Getting to know Dr Jacob Teitelbaum

Jacob Teitelbaum MD is the author of 'From Fatigued to Fantastic!' a popular book on managing chronic fatigue, and 'Pain Free: 1-2-3', a step-by-step program to help identify the source of pain and understand how to alleviate it.

He frequently speaks on chronic fatigue, Fibro and on the use of supplements to manage these conditions, and has previously appeared on CNN, FOX News and the Oprah and Friends Show with Dr. Oz in the US.

FibroAction founder Lindsey Middlemiss, was given the opportunity to interview "Dr T", allowing us to get to know a little more about him and what he does.

Lindsey: Dr T, I know that you had personal experience of the conditions you talk about, having had to take a year out from med school after becoming ill. Do you consider that you suffered from Fibromyalgia Syndrome (Fibro) or Chronic Fatigue Syndrome (CFS)?

Dr T: Both. The majority of people who have one of these have both, though they may not necessarily fill all of the criteria.

Lindsey: What would you consider to be the differences – or similarities – between Fibro and CFS?

Dr T: Different people fall in different patterns on the spectrum, and no 2 cases are exactly the same. In the fibromyalgia pattern, the widespread pain is the dominant symptom. With CFS, the post-exertional fatigue and sometimes flu-like Symptoms may predominate. Though some have pure CFS without the pain (often with ongoing viral infections), the majority also have pain.

Lindsey: On your website, you talk about myofascial pain being a cause of Fibro pain. Do you consider Fibro and Myofascial Pain to be different conditions or the same?

Dr T: Widespread Myofascial pain (or muscle shortening as I sometimes call it) is a component of Fibro. That it is widespread suggests that there is an underlying biochemical cause (as it affects the whole body). When it is localized and affecting only one area - for example, with low back pain - although the biochemical factors need to be treated, there is more likely to also be a structural component - such as one leg being shorter than the other.

Lindsey: I know that you recommend extra testing for patients, above what may be done normally by a GP. What would you normally test for?

Dr T: The tests I recommend patients get include:

1. A chemistry panel which checks 12 to 20 different basic chemistries - it is critical to check for diabetes, kidney function, liver function, electrolyte disorders and other common problems, but it should also include sodium, potassium, magnesium, calcium and glucose.
2. Free T4 (not a T4 Index.) This is the most important Thyroid test, as it checks the actual active hormone level which is much better for CFS/Fibro patients.
3. Vitamin B12 Level.
4. DHEA-S, a test for DHEA-Sulphate. The regular test just checks the DHEA level which is usually not reliable.
5. Cortrosyn Stimulation Test, to check adrenal function. This test requires an injection and many places can't do it, in which case I recommend a morning cortisol level test.

There are other tests that are less important, but that can be helpful, such as:

1. Stool Test, checking for ova & parasites. However, this test is easily ruined and I only use 2 labs in the US for it. Checking for for Clostridium Difficile is also useful if diarrhoea is a severe problem.
2. Urine Analysis.
3. Free Testosterone. This must be the Free Testosterone level as a simple "Testosterone" test or "Total Testosterone" test is not adequate unless the result is below the normal range.
4. 25 (OH) D (25-hydroxyvitamin D), a good indicator of Vitamin D Status, and 1,25 (OH) D (1,25-hydroxyvitamin D) which, if high, suggests infections and a possible need for decreased Vitamin D intake.
5. Lyme Titre, checking for Lyme Disease (a tick-borne disease).

Note: A full list of the tests Dr T recommends can be found on his website here.

Lindsey: The first part of your SHINE (Sleep-Hormones-Infections-Nutritional Supplements-Exercise) Protocol for restoring energy is to get enough sleep. What do you recommend for patients who are getting plenty of sleep, but it is non-restorative so they never wake up feeling rested?

Dr T: Check for sleep apnea, restless leg syndrome and Upper Airway Resistance Syndrome. Also, avoid valium family medications (benzodiazepines), except for clonazepam and Alprazolam, and use natural or prescription sleep aids that deepen sleep, instead of keeping you in light, stage 2 sleep. Once you've done this, and have made sure you are not sedated from medications, the rest of the "SHINE Protocol" usually restores energy.

Lindsey: I know you use medications as well as supplements with almost all patients. Would you recommend that traditional practitioners who are dealing with Fibro and/or CFS patients and only use medications learn about how to use supplements to help their patients?

Dr T: If they want their patients to get better!

Thanks to Dr T for this interview.

For more information on the supplements Dr Teitelbaum recommends, see his 'The Top 10 Supplements for CFS or Fibromyalgia', reproduced with permission in FibroAction's Patient Section.

For more information on Dr Jacob Teitelbaum, see his website www.endfatigue.com. On this website, you can also sign up for his newsletter, as well as checking out the free short online program which will analyze your symptoms and history using the same assessment criteria that Dr. Teitelbaum uses.