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Dr. Paul Goldberg served for twenty three years as a Professor of Gastroenterology, Public Health and Clinical Nutrition at Life College. Since 1983 he has had an ongoing practice in Clinical Nutrition, Natural Hygiene, Clinical Epidemiology and Biological Medicine as the Director of The Goldberg Clinic in Atlanta, Georgia. He also currently serves as the Director of Physician Education for Garden of Life, Inc.     Email:


by Paul Goldberg M.P.H., D.C.

Patient Presentation:
A 41-year-old female presented to our office with the diagnosis of "fibromyalgia" which she had received from her medical physician. She suffered from diffuse muscle discomforts in the shoulders, neck, knees, thighs and intermittently throughout the upper back.
The physician had advised non-steroidal drugs, along with the use of an antidepressant. He also encouraged her to seek psychiatric counseling if the problem did not improve. The patient was also seeing a doctor of chiropractic, and during visits she was receiving massage and spinal adjustments.
The patient pointed out the different areas of her body that hurt, being particularly concerned about the pain in the muscles of her shoulders, neck and back. She noted that the pains had begun five years previously, and although they came and went in intensity, they had increased over the years.

In addition to having had extensive medical and chiropractic care, she had taken a number of "remedies," including homeopathic potions, popular herbal formulas and some multi-level marketed products. While the patient's complaints centered around her muscular discomforts, questioning brought out that she suffered with moderately severe fatigue, poor bowel functioning and mood swings varying from anxiety to depression.
Dietary habits were inconsistent, but included a high-refined carbohydrate intake including health food candy/power/sports bars, which the patient thought were very healthful. She carefully picked out foods that were "fat-free" on the advice of a local dietitian, who she consulted with "to keep her weight down". Coffee was utilized regularly as an "energy booster".
She slept poorly and usually went to bed with the television left on to "help her fall to sleep": Her relationship with her husband was strained and she reported a lack of interest in sexual activity, which created tensions with her spouse, with whom she frequently argued. Her periods had been irregular and uncomfortable for the past several years. She had two children in their teenage years. She avoided exercising since it caused her muscular discomforts.

I initially elected to have her arrange to have a couple laboratory tests, i.e., a blood chemistry and blood count (SMA and CBC). While the CBC was normal, the SMA showed a depressed cholesterol of 103 and an elevated triglyceride level of 400. The fasting blood glucose level was at 108.
The patient's initial delight at having a cholesterol of 103 was dampened by my pointing out that cholesterol is a normal constituent produced by the liver and that while elevated levels posed a risk, depressed levels were not necessarily consistent with good health. When I explained that triglycerides were fats, the patient was aghast in that she "only ate fat-free foods". I explained to her that triglyceride levels were affected by a number of factors, including emotions, sugar and other refined carbohydrates and caffeine, a fact that few people appreciate.
In light of the fasting blood sugar level being at 108 (I like to see a fasting blood sugar between 70 to 90) a six-hour glucose tolerance test was done as a followup with the patient. During the fourth hour of the test, the patient's blood sugar fell to 38, while simultaneously the patient felt a dramatic increase in her muscular pains and discomfort and felt very fatigued. By the fifth hour of the test, the blood sugar was still low at 58.

After reviewing the results of the test with the patient, she was put on the following program:
1. A dietary plan devoid of refined carbohydrates, including the power bars and fat-free foods her dietitian had advised for her to "lose weight." These were replaced by fresh vegetables, raw nuts, modest amounts of lean animal proteins, brown rice and millet. A small amount of fresh fruit was also allowed. She was to eat slowly and to chew well for three meals per day
2. Bed time was set at 10 p.m., with no television to precede or accompany it.
3. Coffee was eliminated. The patient was instructed to drink water.
4. A program of easy swimming was implemented.
5. I advised the patient not to focus on her symptoms and to get busy with activities that she enjoyed doing.
6. We discussed the possibility of having hormonal testing performed if the patient's overall health did not improve over the next 60-90 days. This turned out to be unnecessary in her case as improvement occurred prior to this time.
7. Periodic office visits included dietary reviews, stress reduction counseling and gentle body work utilizing acupressure and NIMMO.

While during the first 10 days, the patient felt worse as withdrawal from the caffeine and junk food took place, but by the second week, she felt a significant improvement. By the end of the sixth week, her pains had diminished by 80 percent and she had become more receptive to communicating and being physical with her husband.
She has become an swimming devotee and has lost 20 pounds without any special "fat-free foods" or special reducing plans. She sleeps soundly, has noted much improved digestion by the altering of her diet and by changing her habits. She describes her mood as being much more upbeat. Her menstrual discomfort have lessened.
The patient recovered her health, not by "treating" her fibromyalgia, but by a comprehensive health program directed at her specific health picture. After two months of supervision, the patient was dismissed from care with the knowledge and tools necessary to maintain herself in a good state of health for the present and to prevent health problems in the future.

This article originally appeared in: Fibromyalgia - Another Name for Impaired Health (14 pages) - about understanding it's causes & how to regain good health. --- Web Site: - where you can find 50 patient case studies.

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