Introduction
Currently, about one half of Dr. Gordon's patients have CFS/FM. He does a lot of work with hormones, which he believes is a key issue in chronic pain, especially if you have had chronic pain for a long time.

By way of explaining why so many doctors have problems dealing successfully (or tactfully) with CFS/FM, Dr. Gordon says it is because of the way they were trained and the way the majority of doctors today practice medicine. There were taught the disease-based model, which works wonderfully well if you have a specific well-documented illness or injury. "Conventional medicine is easy - after my third year, I rarely had to look anything up," said Dr. Gordon, of his years spend practicing conventional and emergency room medicine. "High blood pressure, broken leg, pneumonia - despite the individual differences presented by each patient, each case was pretty much the same, medically. CFS/FM, on the other hand, is an unending challenge. We can give one of you something and it works wonderfully, but we give it to another one of you at 1/4 the dose, you're sick for a week!" CFS/FM, he says, is a smorgasbord of a variety of different illnesses.

Conventional, disease-based medicine makes a major erroneous assumption: that we are all clones of one another who all have the same needs (i.e., nutritional requirements), who all function in the same way (i.e., digesting and absorbing nutrients), and who all react the same way to the same stimulus (drug, treatment, chemical exposure, etc.).

But we aren't. "People are dynamic organisms and we are all different," says Gordon.

"Conventional medicine," says Dr. Gordon, "only cares about what kills you, not about what is optimal for you."

Thyroid
The TSH (thyroid stimulating hormone) has become the "gold standard" of thyroid function. When most doctors do a "thyroid test" they measure your TSH and decide, based on the test result, whether you have a thyroid problem or not. It doesn't seem to matter if you are exhibiting all of the classic signs of hypothyroidism, since the test says you're thyroid is normal, then you're normal, period. The fact that your hair is falling out, you have headaches, weight gain, brittle nails, abnormal fatigue, etc., is irrelevant since the test is normal.

Some doctors may go a step further and look at your free T4 -- but not the free T3. To further complicate matters, the actual test procedures most labs use to test total T4 and T3 are essentially antiquated; there is new technology that can test the free hormone levels much more accurately.

In addition, without also testing the free T3, the doctor has no way of knowing if your body is properly converting the T4 it makes into T3. Just because the TSH level is normal doesn't mean it is present in your system in sufficient amounts, and just because your free T4 level is good doesn't mean your body is converting it like it should. "If you are exhibiting signs of low thyroid, your free T3 will be low despite your TSH being 'normal'," says Dr. Gordon. "The TSH only shows what is going on in your hypothalmus, not in your liver or elsewhere in your body."

Treating thyroid deficiency isn't always as easy as it seems when looking at disease-model medicine. In most people, their bodies convert the T4 they take into T3 just fine. For the others, "we may need to give them T4 and T3, or just T3, to see if we can fix the problem in the liver that is preventing their body from being able to do the conversion of endogenous T4 into T3."

Dr. Gordon's observation on conventional medicine:
"The body is very complex; doctors don't want it to be. The disease model we were taught does not allow for complexity, for biochemical individuality.

"To further hamper creating medicine, in the past 30 years, especially the last 10 years, the accountant-model has taken over. In a double blind placebo study, if a small percentage of the test group shows enormous improvement, the statistician/accountant model throws the result out as 'chance" instead of looking to see why it works. They dismiss what they see as aberrant or "coincidental" results, instead of addressing that group of subjects to find out why they responded in that way."

When you go to the doctor and they order liver function tests (LFT, which are also part of some standardized chemistry panels, such as the Chem 20), they test the ALT (alanine aminotransferase) and AST (aspartate transaminase), formerly called SGOT. While these tests are effective when the liver cells are dying or when a disease process, such as hepatitis, is present, they are unable to test the liver's detoxification ability.

Detoxification has been a sort of dirty word in the medical profession, where the idea that toxins (other than acute poisoning) affect the body - its organs, glands, and ability to function - has been dismissed as a sort of old wives tale or old-fashioned. The idea that the gut and its ability to function, or not function, may have something to do with how you feel has been dismissed in disease-based medicine if the cluster of reported symptoms don't match an existing disease model. The disease-based model ignores the fact that all chemicals that enter the body - through the mouth, respiratory tract, and skin - have to be rendered inert by the liver. In addition, the liver has to deal with all of the hormones produced by our bodies. If the liver is impaired in any of this detoxification pathways, it cannot detoxify everything to bloodstream carries to it. If the liver is overwhelmed by environmental estrogen, for example, it is going to be unable to adequately deal with the estrogen made by the body, and anything else that uses the same pathways.

On the other hand, alternative or complementary medicine acknowledges that the gut has a great deal to do with how we feel and may in fact play a significant role in how our bodies are able to function. Alternative/Complementary medicine, then, looks at ways to identify what is wrong and then to help or fix the problem.

Detoxification Profile
The Great Smokies Detoxification Profile is their basic test to assess the body's capacity to carry out specific aspects of detoxification and free radical damage, based on samples of saliva and urine collected through the 24 hour period of the test. These functional assessments provide a comprehensive profile of the body's detoxification capacity and potential susceptibility to oxidative damage by measuring the clearance of aspirin, Tylenol and caffeine in two salivary specimens and an overnight urine collection specimen, a sample of which is then submitted for the actual testing. (At present, there are no substitutes for those patients who are unable to tolerate caffeine, aspirin or acetaminophen.)

There are two phases to the liver's function, cleverly called Phase I and Phase II. Conventional medicine spends its time in Phase I, the Cytochrome P450 system, which is the first step in metabolizing a lot of drugs.

We all have different variations on this C-P450 system which is why people don't always react the same when given the same drug. Eventually, labs will be able to test your blood and tell which drug will work best for you. For now, one way we have to test how well your C-P450 works is by looking at how well it handles certain substances, in this case, the GS Detoxification Profile which tells us how your liver metabolizes caffeine. If your C-P450 system is running very high, it is a good indication that you have an ongoing toxic situation in your life which is affecting the toxic loads your liver is trying to deal with. If the C-P450 system is running is very low, you either live in a wonderful place or your thyroid (or some other things) isn't working very well.

In Phase II, there are several detoxification pathways at work, including sulfur, glutathione (environmental toxins), glucaranidation (hormones), and glycination (hormones, environmental toxins). Tylenol and aspirin are metabolized in these pathways. By challenging these pathways by taking aspirin and acetaminophen as part of the GS Detoxification Profile test, we will know what pathways are affected and so can fine-tune which supplements or drugs you need to take to improve your liver function. As an example, perfume sensitivity can be affected by glutathione pathway dysfunction, but there may also be an allergic component to the sensitivity reactions. So, while boosting the glutathione won't necessarily eradicate the sensitivity, it will help your liver better detoxify perfumes when you are exposed to them. Since your body will be better able to deal with the exposure, the stress on your immune system may be reduced enough to lessen the severity of your reactions to perfume exposures.

Given how expensive many supplements and nutriceuticals are, it makes more sense to find out which ones your body needs - what it will take to reduce the loads your liver can't handle or improve the pathway functioning - rather than taking a shot-gun approach by taking everything&ldots;or giving it all up as all too complicated and taking nothing.

A note for Tylenol users: Tylenol uses up glutathione. If you take Tylenol, you should also take N-Acetyl-Cystine (NAC).

Excerpted from:  http://www.anapsid.org/cnd/diagnosis/gordontalk.html