Dry eyes and mouth is a common problem, affecting the majority of people with CFS and fibromyalgia. It's also common in those with spastic colon, and it's common as we get older.
Sometimes it's simply a nuisance, but often it's worse. In FMS it can result in dramatic dental problems, especially cavities and gum disease. And the risk worsens when combined with medications like Elavil.
Saliva is critical for washing away gum-damaging, cavity-causing bacteria; and it also provides an enzyme (amylase) that starts the digestion of carbohydrates.
Dry eyes affects three out of every 10 Americans and is the most common reason for visits to eye doctors. It's a disorder of the tear film (the coating that protects and cleans the surfaces of the eyes) that brings on symptoms such as stinging, burning, grittiness, itching, and sensitivity to light.
In addition of CFS and FMS, common causes of dry eyes include:
- Rosacea, a skin disorder
- Autoimmune disease (the immune system mistakes a part of the body as foreign and attacks it) such as Sjogren's syndrome (moisture-producing glands are attacked)
- Perimenopause and postmenopause
- Laser or cosmetic eye surgery
When dry eyes and dry mouth occur together, the condition is called sicca syndrome, and it's a common feature of CFS/FMS. For example, one study found that 90% of people with fibromyalgia have decreased tear production. In my clinical experience, dry mouth is also common. (If you've suddenly gotten a lot of cavities along with your CFS/FMS, dry mouth is usually the cause.)
Fortunately, there are simple, natural ways to optimize eye and mouth health, banishing dry eyes and dry mouth — starting with nutritional support. Essential oils, such as Omega-7 and Omega-3 (I use Vectomega for the latter) are especially effective for optimizing tear and saliva production.
Three Key Ways to Optimize Eye and Mouth Moisture
Just as oil lubricates your car, dietary oils can help lubricate your body. Three key oils are especially important for dry eyes:
1. Fish Oil
Fish oil is rich in the essential fatty acids EPA and DHA, which studies show help with dry eyes. Eat a portion of oil-rich salmon or tuna daily. Or supplement your diet with Vectomega, by EuroPharma. It supplies all the essential Omega 3 fatty acids you need in 1 to 2 tabs a day (instead of the 8 to 16 tabs needed with most other fish oils).
2. Sea Buckthorn Oil
The berries from this cold weather shrub contain Omega-7, a unique essential fatty acid. Studies show that this little known but remarkable nutrient is very effective at improving lubrication throughout the body — helping to remedy dry eyes, dry mouth, and even vaginal dryness and bladder lining issues.[3, 4, 5] Feeling dry or irritated anywhere? This oil is a very powerful way to optimize moisture throughout your body! I recommend Omega-7 by EuroPharma.
Other benefits of Sea Buckthorn Oil include younger looking skin with less wrinkles (as skin moisture improves) and even helping digestion.[6,7] Give it 8 weeks to start working and 3 months to see the full effect. Take 2 caps twice a day the first 3 months for optimal effects (though even lower doses can be helpful). You can then lower the dose to the amount needed to maintain the benefits.
3. B Vitamins and Magnesium
Take a daily high dose (50 mg) B-complex vitamin, plus 200 mg of magnesium. You'll find these dosages in the Energy Revitalization System vitamin powder, by Enzymatic Therapy.
Check Your Medications
Many medications used in CFS/FMS cause dry eyes and dry mouth, but your doctor can prescribe alternatives that don't have this side effect. Ask your doctor about this during your next visit, and also ask your pharmacist if any of your medications are likely to cause dry eyes or mouth. Common culprits include:
Antihistamines. These include Benadryl, Zyrtec and Claritin. Important: Benadryl and other antihistamines are often found in over-the-counter sleep aids.
Antidepressants. Elavil is a major trigger of dry eyes and dry mouth. But most antidepressants can also cause the problem. And watch out for Cymbalta and Savella; they're used for fibromyalgia pain, but they're also antidepressants.
Birth Control Pills. These can cause dry eyes. (And so can pregnancy!)
Diuretics. These drugs, such as Microzide and Lasix, are usually prescribed for high blood pressure.
ACE Inhibitors. Also used to treat high blood pressure, they include Vasotec, Prinivil, Zestril and Altace.
Acne Drugs. Accutane is off the market, but any high-dose systemic retinoid (vitamin A) medication can cause the problem.
Opiates. These include morphine and codeine, and their variants, such as Vicodin, Oxycontin, Percoset and Dilaudid.
Self Care for Dry Mouth
These few tips can make a lot of difference!
- Drink sips of water throughout the day, as needed.
- Drink sugar-free lemonade, which stimulates saliva. A good recipe: 3½ cups water; ½ to ¼ cup lemon juice; and Stevia to taste, usually about 50 drops.
- Avoid sugar and regular sodas, as these can make dental problems worse.
- Suck on sugar-free lemon drops or other sugar-free hard candy, or chew sugar-free gum.
Some doctors who are not familiar with CFS/FMS immediately think of an autoimmune disease called Sjogren's Syndrome when they are diagnosing a person with both dry eyes and dry mouth — and end up chasing the wrong problem. Though Sjogren's Syndrome can cause CFS/FMS, most people with CFS/FMS and dry eyes and mouth do not have Sjogren's. So your doctor should confirm a Sjogren's diagnosis with an SS-A and SS-B blood test and a biopsy. If you have widespread achiness and fatigue with insomnia, you likely have fibromyalgia that needs treatment, whether or not one also has Sjogren's.
Some helpful forms of medical care:
- Use Restasis — prescription eye drops that produce tears in chronic dry eyes.
- In severe cases, consider an operation to plug up tear-draining ducts.
- For dry mouth, ask your dentist about saliva substitutes.
 "Decreased corneal sensitivity and tear production in fibromyalgia," Gallar J, Morales C, et al, Investigative Ophthalmology & Visual Science, 2009 Sep;50(9):4129-34
 "Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women," Miljanovi A, Trivedi K, et al, Am J Clin Nutr, 2005, 82 (4): 887–93.
 "Oral Sea Buckthorn Oil Attenuates Tear Film Osmolarity and Symptoms in Individuals with Dry Eye," Larmo P, Jarvinen R, et al, Journal of Nutrition, 2010 Aug;140(8):1462-8.
 Presented at the International Association for Dental Research (IADR) Annual Meeting. San Diego, California. Le Bell AM, Söderling E, et al, March 6 - 9, 2001.
 Presented at the American Oil Chemists' Society Annual Meeting. Yang B. 2006. St. Louis, MO
 P. Mazliak P, eds. Plant LipidMetabolism. Dordrecht, NL: Kuler Academy Publ; 1995. Cited in LI TSC, Beveridge THJ. Sea Buckthorn (Hippophae rhamnoides L): Production and Utilization. Ottawa: NRC Research Press; 2003.
 Yang B, Bonfigli A, Pagani V, Isohanni T, et al. J Appl Cosmetol 2009;27:13-25.
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of four research studies on their treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.