Below is an excerpt from a previous teleconference call that I held on Treating and Beating Anxiety & Depression. If you are interested in the full transcript and/or to listen to the audio of this conference, please visit my new Treating and Beating Fibromyalgia Members Site for your $1 trial today!
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Hi, good evening, this is Dr. Rodger Murphree, https://yourfibrodoctor.com/, author of “Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome”. Thank you for joining me tonight for my first Tuesday of the month “Treating and Beating Fibromylagia” teleconference. Tonight I’m going to be talking about anxiety and depression. I don’t think, like a lot of doctors, that just because you have fibromyalgia you’re depressed. I think it’s the other way around. I think that, for fibromyalgia, it’s the illness that causes the low moods and the fibro fog and probably a lot of the stress that goes along with that. A lot of doctors will lead patients to believe that they’re either lazy, crazy, or suffering from a Prozac deficiency.
It takes, on average, 12 doctors and 7 years before someone gets the diagnosis of fibromyalgia, and during that time, you’re passed from one doctor to the next. Because of that, many patients are led to believe that it’s their fault.
It’s their fault that the drugs don’t work. It’s their fault that they’re not getting better. It’s their fault that they can’t sleep at night, that they have this incredibly diffuse achy muscle pain that won’t go away no matter how many pain pills they take or how much Neurontin that they’re on. So it’s no wonder that patients with fibromyalgia start to have low moods. They start to suffer from anxiety and depression. The problem with that is, if we just give in to that as a fibromyalgia community, then it’s pretty easy just to throw our hands up and give up.
But when we look at a complicated illness like fibromyalgia, with the diffuse achy muscle pain, insomnia, the fatigue that goes with it a lot of times, the headaches and irritable bowel syndrome, restless leg syndrome-You can’t explain that away as ‘someone is suffering from an antidepressant deficiency’, and expect that just because they go on Cymbalta or Savella, that they are going to start to reverse their fibromyalgia. It just doesn’t happen that way.
For me, specializing in fibromyalgia for the last 13, almost 14 years, and having a very large integrated medical practice on the campus of Brookwood Hospital, here in Birmingham, Alabama, where I had five medical doctors who worked for me, we came to the conclusion after a time, that drug therapy, at least long term, was a dead end. It was a very frustrating dead end. Not only for the patient, but us as physicians, because we saw that those medications often created more problems.
The first edition of my “Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome,” came out in 2003 and since that time I’ve been out practicing solo. At this point, 10 years later, my practice is 90% phone consults and I get to work with patients all over the world.
I’m not encouraging you to stop your antidepressants. I think that gets people in a lot of trouble, because they don’t know how to do it. Even when they’re working with their doctors, they oftentimes do it the wrong way, and then they think, erroneously, that they need to stay on these medications forever, because if they try to come off of them, they get brain zaps or have withdrawal symptoms and they feel bad. It’s not that they need the medication; it’s the withdrawal symptoms from some of the medication.
These medications, along with the selective serotonin-norepinephrine reuptake inhibitors, which are Cymbalta, Savella, Pristiq, these medications have been shown to be no more effective than a sugar pill in 70% of the trials. It’s also been shown the individuals on these medications have increased their rating on the Hamilton scale by 2 points, compared to those on placebo. What that means is that they’ve decreased their depression symptoms by about 20%. Not a lot when we realize the potential side effects of these medications. This may surprise you.
This is the big takeaway from tonight, because most patients I deal with are on antidepressants. I don’t think that your fibromyalgia and the symptoms of fibromyalgia are because you’re depressed. I think it’s the other way around. You’re depressed because you’ve got all these symptoms of fibromyalgia, and it’s robbing you of having a life. Most people don’t understand that the fibromyalgia takes away your social life, and any kind of hobby, whether that’s gardening or exercise. It certainly can take away your job, your family life, or your relationship with your spouse. In so many ways it robs you of having a robust life filled with happiness, so it’s no wonder that you would get a little down with fibromyalgia.
The potential side effects of these medications are (1) anxiety, (2) depression. So you take an antidepressant, and it may make you more depressed. That certainly can be the case the longer you’re on the medication. Eventually it quits working, and I’ll discuss the reason for that in just a moment. Headaches, muscle pain – – that’s some of the things that I find with patients. I’m not anti antidepressants. It’s just that, when you’ve got a complicated illness like fibromyalgia, you’ve got to look at all the different variables. Is it something you’re taking or not taking? Is it something you’re doing or not doing? You’ve got to look at these things. Every drug has the potential to cause a side effect. The more drugs you’re on, the more likely you are to have a problem from one of those drugs. That’s just the way it is.
If you’re taking an antidepressant, you need to be aware that it can be causing some of your achy muscle pain. It can cause chest pain. It can cause nervousness. It can cause sleeplessness, or insomnia. One of the ways it causes trouble with your sleep is it actually depletes your natural sleep hormone, melatonin. So you’re taking a medication and this medication can compromise your ability to get a good night’s sleep. It can make you feel kind of lethargic, it can cause weakness throughout the body, changes in your sex drive so you have a low sex drive, low libido. It can give you tremors, dry mouth, irritated stomach. It can bother your stomach, whether that’s loose bowel movements or constipation. It can cause dizziness, rash, nausea, and weight gain.
We know, in the literature, that at least 25% of patients taking serotonin reuptake inhibitors, SSRI medications, have experienced insomnia or problems with a drugged-out feeling the next day. Because of that, many of these patients are put on more medications.
And it’s not that you have a Celexa deficiency or a Savella deficiency, you’ve got a neurotransmitter deficiency called either serotonin or norepinephrine. Serotonin is made from the foods that you eat. The combination of amino acids, tryptophan or 5-hydroxytryptophan, plus certain B vitamins, B6, B2, B3, magnesium, and vitamin C, when they come together, they allow the brain to have a plenty of serotonin, the happy hormone, serotonin.
The higher your serotonin, the less pain you have because it raises your pain threshold, so pain is less magnified, less pronounced. The higher your serotonin, the happier you are, less anxious you are, the more mental clarity you have, and the less likely you’ll have irritable bowel syndrome. But when you get under a lot of stress, you start to deplete your stress coping chemicals, and one of those is serotonin. So the more stress you’re under, the more likely you are to deplete serotonin or one of the other neurotransmitters, called norepinephrine, which gives you drive, energy, ambition, mental and physical energy, a potent antidepressant, and it’s also a very good pain blocker. But stress starts to deplete those two neurotransmitters and before you know it, you get very depleted.
If you are using a gasoline additive, if you are using Savella or Cymbalta, or Celexa, or Lexapro, these medications don’t make serotonin or norepinephrine. They only allow your brain to hang on to what’s in there. Because of that, you’re using a gasoline additive to help you get more mileage out of your gasoline in your tank, but if you’ve got an empty gasoline tank and you’re using a gasoline additive, it’s not going to do much. It’s the same thing we see with these medications. If you’re using a selective serotonin reuptake inhibitor, and you have nothing to reuptake, then nothing’s going to happen. That’s just the way it works.
In fibromyalgia, we see there’s oftentimes a genetic glitch in this kyronerine pathway, in such that you can’t convert the tryptophan you get in your diet into 5-hydroxytryptophan to make serotonin, or to keep your natural sleep hormone, melatonin, levels up. Stress also depletes B vitamins, and anytime you depress any of the B vitamins, including folic acid, B12, B6, B2, B3, then you don’t have the necessary synergistic vitamins that go with the right minerals, magnesium, and you can’t make serotonin-norepinephrine.
Depression is the most common symptom of folic acid deficiency. B12, folic acid and methionine, another amino acid, are needed to make the antidepressant, S-adenosyl- methionine, or SAMe. B6 levels are typically low in those with depression, and it’s essential for proper neurotransmitting, or brain signaling. B vitamins play a crucial role in the production of the neurotransmitter.
Oftentimes people are deficient in B12 because they are taking antacids or proton pump inhalers like Prilosec, Nexium, and Prevacid. These medications actually will prevent B12 from being absorbed, so you’re deficient in B12, or it could be you’re deficient in B3, niacin, which a lot of people are, or vitamin C. If you’re deficient in one of those 3 things, then you can’t convert the folic acid as needed into the neurotransmitters. The studies show that folic acid is more effective than prescription antidepressants. 92% of those treated with folic acid made a full recovery, while only 70% of the control group (those taking antidepressants) made a full recovery.
Everything I’ve mentioned tonight is very important, because you need to realize that the drugs you’re taking may be causing some of your symptoms. You don’t know that unless you start to experiment. Is the anti depressant that you’re taking actually making you worse? That may be hard to believe, but it could be. You need to realize that the longer you are on an anti depressant, the more likely it quits working, because you get a condition known as down regulation. Down regulation is that you have less and less receptors in the brain the longer you’ve been on antidepressants. You may go to one antidepressant and then it quits working, so 12 months later you go to another one, and 18 months later you go to another one.
That’s typical, because the medication quits working. Unfortunately, when you continue to do this, you might actually experience a permanent reduction in the neurotransmitters so that now the antidepressants really don’t work much at all. That’s not a good place to be in. I’m a strong advocate of trying to do everything natural, and I do it naturally for a reason.
The way I practice functional medicine, the orthomolecular medicine, is using the right chemicals at the right doses, in the right way. It really is just changing a person’s biochemistry. You can do that with the raw ingredients actually needed by the body, that you should be getting through the diet, and use these things as drugs because they’re very high doses.
There are 12 different amino acids, 11 essential amino acids. These amino acids, plus the B vitamins that I mentioned, magnesium, and vitamin C, are what make the neurotransmitters. Neurotransmitters are produced from the foods that we eat, and certain amino acids, along with the B vitamins and minerals, produce the neurotransmitters.
The inhibitor relaxing neurotransmitter including serotonin is produced from the amino acid tryptophan or 5-hydroxytryptophan. How do you know what you need to take? Well, here’s how you need to know. If you’ve got fibromyalgia, you’re low in serotonin, so you need to be taking 5 HTP. That’s just a given. You can’t have fibromyalgia if you don’t have trouble with your sleep, whether it’s hard to fall asleep or you stay asleep, and you have diffuse achy muscle pain. Trouble with your sleep and diffuse achy muscle pain go hand-in-hand with fibromyalgia.
Here’s how you know if you’re low in serotonin. There is a questionnaire that you’ll find in my book. You’ll also find on my website, www.treatingandbeating.com, This questionnaire is called the Brain Function Questionnaire.
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If you are interested in the full transcript and/or to listen to the audio of this conference, please visit my new Treating and Beating Fibromyalgia Members Site for your $1 trial today!
If you know that this membership is for you, then feel free to skip the trial and sign up today to become a member! As my gift to you welcoming you, you will receive a copy of my new 5th edition Treating and Beating Fibromyalgia & Chronic Fatigue Syndrome eBook – FREE!