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News Items by
Dr. Lowe
My Recent Brief Debate at the American Academy of Pain Management On Friday, September 7, 2006, I attended a presentation by a prominent pain management specialist at the annual conference of the American Academy of Pain Management. Half of his presentation was on fibromyalgia. In no way do I wish to embarrass the gentleman, which is why I won't mention his name. Through his career, he has contributed a lot to the welfare of pain patients, and I respect him for that. However, I vehemently disagree with much of what he said about the treatment of fibromyalgia. He made the statement in his presentation that amitriptyline is the first line treatment for fibromyalgia. This was exceedingly poor advice to give the doctors in the audience. When researchers studied the effects of this drug long-term, they found that it was no more effective than sugar pills.[1] In 1995, I wrote an editorial pointing out that Dr. I. John Russell, a prominent rheumatology fibromyalgia research, was wrong in reporting that amitriptyline was an effective fibromyalgia treatment.[2] I have posted my critique of Dr. Russell's inaccurate statement so that it's available to our readers and to doctors who heard the unfortunate recommendation from the speaker at the Academy conference. After suggesting amitriptyline, the speaker then recommended a list of other drugs such as anticonvulsants. None of the drugs have been shown in studies to enable fibromyalgia patients to recover. In addition, some of the drugs have the potential for severe adverse effects. Because of this, I believe it would be imprudent of fibromyalgia patients to use the drugs. Anyone using them risks some adverse effects; fibromyalgia patients are at even greater risk. Most fibromyalgia patients have too little thyroid hormone regulation. When the liver is inadequately regulated by thyroid hormone, it detoxifies most drugs more slowly. The drugs therefore remain in the body longer and have more time to cause harm. The week before the conference, I had sent the speaker copies of our two recently published studies showing that fibromyalgia patients have abnormally low metabolic rates and low body temperatures—hallmarks of hypothyroidism and peripheral thyroid hormone resistance. My impression is that he may have read only the abstracts of the reports (or maybe only the titles!). When the speaker was ready for questions, a doctor stood up and asked why speakers like him don't address metabolism as the underlying problem of fibromyalgia. The speaker answered by saying in effect: "A member of the Academy was nice enough to send me two papers that address that issue. But the problem with ideas like that," he said, pointing to the screen where his slides were projected, "is that they don't account for things (symptoms and signs) I've mentioned in my presentation." That statement propelled me out of my seat and up to the microphone in the aisle. I introduced myself and told him I disagreed with his last statement. I explained that in our study report published in Thyroid Science, we showed in Table 1 that too little thyroid hormone regulation accounts for 38 of the 40 or so objectively verified abnormalities among fibromyalgia patients. As examples, I cited decreased flow of blood through the brain, increased alpha2-adrenergic receptors, and increased levels of pain-amplifying substance P. (In my book The Metabolic Treatment of Fibromyalgia, I heavily document that these abnormalities, as well as the symptoms and signs of fibromyalgia, are most likely caused by inadequate thyroid hormone regulation.) No other hypothesis accounts for more than a few of the abnormalities. He essentially brushed aside my comments, saying that we could debate this all day. But that statement I also must respectfully disagree with. A formal debate, in which I'm allowed to present the logical and scientific evidence, won’t last long. The reason is that no doctor or researcher can refute the overwhelming body of evidence. They can, of course, ignore it as they customarily have. But as our research foundation soon begins broadcasting the truth far and wide, they’ll no longer be able to ignore it. Fibromyalgia patients are suffering human beings, and on humanitarian grounds, doctors and researchers have a responsibility to help relieve the patients' suffering. In that vein, they have an ethical obligation to be rational and scientifically-minded in considering the available logical and scientific evidence. Dr. Russell and his rheumatology fibromyalgia research colleagues have failed to learn the underlying mechanisms of fibromyalgia despite spending thirty-five years studying the condition. The speaker at the conference knows no more about the disorder than Russell does. The time has come for them to capitulate, for as Peter Warmingham of Thyroid UK pointed out in 2002, "The problem of fibromyalgia is solved."[3] References An Apology to My Readers and Request of a Favor In my last email newsletter, I cited our two new studies showing that fibromyalgia patients' have low metabolic rates and low body temperatures. One of the studies was published in Medical Science Monitor and the other in Thyroid Science. Both journals allow anyone to download the full published reports free. Apologies. In that last newsletter, I made a mistake when I gave the webpage address for the Medical Science Monitor report. The link carried readers to a page where they had to scroll down a ways to find our report. Some of my readers wrote and complained. I apologized in return emails for inconveniencing them, and I sent them the webpage address that carries one directly to our report so that they can download it as a pdf file. I've included that link below. I've also included again the link directly to the Thyroid Science report. Request of a Favor. As of today, our Medical Science Monitor report has been downloaded 524 times. That's a lot for the short time it's been available online. At that rate of downloads, the report is likely to become one of the journal's top ten downloaded articles of the year. That will be a notable achievement in that the journal publishes hundreds of reports each year. The journal's editors send out an email at intervals to their 135,000 subscribers to bring to their attention the most popular reports, based on the number of downloads. If you haven't downloaded a copy yet, all of us at the Fibromyalgia Research Foundation will be grateful if you'll do so now. We spent two-and-a-half years conducting the two studies, and a year and a half of the time was devoted to the study reported at Medical Science Monitor. For the studies to benefit fibromyalgia patients, we must now get word of the reports out to doctors and researchers who work to help the patients. You can help us do that by downloading the Medical Science Monitor report and sharing it with anyone you know who is interested in fibromyalgia. (We also encourage you to download and share our Thyroid Science report.) By contributing to the accumulating downloads at Medical Science Monitor, you'll make it more likely that the journal's editors will bring our report to the attention of more of its subscribers. Of most importance, of course, you'll be helping spread word of our study findings to doctors and researchers who may then use the findings to help relieve the suffering of fibromyalgia patients the world over. Thank you for helping. Medical
Science Monitor: Long-Distance
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Dr. John C. Lowe, PLLC © 2006 John C. Lowe. All rights reserved. This email Newsletter may be copied and distributed subject to three conditions: (1) All text within the full document or any section copied must be copied without modification with all pages included. (2) All copies must contain the following copyright notice: "© 2006 John C. Lowe." (3) Neither this full document nor any section of it may be distributed for profit.
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