Guaifenesin Protocol Treatment

6 Steps to Reversing Fibromyalgia

When I first began the guaifenesin protocol, I was severely symptomatic. Reading What Your Doctor May Not Tell You About Fibromyalgia, was very difficult. Over the years, I've heard many newcomers state that very same thing, so I created these steps to help get you started. It's not meant to be a substitute for Dr. St. Amand's book.

Since Dr. St. Amand and many other physicians believe that FM/ME are the same disease that reverse on guaifenesin, I will use the term fibro or fibromyalgia for both FM and ME. 

The majority of people following the guaifenesin protocol begin noticing symptom improvements within a few months. Others begin noticing improvements between 1-3 years. It depends on how long you've been symptomatic, the severity of your symptoms and your genetic makeup-what your clearing dose of guaifenesin is. 

You will feel better before reaching full symptom reversal. On average, two months on guaifenesin will reverse one year of fibro symptoms. 

This is the only treatment that will reverse fibromyalgia when followed precisely  and in the order written. If you have cognitive difficulties, read each step several times before getting started. When available, ask a family member or friend for help.

STEP 1. Receive A Fibromyalgia Diagnosis

If you have a diagnosis of fibromyalgia, go to Step 2.

The guaifenesin protocol treatment will only work if you have fibromyalgia. If you do not yet have a diagnosis of fibromyalgia, make an appointment with your healthcare provider (HCP). 

Your HCP will do a physical examination, searching for pain in 5 areas of the body that has lasted for a minimum of 3 months. 

They will take a health history, asking if you have experienced insomnia, fatigue or cognitive difficulties. If they do not follow these guidelines, they are following the outdated inaccurate test. Schedule with another HCP. 

HCP 's will do lab work to rule out similar diseases before diagnosing you with fibromyalgia. If yours hasn't done so, please make an appointment with them to have your labs done.

If you have a co occurring condition like hypothyroidism, hypoglycemia or sleep apnea, IBS/GERD, etc., they also must also be treated in order for you to feel your best. 

Before your initial appointment, prepare a list for your HCP of all of the fibromyalgia symptoms you have had in the past or currently. Print the symptoms list and highlight your symptoms. https://livingwithfibro-guaiprotocol.com/fibromyalgia

Most HCP 's have not heard of the guaifenesin protocol because they are not needed to help you follow it. Most people are following the protocol by using only the book and online support group-Dr. St. Amand's Guaifenesin Support Public Group

Print a copy of Dr St Amand's Physician paper to offer to your HCP to explain the protocol. 

http://www.fibromyalgiatreatment.com/uploads/2/6/5/7/26574962/physicians_paper_-_march_2014.pdf

STEP 2. Tools To Succeed

Purchase Dr. St. Amand's book, join the Fb support group, and start your symptom journal. purchase guaifenesin, 

Purchase the book What Your Doctor May Not Tell You About Fibromyalgia by R Paul Saint Amand, MD and Claudia Craig Marek, 4th edition, 2019. Available on amazon. Used in good condition are available for under $6.00 at https://www.thriftbooks.com/ with free shipping. 

There is an audio version of the book, but some of the information is outdated, so check back here when you're ready to get started on the protocol. 

Join Dr. St. Amand’s Guaifenesin Support group on Facebook- This will be where you ask questions and learn more about the protocol. 

Dr. St. Amand's Guaifenesin Support Public Group

Purchase Guaifenesin

If guaifenesin is an expectorant for mucus, how can it help with fibro? Guaifenesin is also a mild uricosuric. It promotes the excretion of phosphate in the urine. 

When not blocked by salicylates (you'll read about these in Step 3), guaifenesin helps your sluggish kidneys excrete excess phosphate 6 times faster. This is what decreases your symptoms and reverses the disease. As the excess phosphates decrease your symptoms will decrease until they are gone.

Not all Guaifenesin works for the Guaifenesin Protocol. 

It must meet the following guidelines:

•  12 hour-Extended Release (Long Acting)
•  White only (No dyes)
•  Single Ingredient
•  Single-layer 

The following brands of guaifenesin are approved for the protocol:

• Fibropharmacy.com:

             Guaifenesin 300 mg / NF Vegetarian Capsules  

             Guai600/LA 600 mg Tablets only (cut in half)

             Guardian 600 mg Tablets only (cut in half)

• Amazon.com 

             Aurohealth 600 mg Tablets only (cut in half)

             Guardian 600 mg Tablets only (cut in half)

•  Walmart 

              Equate brand — 600 mg Tablets only — White Only (Some contain dye) 

This information can be found under "files" on Dr St Amands support group on FB https://www.facebook.com/groups/469685523589098

Dr. St. Amand's website is out of date with regard to the type of guaifenesin that works for the protocol. 

However, under "Announcements" he remedies that by stating that Guai Aid and Mucinex are no longer approved for the protocol. Both have a combination of long and short acting with blue dye, respectively. 

Short acting guaifenesin can needlessly increase pain and other clearing symptoms, making it seem as though you are clearing excess phosphates when you are not. The phosphate merely get stirred up, not actually making it out through the kidneys. Dyes have been shown to inhibit energy production, which is already a problem for us. 

It is recommended that you import guaifenesin from fibropharmacy.com or purchase the other approved types from Amazon when at all possible. 

Amazon delivers to internationally. If they aren't yet in your country, this may be an option for you. https://www.myus.com/stores/how-to-ship-amazon-us/.

Your package will be shipped from Amazon to the myus.com store and then shipped to your home. 

Start a Symptom Journal

Track your symptoms for one week before taking guaifenesin to

establish a baseline.

Keeping a journal of your symptoms is of the utmost importance, 

especially if you are not being mapped by one of the 4 protocol 

physicians or a mapper.

Your symptom journal is your guide to find your clearing dose, cycles, patterns and progress. 

Some journal options are:

• HEALTHMINDER Personal Wellness Journal ( amazon)
• App- search for free symptom apps available. Symple has good reviews.
• Use a notebook and write symptoms, pain levels, daily activities.
• I've created several downloadable symptom journal templates.

             https://livingwithfibro-guaiprotocol.com/downloads

STEP 3. Salicylates (sals)

This step has the most information, so take your time reading. This step can feel overwhelming if not impossible. It did for me. I was terrified that I would get it wrong and never get better. I wasn't alone in feeling that way.

It really was as easy as having the sal free list in one hand and the product package in my other hand, while comparing ingredients. You don't have to know what the ingredients are or what they do. All you have to do is compare the lists. If even one product ingredient is found on the sal free checklist, you can not use it. 

Learning something new when feeling ill can be difficult, but you will get this. Remember that you have help. You can ask questions on Dr St Amand's Support group. I check my FB page a few times a week and am happy to answer any questions. 

On to sals...

Salicylates (sals) are contraindicated with guaifenesin. They block or stop guaifenesin from excreting the symptom causing excess phosphates. 

Blocking one day every 6 weeks by using sals is fine. You will still make progress reversing fibro. Use that time to get your hair done, get a massage with oils, have some tea, eat your favorite mint containing foods, or do anything else that will block guaifenesin. 

Keep taking your guaifenesin while using sals. You may only partially block. You will still make progress reversing when blocking once every 6 weeks.

Not everyone is sensitive to sals. Some people do not easily block on sals, others block very easily, and everything in between. Your sal sensitivity is genetically determined. There's no way to know how sensitive you are to sals. 

We can't avoid all sals, but must limit our exposure as much as possible to ensure clearing.

There are both topical (used on skin) and dietary salicylates that must not be used or guaifenesin will not work.

Salicylates (sals) are contraindicated with guaifenesin. They block or stop guaifenesin from excreting the symptom causing excess phosphates.

There are only a few dietary sals that will block guaifenesin. All the rest are neutralized by the digestive process. 

Dietary Sals

• Mint

• Tea (Also avoid drinks that contain tea such as Kombucha). All black, green, white, and oolong tea leaves come from the Camellia sinensis plant.

            Chamomile tea is not made from the Camellia sinensis plant and will not  

            block guaifenesin. 

• Foods eaten in larger than a serving amount. This includes juicing, cleanses and smoothies if they have more than one serving of fruits and vegetable. 

Topical Sals

Topical sals are any product that goes on your skin, your mouth, in your ears, eyes, nose, or genitals. 

Every single product that you use or ingest from shampoo to toothpaste to over the counter medications, etc. must be checked for sals before use. I'll show you how. 

Checking Products For Sals:

Before taking guaifenesin, you must check all your products for salicylates by using the Quick Check for Salicylates Checklist. http://www.fibromyalgiatreatment.com/quick-check-for-salicylates.html

If there’s even one ingredient in your product that is also on the Quick Check for Salicylate Checklist, do not use it.

There's a downloadable Expanded Sal Checklist under Downloads. It contains Dr. St. Amand's Quick Check for Salicylates Checklist plus I've added information on common ingredients that are safe but are often mistook for being unsafe. 

If you do not feel comfortable checking for sals, see step 4 for sal free stores.

QUICK CHECK FOR SALICYLATES (with adaptations, including for the U.K 

"LOOK AT THE LIST OF INGREDIENTS--Below are listed all the things you CANNOT use.

If you do not see one of these on the label, the product is okay to use!!!

NO: SALICYLATE, SALICYLIC ACID 

NO: CHEMICALS WITH THE SYLLABLE SAL-, CAMPH-, OR MENTH-

NO OILS, GELS or EXTRACTS with a PLANT NAME (except Corn, Rice, Oats, Wheat, or Soy which you CAN use)

NO BALSAM OR BISABOL (or PYCNOGENOL in U.K)

SUNSCREENS: No Octisalate, Homosalate, Mexoryl (or MEXORYL SX in U.K), or Meradimate 

VITAMINS: Make sure there are no BIOFLAVONOIDS or QUERCETIN, HESPERIDEN or RUTIN, or any HERBAL INGREDIENTS (plant oils, gels or extracts)

DO NOT USE MINT or ANY PRODUCT WITH A FLAVOR: Make sure the flavor is not mint (of any kind: wintergreen, spearmint, peppermint, etc) and that it does not contain MENTHOL, CAMPHOR, or SALICYLATE.

(Authors note: The only true way to know if flavor contains mint is to call or email the manufacturer and ask for a list of ingredients that are in the flavor. If you ask only if mint is in it, that's all they will look for. They will not understand that you also cannot have menthol, camphor, or salicylate)

DO NOT DRINK TEA"  (Chamomile tea is safe because it isn't tea.)

Dr St Amand- http://www.fibromyalgiatreatment.com/quick-check-for-salicylates.html

The words 'gel' 'oil' or 'extract' may not be used in ingredients. 

Latin names may be a plant, so Google it.

Let's check a product together for sals:

Dove Deep Moisture Body Wash-Ingredients

Water (Eau), Cocamidopropyl Betaine, Sodium Hydroxypropyl Starch Phosphate, Lauric Acid, Sodium Lauroyl Glycinate, Sodium Lauroyl Isethionate, Hydrogenated Soybean Oil, Glycine Soja (Soybean) Oil, Sodium Chloride, Glycerin, Fragrance (Parfum), Stearic Acid, Palmitic Acid, Phenoxyethanol, Guar Hydroxypropyltrimonium Chloride, Citric Acid, BHT, Tetrasodium EDTA, Iodopropynyl Butylcarbamate, Linalool, Limonene, Hexyl Cinnamal, Coumarin, Citronellol, Benzyl Alcohol, Alpha-Isomethyl Ionone. Ingredients correct at time of publishing. Always check product packaging.

Print the Expanded Sal Checklist found in  "Downloads." https://livingwithfibro-guaiprotocol.com/downloads. I've included a list of ingredients that commonly confuse beginners that are safe to us. I also added a list of common activities that block guaifenesin.

Let’s check each ingredient. Comparing the ingredients from the product label, compare to the Expanded Sal Checklist.

The first ingredients in Dove Deep Moisture Body Wash are: 

Water (Eau), Cocamidopropyl Betaine, Sodium Hydroxypropyl Starch Phosphate, Lauric Acid, Sodium Lauroyl Glycinate, and Sodium Lauroyl Isethionate, are not on the Checklist. They are safe.

The next 2 ingredients may be confusing. Here's more information….

Hydrogenated Soybean Oil: Soybean oil is one of the 5 plant oil, gel and extracts that are ok. Corn, Rice, Oats, Wheat, Soy...C.R.O.W.S.

Glycine Soja is soybean oil and is ok to use. Again, Soy is one of the 5 plant oil, gel and extracts  that are ok. 

The next ingredients, Sodium Chloride and Glycerin are not on the checklist, so they are ok.

The rest of the ingredients are listed after Fragrance (Parfum), which do not have enough sals to block guaifenesin. They are safe to use.

We did not find an ingredient on the label that is also on the checklist, so this product is safe to use.

There! You made it! Now, that may be swirling around in your head for a while while you're processing it. That's ok. Give it sometime and then go back and read it again. It will begin to make more sense as you begin checking your products for sals. 

Be sure and check everywhere that you keep products; the primary bathroom, guest bathroom, kitchen, purse, briefcase, office, glovebox, vacation home, boat, etc.If it’s feeling overwhelming, ask a loved one for help. My youngest daughter helped me and I thanked her by giving her all of my products that contained sals. 

STEP 4. Purchase Salicylate Free Products

Another seemingly daunting task, and it kind of is, but you'll only have to do this once. 

I've had people take as long as a couple of months to replace all of their products.

I've also had people who want to start the protocol asap, so they buy a few things to get them started from a sal free store or the starter kit from Fibropharmacy.com. 

Either way is fine. 

I gave all of my products to my adult daughters who were no longer living at home. My husband kept his products separate from mine, so that was never a problem. As I purchased sal free items, I kept them in a basket separate from the other household items that my husband used.

Getting started-

You undoubtedly have many products in your home and many of them may already be sal free. Checking them is a great way to practice looking for sals. 

I suggest starting in your main bathroom if you have more than one. This will be quite a job and take some time, so being organized helps. Take a pen and paper or make a note on your phone of which product you'll need to replace.

Start in the shower. Check your shampoo. If it has any of the ingredients on the sal checklist, make a note to purchase a sal free kind. Once your replacement arrives, give it or throw the old shampoo away. Do the same thing with  each product in the shower. If a product no longer has the complete ingredient list on it, replace it. 

Once you've finished with the shower products, begin with the products in your vanity and then move on to your medication and supplements. 

Then move onto the ...

next bathroom

overnight bag/toiletry kit

briefcase

car glovebox

or any other place where you may have products.

REPLACING YOUR PRODUCTS WITH SAL FREE PRODUCTS

You can purchase sal free products in stores or online. 

You can find over 350 sal free products @ https://livingwithfibro-guaiprotocol.com/sal-free-products-1. 

As always, the only accurate ingredient list is on the packaging so check the package against the Quick check for salicylate list before using. 

Another source is  Dr. St. Amand's Guaifenesin Support Public Group

WHEN PURCHASING PRODUCTS, YOU MUST CHECK THE INGREDIENTS FOR SALS BEFORE PURCHASING  EACH AND EVERY TIME. 

THE MOST ACCURATE INGREDIENT LIST IS ON THE PACKAGING. 

IF YOU BUY 2 OF THE SAME PRODUCT YOU MUST CHECK BOTH FOR SALS BECAUSE THEY CAN BE FROM DIFFERENT PRODUCT LOTS. (One can have sals. This happened to me) 

WHEN SHOPPING ONLINE, MANUFACTURERS DO NOT UPDATE THEIR WEBSITE RIGHT AWAY, SO...

CHECK THE INGREDIENTS BOTH BEFORE BUYING ONLINE AND BEFORE USING. THE PACKAGE IS THE ONLY ACCURATE INGREDIENT LIST.

These 2 Companies are sal free. You do not have to check products purchased from them:

https://www.andrearose.com

https://www.cleure.com

Cluere sells many products on Amazon.com

Sal free toiletry kits to get you started, which includes a bottle of approved 300 mg guaifenesin, are available at Fibropharmacy.com. 

https://fibropharmacy.com/product-category/start-up-kit/

STEP 5. Find Your Guaifenesin Clearing Dose

There are now 4 protocol trained physicians and two trained protocol mappers. If you are not able to work with a protocol trained physician/mapper, that's ok. Most people are following the protocol with only Dr St Amand's book/website and support group. 

If you will not be working with a protocol physician, scroll ahead to "BEFORE TAKING YOUR 1ST DOSE OF GUAIFENESIN"

If you can be mapped by a protocol trained physician or mapper, it is recommended you do so before taking your first dose and again after 1 month to see if your thighs have cleared of phosphate nodules. If the thighs have cleared after 1 month, the amount you are taking is your clearing dose.

Protocol Physicians Trained By Dr St Amand

Dr Melissa Congdon retired as of Nov 2024. Dr MacDonald has taken over her practice. 

Dr. Margaret MacDonald, M.D.

1485 Garden of the Gods Rd Ste 172

Colorado Springs, CO 80907 (719) 249-0217

Dr. Carla Kuon, M.D.

UCSF Medical Center at Mount Zion

1600 Divisadero St, San Francisco, CA, 94143

300 Hospital Drive, Sutter Solano Medical Ctr, Vallejo, CA 94589

(415) 885-3723

Mappers-

Cheryl Kowalewski, Fibrofree Guaigroup Leader, Edmonton, Alberta.

 cheryl@fibrofreerecoverygroup.com

Elke Weigel, Stuttgart, Germany 

http://weigel-elke-fibromyalgie.de/habe-ich-fibromyalgie/ 

BEFORE TAKING YOUR 1ST DOSE OF GUAIFENESIN:

• Track your symptoms for 1 week to establish a baseline. 

• Stop using all products containing sals, including not having had any mint, tea or food in larger than normal servings (such as juicing) for at least 24 hours. 

• Read the symptoms list before taking guai so you know what to look for in finding your clearing dose. You will know that you have found your clearing dose when you have either had an increase in your symptoms or experience a new symptom. 

For a symptoms list pdf, go to

https://livingwithfibro-guaiprotocol.com/downloads

5% of us do not experience an increase in symptoms or any new symptoms. This can make it challenging to determine your clearing dose. You'll need to keep increasing your dose. At some point, you will experience an increase in symptoms, even if it is subtle. This will make sense as you read further.  

-BEGINNING DOSE:

Take 300 mg of approved guaifenesin every 12 hours for 1 week. This is the clearing dose for 18%.

If you have a parent or sibling on the guaifenesin protocol who clear on the lowest dose of guaifenesin, take 300 mg x 2 for two weeks. 

If you notice an increase in symptoms or any new symptoms, this is your clearing dose. 

Low dosers (clearing on 300 mg x 2) almost always feel a very noticeable increase in pain, fatigue or both. You can experience new symptoms.

If your symptoms get worse in that first week (or two if your family member is a low doser) on 300 mg twice daily, you are a low doser fast responder. We have unique issues with the protocol. It can be much harder, but you will reverse your symptoms faster than those taking higher doses. 

The first year can be hard for low dosers, because they clear up to 20 areas at once without any breaks for the first year. They are improving. They are clearing fast. But it's hard to not see for a year or longer any signs of improvement.

It's important to mention that you are a low doser when asking for advice in Dr St Amand's or other support group. Since low dosers are a small group, the majority really do not understand the issues with being a low doser and their advice can hurt. 

If, at one week (or two if your family member is a low doser), you do not feel distinctly intermittently worse - like having a worse than usual flare up- or if you have not experienced any new symptoms, double the dose. See instructions below.

                                                         ~~~~~~

Take 600 mg every 12 hours for 1 month. This is the clearing dose for 80%.

If you notice a distinctive intermittent increase in symptoms, this is your clearing dose.

If you do not feel distinctively worse, check your products for sals.

If you find a sal in your products, discontinue using that product. Wait 24 hours and start the one month time period over. 

If you feel intermittently distinctively worse within one month, this is your clearing dose.

If you have not felt any intermittent increase of symptoms or new symptoms, and are not blocking, you are a high doser. It may take a while to find your clearing dose. That's because you have to increase your dose and stay on it for another month. This must be done until you feel intermittently distinctively worse or experience new symptoms.

Start to find your high dose by increasing your dose to 900 mg every 12 hours for one month.

If you do not feel distinctively worse or check your products for sals.

If you find a sal in your products, discontinue using that product. Wait 24 hours and start the one month time period over. 

If you feel intermittently distinctively worse or within one month, this is your clearing dose.

If you haven’t felt any intermittent increase of symptoms or new symptoms after one month, and aren't blocking, you need a higher dose than most.

High dosers add guaifenesin until they do feel an increase in symptoms or a new symptom. 

This next step is very important! Please do not skip it! It's best to wait until finding your clearing dose before following Step 6.

STEP 6. Test Yourself For Hypoglycemia or Carbohydrate Intolerance.

                There is no diet for the guaifenesin protocol.

However, 30-40% of us are fibroglycemic, having both fibro and hypoglycemia.

These two separate diseases have numerous overlapping symptoms and make each other worse. To feel our best, both diseases must be treated. The guaifenesin protocol for fibromyalgia and the HG diet for hypoglycemia. 

It is difficult to tell which symptoms are from fibromyalgia and which are from hypoglycemia. The best way is by stabilizing your blood sugar levels by following the hg diet for 2 months and remaining on a low carb diet.

There is NO reliable medical test for Hypoglycemia/carbohydrate intolerance. The best test is by how you feel after following Dr St Amand's HG Diet perfectly for 4 weeks. 

For HG RECIPES  for the first two months on the hg diet, go to

https://www.facebook.com/fibrogone #lynnshgkitchen

If you notice a reduction in symptoms, you are carbohydrate intolerant. Continue the hg diet perfectly for another 4 weeks. This amount of time allows the pancreas to heal and blood sugars to stabilize.

After 2 months following the hg diet perfectly, one new low glycemic index (low sugar) food can then be added every 48 hours.

An example of a low glycemic food would be adding brown rice or quinoa instead of white rice. Another would be adding in a sweet potato instead of a russet or red potato.

Chart your daily symptoms. If you react badly to a food, your body cannot tolerate it. Stop eating it.

If you add high carb foods or add too many new foods and become symptomatic, you will need to start the diet over for 3 weeks to heal the pancreas again.

The hg diet treatment will heal the pancreas and stabilize blood sugars, but a low carb diet will most likely need to followed for life, especially if you have a family history of diabetes.

There are other reasons to follow a low carb diet. There is evidence that people with fibro do not process sugar normally and benefit from following a keto diet or other low carb diets. 

A low carb diet also helps the guaifenesin protocol by stabilizing blood sugars. Unstable blood sugars increase insulin production which slows the excretion of phosphate.

South Beach diet and Whole 30 are a good source for adapting recipes to the hg diet.

The HG Diet Foods List and meal ideas can be found at https://livingwithfibro-guaiprotocol.com/hg-diet-and-meal-ideas

For more information on coping with fibro, symptom management, symptom reversal including hg diet recipes for the first two months, go to https://www.facebook.com/fibrogone

For recipes go to #lynnshgkitchen to jump to recipes 

If you are struggling to find your clearing dose or need help to understand the guaifenesin protocol, there are ways to get help: 

• You can ask Dr St Amand's support group for help. 
• You can work with a protocol trained physician. 
• You can work with a fibromyalgia advisor. 

This is not easy, but it's not easy living with fibro. With this treatment, you can get your life back!

Stay Strong! Believe in yourself! Don't quit! 

Medical Disclaimer

I am not a doctor or any other type of healthcare provider. The material is informational only and not to be used as a replacement for your own medical care, diagnosis or treatment. Please see your personal physician for diagnosis and treatment options. The reader is solely responsible for all personal medical treatment and symptom relief decisions, applications and consequences.