Fibro, Fog and Fatigue
Dr. Farhan Tahir Empowers Sufferers to Reclaim Their Vitality
by Michelle BenseAs Pennsylvania’s only rheumatologist who is certified in American Board of Internal Medicine, Rheumatology and Integrative Holistic Medicine, Dr. Farhan Tahir, M.D., believes in the use of integrative approaches to reduce dependence on medications. The Founder and Medical Director of Rheumatology Care Consultants, in Yardley, Tahir works extensively with patients struggling with chronic fatigue syndrome and fibromyalgia syndrome, among many others. In his work with such patients, he has developed an effective, integrative treatment method.
Can you tell us a bit about chronic fatigue syndrome and fibromyalgia syndrome?
Chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) are two syndromes with overlapping symptoms. FMS is characterized by a widespread pain, tenderness on light touch, non-restoring sleep, brain fog, poor metabolism from hormonal imbalances and depressed mood. CFS is a state of energy crisis; there is lack of energy production which cannot match body demands. Symptoms include persistent fatigue, in spite of rest or vacation, extreme exhaustion after workouts, irritable bowel syndrome and recurrent sinus infections.
Both conditions have contributed to significant mental and physical frustration in our communities. CFS has been a subject of controversy for many years, but now it is officially recognized by Centers of Disease Control. CFS affects three out of every 1,000 Americans. Most patients are Caucasian women between the ages of 20 and 50 years old. FMS affects three to six million people in the United States, and is responsible for more disability than rheumatoid arthritis (RA).
What makes the two conditions so difficult to differentiate and diagnose?
Although they can present alone, CFS and FMS can be triggered as a result of an infection or stressful events. In many cases, there is an underlying autoimmune disease such as RA or lupus. Early recognition and diagnosis is quite challenging, but a thorough physician will investigate and discover underlying causes.
To make these conditions easier to understand; think of the body as a house. Having a chronic autoimmune disease or inflammation is like having a house fire. If unaddressed, the fire will set off fire alarms—which is like developing FMS. If alarms remain unattended, the house will eventually collapse—like having CFS settling in the body.
What is the best approach, in your opinion, for treatment of CFS and FMS?
Unfortunately, modern medicine and pharmacologic prescriptions have fallen short in solving the big picture and challenges of these complex disorders. Currently, there is no FDA-approved treatment for CFS. Current FDA-approved therapies for FMS include Cymbalta, Savella and Lyrica. In a majority of patients, there is not a satisfactory response from taking these medications.
Fortunately, over the last decade, integrative medicine research has made progress in FMS and CFS. Dr. Jacob Teitelbaum—an internist and nationally known expert in chronic fatigue syndrome, fibromyalgia, sleep and pain—developed the S.H.I.N.E. approach, which is successful in a majority of patients. S.H.I.N.E. focuses on the five key areas related to the body that, when addressed in combination, can provide a roadmap for optimal energy production.
I modified this protocol to meet the unique needs of my patients with autoimmunity and inflammation. Our approach is “RISE and SHINE,” which has a functional medicine basis. RISE means to Reduce Inflammation, Stress and Exhaustion. SHINE addresses issues of Sleep, Hormonal balance, Immunity and infections, Nutritional deficiency and Exercise and energy.
How exactly do you address each of the areas outlined in the RISE and SHINE method?
To address inflammation and misdirected immunity seen in patients with rheumatologic diseases, I educate patients on an anti-inflammatory diet, rich in omega fatty acids such as fatty fish (salmon, mackerel, sardines), avocados, raw nuts, seeds (walnuts, flax seeds) and extra virgin olive oil. I also encourage probiotics to help intestinal inflammation. Elimination of sugar, allergens and trans-fats can reduce inflammatory chemicals and pain. To boost immunity, increase antioxidants like Vitamin C and Coenzyme Q10. Daily Vitamin D helps to stabilize immune cells. To boost energy, use Carnitine and D-Ribose supplements. Consider starting yoga and Tai Chi—excellent ways to improve flexibility and reduce stiffness.
Relaxed and uninterrupted sleep can be achieved by educating patients about maintaining sleep hygiene and, if needed, non-addicting natural therapies can help. I use a variable combination of valerian root, passion flower, lavender oil and melatonin to create customized dosing for each individual’s needs. Magnesium at night also helps relax muscles and reduce spasms.
Any other words of advice for patients with CFS or FMS?
Before starting any supplements, it is best to get the advice of a healthcare provider. Hope is a great thing; always look for the light at the end of the tunnel. Patients with CFS and FMS must remember, as it took several months to develop these disorders, it may take months to get better. With the RISE and SHINE method, a realistic expected recovery is a 10 percent improvement every month. Eventually, patients are ready to embrace life and shine like a star.
Michelle Bense is a writer and managing editor of Natural Awakenings BuxMont. Connect with her at [email protected]. October 2014.