A Silent Killer: High Blood Pressure

Hypertension, or high blood pressure, is a common disease in both men and women. Hypertension is called the “silent killer” because it generally produces no obvious symptoms even while it causes widespread damage to the heart, brain, kidneys, and other vital organs. Although it can strike anyone at any time of their life, it’s most commonly seen in older individuals. In fact, over 70% of American women and 50% of American men over the age of 70 have hypertension. Other risk factors for this disease include high cholesterol levels, smoking, obesity, and diabetes.1

Normal blood pressure is defined as a systolic pressure of 130 mm Hg or below and a diastolic pressure of 85 mm Hg or below. High normal is pressures of 131-139 systolic and 86-89 diastolic. Hypertension is defined as a pressure of 140 systolic over 90 diastolic and above.

Blood pressure generally rises and falls throughout the day in a cyclic rhythm and is influenced by many factors, such as exercise and emotional stress.  To get the most accurate picture of your blood pressure, take numerous measurements at different times and average them.

Although doctors still don’t know what causes this most common type of hypertension, current research indicates that a complex interaction between genetic, environmental, and other variables is a significant factor. Secondary hypertension, which is much less common, is high blood pressure caused by known medical conditions, such as kidney disease, pregnancy, and sleep apnea.

The real dangers arise when blood pressure is elevated over a period of years or decades. Over such a time span, hypertension can cause significant damage to blood vessels that supply life-giving oxygen and nutrients to all parts of the body. The heart, brain, and kidneys, along with all other major body parts, can suffer irreparable harm from long-term hypertension.

It’s important to remember that an unhealthy elevation in just one of the two pressures (systolic or diastolic) can have disastrous long-term health consequences. Isolated high systolic pressure, which is the most common form of high blood pressure in older adults, is thought by many to be a significant indicator of heart attacks and strokes in people middle-aged and older. Isolated high diastolic pressure is a strong risk factor for heart attacks and strokes, especially in younger adults.

Hypertension Can Be Controlled Naturally

For those who hesitate to use anti-hypertensive drugs for whatever reason, non-drug strategies may significantly help in supporting healthy blood pressure. The Dietary Approaches to Stop Hypertension (DASH) diet is now recommended as a first-line approach in managing the disease. The DASH diet is high in fruits, vegetables, and other nutritious foods that are rich in potassium, calcium, and magnesium. People following the DASH diet are encouraged to decrease their saturated fats and replace them with foods that are high in monounsaturated fats and omega-3 fatty acids.

Other natural ways to control hypertension include not smoking, obesity control, and salt restriction – the current recommendation is for people with hypertension to limit their salt intake to 2400 mg (about 1 teaspoon) per day.

Arginine – The Source of Nitric Oxide

Another natural way to help support healthy blood pressure is through the use of L-Arginine based supplements.  L-Arginine is an amino acid that plays a vital role in promoting vascular health through the production of Nitric Oxide (NO).

Nitric oxide penetrates and crosses the membranes of almost all cells in the body, and it helps regulate many functions. It is even involved in memory function. In blood vessels, NO is vitally important because it regulates the tone of the endothelium, the layer of smooth cells that line the inside of the vessels. If these endothelial cells become dysfunctional, they can cause spasms or constrictions of the blood vessels that can then lead to hypertension.

Learn more about your options today. Visit www.hypertensa-adv.com for more information. 

  1. https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer/know-your-risk-factors-for-high-blood-pressure

Amino Acids, Neurotransmitters and Pain Relief

Chronic pain is a complex condition that can change the way your body works. The natural chemicals (neurotransmitters) that your nervous system depends on to help manage pain and inflammation are in high demand, so making sure you have enough of them available is vital for proper relief.

Did you Know?

Amino acids and nutrients are the building blocks of  the neurotransmitters your nervous system uses to reduce the volume and frequency of pain and inflammatory signals. Addressing amino acid depletion with medical foods is a safe and easy way to restore the foundation of your nervous system’s health and an important part of any comprehensive pain management program.

Everyday Medications that Increase the Risk of Heart Attack

Data out of Stanford University suggest that Proton Pump Inhibitors (PPI’s) such as Prilosec, Prevacid, and Nexium are associated with a higher risk of heart attack.  Published in the journal PLOS One online, researchers looked over 2.9 million patients over a several year period to determine if patients who took PPI’s for gastro esophageal reflux had an increased risk for myocardial infarction than patients who did not.  Concern was raised when scientists discovered that PPI’s potentially reduced the antiplatelet effect of clopidogrel, a drug use to prevent clotting after a heart attack or stroke.  The clopidogrel is used after heart attack to prevent clotting which could lead another heart attack.  They were concerned that if heart attack was raised in this population, it could extend to lower risk patients.

The study showed that patients taking PPI’s had a 16% increased risk of heart attack.  H2 Blockers, such as Zantac and Pepcid were not associated with an increase risk.  Perhaps more importantly, the risk was not just associated with high risk categories such as having had a previous heart attack, the elderly or taking clopidogrel.  It was applicable to all ages and risk groups.

The study has several limitations including the attempt to look back at charts and determine what medications are being taken.  Often patients will take over the counter PPI’s and may not be accurately reporting it to their physician.  Also, retrospective analyses like this are subject to certain biases and are not as valuable as preplanned double-blind clinical trials.  However, the large number of patients reviewed does give the study significant credence.

PPI’s are one the most commonly used medications in the United States and around the world, with over 113 million prescriptions filled globally each year.  PPI’s are used to treat stomach and intestinal ulcers and heartburn, as well as to prevent gastrointestinal bleeding from NSAID’s in higher risk populations.  NSAID’s have been associated with a number of serious complications in addition to bleeding ulcers including kidney and liver issues, fluid retention with swelling in the legs, elevated blood pressure and possibly increasing the risk of heart attack.

Medications that are often used to treat or prevent the side effects of another medication create a potentially vicious cycle for patients who will ultimately end up taking more and more medications to manage an illness. The risk of adverse events increases with the number of medications prescribed, and the number of medications prescribed increases with age.

The avoidance of polypharmacy and therefore reducing the risk of dangerous medication side effects is crucial for patients and providers.  Alternative therapies, such as FDA regulated medical foods, which by definition must be on the FDA GRAS list (generally recognized as safe), may have similar efficacy to standard pharmaceuticals but without the side effects. Understanding the risks and benefits of medications is an important part of being a patient and a healthcare provider. Exploring the medication options that may be better tolerated is something every patient and physician should do.

 

Prescription Drug Overdose Deaths on the Rise

The Trust for America’s Health, a nonprofit organization, reported that in 2013 over 44,000 Americans died as a result of drug overdose.  Drug overdoses have been rising since 2009, despite federal and state efforts to better monitor and control use of narcotics and other potentially addictive medications.  Over half of these deaths were related to prescription drugs and in fact, in 36 states more people died from a Rx drug overdose than from automobile accidents.  These numbers are staggering, especially when you consider that drugs such as narcotics (Vicodin, Percocet, etc.) do not cure any disease, they only mask a symptom, pain.

Physicians are under increased scrutiny for prescribing these dangerous drugs and are constantly looking for reliable, clinically proven alternatives.  Until recently, options were limited to NSAIDs, such as ibuprofen and naproxen, which can have significant side effects most specifically on the gastrointestinal tract, and medications used to treat other conditions such as SSRIs, anti-epileptics, and SNRIs,  but that may also help pain as well. The efficacy of these options are limited at best and often cause significant side effects without providing adequate pain relief.

 

Evidence Based Options for Patients and Providers

Theramine, a amino acid based treatment for pain, has been shown in multi-center clinical trials to significantly reduce pain in patients with chronic low back pain without any appreciable side effects better than over the counter doses of ibuprofen or naproxen.  Theramine is regulated as a medical food by the FDA and is manufactured in the United States at a cGMP facility using ingredients that are Generally Recognized as Safe. As a medical food, Theramine is subject to much tighter regulatory oversight than dietary supplements, providing patients and providers with piece of mind knowing that the formulations are tested and evaluated for efficacy.  There have been over 40 million individual doses of Theramine administered since 2004, without a single reported GI bleed, adverse cardiac event or stroke reported the most commonly known side effects of NSAIDs.  Theramine is not addictive and can be taken with other medications or medical conditions.  Theramine provides chronic pain patients a safe, effective and proven alternative to other potentially more dangerous pain medications.

A Safe Way to Manage Obesity

Over two thirds of Americans are overweight and over one third are defined as obese and the number of people with obesity in the world now exceeds those with malnutrition (1).  Being overweight or obese significantly increases your risk of heart disease, diabetes, high blood pressure and arthritis.  Yet despite the public’s awareness of these issues, obesity remains an epidemic.

People often describe the frustrations of trying to lose weight, whether it is through failed diets or exercise programs.  They either don’t lose weight at all or lose only to gain it back a month or two later. Effective weight loss programs that allow for long term success are desired but many patients struggle despite the available resources. The time constraints of work and family are difficult to overcome and patients often need help or a jump start to get their weight loss regimen going.

The cornerstones of an appropriate diet to lose weight include lowering caloric intake, decreasing complex carbohydrate ingestion, avoiding “empty calories” such as processed sugars and regular aerobic exercise. Fad or gimmick diets that help you to lose weight fast often lead to rebound weight gain and psychological distress.  Healthy weight loss should be targeted for 1-2 pounds per week over the course of many weeks.  The first five pounds usually come off fast and then the weight loss slows down.  People get discouraged and give up during this phase as it can be the most difficult part of the process.  Additionally, many patients suffer from uncontrollable appetite while dieting and this limits the effectiveness of the diet.

5 tips for weight loss

Recent data points to unique nutritional deficiencies as a contributing factor to Obesity. The medical foods  Apptrim and Apptrim-D  are specifically designed to treat these specific nutrient and  micro-nutrient deficiencies by supplying obese patients with a bioavailable source of amino acids and nutrients.  AppTrim and AppTrim-D contain the amino acids that specifically produce the neurotransmitters that are involved in controlling appetite, hunger and satiety.  Neurotransmitters are the brain’s messengers that tell the nerves what to do and help your stomach and brain communicate with each other. Obese patients often lack the neurotransmitters required to suppress appetite and food cravings. AppTrim helps to decrease appetite, carbohydrate cravings and improves early satiety thus helping an individual maintain a diet and weight loss goals.

Several double blind placebo controlled trials using AppTrim have been performed.  These studies have demonstrated that patients taking AppTrim along with diet and exercise lost more weight and felt less hungry than patients using diet and exercise alone.  Also, since AppTrim is a medical food, it contains only ingredients that are Generally Recognized as Safe (GRAS) by the FDA. Obesity is a very complex disease and effective management requires a comprehensive approach that includes addressing the distinct nutrient and micro-nutrient deficiencies in addition to diet and exercise. 

1. Ogden C. L., Carroll, M. D., Kit, B.K., & Flegal K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8), 806-814

The Dangers of NSAIDs

The most commonly prescribed drugs for pain are Non-Steroidal Anti-Inflammatory drugs (NSAIDs).  Approximately 98 million prescriptions for NSAIDs were filled in the United States in 2012 [IMS 2012] and this number does not include NSAIDs that are purchased over the counter.  Although effective in treating pain and inflammation, NSAIDs are linked to adverse side effects which make them inappropriate for use in many patient populations.  There are several serious side effects and toxicity related to use of traditional NSAIDs. Toxic side effects of traditional NSAIDs include:

  • Stomach ulceration and/or bleeding
  • Kidney damage
  • Easy bruising because of loss of platelet function
  • Exacerbation of cardiovascular conditions

Recent studies have also highlighted a higher risk of atrial fibrillation with NSAID use [1] and an increase risk of bleeding and events such as heart attack, stroke or cardiovascular death with the use of NSAIDs in conjunction with antithrombotic therapy [2].

NSAIDs work to reduce pain and inflammation by inhibiting cyclooxygenase, an enzyme.  The action of inhibiting cyclooxygenases, reduces pain and inflammation but is also responsible for many of the side effects of NSAIDs.  This inhibition is problematic because it also inhibits some important functions such as the repair and maintenance of the stomach lining.  This is why stomach ulceration and irritation is so common with the use of NSAIDs.

Inhibition of cyclooxygenase is also associated with reductions in prostaglandin synthesis and is associated with less sodium being excreted in urine and constriction of blood vessels.  This effect of NSAIDs on blood pressure may increase mean arterial pressure by as much as 5 to 6 mm Hg in hypertensive patients.   This consequence may be of particular relevance in patients with preexisting hypertension, edema or congestive heart failure.

One study noted the rate of new-onset hypertension developing in elderly patients for whom nonselective NSAIDs were prescribed was 27% [3]

The extremely high risk of side effects with such commonly used medication resulted in a quest for an analgesic/anti-inflammatory that could provide therapeutic efficacy equivalent to that of traditional NSAIDs but without the gastrotoxicity.

The use of medical foods to treat the dietary deficiencies associated with pain and inflammation has proven to be a safe and effective method for pain control.  Two double-blind, randomized,  trials, which compared Theramine to low dose naproxen and ibuprofen demonstrated statistically significantly reduction in inflammation as measured by inflammatory markers, CRP and IL-6 as well as improvement in low back pain.  Theramine was shown to be an effective pain medication but also an effective anti-inflammatory agent without the risk of gastrointestinal bleeding or other serious side effects.

All of the ingredients in Theramine are GRAS (generally recognized as safe) products and carries no risk of addiction or attenuation.  Theramine has been on the market for 10 years without report of GI bleed or serious adverse side effects.

There are several patient populations that should avoid NSAIDs due to the high risk of side effects.

  • Patients over 65 years of age
  • Previous GI history such as peptic ulcers or previous GI bleed
  • Patients with cardiovascular disease
  • Patients with liver disease
  • Patients with kidney disease
  • Patients on anti-coagulants or low dose aspirin

The cumulative evidence of the danger of NSAIDs is an important reminder that the while NSAIDs can be helpful and at times necessary medications for satisfactory quality of life, use of these medications, particularly among high risk patients must be carefully considered.

 

1.  Gang Liu, MD, PhD, Yu-Peng Yan, MD, Xin-Xin Zheng, MD, Phd, Yan-Lu Xu, MD, Phd, Jie Lu, MD, Ru-Tai Hui, MD, Phd, Xiao-Hong Huang, MD, Phd “Meta-Analysis of Nonsteroidal Anti-Inflammatory Drug Use and Risk of Atrial Fibrillation” The American Journal of Cardiology Nov. 15, 2014 Vol. 114, Iss. 10

2. Anne-Marie Schjerning Olsen, Gunnar H. Gislason, Patricia McGettigan, Emil Fosbøl, Rikke Sørensen, Morten Lock Hansen, Lars Køber, Christian Torp-Pedersen, Morten Lamberts. Association of NSAID Use With Risk of Bleeding and Cardiovascular Events in Patients Receiving Antithrombotic Therapy After Myocardial Infarction. JAMA, 2015; 313 (8): 805

3.  Solomon DH, Schneeweiss S, Levin R, Avorn J. “Relationship between COX-2 specific inhibitors and hypertension” Hypertension. 2004; 44: 140–145

Alternative Therapies for Pain Associated with Peripheral Neuropathy

Diabetic neuropathy can occur when people with diabetes develop nerve damage. Most commonly, the peripheral nerves of the feet are affected first, causing numbness, cramps, loss of balance, extreme sensitivity and pain starting in the toes and over time progressing up the legs. Diabetic neuropathy can affect nerves in hands and arms, as well as parts of the autonomic nervous system that are responsible for regulating heart rate, blood pressure and sleep cycles. Not everyone who has diabetes will develop neuropathy. (1)

Peripheral neuropathy, also known as distal symmetric neuropathy or sensorimotor neuropathy, is the most common type of diabetic neuropathy. Diabetic neuropathy affects 60-70% of diabetics. Certain risk factors increase the chances of developing diabetic neuropathy. These include age, the duration of the disease, and glucose levels in the blood. There are different factors that may lead to diabetic neuropathy. Additionally, certain neurovascular factors, autoimmune factors, mechanical injury to nerves, inherited traits that increase susceptibility to nerve disease, and lifestyle factors can increase the chances of developing diabetic neuropathy.

Preventing diabetic neuropathies is a challenge but is not impossible. Diabetic patients should keep glucose levels as close to the normal range as possible. Maintaining a normal blood glucose level can help protect nerve cells from unnecessary damage and even lesson symptoms associated with diabetic neuropathy.

There are many treatment options currently available to patients for pain relief associated with diabetic neuropathy. Two commonly used medications for pain relief associated with nerve pain are opioids and a class of medications known as anti-epileptics. Opioids were originally developed to help patients manage pain associated with cancer, but have since been incorporated in a number of pain management treatment protocols for non-cancer pain. This class of medications can be a useful for pain relief, but can also lead to addiction and other harmful side effects. Anti-epileptics like gabapentin are also commonly used to manage diabetic nerve pain. This class of medications was originally developed to treat epilepsy, but has since been approved by the FDA to treat nerve pain. Common side effects of gabapentin and other anti-epileptic medications include dizziness, dry mouth, blurred vision, headaches, diarrhea, fluid retention, and weight gain.(2)

Patients and providers have increasingly been looking to certain medical foods as a safe and effective alternative option to some of the more dangerous pharmaceuticals used for the management of pain and numbness associated with peripheral neuropathy. One example is Percura, a medical food that is specially formulated to provide the nervous system with the amino acids and nutrients required to effectively manage the unique nutritional needs of nerve cells. A recent open label study showed that patients with moderate to severe peripheral neuropathy showed improvement in pain after one month taking Percura. Side effects associated with Percura are mild and temporary and include, bloating and diarrhea. Percura and other medical foods may represent a valuable treatment option for patients with diabetic peripheral neuropathy, without the side effects associated with opioids or anti-epileptic medications.


[1] Dyck, Peter J., Feldman, Eva L., Vinik, Aaron I..  “Diabetic Neuropathies: The Nerve Damage of Diabetes”. National Diabetes Information Clearinghouse.  NIH Publication, February 2009. Web. November 26 2013. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/#what

[2]“What are the Real Risks of Antidepressants?”.  Harvard Health Publications.  Harvard Medical School, May 2005.  Web. http://www.health.harvard.edu/newsweek/What_are_the_real_risks_of_antidepressants.htm

Pain Management in Lyme Disease

Lyme disease is spread through the bite of infected blacklegged ticks, also known as deer ticks.  Ticks can attach to any part of the human body, but tend to reach areas that are difficult to see such as the groin, armpits, or scalp.  Ticks must be attached for 36 hours or more before the Lyme disease bacterium, Borrelia burgdorferi, can be transmitted.

There are four stages in the progression of Lyme disease.  The first stage, known as the early localized stage, takes place between 3-30 days after the tick bite.  The infected person can experience fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes.  One of the most prominent signs of this stage is the Erythema migrans rash, also known as the bull’s-eye rash for its unique shape.  This rash occurs in 60% of infected individuals. (CDC)

The second stage is known as the early disseminated stage and it occurs days to a week after the tick bite if the bite is not treated within the early localized stage.  During this stage, a person starts to experience more noticeable and serious symptoms.  These symptoms include Facial or Bell’s palsy, additional erythema migrans rashes, and stiffness due to meningitis.  At this point, patients begin to feel shooting pains that can interfere with sleep as well as pain and swelling in the large joints.

If the disease is not treated, 60% of patients enter into the late disseminated stage which happens months to years post-tick bite.  These individuals typically develop arthritis with severe pain and swelling in the joints.  It is typically found in the larger joints, for example the knees.  Arthritis caused by Lyme disease exhibits itself differently than other causes of arthritis.  Lyme arthritis is similar to osteoarthritis because of stiffness due to painful swollen joints.  This happens because Lyme bacteria invade the joints and cause inflammation to the tissue that lines the joints, and eventually, if untreated, can cause the cartilage within the joints to become damaged.[1]

The final stage is the lingering symptoms after treatment.  About 10-20% of patients experience symptoms after the patient has taken antibiotics.  This is called Post-treatment Lyme disease syndrome (PTLDS).  Some evidence shows this is due to an autoimmune response, in which the immune system is continuing to respond after the infection has been cleared, causing damage to be done to a body’s tissues.  Symptoms of PTLDS can include muscle and joint pain, cognitive defects, sleep disturbance, and fatigue. (CDC)

The quicker a doctor is able to diagnose Lyme disease, the quicker they can treat it.  Patients can be prescribed antibiotics in order to rid their system of the bacteria.  Most patients who are prescribed the antibiotic during the early stages usually recover quickly and completely.

With the antibiotics working to take care of the bacteria, what is taking care of the pain associated with Lyme disease?  A patient can still be experiencing pain while taking these antibiotics, which progressively becomes worse throughout all the stages Lyme disease.  Patients who experience pain in association with Lyme disease are less likely to be active, sleep well, or eat properly due to pain.

Commonly prescribed pain medications are opioids and NSAIDs.  Both, although common, can be very dangerous.  According to a report released by the National Institute on Drug Abuse, there can be consequences when choosing to use an opioid.  Opioids are easy to abuse because of their addictive qualities.  Regular or long term use of opioids can lead to physical dependence and addiction. Once a patient stops using opioids, they can experience withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements.  An overdose can cause severe respiratory depression and death. [2]

NSAIDs, although effective in treating pain and inflammation, are linked to adverse side effects which make them inappropriate for use in many patient populations.  There are several serious side effects and toxicity related to use of traditional NSAIDs which can lead to costly hospitalizations or death.  A study on the effects of NSAID induced side effects in the elderly reflected the average direct costs of GI side effects per patient-day on NSAIDs were 3.5 times higher than those of a patient-day not on NSAIDs. Seventy percent of the cost was attributed to GI events resulting from NSAID treatment.[3]  Treatment of GI problems alone caused by the use of NSAIDs is estimated to add over 40% to the cost of arthritis care.[4]

Stephen Harrod Buhner’s book “Healing Lyme Disease Coinfections” discusses an alternative to these common pain medications called Theramine®. Theramine is a medical food specifically designed for the dietary management of pain syndromes. This specialized natural product, provides the specific amino acids and nutrients required by the brain and nervous system to effectively reduce pain and inflammation. Theramine is non-addictive and is not associated with adverse GI or cardiovascular side effects.  It is used in clinical practice to reduce inflammation and improve pain perception by addressing the increased nutritional requirements of pain syndromes.  In two double blind, multi-center clinical studies comparing Theramine and an NSAID, Theramine was shown to be more effective at treating pain and inflammation than either naproxen or ibuprofen. Lyme disease can alter the metabolic requirements of the body, leading to specific amino acid and nutrient deficiencies. Effectively managing the increased demand for these essential physiologic components should be an integral part of any pain management protocol.

 


[1] American Academy of Orthopaedic Surgeons. “Effective treatment of Lyme-disease-related arthritis depends on proper diagnosis.” ScienceDaily. ScienceDaily, 2 February 2011.

<www.sciencedaily.com/releases/2011/02/110202132605.htm>.

[2] “Prescription Drugs: Abuse and Addiction” NIDA. October 2011. National Institute on Drug Abuse.

[3] Br J Clin Pharmacol. 2001 August; 52(2): 185–192. Cost of prescribed NSAID-related gastrointestinal adverse events in elderly patients

[4] Bloom, BS. Direct medical costs of disease and gastrointestinal side effects during treatment for arthritis. Am J Med. 1988; 84(2A): 20-24

Pain Management without Harmful Side Effects

The reduction and management of pain can involve many approaches: prescription medicines, over the counter medicines, medical foods, cognitive behavioral therapy, physical exercise, surgery, nutritional modification, pain education, massage, biofeedback, music, guided imagery, laughter, distraction, acupuncture, and nerve stimulation.  Two or more approaches combined can have a synergistic or additive effect that is greater than the sum of the parts.  One approach, medical foods, has medicinal value that is just beginning to be understood and can be used as a stand-alone therapy or adjacent treatment for chronic pain.

Due to its’ additive effect and low side-effect profile, Theramine®, a medical foods, can be used with high-risk patients over the age of 65 as an alternative to NSAIDs or narcotics.  Adding Theramine to a pain treatment protocol can lead to a reduction in previously prescribed narcotics and minimize the use of NSAIDs or both.  The ingredients in Theramine are Generally Recognized As Safe (GRAS) by the FDA, have no risk of addiction or adverse GI or cardiovascular side effects.  Reducing the burden of adverse side effects while improving clinical outcomes is critical for the overall patient care and a return to activities of daily living.

Two studies comparing Theramine to a low dose NSAIDs in adults 18 years of age and above found Theramine to be more effective than either naproxen or ibuprofen alone for inflammatory pain.  When Theramine was given in combination with the low dose of either product the results were even more beneficial.  Incorporating the use of Theramine into a clinical pain management protocol, allows physicians the flexibility to use less of a narcotic or NSAID pain reliever and potentially eliminate their use all together.

The two studies comparing the medical food Theramine and a non-steroidal anti-inflammatory medication, Theramine was shown to be more effective than low dose NSAIDs in treating low back pain.  Clinical data indicates significant reduction in back pain with the administration of Theramine alone, and as an adjunct therapy to a low dose NSAID, while administration of a low dose NSAID had no appreciable effect on pain. The use of Theramine as either a standalone or adjunct therapy can significantly improve pain perception.

Theramine is encapsulated with a patented technology that promotes the rapid cellular uptake and conversion of milligram amounts of amino acids and nutrients into the specific neurotransmitters responsible for modulating pain and inflammation.  This patented technology allows Theramine to be effective without losing efficacy over time.

Two multicenter double blind trials have established the safety and efficacy of Theramine in the treatment of chronic back pain. Pain fell by 63% with administration of Theramine and an NSAID as measured by the Roland- Morris Index (Figure 1), and by 62% as measured by The Oswestry Disability Index.

Pain Scale Graph

Traditional pain medication will always have its place in therapeutic treatment and, if used properly, is very effective.  However, physicians, insurance companies, employers and patients are requesting safer, more effective alternatives to treat pain without harmful and costly side effects. The rapidly increasing population of patients 65 years of age and older is a major concern for both physicians and insurance companies as the pain-related costs to overall U.S. health care expenses are likely to rise proportionally as well. The economic impact of pain is certain, as are the physical, emotional, and social impact for millions of people. Reducing the burden of treating chronic pain is a societal necessity, a medical challenge, and an economic requirement.

#medicalfoods #NSAIDs #theramine

Opioid Receptors Impaired in Fibromyalgia Patients

µ-Opioid Receptors Impaired in Fibromyalgia Patients

Chronic idiopathic pain associated with fibromyalgia is complex to manage and is often associated with other co-morbidities such as depression. A recently published University of Michigan study looked closely at µ-opioid receptor availability in fibromyalgia patients, providing sound physiologic data confirming the widespread consensus that the inability of these patients to process pain signals effectively is largely due to the inability of receptors in key areas of the central nervous system to bind to analgesic opioids.

The clinical management of fibromyalgia is very complex and requires a multi-modal approach to pain management that is specific to the individual patient.  Narcotic pain medications are largely ineffective at mitigating idiopathic pain in fibromyalgia patients and often lead to many more serious side-effects that can exacerbate and prolong the condition. The widespread use of narcotics to manage non-malignant chronic pain is a serious problem in the United States and there is no medical evidence showing that these drugs actually work to treat the chronic pain of fibromyalgia. The study’s results are further evidence for clinicians that the use of non-narcotic interventions for pain management of fibromyalgia are more effective treatment options.

Medical foods are a good example of a therapeutic alternative for the treatment of fibromyalgia.  These prescription-only medications treat the nutritional deficiencies in chronic disease and not just the symptoms.  Patients diagnosed with fibromyalgia, for example, may have an increased need for precursors of the neurotransmitters nitric oxide, GABA (gamma-amino butyric acid), serotonin, and acetylcholine.  These include amino acids and nutrients such as arginine, glutamate, tryptophan, acetyl-L-carnitine, and choline. The clinical dietary management of fibromyalgia contains the specific elements the body requires to stimulate production of the neurotransmitters required to support effective pain control.

As a practicing board-certified rheumatologist and internist, I have prescribed medical foods to patients for the treatment of fibromyalgia for a number of years.  Healthcare providers and patients interested in a more efficacious treatment for fibromyalgia with little or no side effects should familiarize themselves with the class of medications regulated by the FDA as medical foods.