DECEMBER 2009 FAMILY - UK Fibromyalgia

Guaifenesin – does it work
By Christine Craggs-Hinton
Page three - Guaifenesin – does it work
In recent years, a medicine called ‘guaifenesin’,
derived from the guaiac tree, has been
propounded by some as a possible cure for
fibromyalgia. However, there are plenty of
others who assert that it is no more effective
than a placebo (simple sugar pill). So what is the
truth of the matter
Guaifenesin was introduced as a medicine in the 20th
century and is a component of many over-the-counter
cough and cold remedies, its function being to loosen
phlegm and mucus in the lungs. It was endocrinologist Dr
R. Paul St. Armand who first advocated its use in
fibromyalgia after determining that the muscles in this
condition become clogged by calcium phosphate build-up
(this is a type of salt). He believes that guaifenesin prompts
the kidneys to eliminate this and other unwanted stored
matter from the body via the urine and sweat, which is
liable to become dark and pungent-smelling, as a result.
For years, the odour and colour-change was taken as a
clear sign that something positive was happening and so
seemed to confirm the efficacy of guaifenesin, as did the
muscle aches, headaches, anal irritation, overwhelming
fatigue and mild depression which arises during the
therapy – difficult to cope with when you are already
struggling with fibromyalgia. In fact, the therapy came with
the warning, ‘Not for wimps’.
In Dr St. Armand’s 2006 book, What Your Doctor May Not
Tell You About Fibromyalgia: The Revolutionary Treatment
That Can Reverse the Disease’, he asserts that guaifenesin
therapy prompts a reversal of the fibromyalgia process,
with increasingly longer cycles of symptom-free periods.
He adds a strong warning that products containing
salicylates should be avoided as they can interfere with
guaifenesin function. Salicylates is a plant hormone, used
in topical creams to ease aches and pains and reduce
fever. It is also a key ingredient in makeup and many
topical products for the treatment of acne, psoriasis,
calluses, corns and warts. It is used in shampoos to treat
dandruff, too.
Interestingly, though, a one-year placebo-controlled
double-blind study which was never published indicated
that guaifenesin was no more effective than a placebo.
Blood tests also showed that it could not possibly work as
Dr St. Armand believes (as shown below). When the chief
author of the study, Robert Bennett M.D., was interviewed
by the U.S. Fibromyalgia Network, he stated that
guaifenesin had been popular for so long because there
are many internet sites promoting it as a ‘cure’ for the
condition – and what fibromyalgia sufferer can’t resist
that
However, advocates for the use of guaifenesin claim that
Dr Bennett’s study was fatally flawed because patients
may involuntarily have used salicylates, which would
render the therapy ineffective. In the interview mentioned
above, Dr Bennett, gave several scientifically-based
reasons that guaifenesin therapy is ‘grossly over-rated’:
In the study, both the serum and urinary levels of uric acid
and calcium phosphate were all in the normal range and
no increase in excretions was noted over time. Thus the
postulated action of guaifenesin was not demonstrated.
If some patients were using salicylates by some means,
there would have been a significantly reduced urinary
excretion and elevated serum level of uric acid. This was
not observed.
Dermatology consultants to Dr. Bennett have explained
that patients would have to plaster their face with makeup
several times a day to absorb enough salicylates to affect
their urinary excretion of uric acid.
In the early days of fibromyalgia, symptoms come and go
on a cyclical basis, becoming more frequent and
heightening in intensity as time goes by. Guaifenesin
therapy is said to take the person back through those early
days except that the symptoms now show themselves in
reverse order through increasingly shorter and less severe
cycles. This claimed ‘cycling of symptoms’ was not
observed in the study.
I have attempted here to present the facts of a contentious
issue – so whether or not you try guaifenesin is entirely
your choice. Plenty people with fibromyalgia are still opting
to use it in the belief anything is worth a try. If it doesn’t
work, they say, there’s no harm done.