Diagnosis, Education and Treatment
Coordination for Adults and Children
1501 Clement St. | San Francisco CA 94118
10 Millwood St., #5 | Mill Valley, CA 94941 | Map & Directions
The guaifenesin protocol is a fibromyalgia treatment pioneered by fibromyalgia specialist Dr. Paul St. Amand. There is no medication (yet) that has been shown to make the syndrome disappear, but Dr. St. Amand, an 87 year-old fibromyalgia specialist (who himself has the syndrome and who has been working with fibromyalgia patients for 50 years), may have found a way to reverse the illness.
Dr. St. Amand believes that patients with FM are probably missing an enzyme needed by the kidneys to effectively remove excess phosphate from the body. Phosphate is an inorganic chemical that is constantly being produced in our bodies, and is necessary for energy production. When levels in the bloodstream get too high, the kidney cannot decrease the level due to the defective enzyme, and the phosphate (along with calcium and water) is deposited in “nodules” throughout the body. This overload of phosphate in the body, and in the nodules, is what is believed to cause the symptoms of the illness. Since phosphate overload can occur in the cells throughout our body, this can explain why so many different organs are effected in FM. This is why patients can have irritable bowel syndrome, body pain, and dizziness all within the same illness. And since the right amount of phosphate is crucial to the production of energy, this can explain why FM patients can feel so tired.
Dr. St. Amand has measured that guaifenesin, used in FM patients at the proper dose, removes phosphate from the kidney 6 times faster than without the drug. Used over time, guaifenesin removes the phosphate from these nodules, and the patient’s symptoms decrease. Eventually, the symptoms disappear as the illness is reversed, which is something no other treatment regimen can show. He has used guaifenesin (which is the active ingredient in the over-the-counter medication Mucinex) successfully since 1992, in patients as young as 2 years of age.
In 1995 a double blind placebo study was done at the University of Oregon, where the results indicated that patients with fibromyalgia who took guaifenesin experienced no benefits over patients who used the placebo (sugar pill). However, this was before the blocking effects of salicylates on guaifenesin were known. Since then, Dr. St. Amand teaches his patients how to avoid salicylates,and the success rate of the program is as high as 95% if the protocol is administered by practitioners personally trained by Dr. St. Amand, such as myself.
This study is probably the reason why many doctors do not use the guaifenesin protocol, do not think highly of it, and may discourage you from trying it. However, many doctors and healthcare personnel throughout the country have successfully used the guaifenesin protocol with their FM/CFS patients. To learn more about the protocol, you can visit Dr. St. Amand’s website at www.fibromyalgiatreatment.com.
I have been trained in the administration of the guaifenesin protocol. I have spent time with Dr. St. Amand, learning how to map (palpate nodules) and dose guaifenesin. I believe the protocol can have great benefit. When I trained with Dr. St. Amand I saw first hand the wonderful improvement patients can make using this safe over-the-counter medication. The drug has no side effects, and can be used with most other FM medications. The idea of reversing the illness is the best possible outcome we have until there is a cure. I view this protocol as one of my many options when I am considering what is the best individual treatment regimen for my patients.
I’m often asked “who is going to take your place”? I assume that’s upon my demise or forced retirement. I reply “no one” when alluding to my office in Southern California. Almost without taking a second breath I quickly add “except for Melissa Congdon” in Marin County, California.
I’ve trained a large number of doctors and taught them to map. Most of them have not kept up with what that demands. It takes too much time to compress into the ten minute slots insurance companies and Medicare think is sufficient to cover office visits. A furtive eyeballing is all patients usually get from that time constraint. The laptop steals most of the fleeting seconds allotted for an office visit.
Melissa is pre-eminent when I review physicians I’ve trained. She maps as I and my Assistant Claudia Marek do. Our maps could be superimposed one on the other. That accuracy is remarkable. Her good hands are backed by her sound knowledge of fibromyalgia.
She lives a long way from Marina del Rey, but she is just as close to the rest of the world as I am. Until we have a blood test for fibromyalgia, skilled hands will remain the diagnostic gold standard and Doctor Melissa Congdon has them.
R. Paul St. Amand, M.D.