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The Metabolic Treatment
of Fibromyalgia

by Dr. John C. Lowe
Readers' Comments

Precise Data-Driven Metabolic Rehabilitation

Dr. John C. Lowe

Latest Updates to drlowe.com

Over the past 15 years, Dr. John C. Lowe and his colleagues have developed, experimentally-tested, and refined a protocol of metabolic rehab for fibromyalgia, hypothyroid, and thyroid hormone resistant patients. Metabolic rehab, then, is science-based.

(The scientific basis of the doctors' approach to fibromyalgia, hypothyroidism, and thyroid hormone resistance is clear to many respected medical and health writers.  Dr. Lowe's research and clinical work have been cited or described in many books, some of which are major textbooks by leading authorities. Some of the doctors' research papers are summarized on line. Other studies will soon be published. Some show that fibromyalgia patients have abnormally low metabolic rates, and another shows that the TSH, free T3, and free T4 are not useful in identifying patients who are hypometabolic because of too little thyroid hormone regulation.)

Needed Adjustments of the Treatment Regimen. As a patient undergoes metabolic rehab, adjustments are made to his/her treatment regimen. These adjustments are for the purpose of optimizing the chances of a successful outcome. The adjustments are evidence-based. 

At intervals, the patient provides the doctor with objective data on his or her status since the last reevaluation. The doctor considers these data in view of the patient's previous evaluations, and based on the data, appropriate changes are made to the patient's regimen. Each step of the way, then, metabolic rehab is evidence based, making it as precise and data-drive as clinical care can be. 

Objective Data. The data that the patient provides the doctor are of various types. For some patients, the data includes repeated measurements of the resting metabolic rate and body composition. For others, the data consists mainly of the patient's resting heart rate and body temperature and estimation of the severity of symptoms on "symptoms severity scales." 

Line Graphs. The scores from the measures a patient is using are posted to line graphs. The trends of the lines on the graphs provide the doctor and patient with critically valuable information about how the patient is responding to the treatment. Whether the patient's metabolic health is remaining the same, worsening, or improving is obvious when he or she visually inspects the graphs. 

Knowledge gained from the graphs enables the doctor to guide—with precision—most patients to improvement or recovery. As Dr. John L. Gedye[1] (physician, behaviorist, and philosopher of scientist) once wrote of the clinician using the data-driven protocol of metabolic rehab: "The basic principle, it seems to me, is simple and fundamental: It is the concept of behaving as a controller in a system controlled by feedback." The data from the graphs provide the doctor with feedback, giving him or her a high level of control in managing the patient's metabolic status.

This approach is essential for effectively managing a patient's condition. As Dr. Gedye
[1] also wrote, "It has always seemed to me to be obvious that this is what physicians are doing in, for example, post-surgery intensive care; that is why they have all the instrumentation." Similarly, Dr. Alan J. Reichman[2] (family physician and former FRF research colleague) compared the use of feedback data during metabolic rehab to properly managing a patient's high blood pressure. He noted that the patient with high blood pressure may appear completely normal, so measuring his blood pressure is critical to making an intelligent decision about the proper dosage of blood pressure medication.    

Patient and Doctor Using Their Respective Brains. Objective measures are not all the doctor and patient must consider. The patient's and doctor's subjective judgments of the patient's condition are also important. 

The results of metabolic rehab are best when based on both objective measures and subjective judgment. Without both forms of assessment, the doctor and patient essentially "wing it." By winging it, the doctor exerts little control over the patient's metabolic and health status. On the other hand, by basing the patient's care on objective feedback, the doctor can guide the typical patient to improvement or recover with a high degree of precision.

Read about what's needed for patients to recover with metabolic rehab and questions and answers on the subject.

References

[1] John L. Gedye, M.B., B.Chir.: Personal communication with Dr. John C. Lowe, October 12, 1998.

[2] Alan J. Reichman, M.D.: Personal communication with Dr. John C. Lowe,  October 15, 1997.

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