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.

The Nutrient Management of Hypertension

Hypertension, or high blood pressure, is a chronic medical condition in which the blood pressure in the arteries is elevated.  Blood pressure measures the force pushing outward on your arterial walls.  Since your body needs oxygen to survive, it is carried throughout the body.  Every time that your heart beats it is pumping oxygen through a network of blood vessels and capillaries.  There are two forces to every heart beat.  The first force occurs as blood pumps out of the heart and into the arteries that are part of the circulatory system, also known as systolic pressure.  The second force is created as the heart rests in between heartbeats, also known as diastolic pressure.  These are the two numbers that a person can see in a blood pressure reading.  Problems arise when there is too much force on the heart.  This can lead to conditions such as vascular weaknesses, vascular scarring, increased risk of blood clots, increased plaque build-up, tissue and organ damage from narrowed and blocked arteries, and increased workload on the circulatory system.  When cholesterol or plaque builds up because of scarring, the heart has to work harder in order to pump blood to the arteries.  This can eventually result in damage to the heart which can ultimately lead to heart failure.  This disease affects 76.4 million adults in the United States and can lead to heart attack, heart failure, stroke, and kidney failure.

Hypertension is usually a symptomless condition with complications.  Usually people only feel symptoms in extreme readings, for example if their systolic reading is 180 or their diastolic is 110.  This is what is known as a hypertensive crisis.  It is important that adults be familiar with their blood pressure numbers on a consistent basis in order to prevent this disease from causing serious health issues.

There are simple ways to help control a person’s blood pressure.  According to the American Heart Association, there are 8 main ways to adopt a healthy lifestyle.  Eat a better diet (including reducing salt), regular physical activity, maintain a healthy weight, manage stress, avoid tobacco smoke, comply with medication prescriptions, limit alcohol, and understand hot tub safety.

Prescription medication is commonly used to help patients manage hypertension effectively.  One of the most commonly prescribed medications is lisinopril, a type of ACE Inhibitor that helps relax blood vessels keeping blood pressure low.  As with any drug therapy, there are good and bad side effects associated with lisinopril.  For example, lisinopril and other ACE inhibitors can cause a wide range of side effects, some less serious than others such as cough, dizziness, weakness, headaches, or nausea.  More serious side effects include swelling, difficulty breathing or swallowing, fever, fainting, and chest pain. Any patient taking this class of drugs should be aware of these side effects and monitor themselves at the onset of therapy and periodically throughout the course of therapy to ensure that the medication is more beneficial than harmful.

Another popular prescription option for patients with hypertension, are calcium channel blockers.  Calcium channel blockers relax and open up narrowed blood vessels by preventing calcium from entering the smooth muscle cells of the heart and arteries. The common side effects of this class of medications include headache, swelling, dizziness, flushing, fatigue, nausea, and palpitations.

Diuretics are also commonly prescribed and help expel excess sodium and fluid from the body in order to help control blood pressure.  Some of the side effects associated with diuretics are arrhythmia, extreme tiredness or weakness, muscle cramps, dizziness, fever, and dehydration.

Beta-blockers are also commonly used to treat hypertension. This class of medication is used to reduce heart rate, the heart’s workload, and the heart’s output of blood by preventing certain hormones from stimulating the heart. Side effects of beta blockers include diarrhea, depression, vomiting, depression, nightmares, and hallucinations.  One of the main dangers of beta-blockers is that if they are withdrawn suddenly conditions like angina can worsen, causing heart attacks or sudden death.

Doctors often hesitated to prescribe ACE inhibitors, beta blockers and diuretics until a patient’s blood pressure reaches 160/100. Anything below that level is deemed “mild hypertension” and not considered imminently dangerous, so a drugs’ potential side effects might outweigh their benefits. For patients with mild to moderate hypertension, nutritional interventions are commonly used in an effort to prevent the disease from progressing to a life threatening state.

A safe alternative for Hypertension is a medical food like Hypertensa® which are commonly used to expand blood vessels and improve blood flow through a natural pathway.  This class of medications addresses the increased nutritional demands of hypertension.  It uses specific amino acids and nutrients that are responsible for regulating blood pressure and vascular function.  Unlike drugs, medical foods address the production of the specific neurotransmitters that drive all the automatic functions of your body including heart rate and blood pressure.  Hypertension and many drugs that treat hypertension can alter the way the body uses these substances which are derived from both the diet and internal metabolic processes, creating deficiencies which cannot be fixed by altering diet alone.  By addressing the increased metabolic requirements of hypertension with nutritional interventions, the body will have the tools that it needs to help regulate blood pressure and heart rate.

The Second Brain

It’s 10 pm and you are stressed.  All of the sudden your stomach starts churning and you remember that half eaten carton of Ben and Jerry’s left in your freezer.  Before you know it the ice cream is gone and you are left hoping that it will settle the butterflies in your stomach.  We have all had that feeling, but then the question arises.  What makes us have that “gut feeling”?  Why are our stomachs controlling our emotions, and therefore controlling our eating patterns?

Your gut can work independently without any input from your brain, unlike any other organ in the human body.  This is how the stomach got its name of “the second brain”.  The stomach is controlled by the enteric nervous system (ENS) which is made up of 100 million neurons.  The ENS is used to control the movement and absorption of food through the intestines.  The stomach has the ability to send signals to the brain that can affect certain feelings, such as sadness or stress, as well as influence memory, learning, and decision-making.  The stomach relies on 30 neurotransmitters in order to function that are identical to those in the brain.  The ENS communicates with the central nervous system (CNS) through the parasympathetic and sympathetic nervous system, but does not rely on it in order to function.  Studies have shown that the ENS continues to function, even after the vagus nerve, which connects the CNS to the ENS, has been severed.

Different foods can affect emotions differently.  Specific components of food can influence neurohormones in the gut that are responsible for signaling the brain.  What a person eats affects their mood.  Fatty acids reduce feelings of sadness and hunger.  This is why most people in times of stress and sadness will turn to the help of “comfort foods” to help them feel better.  Ghrelin, a hormone manufactured by the gut, stimulates hunger in the brain and is one of the neurochemicals that sends messages back and forth between the ENS and CNS in order to affect mood. Every time a meal is consumed ghrelin levels fall, and then continue to rise again until the next meal. Obese people tend to have higher levels of ghrelin even after eating, which can leave them feeling hungry more often. High-fat foods stimulate dopamine production and can enhance mood/euphoria, thus encouraging the brain and stomach to seek out more high fat food.

Measuring the beerbelly

During gastric bypass surgery, the part of the stomach which produces the most ghrelin is isolated in order to make the patient less hungry.  The doctor then attaches the stomach to a section of the small intestine called the ileum which produces PPY, a hormone that makes you feel full.  PPY typically takes 20 minutes to send the message to the brain to let it know that the stomach is full.  Making these two sections of the stomach closer together allows the brain to receive the signal quicker in order to encourage the body to eat less.

Surgery is an expensive and drastic solution to fighting a problem such as obesity.  People try to diet, which if done safely and combined with exercise can be effective. One important thing to note is that people dieting will also have increased levels of grehlin, increasing hunger levels.   This is one reason why people find dieting to be so difficult. Food affects mood due and increased cravings caused by certain hormones can be difficult to control.  Perhaps this is why your co-worker who is on a 3-day juice cleanse is in such a sour mood.

If exercise and dietary changes fail to make a dent in hunger, weight and BMI then a more targeted approach can help people interested in managing appetite and controlling food intake. Medical foods is certainly one option that should be explored. As a safe and effective class of medications medical foods deliver the specific neurotransmitter precursors required by nervous system to help reduce appetite and promote early satiety As stated earlier, your stomach uses neurotransmitters just as the brain does.  Using these neurotransmitters help your stomach become more satisfied and helps manage your mood and cravings, helping you manage appetite safely and effectively.  Clinical trials show that a medical food as an adjunct to a weight loss diet and exercise plan can help increase weight loss and decrease BMI.

Ten Foods that May Help Curb Appetite:

  1. Avocados – Composed of monounsaturated fats, which take longer to digest, avocados help suppress ghrelin production and appetite.  The soluble fiber in avocados slow digestion by forming a thick gel as it travels throughout the gut.
  2. Greek Yogurt – A high-protein appetite buster.  Since it is thick, you feel fuller faster.
  3. Legumes – High in soluble fiber, resistant starch, and oligosaccharides.  These complex carbs help slow digestion.
  4. Cottage Cheese –  A good source of protein which helps suppress appetite.
  5. Oatmeal – Contains beta-glucans, a soluble fiber, that helps it travel slowly through the digestive track.
  6. Nuts – Nuts contain healthy fats and fiber which help you digest more slowly.
  7. Fruit – high in fiber, which helps to slow digestion and keep you feeling full longer.
  8. Wasabi – suppresses appetite and also contains anti-inflammatory qualities.
  9. Salmon – Salmon is high in omega-3 fatty acids, which helps the body increase leptin, a hormone used for suppressing hunger.
  10. Cinnamon – Cinnamon helps lower blood sugar which helps control appetite.

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

The Cost of Pain

Pain and the treatment of pain affect every sector of our society with at least 100 million adult Americans reportedly suffering  from common chronic pain conditions, a conservative estimate because it does not include acute pain of children.[1]  The proliferation of pain in the United States has resulted in a sharp increase over the past decade in the overuse of narcotics. The prescribing of narcotics has become a popular option for the treatment of chronic pain associated with back injuries, headaches, arthritis, and fibromyalgia.

Chronic pain takes an enormous personal toll on millions of patients and their families, and leads to increased health care costs. Patients with chronic pain have more hospital admissions, longer hospital stays, and unnecessary trips to the emergency department. Such inefficient and even wasteful treatment for pain is contributing to the rapid rise in health care costs in the United States.

The prevalence of pain has a tremendous impact on business.  A recent report by the Institute of Medicine indicated that the annual value of lost productivity in 2010 dollars ranged between $297.4 billion to $335.5 billion. The value of lost productivity is based on three estimates: days of work missed (ranging from $11.6 to $12.7 billion); hours of work lost (from $95.2 to $96.5 billion); and lower wages (from $190.6 billion to $226.3 billion)[2]. This billion dollar annualized price tag will likely climb as the U.S. population ages.

The cost of pain also includes the cost of treating side effects. The most commonly prescribed drug for pain is Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).  Approximately 98 million prescriptions for NSAIDs were filled in the United States in 2012 (IMS 2012).  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 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]

NSAIDs Image

Treatment of GI problems alone caused by the use of NSAIDs is estimated to add over 40% to the cost of arthritis care[4]

From the perspective of the healthcare system, minor GI side-effects and prophylactic gastroprotection against NSAID-related side-effects may consume even more healthcare resources than severe events because of their high prevalence.

Opioid use has resulted in increased hospitalizations, increased spending on opioid addiction and increased workplace costs.  The cost of the average lost time claim with long acting opioids is 900% higher than those without the use of opioids. U.S. emergency room visits have also increased.  The number of cases in which an opioid other than heroin was cited as a reason for an emergency room treatment in  2004 was 299,498 and in 2011 was 885,348, an almost 300% increase.[5]

While many assume that increase spending and use of pharmaceuticals for pain has had a positive effect on the overall mitigation of pain, there is little scientific data on the relationship between spending on pharmaceutical agents and pain resolution.  Simply treating the symptoms of pain have not proven to be effective nor cost saving in the long run. However, it is increasingly clear that there may be a positive relationship between the use of non-pharmaceutical interventions with or without the use of pharmaceutical and the resolution of pain.

#medicalfoods #NSAIDs #opiods #sideeffects


[1] IMS Health Data, California Workers’ Compensation Institute

[2] Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington DC

[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

[5] IMS Health Data, California Workers’ Compensation Institute

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

Sleepless in America

Eighty three percent of Americans say they do not always get a good night’s sleep on a regular basis, according to the 2013 Rx Sleep Survey conducted by Harris Interactive. The results also revealed that forty-eight percent of Americans say stress and anxiety prevent them from getting a good night’s sleep on a regular basis.  There are gender differences with more women than men are likely to have difficulty falling and staying asleep and to experience more daytime sleepiness. According to the Harris survey more women (88 percent) than men (78 percent) suffer from lack of sleep or sleep disorders, Fifty-six percent of women say anxiety and stress are the leading reasons for lack of restful sleep, compared to 40 percent of men. For all the other top reasons Americans do not always get a good night’s sleep more woman than men report:

  • Inability to turn off thoughts (16% more women than men)
  • Pain (13% more women than men)
  • Being overtired (22% more women than men)
  • Background noise (25% more women than men)
  • Children or pets (33% more women than men)

It is unclear why more women than men report sleep disorders. It is possible that women may require more sleep than men or that they may simply have greater physiological consequences to lack of sleep than men. Pregnancy and menopause too can dramatically alter sleep patterns. What is known is that the consequences of too little sleep on women are dangerous. According to a recent study conducted by Duke University, women who get too little sleep have a higher risk of developing heart disease, depression or other psychological problems. They are also more likely to develop blood clots which put them at greater risk for stroke.

Regarding treatment, the results revealed that while overall 25 percent of Americans would be willing to take a prescription sleep aid to improve sleep quality, the majority of Americans (71 percent) would rather use other means to get a good night’s rest. When it comes to treatment for sleep disorders the gender disparities continue.  More women (29 percent) than men (20 percent) would be willing to take a prescription sleep aid. The survey also found that women (68 percent) are less inclined than men (75 percent) to use other means than prescription sleep aids to help them sleep. These results are supported by research on inflammatory markers showing that women experience chronic pain more frequently, with greater intensity and longer duration than do men.  Having more pain during the day, the ease and facility of pharmaceutical solutions may be most appealing to women.

According to the CDC, the number of prescriptions for pharmaceutical sleep aids has increased dramatically in the past 10 years with more than 9 million Americans or 1 in 25 are using such aids.  While not a cause of death, recent studies suggest that patients taking prescription drugs for sleep were nearly five times as likely as non-users to die over a period of two and a half years. Sleep drugs have very serious side effects which can impair daily function and overall quality of life. The popular misconception of these drugs is that they improve overall sleep quality, when in reality they often interfere with a patient’s ability to achieve meaningful restorative sleep and normal physiologic function. The FDA recently ordered a label change for the popular sleep drug zolpidem (ambien) because women are more susceptible to next-morning impairment. With issues such as addiction, rebound insomnia, morning grogginess and memory loss, many providers are encouraging both men and women to seek alternatives to prescription drugs for sleep.

Alternatives to Prescription Sleep Drugs

There are many non-pharmacologic therapeutic options for patients affected by sleep disorders including educating patients about sleep, sleep hygiene, aerobic exercise and cognitive behavioral therapy. One new and rapidly expanding field of treatment is the use of medical foods to manage the specific amino acid and neurotransmitter deficiencies associated with sleep disorders. Medical foods are a well defined FDA regulatory category established by the Orphan Drug Act of 1988. Medical foods work on a different pathway from other prescription drugs and contain ingredients that are Generally Recognized as Safe (GRAS) by the FDA.

Rather than focusing on a single receptor site or molecule, medical foods work on multiple pathways providing depleted cells with the amino acids and specific nutrients that are needed to help fall asleep and achieve restorative sleep, many of which cannot be replaced by simple dietary alterations or supplements alone. For example, insomnia is often a co-morbidity of anxiety and of chronic pain. These specific conditions alter the metabolic processes of the nervous system resulting in a relative nutritional deficiency. Correcting the nutritional deficiencies is an approach that has shown to be effective with minimal to no side effects. The management of sleep is a complex process that is influenced by other diseases and conditions, and even gender. Talk to your healthcare professional about alternatives to prescription drugs for sleep.

 

 

 

 

 

 

 

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.