Basic Treatment Instructions
These treatment instructions were taken from the site,
of the guai doctor, Dr. R. Paul St. Amand, who developed and pioneered the protocol.
These instructions are specifically designed to include those not
First, rule out any other conditions and locate a doctor who understands FMS.Dr. St. Amand
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
your 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 (see FibroMeet for details on how to
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 byproducts with
salicylates. You should feel significantly but tolerably worse.Statistics show that 300
mg.twice daily (approx 12 hours apart) suffices for 20 percent of patients.
If no severe exacerbation of symptoms has begun in that time, increase to 600 mg 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 who are 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 is necessary.
If the patient has not had a worse time of it at a month on the1200 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 2400 mg 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, Dr. St.
Amand suggests people take the extra pill in the morning, to avoid splitting pills (just
for convenience). He usually titrates dosage by 600 mg, but if you prefer to raise by 300
mg 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
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 4800 mg per day, the highest dose Dr St Amand has had
to use on his patients is 3600 mg daily. A very few patients have cycled on only 300 mg
daily. Reversal cycles are generally intensified symptoms of whatever YOU have already
experienced. 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
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 in 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'll never want to go back!