,000 board-certified holistic practitioners. Their website can help you locate a certified holistic physician near you.
Making an Appointment with Dr. Teitelbaum
Dr. Teitelbaum treats people from all over the world. As many people are too ill to travel to see him, he can treat you by phone consultation as long as your physician has examined you in the last year. New patient visits provide three hours of his one-on-one time. This includes a very thorough evaluation including review of your old records, and will give you a detailed understanding of what's causing the illness and how to make it go away. Learn more about appointments with Dr. T.
My books From Fatigued to Fantastic (better suited to those with a scientific bent), The Fatigue and Fibromyalgia Solution (an easier read for people with brain fog from the illness), and Pain Free 1-2-3 can supply you and your physician with a wealth of information to help understand CFS and fibromyalgia.
Need Help Getting Disability Benefits?
Unfortunately there still remains about 15% of people who don't respond as well as we'd like to S.H.I.N.E.® and need further help. Also unfortunate is that obtaining disability benefits to cover CFS or fibromyalgia can be difficult. In these cases Denise Haire can provide assistance with claim filing, disability appeals or disability paperwork for your primary physician. If you'd like to arrange a phone call with her to help you with your disability claim, please call her at 410-573-5389 or email her at firstname.lastname@example.org.