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Q
A Worthwhile Approach to Chronic Fatigue Syndrome?

Are you familiar with Dr. Jacob Teitelbaum's "From Fatigued to Fantastic" approach to treating fibromyalgia and chronic fatigue syndrome? I've started on the treatment but would like to have your opinion.

A
Answer (Published 1/27/2004)

Chronic fatigue syndrome (CFS) and fibromyalgia have similar features and are difficult conditions to deal with. CFS is marked by disabling fatigue and exhaustion and sometimes includes headaches, short-term memory loss or severe inability to concentrate, muscle pain, joint pain, depression, lack of restful sleep, muscle weakness and lymph node pain. No one knows what causes it although some experts suspect that a hyper-reactive immune system and a viral or other infectious agent may be involved.

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Fibromyalgia combines pain, fatigue, anxiety and depression and may be due to imbalances of chemicals and hormones in the nervous system that amplify sensation, making even the slightest touch feel painful. The super-sensitivity to pain seems to be at least partially hereditary, but fibromyalgia itself is often triggered by a viral infection, emotional stress, injury, or exposure to certain drugs or chemicals.

Jacob Teitelbaum, M.D., an internist who suffers from chronic fatigue syndrome, has written a book titled "From Fatigued to Fantastic" that describes his treatment plan for CFS and fibromyalgia. Dr. Teitelbaum believes that the stress, infections or other triggers of CFS and fibromyalgia suppress the hypothalamus, the brain center that regulates sleep, the hormonal system, body temperature and blood flow. To combat these symptoms he prescribes a long list of herbs, prescription drugs, hormones (including thyroid, ovarian and testicular hormones even if tests show that your hormone levels are normal) plus a vitamin/mineral/amino acid supplement he sells that contains 50 nutrients to overcome "nutritional deficiencies" (which in my experience are rare in this country).

Although I'm aware of Dr. Teitelbaum's program, I have had no first-hand experience with it, so I asked Anthony Komaroff, MD, an authority on CFS at Harvard Medical School for his thoughts. Dr. Komaroff replied that any proposed treatment plan for CFS should be put to a rigorous scientific test before it can be said to be effective and that in his judgment, Dr. Teitelbaum's program has not yet passed that test.

Recently, Dr. Teitelbaum visited the Arizona Center for Integrative Medicine in Arizona and described his theory and treatments to our physician-fellows. Most of them were impressed with his presentation and said they were willing to try his approach with selected patients. I will look forward to seeing the results.

Andrew Weil, M.D.

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