Fibromyalgia and Fatigue

Fibromyalgia is commonly associated with fatigue. At the American College of Rheumatology meeting last month in Chicago, more than 1,000 posters were presented representing various rheumatic diseases.  In last week’s blog I shared a few of these findings.
This week I would like to share findings from a Rheumatology/Pain clinic in the United States where DHEA-s blood levels were taken for their fibromyalgia patients. DHEA is produced by the adrenal glands. Production decreases as we age.  Blood test results showed fibromyalgia patients had levels much lower than expected for their age.
Supplementation with non-prescription DHEA offered benefit in these patients from daytime fatigue, low energy and stamina. In Canada, DHEA is available by prescription only and must be compounded.  It is commonly prepared in a liquid form with drops being placed under the tongue once to twice daily. The blood test is readily available.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Fibromyalgia – New Insights

At the recent American Rheumatology Association Meeting in Chicago, several reports were presented in the area of fibromyalgia. Many of these studies were done at the Rush Medical Centre in Chicago.

In 2010, the criteria for diagnosing fibromyalgia were updated. Despite the estimated 5 million people living with fibromyalgia, scientific articles on less common rheumatic diseases are published with much greater frequency than those focused on fibromyalgia. Some researchers feel that there is a publication bias which can limit the exposure to information clinicians can learn from in the area of fibromyalgia.

Some rheumatologists have limited their practice to exclude patients with fibromyalgia fearing that these patients are more time consuming and difficult to treat. A survey of a rheumatologists and rheumatology nurses asked them to rate patients from 1-3 (easy to difficult) based on several factors. Only 13.7% of patients were identified to be exhausting and difficult to treat. The authors concluded that these patients may have an undeserved reputation for being difficulty to care for, as the majority are not.

Researchers used a word recognition test to assess cognitive function in people with fibromyalgia. In a rheumatology clinic, 28 patients with fibromyalgia and 42 patients without fibromyalgia were selected to do the testing. Those with fibromyalgia had a time delay of 0.07 seconds in processing information compared to the non-fibromyalgia group. Slower processing may account for feelings of fibro fog where the synchrony of certain circuits in the brain are disturbed.


Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Is It a Cold or Is It the Flu?

As cold and flu season ramps up, we know a lot of our patients often wonder whether or not their symptoms are the result of a cold or the flu. Today, we look at the differences between the two common ailments.

Symptoms of a cold come on gradually,  whereas flu symptoms appear quickly with body aches and pains being so severe that many people are bedridden.  During a cold,  body aches and pains tend to me mild and although you may feel tired, a person can still do their daily activities.  A cold may cause some chills and fever is rare, compared with the flu  where a fever is expected.  A dry cough can be more severe with the flu than a cold. A sore throat, runny and stuffy nose can happen with either but sneezing is seen more with a cold.

If you experience the sudden onset of flu symptoms, there is an antiviral that can be prescribed.  It needs to be started within the first 24-48 hours of symptoms to have the most benefit, so don’t delay if you have these symptoms. Complications of the flu can include pneumonia, worsening of existing conditions such as asthma or COPD, having to be hospitalized and even death.  In Canada an average of 12,200 people are hospitalized and 3,500 people die each year from the flu.

The best prevention is having your flu shot and washing your hands regularly.  For more information visit canada.ca/flu.


Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

High Potency vs. Regular Flu Shot

Our pharmacist Carolyn Whiskin just returned from the American College of Rheumatology meeting in Chicago. This is the largest meeting in the world of specialists in Rheumatology, over 16,000 rheumatologists and allied health professionals attended this meeting.  The newest research was presented and it is very promising in regards to new treatments for every type of arthritis. Over the next few weeks, we will highlight some of Carolyn’s top picks from the conference.
In the area of vaccination, leading expert, Dr. Kevin Winthrop from Oregon, shared his thoughts on the high potency flu shot being offered to those over 65 this year.  A study done at McGill University in Montreal, showed that people with autoimmune disease under the age of 65,  also had a greater response to the high potency flu shot.  This high potency flu vaccine is only free to those over 65, so those with autoimmune diseases who are younger would have to pay or use private insurance if they wish this vaccine.
There is however more to this story…
The high potency vaccine protects against three strains of flu virus whereas the regular potency vaccine protects against four strains of the flu virus.  Last year over 50% of the flu cases were from a strain that isn’t included in the high potency vaccine at all but is in the regular potency vaccine with the four strains.  So we have a dilemma, do we give the higher potency vaccine to our senior patients and those who are immunocompromised, to get better protection for three types of flu, or do we get a little less protection for those three strains but get some protection from a fourth strain that was dominant last year?
Dr. Winthrop’s expert opinion is to give the regular vaccine to everyone for protection from the four types of flu.  It truly is a judgement call as we don’t have a “crystal ball” to know which strains will definitely hit our area this season.
As the high potency flu vaccine seems to be in short supply in physician’s offices, this information does give us confidence that getting the regular potency vaccine is still very valuable for everyone.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Don’t Miss It: Annual Chronic Pain Public Forum

This week, we are pleased to bring you information about a Chronic Pain Public Forum. Charlton Health highly recommends this session for anyone living in chronic pain or for people who support those with chronic pain. This amazing public forum has been a well received annual event and is one not to be missed!

For more information, please call the Ontario Pain Foundation at 905-592-1516 or email at theontariopainfoundation@gmail.com.

Public Forum 18 poster_1

Posted in The Charlton Centre | Leave a comment

You May Need More Than Just the Flu Shot…

Last blog we discussed the annual flu shot.  When receiving this vaccine it is a great time to review all your adult vaccines.  At Charlton Health, we have developed an adult vaccination checklist.  Please ask for a copy and we can help you identify what vaccines you may require.
In todays blog, we want to focus on vaccines for pneumonia.  There are several strains of pneumonia bacteria which can cause chest infection, sinus infection and ear infections.  The National Advisory Committee on Immunization (NACI) suggests everyone over the age of 65 receive the pneumonia vaccine.  Adults under age 65 who have increased risk of pneumonia should also be vaccinated.  This includes people with asthma, COPD, diabetes, heart disease and those who are taking immunosuppressive treatments such as biologics.
There are two different pneumonia vaccines.  The suggested protocol is to receive Prevnar 13 ( which protects against the 13 main strains of pneumonia for at least 20 years), followed 8 weeks later by the older vaccine Pneumovax.  This vaccine only lasts for 5-8 years, so it is less effective than Prevnar 13, but as it offers some protection for an additional 10 strains of pneumonia, it is still worth having this dose at least 8 weeks after Prevnar 13.   If you have received Pneumovax in the past, you can still benefit from getting Prevnar 13, as long as it has been at least one year since receiving Pneumovax.
Our pharmacists are happy to answer any questions regarding vaccination; including which vaccines require a prescription and which are covered by the government.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

New High Dose Flu Vaccine Provided Free For Seniors

NACI is the National Advisory Committee on Immunization.  Their 2018-2019 statement regarding the seasonal influenza vaccine was released in June.  This statement acknowledges that “together, influenza and pneumonia are ranked among the top 10 leading causes of death in Canada. Although the burden of influenza can vary from year to year, it is estimated that, in a given year, there are an average of 12,200 hospitalizations related to influenza and approximately 3,500 deaths.”
NACI  recommends influenza vaccination for all individuals aged six months and older who do not have contraindications to the vaccine, with particular focus on people at high risk of influenza-related complications or hospitalization and people capable of transmitting influenza to those at high risk of complications.
The flu vaccine is available in a few different formulations.  The quadrivalent vaccine contains 4 different strains of the influenza virus and is not a live vaccine.  This vaccine will be available at Ontario pharmacies and physicians offices provided at no charge through public health.  For people age 65 or older, a high potency trivalent vaccine (containing 3 different strains of the influenza virus) is now available at no charge through family physicians only. This is not a live vaccine, so you cannot get the flu from receiving the vaccine.  New studies have shown this high potency vaccine to be  more effective than the standard-dose vaccine in preventing influenza-like illness, hospitalization and  serious cardiorespiratory events possibly related to influenza.  For this reason, we suggest people age 65 or older contact their family physician to receive this vaccine.
The flu vaccines will be available starting mid-October.  Pharmacies offering the standard dose vaccine,  may offer flu clinics on specific days along with  open drop-in  times without appointments.  It is suggested that you call  ahead to see if your community pharmacy is taking appointments for flu shots.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Exercising with Inflammation

In our last blog, we discussed the impact of excess weight and inflammation in the body.  While we all know exercise is one of the fundamental ways to increase weight loss, we also know that it is not always easy for people to add exercise to their routines. One of the best ways to incorporate exercise into your routine is walking! Increasing every week by a few minutes to reach the 150 minutes/week goal may be a great way to start.

With that, we know that walking is not a viable option for some. For many people with joint issues, movement in the water is the most beneficial. This allows for increased blood flow to the brain and other parts of the body while moving in the water, and in addition, water provides a benefit of hydrotherapy to the joints. Many communities have a hot water pool to facilitate exercise for those with arthritis and may even provide a lift chair to lower you into the water.

For those who prefer the comfort of their own home, a wonderful program called “from soup to tomatoes” is available as an online session promoting movement while seated. Learn more about this program here.

The Arthritis Society provides physiotherapists for those living with arthritis. They can help structure an exercise program that is safe for you. Please don’t hesitate to use these resources – you can learn more here.

The vast majority of disease states are improved through exercise. In fact, one of the best strategies to preserve memory is exercise. Ultimately, The most important thing is to keep moving. If you’d like more help, speak to your healthcare provider today.


Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Inflammation and Weight: Are They Related?

At the recent international menopause Society meeting in Vancouver, a session on the relationship between excess weight and inflammation was presented. Fat cells called adipocytes,  produce hormones such as TNF( tumour necrosis factor), IL-6 ( interleukin 6), leptin and resistin.  These substances cause a pro-inflammatory state which leads to decreased sleep quality, increased pain and increased potential for cancer development.    It is also very negative for heart disease risk and the development of diabetes.

As the prevalence of obesity increases in menopause, we must be mindful of the impact that this weight is having.  It is known that people who have a lower caloric intake diet have an expanded life span over those with high calorie diet.  Of interest, women who have greater amounts of abdominal fat have a harder time dissipating heat during a hot flash and therefore are more affected than those who have less fat accumulation. Not only is excess weight hard on the joints and worsens osteoarthritis, the fat cells themselves are generating excess inflammation which contributes to further pain.

Setting reasonable goals is important. A weight loss of even 5% can be very meaningful.
Currently 14% of the global population is obese,  with a rate of 34.8% in the United States.

Caloric restriction and exercise are the fundamentals of weight management.  A healthy goal is 150 to 175 minutes of aerobic exercise per week which can be split over 3 to 4 sessions. In addition, 2 sessions of resistance training is suggested per week. This can be easier said than done, especially when people have mobility and joint issues.  Stay tuned to our next blog to address some strategies for exercise with these limitations.


Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Posted in The Charlton Centre | Leave a comment

Diamond Chef Challenge

Last week, we brought you the news that September is Arthritis Month. With that in mind, we wanted to share this great event that is coming up to benefit the Arthritis Society.

The 2nd Annual Diamond Chef Challenge is taking place on Friday, October 26th at the Art Gallery of Hamilton and will have Stacie Royds and Paresh Thakker battling it out for the Diamond Chef Award. These two Chopped Canada contestants will battle and make the best tapas in town.

This event is to help Arthritis Society, shine the light on the 24,000 Canadian children who suffer from arthritis.

Learn more and get your tickets here.

Posted in The Charlton Centre | Leave a comment