Guaifenesin treatment instructions
(Source: www.guaidoc.com)

These treatment instructions are specifically designed to include those not being mapped.

First, rule out any other conditions and locate a doctor who understands FMS. R. Paul St. Amand M.D. recommends a basic work-up that includes a blood count to rule out anemia or infections that mimic FMS. In addition include a thyroid test known as a TSH. Then be sure you tell you doctor all of the medications and/or vitamins you are taking. You will also want to discuss with your doctor whether or not you have hypoglycemia or carbohydrate intolerance.

Guai treatment reverses the entire process of fibromyalgia in a more intense cyclic progressive fashion. This is due to a rapid attack on multiple areas simultaneously. A classic cycle is begun with exacerbation of symptoms followed by good days, generally within a few months. An average reversal rate is about one year for every two months at the proper dosage. Mapping is strongly recommended for everyone, but particularly if you do not experience a clear response of exacerbation of symptoms during titration of dose, or don't have clear cycles within a few months. Without mapping it's impossible to give any guarantee whether a dose is too low or high, or if one is blocking. It is suggested you approach a physiotherapist, chiropractor, massage therapist, etc., (as most physicians are not used to palpating the muscular lesions that we call the "lumps and bumps" of fibromyalgia), with Dr St Amand's mapping video. 

Everyone should begin Guaifenesin at 300 mg. twice per day. Cycling can begin any time before the seventh day if this dose is sufficient and you aren't blocked by products with salicylates. You should feel significantly but tolerably worse. Statistics show that 300 mg. twice daily suffices for 20 percent of patients.

If no severe exacerbation of symptoms has begun in that time, increase to 600mg twice per day. Dr St Amand holds his patients at 600 mg. twice daily for three more weeks, until he sees the patient again and re-maps. This dose suffices for 70 percent of people. Those of us NOT being mapped would do well to hold at 600 mg. twice daily for a month rather than the 3 weeks. If you do have to raise your dose again it would be best to hold for one month minimum each time. If you raise the dose of medication too fast you will likely end up in too much pain or with too much exacerbation of symptoms. Plus you will never know what your proper dose is and put yourself through a more severe reversal than necessary.

If the patient has not had a worse time of it at a month on the 1200 mg dosage, Dr St Amand would then raise her/him to 1800 mg. daily. By this point, 90 percent of people will have found their proper cycling dose. The higher dosages of 2400mg on up will only be needed by 10 percent of patients.

For the higher dosages, when the amount of pills for a day equals an odd number, R. Paul St. Amand M.D. suggests people take the extra pill in the morning, to avoid splitting pills (just for convenience). He usually titrates dosage by 600mg, but if you prefer to raise by 300mg that is okay.

Roughly 10 percent of patients have no severe symptoms during reversal. On occasion someone might feel no different but if mapped may have made remarkable progress. Some of these people have a variably high pain threshold and don't see much happening despite great success. Another minority of patients progress very slowly with practically no good days over a long period of time. In most cases this indicates the person is at too high or low a dose, or is blocking, but it can also just be their particular pattern of reversal.

Apart from 6 patients who cycle on 4800mg per day, the highest dose Dr St Amand has had to use on his patients is 3600mg daily. A very few patients have cycled on 300mg daily.

Reversal cycles are generally intensified symptoms of whatever YOU have. For example: If your primary complaint is fatigue or nerves, this will get worse. If it is pain, this will get worse. You should just feel worse. It's really that simple. In addition, because the guaifenesin makes one's symptoms more intense, certain things which were not apparent or bothersome before beginning the protocol, may become so. At each level, too, it is recommended you take an INVENTORY of your PRODUCT usage to ensure you are not blocked by anything. Refer to the Salicylates portion of this Web site. Before beginning treatment it is imperative to make sure one is allowing no source of salicylates. It is important that you use no aspirin compounds since these completely block the effects of guaifenesin. The greatest source of patient error lies in the use of aspirin-related compounds, salicylate or salicylic acid, which interfere with guaifenesin at the kidney level. Skin readily absorbs these compounds. Many pain medications contain aspirin or have the word 'salicylate' or 'salicylic acid' as part of the contents. You cannot use these. Tylenol, Advil, Darvon and other anti-inflammatory drugs are OK. ALL plants manufacture salicylates, and many do so in large quantities. Herbal medications, cosmetics and skin creams or lotions containing herbs are also high in salicylates and must be avoided. Among others, these include aloe, camphor, castor oil, witch hazel, ginseng and plant-derived vitamins. You must read all ingredients contained in anything you apply to your skin.

These warnings do not apply to foods, including herbs and spices used in cooking even though some contain salicylates. Apparently, the amount is insufficient for blocking because of the action of the digestive tract and because the liver processes small amounts by a process called glycination.

There are no restrictions on diet, unless you also have hypoglycemia. Assume you are very sensitive and be meticulous in conducting your search for salicylates in topicals, supplements and medications,and be assiduous in eliminating them, because, especially in the early days of the treatment, it is almost impossible to tell physically whether or not one is blocking the guaifenesin. Further along in the treatment when you have begun to experience long periods of good days, blocking may be easier to detect. Actually the process is simple. Some people make it very complicated, perhaps because they want to bargain and not give up this or that. Those who are very sick consider it no big deal to give up aloe in lipstick or to use one sunblock instead of another. Once you get well, you never want to go back. When in doubt, don't. The reward is getting well.


"Understanding these steps and following them precisely are important. (They are) meant to be a road map to tell you exactly how to go about using guaifenesin to get well."
- Page 145 What Your Doctor May Not Tell You About Fibromyalgia