Complementary Medicine

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Treating Dry Eyes and Dry Mouth in CFS/FMS

Treating dry eyes and dry mouth in CFS/FMS

A study found decreased tear production in 90% of those with fibromyalgia. Experience has shown that dry mouth is also common, aggravating dental and digestive problems. In those who suddenly get a bunch of dental cavities along with their CFS/FMS, dry mouth is the usual cause. This occurs because saliva is critical for preventing dental infections.

Dry eyes and dry mouth (called "Sicca Syndrome") is treatable. It is caused by autoimmune disorders that injure the glands that make tears and saliva, but also is aggravated by nutritional deficiencies and many medications. Some doctors who are not familiar with CFS/FMS immediately think of an autoimmune disease called Sjogren’s syndrome — and go chasing the wrong problem. Though Sjogren’s syndrome can cause CFS/FMS, it is less common, and a Sjogren’s diagnosis should be confirmed with an SS-A and SS-B blood test and a simple biopsy. If you have widespread achiness and fatigue with insomnia, think fibromyalgia.

How to Treat Dry Eyes and Mouth

Check Your Medication(s)

Many medications used in CFS/FMS cause dry eyes and mouth — and alternatives can be used that do not have this side effect. Bring this up with your doctor at your visit and ask your pharmacist if any of your medications are likely to cause dry eyes or mouth. The most common culprits include:

  • Antihistamines — Including Benadryl, Zyrtec and Claritin. Benadryl and other antihistamines are often found in over the counter sleep aids.
  • Antidepressants — Elavil is a major trigger of dry eyes and mouth, but most antidepressants can cause this problem. Cymbalta and Savella, though used for fibromyalgia pain, are also antidepressants.
  • Birth Control Pills — May cause dry eyes as a side effect. However, pregnancy is also known to cause dry eyes. Testosterone cream applied to the upper eyelids was reported to help those with dry eyes, but I have not been able to confirm this finding.
  • Diuretics — These drugs are mostly used to treat high blood pressure.
  • ACE Inhibitors — Angiotensin-converting enzyme inhibitors are mostly used to treat high blood pressure.
  • Acne Drugs — Including Accutane and high dose vitamin A.
  • Opiates

Treat Nutritional Deficiencies

Symptomatic Relief for Dry Eyes

  • The medication Restasis eyedrops.
  • Plugging up the tear draining ducts (in severe cases).
  • Discuss with your eye doctor.

Symptomatic Relief for Dry Mouth

  • Drink sips of water throughout the day as needed.
  • Avoid sugar and sodas. Dental problems can be severe with dry mouth, and eating a lot of sugar can make these much worse.
  • Lemon juice (e.g., lemonade made with 3 and 1/2 cups of water, 1/4-1/2 cup of lemon juice, and about 50 drops of Stevia to taste (brand is important — I use the one from Body Ecology, also available from 1-800-4STEVIA). Lemon juice stimulates saliva flow. Do not use lemonade containing sugar (if it has more than 5 calories it has sugar) as it can rot your teeth.
  • Suck on sugar free lemon drops or other hard candy or chew sugar free gum. Be sure these are sugar free!
  • Ask your dentist about saliva substitutes.

Jacob Teitelbaum, M.D., internist and author of From Fatigued to Fantastic!, researches treatments for Chronic Fatigue Syndrome and fibromyalgia.

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