Rational Wellness Podcast 040: Chronic Fatigue and Fibromyalgia with Dr. Kent Holtorf

Dr. Kent Holtorf speaks with Dr. Ben Weitz about how to help patients with Chronic Fatigue Syndrome and Fibroymalgia.   [If you enjoy this podcast, please give us a positive review on Itunes, so more people will find The Rational Wellness Podcast] 

 

Podcast Highlights

1:49  Dr. Holtorf tells his story of dealing with Chronic Fatigue Syndrome that turned out to be caused by Lyme Disease. He was having thyroid and adrenal problems and needed support for them as well as HGH and testosterone.  He became a new person.

2:47  A few years later he was going through a stressful divorce and he crashed.  He found out he had Lyme Disease and he was being treated with round after round of high dose IV antibiotic therapy. He was even going into heart failure because his blood had become too thick. The antibiotics were not bringing about a long term cure, so he figured out that he had to treat the immune system to create balance.  He used ozone, umbilical cord stem cells, and peptides, all of which helped. The TH1 was suppressed and TH2 was increased and this has to be balanced to overcome these chronic infections.

5:30  We discussed worm therapy for immune system balance

6:07 We talked about a subtle form of hypothyroidism that is not picked up just by looking at TSH that is an important component in patients with Chronic Fatigue Syndrome and Fibromyalgia. Dr. Holtorf said that conventional thyroid testing–looking at TSH misses about 80% of cases of hypothyroidism and he likes to look at the Free T3/Reverse T3 ratio and Sex Hormone Binding Globulin and he is developing a new test, Active TSH. He also explained that the new T3/Reverse T3 assays are not as accurate since they crunch everyone together. He also uses a computer to measure achilles tendon reflex and if it is slow it indicates hypothyroidism.

13:12 We also discussed the role of adrenal dysfunction in chronic fatigue and fibromylagia. Dr. Holtorf will often use low dose timed release cortisol in these patients for three to six months. It’s usually not a primary adrenal problem, it’s a hypothalamic-pituitary-adrenal problem.

17:39 I asked Dr. Holtorf about his articles where he talks about the use of growth hormone for patients with chronic fatigue and fibromylagia. He said he tends to use growth hormone secreting peptides, since growth hormone is so regulated.

20:28 Dr. Holtorf talked about the role of chronic infections in fibromyalgia and chronic fatigue syndrome and he said that he especially sees Lyme Disease. There are often co-infections with Babesia and Bartonella. There may be other chronic infections like Epstein-Barre, HHV6, or CMV. The key to correcting these is to strengthen the immune system along with antibiotics or antimicrobials. He also often uses Low Dose Naltroxene (LDN), which is an opiate blocking drug, but it helps to balance the immune system. It’s also very inexpensive and very safe.

23:43 We discussed the fact that fibromyalgia and chronic fatigue syndrome patients often have coagulation problems. This is because the body responds to infection by increasing coagulation as part of the immune system activation.

 

 


Dr. Kent Holtorf can be contacted at his website https://www.holtorfmed.com/ and he is accepting new patients by calling 877-508-1177.

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling the office 310-395-3111.


 

Podcast Transcript

Dr. Weitz:                            Dr. Ben Weitz here, and I’m here with a very interesting guest, Dr. Kent Holtorf, and we’re going to talk about fibromyalgia and chronic fatigue problems. Dr. Kent Holtorf is a nationally recognized expert on fibromyalgia, chronic fatigue, and thyroid problems. He’s the medical director of the Holtorf Medical Group, and he has affiliate centers across the country. He’s also founder and director of the nonprofit National Academy of Hypothyroidism, which is dedicated to dissemination of new information to doctors and patients on the diagnosis and treatment of hypothyroidism. We’re going to speak to Dr. Holtorf today about fibromyalgia and chronic fatigue syndrome, two related and very difficult to treat conditions, often affecting women and affecting quite a number of people in the United States. Dr. Holtorf, thank you for joining us today.

Dr. Holtorf:                         Thank you so much. Pleasure. Thanks for having me.

Dr. Weitz:                            How did you get interested in treating chronic fatigue and fibromyalgia?

Dr. Holtorf:                         Well, basically, I was a very standardly-trained physician and going through medical school. I got so fatigued, I was like, “Something’s wrong.” Went to the doctors, who said, “Oh, you’re stressed out like the other students.” I’m like, “That’s not it.” “Oh, you’re depressed. Do they treat you bad?”  “That’s not it,” and just, basically, worried about functioning. Went on to residency and it got very bad. I’m like, “I don’t know if I can see patients.”

                                                Now, you’re kind of trained in medical school about alternative is quackery and all this, and I’m like, “I’m not getting help here. I’m going to some of these so-called alternative conferences,” and I realized, “Oh, my God, they are more evidence-based than what I was learning in residency.”

                                                And basically, I treated myself with … thyroid was the big thing, a little adrenal support, cortisol, growth hormone, testosterone. “Oh, my God, I’m a new person,” and so I was able to function. And then I was doing anesthesia. Got out of that, because I’m like, “Okay, this is so boring.”  But the energy after that.

                                               And then, a number of years later when I was doing fine, I went through a stressful divorce, just crashed. We were treating Lyme disease at the time, and I’m like, “I know it’s Lyme.” This is just too bad, not just chronic fatigue syndrome, but a lot of chronic fatigue is Lyme. And then I went into heart failure, my blood was too thick. You could not pull it out. And what I found … I did four years at the highest dose IV antibiotics that I would never even give a patient. I’d stop for two weeks, it would come back. So, essentially, went all over the world looking at treatments, and I found that really, immune modulation is the cornerstone of successful treatment. Because all these patients just … they get a little better or worse with these antibiotic treatment, but you don’t treat the immune system. That’s the key, that’s what you need to do for long term improvement.

Dr. Weitz:                            So, what kind of treatment did you do to balance the immune system?

Dr. Holtorf:                         I did so many treatments. A lot of things work, but each thing works for different people. Ozone was very helpful, but we really found umbilical cord stem cells, great for immune modulation, lowering inflammation. And peptides, which is a new therapy that’s becoming again, a cornerstone of our therapy.

                                                Really, what you see is what happens with chronic illness, especially chronic fatigue syndrome, chronic Lyme … there’s two sides to the immune system, Th1 and Th2. Th1 gets stuff inside your cells, Th2 gets stuff outside, because normally they’re balanced. With chronic Lyme and when Th1 gets suppressed, then your body increases Th2 and all this inflammation symptoms. But if you don’t increase this, modulate that immune system, then its long term success is very difficult.

Dr. Weitz:                            Yeah, yeah. Isn’t it also important to stimulate T regulatory cells as well?

Dr. Holtorf:                         Yeah, all that goes into it. The immune system is very complex. Th1 and Th2 is a way of looking at it. We’re practitioners, it makes sense, and what you really see … for instance, HIV. You look at who progresses in HIV directly correlates with how low the Th1 and how high the Th2 is.

                                                So, it really shows with these chronic infections, we’re beating on people with these antibiotics, antivirals, and if you don’t address the immune system, you never get there.  Because the immune system is so low, you can get the antibiotics down, but the immune system has to basically, take over, because most people that have chronic Lyme or chronic infections, they basically, are able to suppress the infection, even though they have it. For instance, like getting chicken pox. You say, “Well I’m over the chicken pox, you’re really not. The body just basically, hasn’t suppressed it. It comes back out as shingles when your immune system’s low.

                                                So it’s a good model for, “Hey, keep the immune system high, and you don’t get shingles again.” Same thing with Lyme, chronic fatigue syndrome, fibromyalgia.

Dr. Weitz:                            Yeah, it’s interesting. I interviewed Dr. William Parker last week and he was talking about using worms that you ingest and live in your intestines and the main effect is to help regulate the immune system.

Dr. Holtorf:                          Yeah, and those are great. As you said in your previous podcast, where they’re great with respect to autoimmune diseases of the gut. You find that third-world countries don’t get Crohn’s and Ulcerative Colitis because they have these worms. So, yeah, it modulates the immune system. Same thing, increased Th1 lowers that Th2 and we find … we haven’t used worms, but they seem like they fit right in with the model.

Dr. Weitz:                            Yeah. One of your articles on your webpage, you write that, “Central hypothyroidism and cellular resistance to thyroid hormone exists in the majority of patients with fibromyalgia and chronic fatigue syndrome.” What did you mean by this? How can this be tested for, and then how does it get treated?

Dr. Holtorf:                         When you look at studies that use TRH tests … so, most doctors, they basically look at TSH. The TSH, the basic hormone produced in the hypothalamus, tells the pituitary to excrete thyroid stimulating hormone, which then tells your thyroid to excrete T4, which then needs to go into the cell to convert to T3. So, all these things need to happen. Now, what do most doctors check? The TSH, which tells the level in the pituitary.

                                                So, when the pituitary level goes up, the TSH goes down, or the pituitary level goes down, TSH goes up. Now, what we’ve found with chronic inflammation, chronic infections, diabetes, dieting, obesity, what happens is that the pituitary’s different from every other tissue in the body. You have all this inflammation and this chronic illness going on, the pituitary levels go up, but the rest of the body goes down. So, what happens is, you get low TSH, which doctors will say … they’re taught that thyroid is very easy. If your TSH is high, your thyroid is low, if TSH is low, your thyroid is high. It’s normal, it’s normal.

                                                That is not the case with so many illnesses, especially with chronic fatigue syndrome and fibromyalgia. For instance, they did TRH testing in fibromyalgia patients. All of them were low, even though they had a TSH that was low normal, so it looked like they had a little bit high thyroid. So, it is totally inappropriate to use TSH in chronic fatigue syndrome and fibromyalgia. Also, we’re finding diabetes, and anyone with chronic dieting, any autoimmune disease, inflammation, all these things, the standard blood tests we’re using is missing about 80% of people with chronic illness.

Dr. Weitz:                            That’s kind of a controversial viewpoint, though, isn’t it?

Dr. Holtorf:                         Well, it is, because we’re just taught over and over that the TSH is what you look at, but I’ve published numerous reviews on this with hundreds of references from standard medical journals. It’s clear, it shows it, and when you show this data to people … “How come I don’t … why haven’t I heard this before?” I’m like, “It’s very complex. Doctors learn what they learn.”

                                                Basically, you look at the studies, most doctors are practicing twenty years behind what’s available in the medical literature. And they did a study and they found that it takes an average 17 years for a proven, new concept to be accepted into mainstream medicine.  And why is that? One, doctors don’t read medical journals. They don’t. They don’t have time, and if they do, they read the abstracts of the whole thing. Also, drug reps, basically, drive doctors prescribing, but the biggest reason was they found that if you give a doctor … Here’s a study, here’s five studies, ten studies, a hundred studies showing what you’re doing is wrong, they don’t want to read it. They say, “No, what I’m doing is fine.” They don’t have time. When you look at all these tests we’re doing for thyroid, you can’t just do the blood test. Doctors are like, I don’t have 15-20 minutes to spend with the patients and ask them all their symptoms. They have nine minutes, now.

                                                So, what do you get? You get an antidepressant. If your TSH is high, you get Synthroid, which doesn’t work very well, or if it’s normal, again, you’re just depressed or stressed. Go away, you’re done. So, that’s the really driving force. No one wants to take the time that it does to basically, treat thyroid appropriately.

Dr. Weitz:                            So what are the best tests to get an accurate measure of thyroid?

Dr. Holtorf:                         Now, we’re developing a new test called the Bioactive TSH. You find with, again, that pituitary dysfunction, your body secretes less active TSH, but that’s not available right now. That’s up and coming, hopefully.

Dr. Weitz:                            Active versus inactive TSH?

Dr. Holtorf:                         Yeah. And the standard test just picks up the amount of TSH, not the activity. So, you can see that if you have chronic illness, the TSH may be the same, but it’s less active. We’re working on that for 10 years, but we’re making some progress. You need to look at the Free T3, Free T4 levels. But one key is the Free T3/Reverse T3 ratio.  So, the body will take T4, which is inactive, secreted by the thyroid. It can either convert to T3, which is active, or Reverse T3.

                                            So Reverse T3 is the same thing, but backward. So it goes to the cell receptor, sticks there, but doesn’t do anything, so they say it’s inactive. But actually it’s blocking the active thyroid, so it’s a brake pedal for the thyroid. With stress or chronic illness, inflammation, chronic infection, you’ll make high Reverse T3. If you look at the Free T3/Reverse T3 ratio, it’s a very good marker. Now, with the little caveat, the new assays out are not that good. They kind of crunch everyone together. Before, five years ago, they were very telling. Now they’re a little … they’re telling, but not everyone’s exact cutoff. We need to look at that.

                                             Another marker is sex hormone binding globulin. People think of that in terms of testosterone, because it binds up testosterone, so people will say, “Well, we want to see what’s the free testosterone.” So, hormones can be bound up or free. The only ones that are active are the free. But sexual binding globulin goes up in the liver in response to two things. One is estrogen, one is thyroid. So, a woman comes in. Let’s say she’s menstruating normally, probably normal estrogen. If her sexual binding globulin is below 80, you know they’re low thyroid. And also, if you give thyroid and SHBG does not go up, you know they have thyroid resistance. So that’s a key test that so many doctors don’t know about, and they just don’t think about it.

Dr. Weitz:                           Interesting.

Dr. Holtorf:                         Symptoms are key, also. I mentioned body temperature, low body temperature, symptom assessments correlate very well. We have a computer that measures the relaxation phase of the muscle reflex. So, normal thyroid, the reflex will go “chu-chu”, but the lower the thyroid it goes “duhn-nyah.” The computer measures that.

                                            British Medical Journal, obviously, a major medical journal, showed that that test was better than blood tests for thyroid, correlated with symptoms better. Then we’ll also check everyone’s basal metabolic rate. And we’ll find that most people come in that have…

Dr. Weitz:                            How do you measure their BMR?

Dr. Holtorf:                         Basically, with a device that measures the oxygen output over 10 minutes. And it extrapolates for the whole day, so it tells you how many calories you burn. How much oxygen utilized equals how many calories you burn. Let’s say my metabolism is low, everyone’s like, “Yeah, right.” They’re metabolism is 25% lower. That correlates to about 500 calories a day, so they either have to eat 500 calories or less just to stay even, or exercise for about two hours. Or fix your metabolism. So we find that is a gold standard for basic metabolism, which equals the thyroid. The thyroid is the gas pedal for the metabolism.

Dr. Weitz:                            Right. So you’ve also written that most patients with fibromyalgia and chronic fatigue syndrome suffer from clinically significant andrenocortico dysfunction due to hypothalamic and pituitary dysfunction. And I see from some of your articles that you often treat both of these conditions with low-dose cortisol. How does this help, and maybe you could explain the mechanism.

Dr. Holtorf:                         The adrenals, as you know, basically, and a lot of people know, it’s a stress response. It helps your body to deal with stress. So many people say adrenal fatigue, I think that’s overused, you know that …

Dr. Weitz:                            Right. That seems to have been critiqued, right?

Dr. Holtorf:                         Yeah, and everyone’s like, “Okay, adrenal fatigue [inaudible 00:13:58].” But when-

Dr. Weitz:                            Do you like the four part adrenal-cortisol testing with the saliva?

Dr. Holtorf:                         I do. That way … because a lot of times you’ll see it. They’re not, in fact, when are they low or high? But it should be high in the morning and then come down and low at night. But, you’ll see people completely opposite. They don’t sleep, then they’re tired during the day. So, I think it is a good test.

                                               We’ll do a lot of blood tests, because we’ve been doing them a long time. We don’t need to do those things, but they’re certainly useful, because you get multiple times during the day. What happens with chronic infection, we talked about.  Pituitary dysfunction with the thyroid, same thing happens with the adrenals. The pituitary secretes ACTH, which tells the adrenals to go up.

                                               Now, what we find, it’s usually not a primary adrenal problem, it’s a hypothalamic-pituitary-adrenal problem. Normally, what they did, was do ACTH stimulation tests, which was considered the gold standard for adrenal dysfunction, and they found no difference in chronic fatigue syndrome or fibromyalgia. But the problem is, that only tests for primary. But when they did central testing they found that there’s again, hypothalamic-pituitary-adrenal dysfunction, which these tests showed up 90+ percent actually had HPA axis, hypothalamic-pituitary-adrenal dysfunction and responded very well to treatment. And they found that the ACTH stimulation test was no better than flipping a coin. So, again, that gold standard testing missed 80% of them, was no better than flipping a coin.

                                                And it’s very hard to do the central stimulation test. But if you look at the studies, for instance, the Journal of Infectious Disease in Brazil looked at chronic infections and how the adrenal levels correlated to serum levels. They found if they were lower than 12.6, they had about an 85% chance of being low adrenal, because when you’re sick, you should be higher, right?

                                                Let’s say, “What is normal adrenal function?” It depends on the person, it depends on the stress. If you’re in the ICU and have a normal adrenal level, you’re probably going to die. You need much more during times of stress, so with chronic infection you need more. So that’s just a quick and easy test to do for adrenal function, and say, “Hey, is this person low?” Look at all the symptoms. Giving low-dose cortisol, everyone’s like, “Oh, my gosh.” You know, especially if you’re an endocrinologist. It’s safer than actually doing the testing, the basic stimulation test. Much safer, does not suppress the adrenals, actually at low dose, it will improve adrenal function. And then, as you treat everything else, that will get better. Usually, we’ll treat for three to six months, or depends on the case. They’re often not on it longterm, and a lot adrenal support as well, and that often comes back.

Dr. Weitz:                             Yeah, I guess a lot of us have seen patients who are on prednisone for a long period of time for asthma, or some other condition, and they have all these side effects, and loss of bone, and all kinds of other things. That, I think- [crosstalk 00:17:01] worry comes from.

Dr. Holtorf:                          I also have written on this, about the low-dose, completely different. And I can’t remember the last time I gave prednisone, or any high-dose, because, yeah, you’re basically doing a disservice to the patients. Suppressing their adrenals, they’ve got to be on it, all the side effects, but again, optimal is optimal. Prednisolone is mega-doses, which, it’s going to have issues.

Dr. Weitz:                            Does it matter if you use cortisol or cortisone? Those are different, right?

Dr. Holtorf:                         Yeah, cortisol or hydrocortisone are the same thing. Those are interchangeable. We used to give time-released, compounded.

Dr. Weitz:                            You’ve also written about lower levels of growth hormone being correlated and being a contributing factor in fibromyalgia and chronic fatigue syndrome.

Dr. Holtorf:                         Again, the same thing. Growth hormone produces pituitary, usually at night, and it goes through your liver, increases IGF-1, things like growth factor, which has a lot of effects on healthy immune system, weight, all those things. Just like everything else, again, when you look at these chronic illnesses, everything that the pituitary controls, which is a lot of things, are dysfunctional.

                                           Studies by Bennett from the University of Oregon found that giving growth hormone, dramatic improvement in symptoms. And growth hormone is very controversial and very regulated because of athletes using for performance, which shows that it does work. We stopped over the years using straight growth hormone and more using secretagogues that stimulate your body’s own production, including peptides, we’re finding our key for that.

Dr. Weitz:                           Which peptides?

Dr. Holtorf:                         Ipamorelin, CJC. I’ve done a lot of lecturing on growth hormone secreting peptides, growth hormone secreting hormone. Now, you’ll get Sermorelin, or Semorelin, however people pronounce it, but either way. That is a growth hormone secreting hormone, and it does work, but it stops working in a couple months, so if you had a growth hormone secreting peptide to that, it works much better and longer. And it’s really, you can’t overdose, because your body will actually regulate it.

                                           It’s a nice way, very safe, much more cost-effective than growth hormone and you get the effects. It’s not great for bodybuilders, which we don’t see, but for the sick patient. Usually, the sicker the patient, the better the response to growth hormone, and healthy people, they might see some performance, endurance, but usually they don’t see dramatic effects. But, the sicker the patient, the more they respond, and very well-tolerated. I can’t remember the last I’ve had a side effect from growth hormone, or especially the secretagogues.

Dr. Weitz:                            What about some of the natural methods of elevating growth hormone levels, including certain amino acid supplements, and even heavy weight training has been shown to elevate growth hormone levels.

Dr. Holtorf:                         I think especially those you’ll see with healthy patients, the people that need it the most, those don’t work too well. Usually, they can’t do that stuff, especially heavy  weight training. They’re so fatigued. But healthy people can see benefit in those things, although, oftentimes, it’s highly variable and depends on the person. Those things can work, but usually with someone who’s very motivated to do those things.

Dr. Weitz:                            Okay. I see that you often see chronic infections as a factor in fibromyalgia and chronic fatigue syndrome. Which infections do you see most prevalently?

Dr. Holtorf:                         The big thing we’re seeing is Lyme, but there are so many other infections that go along with it. When someone has Lyme, they usually have multiple other infections, including co-infections. Babesia is a huge problem. It makes Lyme symptoms much worse and the treatment much harder. Bartonella, we’ll see much worsening symptoms, a lot of neurologic. People get diagnosed with schizophrenia and bipolar and they actually have Bartonella. But also when you see with Lyme, it suppresses the immune system, so you get all these … they’re not new infections but they’re reactivating infections. Such as Epstein-Barre, HHV6, CMV.

                                                The problem is when you test them. Normally, when you get an infection, we’re taught in medical school, your IgM antibody goes up first, and then after a while, IgG.  If it’s a new active infection, you should up IgG positive, whether HHV6, Epstein-Barre, but these are not new infections, they’re reactivating. So the body secretes  IgG.  The higher the IgG, the more like you have this active, chronic active infection. But a lot of people are told they don’t have these viruses. Not uncommonly, you need to treat the virus along with the Lyme or the other bacterial infection, because that’s suppressing the immune system. Antibiotics don’t touch it. But immune modulation, again, is key for all those, because they’re all coming out, because the immune system’s too low.  Whatever antibiotic or antiviral you need to get down the immune system. But if you get the immune system up, those start working. They work much better together.  We rarely give antibiotics or antivirals without the immune modulator.

Dr. Weitz:                             Do you use Immunoglobulin?

Dr. Holtorf:                          I love Gly BIG. And it, again, is another immune modulator.  It does the same thing; it increases Th1 and lowers Th2. It can also kill passively with the infections. But, the problem is, it’s expensive. So we’ll do, typically, the lower doses so people can afford it. It’s a great treatment. I wish it wasn’t so costly.

Dr. Weitz:                           What about LDN? Have you used that?

Dr. Holtorf:                         Yeah. LDN, I’m …

Dr. Weitz:                           Which is Low Dose Naltrexone.

Dr. Holtorf:                         Yeah, Low Dose Naltrexone, I’m on the advisory board for them, spoke at their conferences many times, and written a couple of chapters on LDN in chronic fatigue syndrome and fibromyalgia. Your listeners have probably heard of it before. It’s an opiate blocker, and they found that it’s usually used for people who go to the emergency room. They overdosed on opiates, pain pills, they give them that, it reverses it. But, what they found at a very low dose, it modulates the immune system. It kind of does that same Th1/Th2, so it’s a first-line treatment. Very safe, very little side effects. Some people get a little insomnia with it, but like anything, it doesn’t work for everyone, but it’s something to try because it’s very inexpensive, very cheap, very safe.

Dr. Weitz:                            I notice in your writings, you also talked about coagulation problems, fibrinogen, that kind of stuff, as being related to fibromyalgia and chronic fatigue.

Dr. Holtorf:                         And that’s another big issue that if you miss this, you may not get better. And what we found is, you get immune activation coagulation. A number of studies by Berg,  and others. The infection sets off the coagulation system, the body tries to wall off the infection by laying down fibrin and the blood gets very thick. I’ve mentioned that you could not draw my blood when I was very sick. You couldn’t take it out with a giant needle. And my D-dimer, which is a marker for this immune activation, was so high it was at about 50-fold increased risk for cardiovascular event in the next year. I said, “Oh, gee, I’ve got to get that down.”

                                               So the body lays down this fibrin, covers up the infection, which is good in the short-term, but now the body can’t get at it. And oxygen that normally takes two seconds to get in the cells, now takes up to two minutes. The cells are starved for oxygen, hormones can’t get through, waste products can’t get out, so until you clean up that fibrin, which may be a little bit of blood thinner, like Heparin. Coumadin and those other new ones don’t work. Or some fibrolytic enzymes can also help. And once you clean that up, it’s interesting. You’ll have people doing, let’s say, that it didn’t work. You give them a little, clean that up, do the same treatment again, and they’re like, “Oh, my gosh, it works.”

                                           That’s one of the keys that I think are missed frequently in providers that are treating Lyme, and it can make all the difference in treatment.

Dr. Weitz:                           Yeah, I found a combination of those enzymes along with high-dose fish oil also very helpful.

Dr. Holtorf:                         I agree. Again, multifactorial treatments usually are the key.

Dr. Weitz:                           Good, good, good. I think that’s all the questions I had for you. Anything else that you want to say about fib … By the way, fibromyalgia and chronic fatigue, for the most part, they can be treated as one condition?

Dr. Holtorf:                         Yeah, they’re essentially the same. You look at the … also the diagnoses are crazy, like, fibromyalgia, 11-18 tender points. There’s nothing special about those tender points. Look, you ask the patient if they’re significantly fatigued, if they have brain fog, sleep disorders, may or may not have muscle pain. They have it. You look at the blood test. People will say, the standard is, “Oh, there’s no blood test to detect it.”

                                            We can pick out chronic fatigue syndrome, fibromyalgia, on a blood test, on a panel, and how severe it is, about 80% of the time. So when people say, “Oh, there’s no  blood test that’s …”, we can pick how this person’s going to be essentially, probably bedbound, this person’s probably not too bad. And the blood test tells you. So it’s  not … everyone’s “Oh, it’s mental, it’s made up.”

Dr. Weitz:                            Right.

Dr. Holtorf:                         Well.

Dr. Weitz:                            And so the blood panel basically includes thyroid and cortisol and all these other factors we’ve been talking about?

Dr. Holtorf:                         Right. It’s usually a large blood panel because we like to get all the information, because they’re so many symptoms that are dysfunctional. We talked about a couple of  them. You got the pituitary-hypothalamic pituitary, all the hormones, mitochondrial dysfunctions, so the cells can’t make energy. You have the coagulation defects, you have the gastrointestinal system, what else? So many things you got, you got toxins, that are wrong with this condition, so when you look at studies, people say, “Oh, it’s because of sleep” or “it’s because of mitochondrial dysfunction or hormones or thyroid.” Who’s right? Well, they’re all right and it depends. You’ve got to find in the patient which things are affecting them the most.

Dr. Weitz:                            Great, great. You’ve provided us some really useful information, Dr. Holtorf. Thank you.

Dr. Holtorf:                         Great.

Dr. Weitz:                            For listeners and viewers who would like to get ahold of you, what’s the best way for them to get in contact with you?

Dr. Holtorf:                         Have them call the office, so we are in El Segundo by Los Angeles. We have centers also in Foster City, by San Francisco, Philadelphia and Atlanta. But you can call our 800 number, which, I’m not sure what it is. Our L.A. number is (310) 375-2705, or go to our website, holtorfmed.com or our nonprofit National Academy of Hypothyroidism, where all these studies that say, “Oh, they say my thyroid’s normal” and you’ll see hundreds of references showing that’s not true. And that’s N-A, like national academy, nahypothyroidism.org.

Dr. Weitz:                            That’s great. Thank you, thank you.

 

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