Guaifenesin is the active ingredient in many cough medication expectorants. If possible, use the pure guaifenesin (now only available in the USA in prescription form), because the over-the-counter varieties have sugar and alcohol. Store guaifenesin between 59 and 86 degrees F -- not in the refrigerator or very warm room. You may become thirsty at first, and want to carry some pure water around. Drink a lot of water. Guaifenesin will thin your thick secretions, and help your body get rid of some wastes. 

The average starting dose is 300 mg twice a day, although some people who are sensitive to medications may have to start at 300 mg a day. (If you have reactive hypoglycemia as a perpetuating factor, you MUST be on a balanced "Zone" diet for the reversal to take place. (See "Mastering the Zone" by Barry Sears PhD for recipes and information.) Dr. St. Amand has found less patients needing the diet than I have, but his patients appear to be more sensitive to "blocking" factors. Remember, we are trail-blazing here.) There will probably be a period of flu-like fatigue as stored toxins and excess phosphates start releasing. You should have a noticeable reaction in 3 to 10 days. If you get no reaction, something is blocking the guaifenesin, you have reactive hypoglycemia, or you need to raise the dosage to 600 mg twice a day if tolerated. Your body is working hard during this time to process wastes so that they can be excreted. After this, if needed, guaifenesin dosage is generally raised 300 mgs a day at a time, after 10 days, until the reversal begins. Map your pain patterns before starting this therapy, and mark each area from 1 to 10 in pain intensity to help you monitor therapy progression. 

AVOID SALICYLATE USE DURING GUAIFENESIN TREATMENT. SALICYLATES, FOUND IN MEDICATIONS LIKE ASPIRIN, MANY HERBS AND TRILISATE WILL BLOCK THE BODY'S EFFORTS TO EXCRETE EXCESS PHOSPHATES. If you use salicylate, the wastes are liberated, but will circulate in the blood without being excreted. Large quantities of herbs and herbal teas should be avoided -- many are rich in salicylate. Small amounts of herbs for seasoning are acceptable. Even aloe has salicylate. Every person has a different degree of sensitivity to salicylate on guai. Some people are able to tolerate more than others without guai being blocked. Many topical creams, such as some topical rubs, sunscreens and cosmetics are salicylate-containing. Check with your pharmacist. Many common medications such as Alka-Seltzer, Listerine and Pepto-Bismol have salicylate. 

Dr. St. Amand has found three subsets in his practice. One group goes through FMS reversal relatively quickly at 300 mg twice a day. They often feel bad solidly until their symptoms clear suddenly. The largest subset reverses at 600 mg twice a day. Another subset needs 1800 mg a day or more, and just goes along slowly through the reversal process. Soon you will get periods of time where symptoms ease. Often the reversal is cyclical, with symptom-free periods interspersed with "cycling". At least 40% of the people need more than 1600 mg a day. The calcium excreted is limited to inappropriate calcium surplus. None of Dr. St. Amand's patients have developed osteoporosis. Dr. St. Amand warns people that guaifenesin therapy is "not for the faint of heart". During the cycling you can have odd skin rashes, hair loss, burnt taste in your mouth, pimples, gunky eyes, and an acidy smelling perspiration unique to guaifenesin reversal (fortunately), and very strong-smelling, acid urine. The urine gets very dark -- deep yellow, or even brown. Vaginal secretions turn acidy, and can irritate. During guaifenesin therapy, avoid adding a lot of phosphoric acid to your body. Colas are loaded with it. It makes no sense to add a lot of phosphoric acid to when your body is already working hard to get rid of its excess. 

Reversal signs and symptoms are NOT side-effects of guaifenesin. They are from toxins and waste being released by the guai, and are a good sign, though it won't feel like it. At least you'll understand why you often felt "toxic". You were. 

Headaches are very common. Don't try to rush detox. It took a long time for your body to get this sick. You can't clean it up overnight. 

Sometimes guai works on feeder deposits. These are large deposits which release vast quantities of debris as these huge myofascial lumps dissolve. Your body can only handle so much at one time. Excess debris forms temporary deposits -- even on the teeth sometimes, until the body catches up processing the wastes. Expect plateaus in the reversal process. Don't get discouraged. We are all different. Allow your body to find the best pace. It will eliminate the waste material as efficiently as it can. Meanwhile, do whatever you can to help it. Drink lots of water, get as much rest as you can, and avoid stress. 

Knowing that guai thins secretions and works at a cellular level, I think it may partially work mechanically, cleaning off gummy cellular membranes. Thinner secretions also allow more efficient breathing. I feel that our reversal depends on the nature of our deposits: how many, how dense they are, how much and what kind of tissue is displaced and how good your body is at detoxifying. Also important is our electrolytic balance -- we need balance for body maintenance, and to handle the disruption caused by extra calcium phosphate (and who knows what else) release. A good mineral supplement will help. This reversal process is not easy, but neither is FMS/MPS. There's no way out but through. 

Controlled studies measure group response, not individual response, each of us is unique. The only double-blinded study on FMS guaifenesin therapy was done by Robert Bennett M.D. at Oregon Health Sciences University. This study of 20 women showed guaifenesin equal to placebo. This response is not uncommon when attempting to design experiments for old medications with new usages. The study is flawed by no fault of Dr. Bennett, who has done great things for "fibromites", nor of Dr. St. Amand, who served as advisor to the study. We are only now discovering some of the variables and fine-tuning treatment. This is experimental. 

Point 1: The study was started before we knew the reversal does not take place if reactive hypoglycemia is present. I have found that a little over 85% of the people I have seen with FMS have reactive hypoglycemia as a perpetuating factor. We are talking of about 1000 patients. Some of these with mild FMS "reversed" with the Zone diet alone. Of those who tried guaifenesin (over 500), we are getting about 75 to 80 % drastic improvement. The others didn't stay with the therapy due to the toxic-release effects or inability to follow the diet, except for a less than 5% who did not get better. Some needed to delete colas from their diet, since they took in as much phosphoric acid as was coming out otherwise. Much of this therapy may depend on the acid/base balance of the body. Nancy Medeiros (see the end of the chapter) is keeping a running tally of Internet fibromites on guaifenesin therapy. 

Point 2: All the patients in the study were given 600 mgs of guaifenesin twice a day. Dr. St. Amand, an internist/endocrinologist and professor of medicine at UCLA, has now found that only about 50% of patients respond at this dosage, even these won't respond if they have reactive hypoglycemia. FMS is not a condition that responds to "cookbook" medicine. 

Point 3: Dr. St. Amand did not know about the blockage of guaifenesin by some salicylate-containing herbs until September 1995. The study ended in June 1995. Each of us has a varying tolerance of salicylate. Now that I am "clearer" of whatever acids and materials come out on "guai" therapy, I can tolerate cola now and then. I still can't use stevia as a sugar substitute. Taking even a little of this herb brings on the FMS achies. 

Point 4: The response to guai is not a placebo response. Placebos do not result in dark, smelly urine that cleans iron stains off the toilet bowl. Toilet bowls do not respond to placebo effect. I have heard stories from fibromites who years ago had been placed on guaifenesin therapy for asthma or upper respiratory problems. They had to discontinue guai due to a "worsening" of FMS symptoms, darkened urine etc. years before they heard of FMS guai therapy. Patients who have been seen by Traditional Chinese Healers, Naturopaths and other alternative specialists have reported that they had been very toxic and acidic, but that they became "balanced" on guaifenesin therapy. 

Perhaps the phosphoric and oxalic acids coming out in the urine (and dark "toxic sweat") carry with them quinolinic acid. I. Jon Russell has found that we create this toxin instead of serotonin in an alternate tryptophan (kynurenine) metabolic pathway. We just don't know. Yet. Guai is not a cure. But I have tried many remedies. Some have helped. Most have not. I have seen many people given a new lease on life with guai, and have experienced it myself, as has Dr. St. Amand. Others have enjoyed periods of symptom remission. 

With most people, guaifenesin therapy seems to result in remission of symptoms. This is not a cure. The symptoms will reappear if you overdo. We have found that at least 50% of people with FMS have reactive hypoglycemia, and need this. Otherwise you can be "reversed -- have all the tender spots go away -- and you will still feel bad until you deal with the hypoglycemia. You may never become symptom-free, because many symptoms may be due to other processes, but you will be a lot more comfortable until a cure can be found. 

 Most people will begin dosage at 300 mg twice a day, understanding that there will probably be a period of flu-like fatigue as stored toxins and excess phosphates start releasing , your body may urge you to sleep. Listen to it. Your liver and kidneys are working hard to process toxins and excess materials, so that they can be excreted. Following this initial period, raise the dosage to 600 mg twice a day if tolerated. Guaifenesin dosage is generally raised 300 mgs a day at a time. As the FMS starts reversing, adjust the dosage higher or lower on an individual basis. Every pattern is different. IT IS EXTREMELY IMPORTANT TO AVOID SALICYLATE USE DURING GUAIFENESIN TREATMENT. SALICYLATES, FOUND IN MEDICATIONS LIKE ASPIRIN, DOLOBID (DIFLUNISAL) PABA, AND RILISATE WILL BLOCK THE BODY"S EFFORTS TO EXCRETE THE EXCESS PHOSPHATES. The toxins will be liberated from the myofascia, but will circulate in the blood without being excreted. 

 Large quantities of herbs and herbal teas should be avoided, as many are rich in salicylates, unless you can be sure without doubt that the herbs have none. Small amounts of herbs for seasoning are acceptable. Listen to your body. If you get a sudden worsening of symptoms, seek what may be blocking the guai. Many topical creams, including PABA sunscreens, are salicylate-related. Ask your pharmacist. Many commonly used medications, such as Alka-Seltzer, are also rich in salicylates. Read your labels. 

 The amount of fatigue and symptoms the reversal entails will vary with the patient, possibly due to the amount, placing and nature of myofascial deposits, the length of time and severity of the FMS/MPS, how efficient the liver and kidneys are at detox, and how much bodywork has already been done to break up deposits in the myofascia and elsewhere. Dr. St.Amand suspects that one inherited problem in FMS is a tendency toward a defect in phosphate excretion, which ultimately causes an accumulation of phosphates within the mitochondria (our cellular "chemical factories"). Dr. St. Amand has found that FMS is cyclic in nature. Symptom cycles start long before there is any suspicion of disease--often as "growing pains" in childhood. During guaifenesin treatment, previous symptoms may be relived by the patient--physical and emotional--often in a reverse of their first occurrence. He has found the FMS reversal to be a cyclic process as well, although we have not seen exact reversal of symptoms in our local group. Most people on guai for FMS reversal gradually begin to have more and more good days and finally, the good days start to cluster. He has found that, on the average, several months of treatment at the proper dosage will reverse one year of accumulated deposits. The longer the patient has had the illness, the longer it will take to recover. 

 Dr. St. Amand warns people that guaifenesin therapy is "not for the faint of heart". When the toxins and excess stored material are liberated, you may experience nausea, fatigue, increased aches, eye irritation, abnormal sensations, abnormal taste (foul or metallic), burning on urination (excess phosphates are excreted as phosphoric acid), pungent smelly urine, and bladder infections. 

 I have found that people who have done a great deal of body work--accupressure, tennis ball compression, sine-wave ultrasound with electrostim, GMS, stretching, etc. and pay attention to good body mechanics, good nutrition, and use the FMS/MPS vitamin regimen while taking the guaifenesin seem to have much more rapid reversal of FM/MPS without most of the symptoms reversal phenomenon. 

 Dr. St. Amand has found three subsets in his clinic practice. One subset goes through FMS reversal relatively quickly at 300 mg twice a day. The largest subset reverses at 600 mg bid. Another subset needs 1800 mg a day or more, and just sputters along slowly through the reversal process. Some people need more than 1600 mg a day. 

 The calcium excreted is limited to inappropriate calcium surplus. None of Dr. St. Amand"s patients have developed osteoporosis. Odd skin rashes can be common during the reversal period. These can be scaly rashes, like eczema, blistering, adult acne, or skin cracking. He has also found that at some time after the adequate dosage for reversal has been reached, the patient may lose a large amount of "inferiorly-formed" hair that is replaced with healthy hair. We have found significant hair-loss to be rare. During guaifenesin, avoid adding phosphoric acid to your body. Colas, for instance, are loaded with it. It makes no sense to add phosphoric acid to your metabolism when your body is already working hard to get rid of its excess. 

 You may also have a burnt taste in your mouth, pimples, gunky eyes, and an acidy smelling perspiration unique to guaifenesin reversal (fortunately), and very strong-smelling urine. The urine can get very dark--deep yellow, or even brown. Vaginal secretions turn acidy. Women may get rashes and burning from it. Male partners sometimes also feel the effects. You may experience soreness in the crease between your buttocks, possibly due to the acidic nature of the urine. It is important to remember that these signs and symptoms are NOT side-effects of guai. They are from the toxins and excesses being released by the guai, and are a good sign, although it won"t feel like it at the time. At least you"ll understand why you often felt "toxic". You were. 

 Headaches are very common on the first reverse cycle. There are some "ouch spots" on the back of the neck you can find with moderate pressure, on the hairline. Ice on these sometimes helps endure the first cycle. When I saw Dr. St. Amand, he warned me that my hardest job would be encouraging people to continue guaifenesin therapy through the first cycle. He was right. Encouragement isn"t as difficult lately. Almost every time our group meets, someone mentions they are working full-time and their symptoms are in remission or greatly eased, thanks to guai. I know I have had severe FMS/MPS for a long time, and I have a lot of perpetuating factors--some of which I can do nothing about. It's a long, tough road ahead, but I know it"s the right one. In a year and a half on guai (and a lot of bodywork, mindwork, and attention to perpetuating factors, I feel I"m a lot better. It is interesting to know that besides using guaifenesin for its expectorant qualities, it has also been used to help women get pregnant. It thins the cervical secretions, making it easier for the sperm to reach the egg. For the first few months on guaifenesin, expect to be spitting out mucous that has been clogging your airways. It"s a wonder we get enough oxygen. 

 We"ve had several people who have had blood analyses report that their liver enzymes were high. That could be due to the heavy detoxification. You may have to cut back on the guaifenesin and/or the bodywork. Don"t push it. It took a long time for your body to get this toxic. The liver and kidneys can"t clean it up overnight.Be good to them. They are working very hard for you. Allow enough time between bodywork sessions so that you recover from one before the next begins. You shouldn"t be totally fatigued before a bodywork session. You may also want to allow some time for your body to adjust to healing. It will be finding a new balance every day. You may have to adjust the guai so that too much toxin isn"t hitting the liver at once. We have one elderly person who has severe chemical cirrhosis, and many other perpetuating factors, and yet has very slowly been able to detox her body with guaifenesin. She is now able to take aquatic aerobics. 

 Sometimes guai is working on feeder deposits. These are large deposits which release vast quantities of debris and toxins as these huge myofascial lumps dissolve. The liver and kidneys can only handle so much at one time. Excess debris forms temporary deposits--even on the teeth sometimes, until the liver and kidneys catch up processing the wastes. 

 Expect plateaus in the reversal process. Don"t get discouraged. We are all different. Allow your body to find the best pace. Knowing that guai thins secretions and works at a cellular level, I have a theory. It may work mechanically, cleaning off gummy cellular membranes. I suspect it works on the inner mitochondrial membrane, but that"s just a guess. I feel that the nature of our reversal depends on the nature of our deposits: how many, how dense they are, how much and what kind of tissue is displaced and how good your body is at detoxifying. Also important is our electrolytic balance--we need good balance for body maintenance, and to handle the disruption caused by extra calcium phosphate (and who knows what else) release. A good mineral supplement will help. This reversal process is not easy, but neither is FMS/MPS. There"s no way out but through. 

 Fibromites usually have thick secretions. If you wear glasses, they gunk up from nasal secretions when you blow your nose. Our sweat can precipitate photoreactions from the sun. We often need more toilet paper than most to cleanse, or we need to use wet wipes, though this observation isn"t something that people often volunteer. Guai thins our sticky secretions. It"s all connected. During each stage of FMS regression, your body/mind needs to find its new balance, and you may have to adjust your medications. You may be able to drop medications altogether. I was off reflux meds for a year, until recently, when the extra burden of writing the book, coupled with an incredibly hot summer, caused the return of reflux. I know that as soon as I cut back on the work, the reflux will go. Listen to your body. Help it detoxify as much as possible. 

 While taking guaifenesin: 

• Get plenty of rest. 
• Drink six to eight glasses of water to help flush out the toxins. 
• Eat healthy food, but not too much of it. 
• Visualize your mitochondrial factories and their dirty smokestacks. 
• Then visualize them running cleanly, with the free flow of energy restored. 
• Pay attention to your posture. 
• Lay down for 5 minutes a few times a day if possible--with a cold pack on your neck, if it helps. Listen to soothing music. 
• Laugh as much as you can. Laughter triggers electrical impulses in brain, to secrete natural tranquilizers and painkillers to help you through reversal. 
• Stretch. Get a massage. Meditate. 
• Take 15-20 minute warm baths, not hot.