Thursday, May 24, 2007

Debating the use of Guiafenesin in Fibromyalgia.

clipped from stuff.mit.edu
Dr. Robert Bennett, a recognized expert in the fibromyalgia field, agreed to do a study on guaifenesin, with Dr. St. Amand
The results of this long term study showed that guaifenesin had no effect on fibromyalgia.
much of Dr. St. Amand's success with guaifenesin, could be attributed to the placebo effect.
Additionally, any worsening of fibromyalgia symptoms during the treatment, is also a good sign, since these symptoms are attributed to guaifenesin's reversal process, that rids the body of "metabolic debris".
Not to mention, that guaifenesin often causes a change of smell or color in the urine. Many people attribute these changes to toxins being released from the body, when in all likelihood, this is simply due to the fact that the guaifenesin is metabolized by the liver, resulting in a form of lactic acid, that is then excreted in the urine.
guaifenesin has a skeletal muscle relaxant property,
It likely also has an analgesic, or pain relieving capability
Amongst the many "alternative" treatments in existence today, is the use of guiafenesin, a common over-the-counter mucolytic, in the treatment of fibromyalgia. The most influential proponent of this treatment, one Dr. St. Armond, has written a book on the topic entitled, "What Your Doctor May Not Tell You About Fibromyalgia : The Revolutionary Treatment That Can Reverse The Disease."

Reading the book, as a new physician, several aspects of Dr. St. Armond's case raised immediate red flags in my mind. First, Dr. St, Armond has (admittedly) failed to show any clinical evidence that the treatment works, relying instead on extensive anecdotal evidence. Second, the proposed mechanism of action in the treatment of the fibromyalgia simplifies for the laymen to the all-to-common "ridding the body of metabolic toxins." Third, fibromyalgia itself, and this treatment regimen in particular, lends itself to significant percentages of placebo affected patients. And finally, his line follows the all-to-common theme of the underdog treatment, conspired against by the likes of Big Medical and Big Pharm.

A wonderful response to this theory has been written by Mark London (presumably) at MIT. His response addresses all of the aforementioned points, but most extensively covers the dubious mechanism of action. Some of the basic points in his article are quoted below.

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