The Guaifenesin Guide for Treating: Chronic Fatigue; Fibromyalgia; Irritable Bowel Syndrome (The Nonplus Conditions)

By Gregory K. Penniston, D.C.
Reviewed by Debra LeRiche

Dr. Penniston, a chiropractor who has practiced for 23 years, has written a short book concerning a treatment option for what he calls the "nonplus conditions." Nonplus conditions are baffling medical conditions, two of which are Chronic Fatigue Syndrome and Fibromyalgia.

The author believes that the compound guaifenesin, if used properly, can result in long-term reduction or elimination of the symptoms of nonplus conditions. Touted as a continuing treatment and not a cure, guaifenesin seems to have been beneficial for the author himself and many of his patients.
 
Guaifenesin is related to "guaiac," which was used to treat rheumatic conditions from the 1500s through the 1800s. It is an expectorant commonly found in over-the-counter cough, cold and flu medications. Guaifenesin thins mucus secretions, makes coughs more productive, and helps clear bronchial and sinus passages. There are no interactions between guaifenesin and other drugs, and it is low in cost.
 
This treatment is not for those seeking a quick fix, as it requires a major commitment of time and effort on the part of the patient. The book breaks down the treatment into 4 steps: (1) completing the symptom checklist included in the book; (2) eliminating products which contain salicylates, such as those found in aspirin and cosmetics; (3) changing to a diet that is low in sugar and starchy carbohydrates; and finally (4) taking guaifenesin, starting in small doses of 200 mgs. to 300 mgs. twice a day, and increasing the dosage gradually until you reach the therapeutic dose that is best for you.
 
The author devotes at least one chapter to each step, and provides a website that contains an extensive list of salicylate-free products: http://www.psha-inc.com/guai-support/sf/Sal-FreeProducts.htm.
 
Dr. Penniston points out that salicylates, which are ingested through food, are not problematic as they are eliminated by the liver. Only salicylates that are applied topically to the skin, scalp, gums and surface of the mouth pose problems, because these salicylates go directly into the bloodstream and make their way to the kidneys. Once there, the salicylates bind to receptors, blocking the absorption and benefits of guaifenesin.
 
As the elimination of salicylates is clearly key to the success of guaifenesin treatment, I visited the website. I found myself overwhelmed by the number of salicylate-free products (and, by association, how many products contain them). Salicylates are found in an enormous number of personal products: toothpaste, mouthwash, breath mints and flavored dental floss; aloe, sun screen, soaps and lotions; makeup; vitamins and herbal supplements such as Valerian root, St. John’s Wort, ginseng, gingko biloba; and herbal teas. It seems virtually impossible to eliminate them easily and inexpensively. Shopping for and incorporating so many "sal-free" products into one's lifestyle would likely serve as a barrier for many people.
 
Even if a person is disciplined enough to live salicylate-free, the actual treatment protocol is a challenge. According to Dr. Penniston, most patients take guaifenesin for several years before finding a dose that is most therapeutic. Only 10 percent achieve good results within the first one to two years. Once the ideal dosage is identified, patients must continue taking guaifenesin indefinitely or symptoms will return. In some cases, symptoms return on their own, requiring a readjustment of the dosage over time.
 
Though I personally find the guaifenesin and salicylate-free treatment options proposed by this book too daunting to undertake, it may be a viable option for those who have exhausted other options and are willing to commit to its arduous regimen.