Q&As
Guaifenesin
[Q&As are placed in reverse chronological
order. In other words,
the latest Q&As come first. Earlier ones are further down the
page.]
This
page contains not only Q&As about guaifenesin as a
fibromyalgia treatment; it also contains criticisms and reprimands
from some readers and my replies to them. Those who’ve criticized my
conclusions about guaifenesin treatment and reprimanded me for
stating them appear to fervidly hold a peculiar belief—that
Dr. Paul St. Amand's approach to fibromyalgia should be exempt
from logical and scientific scrutiny. Some of these people also
appear to falsely think that critiques of his beliefs are personal
attacks on his character. I feel that visitors to drlowe.com
deserve to read these people's criticisms and reprimands, so I've
published them here. Their statements appear below just as they
wrote them, with editing restricted only to the correction of gross
errors in grammar and punctuation. The criticisms and
reprimands and my replies to them appear along with Q&As in
reverse chronological order; that is, the latest e-mails and my
replies to them come first, and earlier ones appear further down
the page. —Dr.
John C. Lowe
July
17, 2002
Question:
I was told by Dr. Amand's office when
I called them with an unusual complaint about his guaifenesin that there are
no side effects of the drug . . . baloney! Lucky me to be the first—or was
I?
Here’s what happened to me: I ballooned up 8 pounds in four months of
taking this stuff, and, yes it’s true, my ability to have and orgasm came
to be almost nill! This, in all my17 years of pain and trying different
medications, had never happened. I was told by a few "well
meaning" people, "Maybe something else was going on. Like I don’t
know my own body? The sexual problem started two days into the medication,
which is interesting because I was told that it can take 12 or 24 hours to
get into or get out of your system. Hmm . . . .
It took almost 11 months for the side effects to stop, and I still feel
like there is a "residue" left in me (or whatever). The water
weight came off just by stopping the guaifenesin, but the most frustrating
side effect took it's own sweet time. I said, To hell with gaui, and didn’t
choose to continue. How could something that’s supposed to help you make
your body go wonky? I was only on it for four months, and I had no intention
of staying on it 2 years and 10 months like the "Doc" recommended.
Have you heard of such side effects with guaifenesin before?
Dr. Lowe:
Sorry for the adverse reactions you apparently had to guaifenesin. As you
indicate, most people believe the agent is completely without adverse
effects. And I admit, yours is the first description of severe, troubling
adverse reactions I've heard. But that certainly doesn’t mean other
patients don’t experience them.
Many patients say they have the symptom exacerbations Dr. St. Amand
predicts during the course of their guaifenesin treatment. Rather than
adverse reactions, he views these as part of the therapeutic process during
guaifenesin treatment. However, I believe the conclusion that these
exacerbations are therapeutic effects induced by guaifenesin is logically
unsound.
As you noted, patients take guaifenesin for a long time. During this span
of time, any fibromyalgia patient is naturally going to experience
fluctuations in the intensity of her symptoms—times when the symptoms are
better and times when they’re worse. In research, we refer to these
fluctuations part of the "natural history" of a disease. Patients
taking guaifenesin do experience periodic exacerbations, but so do patients
who never take it. Because the two groups of patients (those taking
guaifenesin and those not) both experience the exacerbations, it’s
illogical to conclude that guaifenesin induces them. With a high degree of
probability, if the patients taking guaifenesin weren’t taking it, they’d
still have the periodic symptom exacerbations. So, contrary to the belief of
guaifenesin advocates, I don't consider these exacerbations of symptoms
evidence that guaifenesin is working. Instead, the exacerbations are
evidence that it's not working.
(If anyone has questions for this patient about her adverse reactions to
guaifenesin, please send an e-mail to us at AskDrLowe@drlowe.com. We'll
forward your e-mail to her.)
Continued at top of right column . . .
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Continued
from the
bottom of left column . . .
December 12, 2001
Dear
Sir:
Attacking a medical doctor with excellent credentials on the
Internet says more about you than it does the doctor you are attacking. How
dare you malign Dr. St. Amand. I feel certain that he would never do that to
you. Are you jealous? Do you think attacking him will hurt him? No, it only
hurts you. Please take your unfounded remarks about all medical
professionals off your web site. Those remarks make you look like a fool and
worse. Are you a licensed medical doctor? You should be ashamed.
Dr. Lowe:
I’ve never personally
maligned Dr. Paul St. Amand or any other doctor on my web site. I have,
however, quite properly criticized some of Dr. St. Amand beliefs, which I
judge to be scientifically false. And I’ve properly criticized his
guaifenesin treatment for fibromyalgia, which I consider nothing more than a
placebo. I am mandated to provide such criticisms, as scientific and
educational activities, by the corporate charter of the Fibromyalgia
Research Foundation, of which I am Director of Research.
The views we express on drlowe.com serve the needs of many
people. Roughly 22,000 people per month visit our
site, looking for alternatives to mainstream medicine’s largely inept and
injurious methods. Mainstream medicine fails to help 75% of its patients,[1]
and it causes the unnecessary deaths of 224,000 United States citizens each
year.[2][3]
In view of these tragic findings, I believe mainstream medical professionals need all the help they can get to
rectify their horrific track record, and I feel a humanitarian
responsibility to continue providing my modest assistance on drlowe.com and
elsewhere. That sense of responsibility compels me to decline your request
to remove "remarks about all medical professionals off your web
site,"—none of which, contrary to your opinion, are
"unfounded."
References
[1]
Lown, B.: The Lost Art of Healing: Practicing Compassion in Medicine.
New York, Ballantine Books, 1999.
(Dr.
Bernard Lown, who described the dismally low effectiveness rate of
mainstream medicine, is a Nobel Prize winning Harvard Medical School
Physician.)
[2]
Starfield, B.: Is US health really the best in the world? JAMA, 2000
Jul 26;284(4):483-485, 2000.
[3]
Starfield, B.: Deficiencies in US medical care. JAMA,
284(17):2184-2185, 2000.
(Dr.
Barbara Starfield is with the
Department of Health Policy and Management, Johns Hopkins School of Hygiene
and Public Health, 624 N Broadway, Room 452, Baltimore, MD 21205-1996, USA.)
April 12, 2001
Question:
If fibromyalgia is caused by impaired metabolism or
thyroid problems, how do you explain Dr. St. Amand curing FMS with
guaifenesin?
Dr. Lowe:
I have talked with many
fibromyalgia patients who have used guaifenesin. None of these patients
recovered their health while using it. They didn’t recover even though
they followed Dr. St. Amand’s treatment protocol precisely. The minor
improvements some of these patients had while using guaifenesin can be
attributed to the diet changes Dr. St. Amand recommends. The diet changes
are the useful part of his protocol. The guaifenesin is a safe medication,
but it is useless as a fibromyalgia treatment. (Incidentally, some of the
patients who didn't benefit from the use of guaifenesin subsequently
completely recovered from their fibromyalgia symptoms with metabolic rehab.
We have meticulous records quantitatively documenting their recovery.
Researchers are free to examine these records pending approval by the
patients.)
Dr. St. Amand's portrayal of how guaifenesin alters fibromyalgia
patients' biochemistry and benefits them is completely fictional. In trying
to understand his beliefs, I’ve read every scientific publication I could
find on guaifenesin. Despite having read almost every published paper on the
topic, I’ve found no evidence whatever to substantiate his views. Instead,
I’ve only found evidence that contradicts his views. Moreover, Dr. Robert
Bennett conducted a well-designed
study to determine whether Dr. St. Amand’s protocol worked. The
outcome was that the treatment didn't work.
I personally don't think Dr. St. Amand can credibly document that he’s
ever gotten a single patient well from fibromyalgia with the use of
guaifenesin. In his book, he pronounced, "Thyroid conditions are not
related to fibromyalgia."[1,p.146]
This statement clearly shows that Dr. St. Amand doesn’t understand the
nature of fibromyalgia. If he did, he would be compelled to retract this
pronouncement and abandon his false belief that guaifenesin is an effective
fibromyalgia treatment.
1. St. Amand, P.R. and Marek, C.C.: What
Your Doctor May Not Tell You About Fibromyalgia. New York, Warner Books
Inc., 1999.
June 5, 2000
Question:
Is there any harm in taking 100 mcg of T4 and guaifenesin at the same time
to treat my fibromyalgia?
Dr. Lowe:
I know of no reason in general why one shouldn't use T4 and guaifenesin at
the same time. However, whether one uses them separately or in
combination, 100 mcg of T4 or guaifenesin at any dosage isn't likely to
improve fibromyalgia status.
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