Rather than a patient asking why did this illness happen to me, which is the common complaint, the better question might be why is this illness happening at all. Often when patients probe their own life circumstances-to see how they feel about what is happening-the "why" behind the illness becomes clear and the condition usually clears up more quickly and thoroughly than expected.

The Career Upset behind Her Rheumatoid Arthritis
Tara, aged 36, came to me with symptoms of rheumatoid arthritis. Although she had been consulting a conventional rheumatologist and was receiving gold injections and the nonsteroidal anti-inflammatory drug Daypro, she was still highly uncomfortable. Tara continued to experience considerable pain in her hands, knees, ankles, and feet, morning stiffness, and extreme fatigue--all typical symptoms of active inflammation. She was ready to try a natural alternative.

To start with, I prescribed a high dose of vitamin C to act as a natural anti-inflammatory. I told Tara to take vitamin C to bowel tolerance. This amount varies among individuals, but refers to that amount of vitamin C your body can tolerate just short of producing diarrhea, which signifies you've had too much. Next, I put her on a bioflavonoid called Bioquercetin, to be taken at the rate of two tablets, three times daily. A bioflavonoid is a vitamin C "helper" substance that enhances the beneficial activities of vitamin C and increases its absorption by the liver, kidneys, and adrenal glands.

In addition, Tara started taking a proteolytic enzyme formula called Inflazyme Forte (three capsules, four times daily) to improve her digestion and decrease inflammation. Finally, during her office visits, I gave her a "Meyer's cocktail." This is an intravenous infusion of nutrients given not as a drip, but as a slow push. The push contains calcium, magnesium, vitamins B5, B6, and B12, the entire vitamin B complex, and vitamin C. She had these nutritional "cocktails" once weekly for about six weeks.

The purpose of this intravenous mineral and vitamin protocol is to improve fatty acid metabolism, provide energy, and introduce antioxidants into the body. These nutrients are involved in hundreds of biochemical reactions, yet most people are deficient (at least, relatively) in one or more of them.

At the same time, I encouraged Tara to look at her life to see if any psychological, emotional, or lifestyle factors might have contributed to the onset of her arthritis. Although I am a rheumatologist by training, to me the context in which the healing process takes place is just as important as the specific healing tools, such as nutritional prescriptions. You can't separate what's happening in one part of the body--in Tara's case, her joints--from the rest of the body or from what's happening in the patient's life.

You don't just walk down the street through a Martian arthritis ray and suddenly come down with rheumatoid arthritis, or any other illness. Yet many conventional doctors behave as though this is the case, acting as if a condition just came out of the blue and will go away if you take certain drugs. But illness does not happen just to the physical body. It doesn't matter whether we're talking about colds, high cholesterol, asthma, cancer, or arthritis, there are emotional and psychological factors involved.

Since the 1970s, the developing science of psycho-neuroimmunology (PNI) has proven that there is an ongoing chemical communication between the psyche and every part of the body, including the nervous, immune, and endocrine systems. More specifically, the parts of the brain involved with emotions chemically "talk" to every other part of the physical body.

What this means on a practical daily level is that you cannot have a thought without it having some physical effect on you. If they're fleeting thoughts, the effects are usually minor or unnoticeable, but if they are thoughts with a lot of strong feeling behind them or thoughts that recur or that we continually dwell on, the physical effects can be much more significant. So I asked Tara to look into the why behind her arthritis, to become aware of the emotional factors contributing to it.

As a successful realtor, Tara had enjoyed a niche in her community. She knew the neighborhood, the market, and the people. But her company decided to put somebody else in her place and relocated her to another town. This was a huge change that was emotionally disturbing to her. She was suddenly uprooted from a secure and familiar position and community. At the same time, a relationship in her life was falling apart. This breakup and the job change were significant precipitating factors; her arthritis symptoms began after these events.

Patients need to be encouraged to find the meaning in their health crisis. Most people have some kind of innate knowing of this, but it is not usually supported by conventional doctors as part of the healing process. Why do I need this in my life now? What might this condition or pain or symptom or limitation be trying to get me to do or stop doing? If you can ask yourself these questions without guilt or self-blame, get in touch with the answers, and start to make changes accordingly, then real progress in your healing becomes possible.

The body speaks its own language, and often illnesses affecting different parts of the body are associated with certain emotional states. For example, in many cases I have seen, arthritis is the physical manifestation of anger or resentment that has not been verbally expressed. Correlating certain emotional states with specific symptoms and illnesses is not the point of my approach. Rather, I'm suggesting that there are always emotional, psychological, and/or spiritual issues involved in illness.

If these are not attended to, all you're doing is treating symptoms, even if you're using the highest quality remedies. That is a trap that a holistic, alternative physician can fall into the same way conventional doctors do. It's selecting a different herb or vitamin for a particular symptom, but losing sight of the whole picture.

Along with the program to address her physical imbalances, Tara made changes in her life as well. She became involved with a therapeutic support group and began to deepen her understanding of the reasons behind her illness.

The Progression of Healing
Six weeks after Tara began the nutritional program, she had much less pain and stiffness and more energy. She was definitely feeling better and was able to discontinue the Daypro. But she was not all the way home yet; she still felt more tired than she wished. I suggested she start a colon cleansing program using an inexpensive formula called Cleanse Thyself(tm), which includes an herbal laxative, herbal nutritional supplements, liquid bentonite, psyllium husks, and Flora Grow, which restores healthy intestinal bacteria. Tara did this program for two weeks and reported continuing improvement in her joint symptoms, better digestion, and more energy.

At the six-month mark, I ran a blood test to check Tara's DHEA levels. This is a hormone naturally produced by the adrenal glands and gonads that functions in the body as an antioxidant, hormone regulator, and the building block for estrogen and testosterone. It's the hormone believed to maintain a youthful body, as its levels are highest when men and women are in their early twenties.

The use of supplemental DHEA has been associated with reduced joint pain, among other benefits. Technically, Tara's DHEA level was in the lower end (113) of the normal range (35-430), but I wanted to raise her DHEA to the upper end. She started taking 25 mg of DHEA every day. At the same time, I started Tara on an essential fatty acid (EFA) supplement called Max EPA and borage oil. This would help to further reduce her arthritic symptoms. Both omega-3 and omega-6 oils (EFAs) can produce positive benefits in cases of inflammation such as rheumatoid arthritis.

Generally, Tara continued to improve, although when business called her away for travel and she missed the Meyer's cocktails, her symptoms temporarily worsened. She felt sufficiently improved to begin noticing other symptoms that had been previously obscured by her more severe arthritic pain.

Tara had extreme cold sensitivity, chronic constipation, and thinning hair, symptoms which generally indicate an underactive thyroid gland. The thyroid gland, shaped like a bowtie wrapped around the trachea in the throat, is the body's metabolic thermostat, controlling body temperature and energy use. Its proper function is central to numerous body activities, including digestion and intestinal elimination.

Tara's blood test showed normal values for thyroid hormones yet when she checked her temperature upon rising in the morning, it averaged 97.1°F (normal is 98.6°F), indicating that functionally her thyroid was underactive because her resting (basal) body temperature was too low. The blood test tells how much thyroid hormone is in circulation in the blood, but it does not tell you how well that hormone is functioning or how thoroughly it is entering the cells.

To correct this, I put Tara on a broad-spectrum glandular formulation called TG 100 containing thyroid, adrenal, pancreas, spleen, and thymus extracts, along with ascorbic acid. She took two 40 mg capsules daily and within a few weeks her constipation improved, her hair started to thicken, and Tara was less cold sensitive.

At this point, Tara no longer has any of the severe symptoms of rheumatoid arthritis that once kept her from functioning. She is not yet entirely symptom free but she is no longer limited by any disability related to the arthritis. Tara came to appreciate how these apparent deterrents to living-the arthritis symptoms-actually helped her turn her life in a new direction. They forced her to make changes that turned out to be quite positive.

Michelle Stops Carrying the Weight of the World
Fibromyalgia, or constant muscle aches, spasms, and tender points, sleeping problems, and fatigue, is a condition poorly understood by conventional medicine and one from which patients do not normally (or easily) recover. Before seeing me, Michelle, aged 39, had suffered from severe muscle pain for about two months.

On the surface, it seemed ironic that a woman as physically active as Michelle should develop the classic symptoms of fibromyalgia. Michelle taught a full-time schedule of aerobics classes, along with running to keep up with her two young children. She was the kind of person who tried to do and be everything for everybody. As we discovered, this attitude was at the core of her muscle aches.

When a person has problems with muscle spasms or muscle irritability, often there is an absolute or relative deficiency of magnesium in the body. Almost as a general rule, I will give the Meyer's cocktail to patients with fibromyalgia or muscle spasms to get sufficient magnesium into their systems. As with thyroid testing, you must be careful not to take the results of a standard blood test for magnesium levels at face value.

First, a regular blood test does not necessarily tell you the amount because most magnesium is stored inside the cells. Second, even ascertaining how much magnesium exists in the cells (intracellularly) is not the final answer because the reading could be normal yet the patient responds favorably to extra doses of magnesium (as was the case with Michelle).

In addition to considering magnesium supplementation, it is often advisable to run a delayed allergy hypersensitivity test on a person with these symptoms. Frequently, there are hidden food or substance allergies that can aggravate the symptoms, although the reaction may not take place until hours--12 hours is not uncommon--after eating the food, thereby displacing our attention away from the allergen itself.

For example, you could eat wheat and have a migraine headache the next day, or have some corn and experience an arthritis flare-up 24 hours later. You may think you're on a healthy diet and actually be allergic to one of the "healthy" foods you're eating. For instance, drinking organic carrot juice may contribute to your physical symptoms if you're allergic to carrots.

Michelle's allergy test indicated she was reactive to most dairy products (Romano cheese, yogurt, and whole butter, in particular), tuna fish, raspberries, cherries, coffee, food additives and preservatives (MSG, saccharine, sodium benzoate), and environmental chemicals such as cleaning products, benzene, and trichloroethylene. As a first measure, Michelle began avoiding these substances.

Next, we used a laboratory test called the Comprehensive Digestive Stool Analysis to see how her digestion and intestines were working. The results indicated large amounts of residual fats and vegetable fibers, which told us that Michelle had a nutrient malabsorption problem. I put her on a digestive enzyme formula called Digestin that contained the primary enzymes for each food group (fats, proteins, carbohydrates, and fibers), hydrochloric acid (the stomach's principle digestive juice), and ox bile (to aid the small intestine in its digestive processes).

Concurrently, I put Michelle on several other nutrients and formulations. She took esterified vitamin C to bowel tolerance; the ester form is better absorbed. She took Fibroplex to provide nutrients for muscle energy. Specifically, this formula contains magnesium, malic acid, manganese, and vitamins B1 and B6. Providing magnesium and malic acid in adequate amounts often produces favorable benefits for fibromyalgia, possibly by removing aluminum from the body.

Michelle also took a supergreens concentrate called Greens Plus, taken twice daily as a powder added to water or juice. The purpose here was to provide a full natural nutrient array in organic form that could be easily assimilated by the body. The product contains a large amount of chlorophyll, which is a natural, easily absorbed source of magnesium. Michelle also took vitamin B12, taken as a capsule that dissolves and is absorbed under the tongue (sublingually). She responded better to B12 when it could enter her body without having to pass through her digestive tract.

In addition, after checking Michelle's DHEA levels, which tested low, I started her on 5 mg daily of this hormone. I had her slowly increase her DHEA intake until she achieved the maximum benefit and before she started experiencing adverse side effects (in her case, 25 mg daily).

Most people tolerate DHEA well, but sometimes in women DHEA, because it is a precursor hormone, can be turned into other hormones by the body, such as estrogen or testosterone. This can lead to abnormal bleeding, breast tenderness or swelling, acne, or unusual hair growth. I also had Michelle take 5 mg of melatonin at bedtime to aid her sleeping. Not being able to sleep easily or well was a major problem for her.

Michelle also consulted a chiropractor who used a deep-muscle massage technique called myotherapy to release "trigger points" in her musculature. These are specific points on the body known to carry and concentrate stress; releasing them through massage is an effective contribution to overall pain reduction.

After about four weeks of following this program (including the once-weekly Meyer's cocktails), Michelle reported considerable gains. Her digestion was improved, she was coping better with stress, and she felt more at peace with herself and in greater control of her life. She told me, "I feel like I have more energy. I feel less shaky, the muscle spasms aren't as bad, and I'm starting to get a little perspective on my condition."

The perspective Michelle was gaining had to do with insight into why she had fibromyalgia. She was highly motivated to get well, willing to do the hard psychological inner work and to make the life changes such insight required. In a sense, she had to, because she had reached the point where the pain was so severe she could no longer function. Pain had forced her to cut back on her aerobics classes and teach only the much less demanding water aerobics. Then she had to give that up as well.

In answering the questions I urged her to ask herself about the message of her condition, Michelle began to see that she always strove to be the super mom, super wife, super teacher, the super performer in every situation or relationship. Her striving wasn't egotistical, but came out of her caring and industriousness. Michelle saw how everybody leaned on her and how, because she felt this was her role, she could never say no-and it was too much.

Michelle understood how she had developed severe, almost total body pain to force her to stop in her tracks. She saw what she had been doing and appreciated that she could no longer do it nor did she want to. Finally, Michelle realized that it was okay to say no and to ask for help.

Not everyone with fibromyalgia will fit this pattern, but there is a certain general trend to the psychological factors involved in chronic muscle pain of this type. A person feels burdened and overwhelmed, as if everybody is leaning on their body, as if they are carrying the world's weight on their shoulders. So the "weight" goes to the muscles which eventually complain, using the body language of aches and spasms.