with Jacob Teitelbaum, M.D.
I noticed that you talk about Elavil. I have so many clients that take it and the weight gain is horrendous. Can you comment on that as a side effect and how you would recommend to manage it if Elavil is the med of choice? I didn’t realize Elavil was used for pain. My oral surgeon keeps trying to get me to take it for my TMJ which is really bad but I resist. I prefer to manage the pain with an occasional pain med or 1/2, lots of chiropractic treatments, acupuncture, mouth guards, TNS therapy, and my supplements including the EF regime. Most of the time that helps. The Elavil made me so foggy and dumb. Anyway, I have a client now that gained 55 pounds in one year. She did not really do anything differently as far as diet and the weight gain started with the Elavil. I absolutely love what you say about pain meds. If you are in pain, the goal is to be Pain Free…My goal always.
Dr. Teitelbaum’s response:
Because it is high in side effects, Elavil is one of the LAST meds I use (there are dozens I prefer) except in cases of neuropathic pain and/or pelvic pain syndromes (vulvodynia, interstitial cystitis).
For TMJ, I would fix the bite and treat with the same “SHINE Protocol” as for FMS. I would use the topical pain gels discussed in my Pain Free 1-2-3! book and apply them over the tender areas over the masseter and other face muscles. If oral meds were needed, I would begin with Ultram and Skelaxin (along with the topical creams/gels—which can be ordered by mail by prescription from ITC compounding pharmacy @ 303-663-4224—ask for the nerve pain lotion and apply a thin layer 3x day and give it 2 weeks to work). Elavil is NOT my drug of choice for TMJ or Fibromyalgia pain (it’s about 20 down on the list!).
SHINE represents four areas of health issues that need to be addressed when creating a treatment program. These health issues and their roles in treating CFS/FM are as follows:
S = SLEEP: Get adequate sleep, preferably eight to nine hours a night. Sleep replenishes the body's energy and heals its muscles. Inadequate sleep will leave you exhausted and in pain.
H = HORMONES: Get tested for hormone deficiency and treated if needed. Hormone deficiencies can contribute to fibromyalgia and chronic fatigue syndrome.
I = INFECTIONS: Get treatment when symptoms of infections occur. The lack of restorative sleep in CFS/FM leads to dysfunctional immune systems. Underlying viral, bacterial, bowel, sinus and yeast infections are common and can be a contributing cause or result of CFS/FM.
N = NUTRITIONAL SUPPLEMENTS: Optimal nutritional supplementation is essential. Many nutrients can be depleted as a result of CFS/FM. B-12, magnesium, Acetyl L Carnitine and glutathione, as well as your basic A, B, C and D vitamins need to be supplemented at a level that your average over the counter multivitamin cannot provide.
E = EXERCISE: Exercise as able. After 10 weeks on the 4 steps above, you will be able to slowly increase your exercise—without being wiped out the next day!
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posted on July 30, 2008 | 959 views | tags: CFS, chronic fatigue syndrome, Elavil, fibromyalgia, FMS, TMJ, weight gain
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