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.

Are you Overweight or Obese? Here is what you should know

Know your body mass index (BMI) so you can improve it.

You BMI is a measurement of body fat that is based on your height and weight. Your BMI is a major factor that your healthcare provider considers when determining treatment protocols. A person with a BMI of between 25 and 29.99 is classified as ‘overweight,’ and a BMI of 30 and above is classified as obese. People who are overweight or obese are at a higher risk for chronic conditions such as high blood pressure, diabetes and high cholesterol. Click here to calculate your BMI.

What is causing the obesity epidemic?

Simply put, too many calories. If you are eating more calories than you are burning throughout the day, you will inevitably gain weight. The increased availability and accessibility of energy dense foods is contributing to an unhealthy increase in weight across the world. Combine that with a steady decline in physical activity and the results are fatal and very costly.

Can the course of obesity be changed?

For most people struggling with obesity, the answer is yes! Unfortunately the process is not simple, as reducing calories and increasing physical activity is not easy and not always the answer.

If you are looking to improve your diet try reading this post. Drastically reducing calories is not the best answer, because not all calories are bad. There is no quick fix to obesity, but rather micro lifestyle changes that are implemented daily and maintained for long periods of time.

To simplify your journey to a healthier you, try starting with these tips:

  1. Avoid eating saturated fats
  2. Increase the amount of fruits, vegetables, whole grains and nuts you eat daily.
  3. Cut out sugars and sodium from your diet gradually.
  4. Exercise 15 minutes every day for the first two weeks, then push to 30 minutes every day for the next two weeks, then try an hour every day.

Enjoy the process and don’t go at it alone! Work in teams to meet your goals.

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.

Is Your OTC Pain Reliever Going to Kill You?

Although acetaminophen (Tylenol) is heavily marketed for its safety, FDA recommends health care professionals to discontinue prescribing and dispensing drug products with more than 325 mg of acetaminophen due to the high risk of liver injury.  Severe liver injury may occur in patients who:

  • Took more than the prescribed dose of an acetaminophen containing product in a 24 hour period.
  • Took more than one acetaminophen containing product at the same time.
  • Drank alcohol while taking acetaminophen products.

Acetaminophen is widely used as an over the counter pain reliever and fever medication and is often combined with other ingredients such as cough and cold ingredients.  Patients may be unaware that many products (both prescription and OTC) may contain acetaminophen, making it easy to accidentally take too much [1-5]. In fact,  acetaminophen poisoning accounts for approximately one-half of all cases of acute liver failure in the United States and Great Britain[16].

Ibuprofen (Motrin, Advil) is also widely used for pain and inflammation but not without risk.  Ibuprofen carries a black box warning from the FDA regarding the cardiovascular and gastrointestinal risks associated with its use.  Patients taking ibuprofen have an increased risk of serious cardiovascular thrombotic events including myocardial infarction and stroke. Researchers in Denmark observed a nearly threefold increase in the number of deaths from gastrointestinal bleeding within one year of ibuprofen prescription [14].  The risk of side effects is so high for elderly patients the American Geriatrics Society has recommended that patients over the age of 65 avoid NSAID use if at all possible [6-10].  This real risk was studied by RE Tarone who noted a marked rise in baseline rate of gastrointestinal bleed with advancing age with the large majority of cases occurring among persons age 65 or older.  The average relative increase in risk of gastrointestinal bleeding was found to be fourfold or slightly higher in NSAID users and six fold or higher at heavy prescription levels [15].

NSAID High Risk Groups

Medications such as Tylenol and ibuprofen, which are readily available over-the-counter, are perceived to be safe medications; but research has proven that they are not without risk.  Physicians, payers and patients are requesting a safe more effective alternative to treat pain which becomes increasingly important as the population ages.

Medical foods such as Theramine treat the dietary deficiencies that are associated with pain and inflammation.  Pain reduction is accomplished by moderating responsiveness to noxious stimuli, regulating the transmission of pain signals and controlling inflammation. The use of medical foods has been long standing and there have been no reports of GI bleed in over 10 years on the market.

Two multi-center double-blind clinical trials established the safety and efficacy of Theramine in the treatment of chronic back pain.  In a clinical study 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 indicate significant reduction in back pain with the administration of Theramine alone, while administration of a low dose NSAID had no appreciable effect on pain.

An important observation by researchers EL Fosbol and L Kober note that, “Individual NSAIDs have different cardiovascular safety that needs to be considered when choosing appropriate treatment.  In particular, rofecoxib and diclofenac were associated with increased cardiovascular mortality and morbidity and should be used with caution in most individuals.  This notion is also valid for healthy individuals and underlines the importance of critical use of NSAID therapy in the general population and also that over-the-counter retail of NSAIDs should be reassessed.”[13]

 

REFERENCES

 

1.  Wolf M; King J; Jacobson K; et al “Risk of Unintentional Overdose with Non-prescription Acetaminophen Products”  J Gen Intern Med 2012 Dec; 27(12): 1587-1593

2.  “Acetaminophen Toxicity in Children” Pediatrics vol. 108 No. 4 Oct. 1 2001

3.  Farrell S; Tarabar A; et al “Acetaminophen Toxicity” Medscape June 24, 2011

4.  Plaisance K “Toxicities of Drugs Used in the Management of Fever” Clinical Infectious Diseases 2000 31 Supp 5: S219-S223

5.http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm381650.htm

6.http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm085282.htm

7.  Pilotto A; Franceschi M; Leandro G; Di Mario F; “NSAID and aspirin use by the elderly in general practice:  effect on gastrointestinal symptoms and therapies:  Drugs Aging 2003; 20(9): 701-10.

8.  Smith SG “Dangers of Non-steroidal Anti-inflammatory drugs in the elderly” Can Fam Physician vol. 35 March 1989

9.  American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

10.  Gurwitz JH; Everitt DE; Monane M; Glynn RJ, Choodnovskiy I; Beaudet MP; Avorn J; “The impact of ibuprofen on the efficacy of antihypertensive treatment with  hydrochlorothiazide in elderly persons” J Gerontol A Biol Sci Med Sci 1996 Mar; 51 (2): M74-9

11.  Shell WE; Charuvastra E; DeWood M; May L; Bullias D; Silver D “ A Double-blind controlled trial of a single dose naproxen and an amino acid medical food Theramine for the treatment of low back pain”  Am J of Ther 2010

12.  Shell WE; Pavlik S; Roth B; Silver M; Breitstein M; May L; Silver D “ Reduction in pain and inflammation associated with chronic low back pain with the use of the medical food Theramine”  Amer J of Ther 2014

13.  Fosbol EL; Kober L; Torp-Pedersen C; Gialason GH “ Cardiovascular safety of non-steroidal anti-inflammatory drugs among healthy individuals”  Expert Opin Drug Saf 2010 Nov; 9(6): 893-903

14.  Lipworth L; Friis S; Blot Wj; McLaughlin JK; Mellemkjaer L; Johnsen SP; Norgaard B Olsen JH “ A population based cohort study of mortality among users of ibuprofen in Denmark”  Am J Ther 2004 May-Jun; 11(3): 156-63

15.  Tarone RE; Blot WJ; McLaughlin JK “Nonselective non-aspirin non-steroidal anti-inflammatory drugs and gastrointestinal bleeding:  relative and absolute risk estimates from recent epidemiologic studies”  Am J Ther 2004 Jan-Feb; 11(1): 17-25

The Problem with Prescription Pain Killers

Pain is a big deal. On one level, it’s very useful. It tells us when there’s something wrong, and is pretty efficient at giving us a handy indication when what we’re doing may not be particularly good for us. Those who cannot feel pain [1] suffer from horrendous associated problems, and frequently damage themselves quite badly without being alerted to the fact that they’re doing so by pain. However, unlike a man-made alarm, the body does not come with an ‘off’ switch which one can hit once one’s been made aware of the problem. Chronic pain is a major issue, and one of the most troubling symptoms of a great many medical conditions. It’s a factor which seriously affects people’s lives, and good pain management is recognized as being vital to the all-important quality of life [2] experienced by those needing medical treatment. Having said this, however, it is also being increasingly recognized that the people of North America are becoming dangerously dependent upon prescription painkillers. All too often, we pop a pill when we do not really need to, and plenty of us are relying on prescribed narcotic painkillers when we would undoubtedly be a lot better off with some other method of pain-relief. While there is certainly a place for narcotic painkillers in the management of seriously painful conditions, it needs to be recognized that these drugs do come with a major health warning – and alternatives or avoidance should be the preferred options if at all possible.

Narcotic Painkillers

Opioid painkillers were originally designed for cancer pain and somehow over time have become a first line therapy for many physicians despite the potential for addiction. What may be lesser known, however, are the dangers inherent within these drugs, and the startling scope of America’s dependence upon them. Put simply, opioids such as Vicodin and codeine bind to opioid receptors within the brain, which dulls the brain’s pain response. These receptors are designed to work with the body’s natural opioids – endorphins [3]. Endorphins are released during exercise, and numb pain as well as promoting a feeling of wellbeing, enabling and motivating us to stay on the move and thus potentially to survive for longer. Narcotics fulfil the same role – but in hyper-exaggerated form. Narcotic analgesics swamp our opioid receptors, saturate them to the point where we’re utterly numbed and frequently rather high. They’re very effective as a method of pain relief, but also quite dangerous and are associated with a host of dangerous side effects.

Painkiller Addiction

It’s very easy to develop a taste for opioid painkillers. Why wouldn’t you? They keep pain at bay, and they make you feel good. They’re also, unfortunately, highly addictive. Their very nature means that you’re inclined to seek out more and more – and America’s healthcare system doesn’t exactly discourage you from overdoing it. Big pharmaceutical companies do, after all, stand to make a lot of money from plenty of pill-popping patients. North America has the world’s worst rate of prescription painkiller addiction by a long, long way [4]. Places with nationalized healthcare (in which pharmaceutical companies would have nothing to gain from touting their product to the public) are not in any more pain than the people of America, but they’re far less addicted to painkillers. The solution for someone from the USA to the slightest malady invariably involves popping a pill, while those from other countries are put on courses of pills only when necessary, and given alternative pain-relief methods more often. Each system obviously has its pros and cons – but in this particular case the figures concerning painkiller addiction speak for themselves. More overdose deaths in the USA have been caused by prescription narcotics since 2003 than cocaine and heroin put together – partly (if not wholly) because narcotic prescription rates have increased enormously in this time [5].

An Easy Death

A major issue with opioid painkillers is that they’re not only all too easy to get hold of, and highly addictive – they’re also unpredictable killers. While medical science is pretty good at estimating doses according to body weight and so on, the problem of tolerance is always going to rear its ugly head. The body develops a resistance to opioids over time which means that one must take a higher and higher dose in order to achieve the desired effect. And, at any moment, that dose might prove just too high for the body to cope with. Opioids kill in a number of ways. The most common of these is respiratory depression. This can be reversed – but only if the overdose is low and medical aid arrives quickly [6]. If this is not the case, then the overdoser finds themselves unable to adequately fill their lungs and essentially starves of oxygen. It is far better not to risk this, not to get addicted, and to seek alternatives to narcotic analgesics whenever possible!

[1] Gillian Mahoney, “Meet the Child Who Feels No Pain”, ABC, Oct 2013

[2] Nathanial Katz, “The Impact of Pain Management on Quality Of Life”, Journal of Pain and Symptom Management, Jul 2002

[3] PBS, “Role of endorphins discovered, 1975”

[4] Arnold M. Washington, “America’s Painful Love Affair With Painkillers”, Rehabs

[5] National Safety Council, “Opioid painkillers: How they work and why they can be risky”

[6] Ben Wolford, “Respiratory Depression Reversed In Trials With Drug That Fights Opioid Side Effect”, Medical Daily, Aug 2014

 

Safer Options for Pain Management

Pain is complex and there are several treatment options to choose from depending on the type of pain you are experiencing including medications, therapies and mind-body techniques.  The most common treatment consists of analgesics:  narcotic (opioid) and non-narcotic (non-opioid) analgesics.

Narcotics vs NSAIDS
Primary Differences Between Narcotics and NSAIDs

Narcotic analgesics are derived from or related to opium.  Opioids bind to opioid receptors which are present in many regions of the nervous system and are involved in pain signaling and control.  Opioid analgesics relieve pain by acting directly on the central nervous system.  They block incoming pain signals but also work in other parts of the brain, modulating pain receptors in the nervous system, primarily located in the brain and the spinal cord.

Non-opioid analgesics or NSAIDs work by blocking the production of prostaglandins by inhibiting the cyclooxygenase enzyme and therefore decreasing the formation of pain mediators in the peripheral nervous system.   Non-opioids work more directly on injured or inflamed body tissue. In a basic sense, opioids decrease the brain’s awareness of the pain whereas the non-opioids affect some of the chemical changes that normally take place wherever body tissues are injured or inflamed.

Although non-opioids are often preferred for certain types of chronic pain, they have two serious drawbacks.  The first is the ceiling effect; Non-opioids have an upper limit of pain relief that can be achieved.  Once the upper limit is achieved; increasing the dosage will not provide any further pain relief but may exacerbate side effects.  Opioids on the other hand tend not to have a ceiling.  The more you take, the more pain relief you will get.  The second major drawback of non-opioids is the side effects profile.  The side effects of NSAIDS make it impossible for certain patient populations to use NSAIDs such as those with history of peptic ulcer disease, cardiovascular disease and the elderly. In 2014, the American Academy of Neurology determined that the risks of opioids outweigh the benefits for certain chronic pain conditions.

Treatment of pain with the use of medical foods gives patients a safer option for pain management by approaching pain from a new perspective.  Medical foods treat the nutritional deficiencies that are found in patients with acute and chronic pain.  By restoring an optimal balance between the chemicals in the body, substances called neurotransmitters, that are responsible for transmitting and dampening pain signals, one can better manage pain.

Research has found low levels of the amino acids gluatamate, tryptophan, arginine, serine, and histidine in patients with chronic and acute pain.  The perception of pain can be modified by providing amino acids and nutrient precursors to the key neurotransmitters involved in the pain process. Amino acids are able to cross the blood brain barrier and are necessary to produce the appropriate neurotransmitters needed to reduce pain signals and lower inflammation. Increasing the intake of amino acids and nutrients lead to an increase in neurotransmitter levels [1].

The theory that the body’s need for amino acids and nutrients are modified by a disease has been long recognized and is supported by studies that reflect changes in plasma, urinary and tissue levels of nutrients with modified intakes of these nutrients [2].   There are various reasons for depletion of nutrient levels including diet, metabolic demands and genetics.  The required amount for each patient varies depending on the duration and severity of pain. Addressing the increased demand for amino acids and nutrients is a key component for improving clinical outcomes.

Two double-blind clinical trials compared Theramine, a medical food specially designed to address the increased amino acid and nutrient requirements of pain syndromes, to low dose naproxen and ibuprofen.  In both studies, Theramine showed statistically greater pain relief than either naproxen or ibuprofen.  This was measured by patient report and a reduction in the inflammatory markers C-reactive protein (CRP) and interleukin-6 (IL-6) [3, 4].  Treatment with amino acid precursors was associated with substantial improvement in chronic back pain and a reduction in inflammation.

Pain Reduction with TheramineThe improvement in pain directly correlated with increased amino acid precursors to neurotransmitters in the blood.

Theramine is designed using Targeted Cellular Technology (TCT), which facilitates the uptake and utilization of the neurotransmitters precursors that are used in the modulation of pain.  TCT allows for the production of neurotransmitters from ingestion of smaller amounts of amino acids to elicit the same response as larger amounts, making daily dosing more feasible and reducing the potential for tolerance.

At least 100 million adult Americans suffers from chronic pain, a safe and effective treatment option such as medical foods that do not treat symptoms alone but addresses the distinctive nutritional needs of adults who have different or altered physiologic requirements due to pain is vitally needed.

To date, Theramine has been in clinical use for over 10 years with no report of GI bleed or adverse side effects and the clinical trials of Theramine clearly support the theory that the nutritional management of pain syndromes is a safe and effective treatment for pain.

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 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

A New Approach to Improving Neuropathic Pain

In the United States, approximately 20 million people suffer from neuropathy. The most common form of neuropathy is diabetic neuropathy with over half of diabetes patients living with this condition. Neuropathy may also be caused by poor circulation, herpes outbreaks or can be drug induced.

Neuropathic pain is the result of degeneration of the outer sheathing or myelin sheath of nerve cells. This is analogous to an electrical wire that is covered with insulation, and the insulation is beginning to breakdown. Without insulation the unprotected wire will start short-circuiting. In the same way, when the sheathing of nerve cells degenerate, the signals being transmitted start to  misfire, resulting in the body receiving signals that are interpreted as numbness, heat, cold, tingling and pain in the toes, feet legs, fingers, hands and arms.

Degradation of the myelin sheath results in unusual sensitivity of the neurons and abnormal excitability and heightened sensitivity to stimuli, also known as peripheral sensitization. The heightened sensitivity results in an increased demand and competition for nutrients involved with the pain receptors, particularly arginine, choline, GABA, glutamine, histidine, and serine.

The degradation of nerve pathways increases the turnover rate of the precursors needed for neurotransmitter function.  This results in a reduction in the level of production of neurotransmitters. The nutritional requirements for proper neurotransmitter function are such that they cannot be achieved by the modification of diet alone.

Unfortunately, current neuropathy treatment exists primarily of palliative treatment of symptoms. There are a variety of treatments available that range from pharmaceutical drugs and creams to therapies that stimulate the nervous system.  Antidepressants, especially tricyclics and selective serotonin-norepinephrine re-uptake inhibitors (SNRI’s), have been mainstay treatments for neuropathic pain along with antiepileptic drugs such as Lyrica and Neurontin. Opioid narcotic treatments for neuropathy are used as well but are less favored because of the risk of dependency. Most topical treatments have been largely ineffective at improving symptoms or the disease.

Treatment that addresses the distinctive nutritional needs of adults suffering from neuropathic pain rather than treating symptoms alone is a rapidly expanding field of interest for podiatric medicine.  The unique nutritional needs that arise in patients suffering from neuropathic pain cannot be satisfied through a conventional diet or through supplementation (i.e., use of a dietary supplement).

An open-label pilot study of an amino acid-based oral formulation was shown to reduce symptoms of pain and numbness related to peripheral neuropathy by supplying amino acids and other dietary factors which support induction, maintenance, and enhancement of the specific neurotransmitters involved in pain. Use of neurotransmitter precursors in a patented Targeted Cellular Technology system allows for smaller amounts of amino acids to be rapidly utilized by target cells making daily dosing more feasible and efficient.  Supplying the nutrients involved with the various pain signaling pathways in a targeted delivery system  can synchronize the availability of the precursor supply with the fluctuating demand for the corresponding neurotransmitters resulting in reduced pain, inflammation and numbness.

Neuropathic pain may not be completely preventable. Controlling blood sugar levels if you have diabetes, smoking cessation, alcohol moderation and regular exercise can help. In many cases a prescription nutrition program that addresses the increased requirements of the disease is needed for optimal clinical results and increased patient satisfaction.