Guaifenesin protocol is an unapproved treatment for fibromyalgia suggested in the 1990s by R. Paul St. Amand. The protocol involves three parts: titrating the guaifenesin dosage, avoiding salicylates, and following a low-carbohydrate diet if the patient is hypoglycemic. Guaifenesin has not been approved by the FDA for the treatment of fibromyalgia, and the protocol has not been shown to be effective in clinical trials. Despite the demonstrated lack of clinical efficacy, the protocol has been adopted by many due to anecdotal evidence of success.[1][2][3]

Efficacy

Results of the only reported randomized clinical trial in 1996 found that guaifenesin had no significant effects on pain, other symptoms, or laboratory measures (serum and urinary levels of uric acid and phosphate) over 12 months in a sample of people diagnosed with fibromyalgia syndrome,[2] The lead author of the study has suggested a number of reasons why some patients may have previously reported benefits on this protocol, concluding "St. Amand has unknowingly used guaifenesin as a powerful focus in a program of cognitive behavioral therapy, in which his empathy, enthusiasm and charisma were the real instruments in effecting a beneficial change."[4] St. Amand, who participated as a "Study Advisor" to this clinical trial, has stated that the study did not control for salicylate use, and therefore did not study the protocol as a whole. He has recommended a follow-up study be conducted which controls for all elements of the protocol.[5][6] The lead author of the study counters that none of the subjects exhibited any signs of salicylate use.[2]

History

This hypothesis arose when St. Amand noticed that patients with fibromyalgia symptoms had an increase of tartar on the teeth in the form of calcium phosphate. Crystals are also often found on urinalysis, which further points to calcium phosphate, and muscle biopsies show an steady state of phosphate in the cytosol as well as a dearth of ATP and phosphocreatine. The implication is that insufficient energy formation is the basis for the generalized cellular fatigue expressed in many tissues of fibromyalgia. Lesions of muscles, tendons, and ligaments can be felt by simple palpation. St. Amand calls this 'mapping' and uses it to confirm the diagnosis and in followup reversal of fibromyalgia. He feels that a genetically induced retention of phosphate also draws excess quantities of calcium into cells and exhorts them into overdrive. Contracted musculoskeletal tissues are the result and they produce the palpable lesions.

The treatment was discovered serendipitously when the physician found that uricosuric drugs for treating gout also coincided with relief of fibromyalgia symptoms. Guaifenesin is mildly uricosuric but, unlike standard uricosuric drugs, has almost no side-effects. St. Amand therefore began to study whether guaifenesin might relieve the symptoms of fibromyalgia while causing fewer side-effects than the earlier medications.

I read about this guaifenesin thing in the internet. The protocol also involves eliminating all plant oils from your body--this includes even hand lotion that contains plant oil.

Anyway, I haven't followed the protocol, but I have noticed that when I have a cold and took guaifenesin, my body aches decrease. Someone (at MIT?) did a study and his conclusion was that guaifenesin has an effect as a body relaxant.

I have tried it. It is very hard to follow this regimen. Everything you use: soaps, lotions, makeups, etc etc... all have some kind of plant ingredient in it. I learned it's pretty much impossible to eliminate it completely. Even the most basic soaps have a form of coconut oil in it. But I did try for about yr. They told me it would take a year to 2 years before I would notice any difference. I started feeling great a year later but I don't know if it had anything to do with the guaifenesin because I didn't exactly follow the dosage they told me to follow and at the time my docs had changed my meds. Took me off cymbalta, started taking CoQ10, changed my sleep medicine, etc. So it's hard to tell which one helped me feel better.

There's a group here in Honolulu who only focus on the guaifenesin treatment and I've seen their videos on the internet all claiming they are doing better, so who knows. Maybe it does help (if done properly).