ABSTRACT
We describe fibromyalgia and our treatment using the weakly uricosuric agent guaifenesin, and we critique the recent Oregon study of guaifenesin treatment for fibromyalgia. Guaifenesin has proven to be our most effective medication to date for the treatment of fibromyalgia. Salicylates from any source will block the benefit of guaifenesin at a renal tubular level as they do in gout. Salicylates, which all plants make, are readily absorbed through skin. Even small amounts in cosmetics and other topicals will negate or slow the effects of all uricosuric agents we have used. Many maps made during treatment of patients' palpable lesions illustrate their becoming static or worsening in previously improving patients who unwittingly began using such preparations. More than half of the usual skin preparations could block patient improvement. Many patients are carbohydrate intolerant and must also be treated through diet. Dietary corrections for hypoglycemia and avoidance of salicylates must be maintained or there will be no improvement. The conclusion of a study of guaifenesin treatment recently conducted in Oregan was that there was no difference in results between the guaifenesin and placebo groups. It is likely that this outcome resulted from two faults: patients' use of hidden salicylate sources and failure to exclude hypoglyccmics from the study. Another study in which these faults are corrected should be conducted.
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