Acid Reflux: Supplements, Foods to Avoid, and What to Eat

Heartburn—that painful, burning sensation in the upper chest that usually follows a meal—is a familiar sensation to many of us. The condition is often accompanied by stomach upset, belching and other symptoms of indigestion. It is usually treated with over-the-counter remedies such as calcium carbonate tablets or something as simple as baking soda in water.

But when heartburn frequently returns—sometimes after every meal—it may be more than a simple case of too much of the wrong food. Heartburn is caused by acid reflux, an upward flow of stomach acid into the esophagus. In gastroesophageal reflux disease (GERD), chronic acid reflux exposes the esophageal lining to the stomach’s powerful acid on a regular basis. This damage can lead to a condition known as Barrett’s Esophagus, which is associated with an increased risk of esophageal cancer. Clearly, acid reflux can be more than an occasional annoyance.

Learn more about acid reflux below and listen to the Live Foreverish Podcast, in which Life Extension’s own Michael A. Smith, MD discusses the latest information.

What causes acid reflux?
Acid reflux is caused by a backflow of the stomach’s hydrochloric acid upward past the lower esophageal sphincter into the esophagus, which is the passage taken by food when it travels from the mouth to the stomach. While the lower esophageal sphincter normally prevents the passage of the stomach’s contents into the esophagus, relaxation or weakening of this muscular band allows stomach acid to flow backward, resulting in irritation to the esophageal lining.

One cause of acid reflux is hiatal hernia, which occurs when the upper part of the stomach and lower esophageal sphincter move above the diaphragm. Acid reflux is also a common occurrence during pregnancy. A major cause of acid reflux is being overweight or obesity, when abdominal fat exerts pressure on the stomach.

Acid reflux foods to avoid

In addition to overeating in general, some foods can make acid reflux worse. Fatty and fried foods, spicy food, coffee, tea, citrus fruit (which includes tomatoes), mint, chocolate and carbonated or alcoholic beverages are among the more notorious culprits. This does not necessarily imply that these foods can never be consumed, but if one or more is associated with your symptoms, try consuming it in smaller quantities or less frequently.

Foods that reduce stomach acid

Broccoli, kale, radish, cucumber, cold milk and milk curd were shown in a recent study to have acid-neutralizing effects. Of these foods, broccoli and cold milk had the greatest antacid activity, which was similar to baking soda.1 In fact, consuming ½ teaspoon of baking soda mixed in a small glass of water is a great way to temporarily treat acid reflux symptoms by neutralizing stomach acid.

While neutralizing stomach acid may help ease acid reflux symptoms, keep in mind that the stomach’s acid is essential for digestion and helps protect against infection by food-borne pathogens. Neutralizing stomach acid’s pH is ideally a temporary solution; however, some patients may be treated long-term with drugs that neutralize or reduce the production or release of stomach acid.

Supplements and foods to ease heartburn

Other than neutralizing stomach acid, there are other dietary measures that can help improve the symptoms of acid reflux. While snacking on sugar-laden licorice candy may not be helpful, licorice root extract may help prevent the formation of esophageal ulcers.2 Furthermore, flavonoids in deglycyrrhizinated licorice (DGL) may encourage a healthy inflammatory response by inhibiting the production of signaling molecules that promote inflammation.3,4

Calcium carbonate is a common ingredient in over-the-counter heartburn relief products that, when chewed, neutralize acidity in the esophagus without affecting the stomach’s acid.5 Magnesium carbonate is another mineral salt that can be helpful.6 Calcium carbonate and magnesium carbonate have the added benefit of contributing to the body’s essential need for calcium and magnesium.

Aloe vera juice has long been used for gastrointestinal complaints. Aloe vera liquid was associated with a reduction in GERD symptom frequencies in a pilot trial.7 If you choose to try aloe vera liquid, look for one that is free of aloin, a naturally occurring compound that can be an irritant.

Digestive enzymes consumed with food may aid in the prevention of acid reflux symptoms. Eating slowly also helps.

If you have acid reflux, what should you eat?

A study reported in JAMA Otolaryngology Head and Neck Surgery found that consuming alkaline water and a Mediterranean diet, which is high in vegetables, fruit and whole grains and low in red meat, was associated with a greater reduction in reflux symptoms than proton pump inhibitors (PPI), which are a standard drug treatment for acid reflux.8 The finding is important because long-term PPI use is associated with a number of adverse conditions. The drugs’ ability to lower the production of stomach acid may result in reduced absorption of certain nutrients such as magnesium.9

How much one eats is also important. Since having a greater amount of belly fat puts pressure on the esophagus and stomach, losing some of that fat can improve reflux symptoms.10 Eating less may not only result in fewer acid reflux symptoms during a meal but can also help with long-term acid reflux management.

Fortunately, acid reflux is treatable and often reversible. By making a few dietary changes—and sticking to them—acid reflux can be prevented in many cases. However, do not discontinue the use of any medications to prevent acid reflux that have been recommended or prescribed by your physician without his or her approval.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References:
  1. Panda V et al. Complement Ther Med. 2017 Oct;34:111-115.
  2. Aly AM et al. AAPS PharmSciTech. 2005 Sep 20;6(1):E74-82.
  3. Thiyagarajan P et al. Inflammopharmacology. 2011 Aug;19(4):235-41.
  4. Chandrasekaran CV et al. Phytomedicine. 2011 Feb 15;18(4):278-84.
  5. Robinson M et al. Aliment Pharmacol Ther. 2002 Mar;16(3):435-43.
  6. Maton PN et al. Drugs. 1999 Jun;57(6):855-70.
  7. Panahi Y et al. J Tradit Chin Med. 2015 Dec;35(6):632-6.
  8. Zalvan CH et al. JAMA Otolaryngol Head Neck Surg. 2017 Oct 1;143(10):1023-1029.
  9. Nehra AK et al. Mayo Clin Proc. 2018 Feb;93(2):240-246.
  10. Park SK et al. Neurogastroenterol Motil. 2017 May;29(5).

Is it Healthy to Snack? Snacking Pros and Cons

Snacking: good or bad?


We’re all aware of the diet-busting effects of chronic snacking—that mindless munching on what is usually less-than-healthy food that occurs as often in response to boredom as to genuine hunger. With the current buzz around the health benefits of intermittent calorie restriction, frequent eating is discouraged. Nevertheless, smart snacking can help stabilize blood sugar and could help prevent overeating at regular mealtimes.

To learn more about controlling snacking and feeling full, listen to the Live Foreverish podcast on www.LiveForeverish.com, in which Life Extension’s own Michael A. Smith, MD, discusses the latest information with nutrition expert Crystal Gossard, DCN, CNS, LDN.

Why do people snack?

In many people, “snack attacks” arise from a sensation of hunger caused by a decrease in blood glucose. But for others, there’s more at play. Boredom, force of habit, sugar addiction, poor impulse control, family and cultural norms, eating-associated stimulation of dopamine (a hormone associated with reward) and more can contribute to excessive snacking.1,2

The snack habit is often associated with sedentary activities such as watching TV. In fact, a systematic review found that among six studies that reported overall food habits in children aged 1-18 years, all identified an association between TV viewing and the intake of sweets, fried foods, pizza and snacks.3 The combination of junk food consumed in the absence of hunger and sedentary leisure time is detrimental to long-term health.

Why is snacking bad for you?

Negative effects of snacking

While many of us strive to prepare healthy meals for ourselves and our families, we negate some of the benefits by unhealthy eating between meals. Not surprisingly, snack time is associated with “snack foods,” which can be heavily salted, sugar-laden and high in fat. Chips, desserts and sugar-sweetened beverages remain the most popular snacks in several countries.1 This preference for unhealthy food is a large part of the detrimental effects of snacking. Not only are so-called “snack foods” unhealthy, but their calorie content can sometimes be greater than that of meals. It has been estimated that snacking contributes to nearly a quarter of daily calorie intake in the U.S. and Canada.1 When snacking adds potentially hundreds of nonnutritive, “empty” calories each day, maintaining a healthy weight can be challenging, putting people at risk of other health problems.

A study of 80 elementary school children found that overweight or obese girls had a significantly greater intake of calories and carbohydrates in their "afternoon snacks" and snacks prepared and eaten at home compared with girls who were of a normal weight, and that overweight and obese boys consumed significantly more unhealthy saturated fat in snacks prepared and eaten at home in comparison with normal weight boys. This unhealthy pattern of eating could set the stage for major health problems later in life, including metabolic syndrome and diabetes.4

Is it healthy to snack throughout the day?

Health benefits of Snacking

The benefits of snacking depend upon the type and quantity of food consumed. A recent review noted, “The consumption of healthful snacks likely affects satiety and promotes appetite control.”5

Healthful snacking can help manage blood glucose by preventing a noticeable drop in glucose between meals. This can help support energy levels, mood and cognition, and prevent overeating later.

It goes without saying that healthy snacks won’t make up for unhealthy meals. Both should be consumed with nutrition in mind to keep blood glucose on an even keel throughout the day.

Healthy Snack Ideas: What can you do to ensure your snacks are nutritious?

Healthy, satisfying snacks usually contain protein and a prudent amount of complex carbohydrates or healthy fats, while avoiding simple sugars, salt, trans fatty acids or significant amounts of saturated fat. Fiber, while nonnutritive, is important in maintaining a sense of fullness after a meal. While fruit, vegetables and grains have naturally occurring fiber, supplemental fiber can be mixed into shakes, smoothies and baked goods.

Satisfying snacks can be as simple as a handful of nuts or such combinations as celery with nut butter or carrot sticks and hummus.6 Healthy shakes and bars that aren’t associated with the drop in blood glucose that can occur a few hours after eating sugary snacks are a quick and easy option for people with busy lifestyles. Some of these healthy snack options have added ingredients that further boost the ability to manage appetite.

Foods that have a low glycemic index, which is a measure of their effect on blood glucose, are a good snack choice. Higher glycemic indexes are associated with a greater rise in glucose following the food’s consumption. This can result in a “crash” several hours later, which is often rescued by yet another high glycemic index food or overeating at mealtime.7

Finally, if you do end up consuming a large quantity of food during “snack” time, stop fooling yourself. Your afternoon snack just became an early meal. Adjust your subsequent food intake accordingly.

Related Article: Snacking 101: What Should We Snack on, and When?

If you’re away from home a lot, toss a bag of almonds or a nutritious bar into your briefcase or handbag to prevent food desert disasters (like an emergency pit stop at a fast food joint).

Snacking can be healthy when we consume the right amount of the right foods at the right time. Rather than being a diet-buster, smart snacking can help attain and maintain long-term health goals.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References
  1. Hess JM et al. Adv Nutr. 2016 May 16;7(3):466-75.
  2. Thanarajah SE et al. Cell Metab. 2019 Mar 5;29(3):695-706.e4.
  3. Avery A et al. Matern Child Nutr. 2017 Oct;13(4).
  4. Ibarra López M et al. Arch Latinoam Nutr. 2012 Dec;62(4):339-46.
  5. Njike VY et al. Adv Nutr. 2016 Sep 15;7(5):866-78.
  6. Godwin N et al. J Med Food. 2019 Mar 21.
  7. Papakonstantinou E et al. Nutrition. 2017 Oct;42:12-19.

Subclinical Hypothyroid: Underdiagnosed Thyroid Condition

Tired? Bloated? Dry skin and hair? Constipated? Many people write off these symptoms as part of growing older. But these common conditions may not be due to aging. Those who suffer from them could have a condition that even their physician may fail to identify: subclinical hypothyroidism.

Learn more about thyroid health below, or listen to the podcast on www.LiveForeverish.com in which Life Extension’s own Michael A. Smith, MD, discusses the latest information.

What is subclinical hypothyroidism?

The difference between hypothyroidism and subclinical hypothyroidism

Many of us know about hypothyroidism (low thyroid hormone levels), but what is subclinical hypothyroidism? Subclinical hypothyroidism has been defined by American Thyroid Association (ATA)/American Academy of Clinical Endocrinology (AACE) guidelines as the presence of a serum thyroid stimulating hormone (TSH) above the upper reference limit in combination with normal free thyroxine (T4). They note that “This designation is only applicable when thyroid function has been stable for weeks or more, the hypothalamic-pituitary-thyroid axis is normal, and there is no recent or ongoing severe illness.”1

“Sub,” when used as a prefix, means “under” or “below,” and “subclinical” refers to a health condition that may not be overtly apparent and can be underdiagnosed according to standard assessments like bloodwork. Individuals with subclinical hypothyroidism are often asymptomatic, however they may experience the non-specific complaints associated with overt hypothyroidism. Symptoms could include fatigue, weakness, weight gain, cold intolerance and constipation. The condition often precedes the development of overt hypothyroidism.2

If thyroid problems are suspected, clinicians will often test only TSH levels. If TSH levels are outside the normal reference range, T4 levels may then be tested as well. Individuals with high TSH levels and normal T4 levels may have subclinical hypothyroidism.

Thyroid stimulating hormone normally rises in response to a decline in thyroid hormones—increasing thyroid hormone levels should therefore decrease TSH levels. According to the American Thyroid Association, a “normal” TSH range is between 0.4-0.5 mU/L on the lower end and 4-5.5 mU/L on the upper end.3

What are subclinical hypothyroidism treatment guidelines?

The European Thyroid Association (ETA) Guideline for the management of subclinical hypothyroidism recommends the drug levothyroxine (L-thyroxine), the synthetic form of T4, for patients younger than 60 to 70 years with TSH levels of greater than 10 mU/L, even in the absence of symptoms. For patients in this age group with TSH levels of less than 10 mU/L who have symptoms of hypothyroidism, they suggest a trial of levothyroxine, followed by a review of one’s response three to four months after a normal TSH level is attained. Among those who are older than 80-85 with elevated serum TSH levels of 10 mU/L or less, the ETA recommends generally avoiding hormonal therapy, but if the decision is to treat the patient, they recommend daily levothyroxine supplementation with a TSH recheck after two months.4

The hormone T4 normally converts to T3, another essential thyroid hormone. In theory, supplementing with T4 should be all that is needed. However, it is possible that not everyone efficiently converts T4 to T3. Individuals using levothyroxine who continue to experience symptoms of hypothyroidism when TSH levels have normalized may wish to have their T3 evaluated. In addition to TSH and T4, a complete thyroid panel will also measure free T4, free tri-iodothyronine (T3), reverse T3, thyroglobulin antibody (ATA) and thyroid peroxidase antibody (TPO).

If one has low T3 levels, the drug Cytomel, which is synthetic T3, may be prescribed in addition to levothyroxine (T4). It is not yet clear whether combination therapy is more effective than levothyroxine monotherapy, however those who do not respond well to monotherapy may consider combination treatment under the guidance of an experienced clinician.5 An alternative is treatment with Armor Thyroid, NP Thyroid or Naturethroid, which contain desiccated bovine thyroid gland tissue that naturally contains T3 as well as T4.

Is subclinical hypothyroidism dangerous?

Low-normal thyroid function may increase total and low-density lipoprotein (LDL) cholesterol and triglycerides and may be associated with metabolic syndrome, insulin resistance and chronic kidney disease.6


Can subclinical hypothyroidism be reversed?

Nutrients that support thyroid function

With the correct dosage of thyroid hormone replacement and periodic blood testing to evaluate the efficacy of the dosage one has been prescribed, subclinical hypothyroidism can be normalized.

There are also several nutrients that support thyroid function. Iodine is the first that comes to mind, due to its necessity for the synthesis of the body’s thyroid hormones. Other minerals that are supportive of thyroid function are selenium and zinc, which are important for the conversion of T4 to T3.7,8 Preclinical studies suggest that the herb Commiphora mukul (guggul) may also be helpful for this purpose.9

Another herb that may help support the thyroid is ginseng. A study of patients with congestive heart failure found an increase in T3 and T4 levels (which, prior to treatment, were lower than those of normal control patients) among participants who received ginseng for two weeks.10

A small study involving supplementation with the ayurvedic herb ashwagandha (Withania somnifera) resulted in increases in T4 after 8 weeks among all those who received the herb and even normalized subclinical hypothyroidism in one patient, while most of those who received a placebo experienced a decline in T4. These initially promising findings suggest a potential use for ashwagandha in subclinical hypothyroidism.11

The Bottom Line

A study involving a sample of 13,344 participants in the National Health and Nutrition Examination Survey III (NHANES III) who were representive of the geographic and ethnic distribution of the U.S. population revealed subclinical hypothyroidism among 4.3% of the subjects.12 Other estimates of the prevalence of subclinical hypothyroidism are higher, and older women are particularly at risk.13

If you are suffering from some of the symptoms of hypothyroidism, it would be well worth your while to rule out this frequently undetected condition, not only to feel better, but to help protect your future health.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References


  1. Garber JR et al. Endocr Pract. 2012 Nov-Dec;18(6):988-1028.
  2. Baumgartner C et al. Swiss Med Wkly. 2014 Dec 23;144:w14058.
  3. Woodmansee WW. Clinical Thyroidology for the Public. 2018 Feb;11(2):3-4
  4. Pearce SHS et al. Eur Thyroid J. 2013 Dec; 2(4): 215–228.
  5. Dayan C and Panicker V. Thyroid Res. 2018 Jan 17;11:1.
  6. van Tienhoven-Wind LJ et al. Eur J Clin Invest. 2015 May;45(5):494-503.
  7. Kawai M. Pediatr Endocrinol Rev. 2019 Mar;16(3):307-310.
  8. Nishiyama S et al. J Am Coll Nutr. 1994 Feb;13(1):62-7.
  9. Panda S et al. Phytother Res. 2005 Jan;19(1):78-80.
  10. Dai X et al. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Apr;19(4):209-11.
  11. Gannon JM et al. J Ayurveda Integr Med. 2014 Oct-Dec;5(4):241-5.
  12. Hollowell JG et al. J Clin Endocrinol Metab. 87:489–499.
  13. Wilson GR et al. Am Fam Physician. 2005 Oct 15;72(8):1517-24.

Are We Getting Enough Nutrients from Food?

Holli Ryan, RD, LD/N

Do the foods we eat provide us with optimal nutrition?

In other words, are we getting enough
nutrients, such as vitamins and minerals, from our food? Even if you eat a varied diet, including the recommended amounts of fruits and vegetables, the answer might still be no. The reason is that factors such as climate change and soil quality play a role in the nutrient profile of a given food.

Is our soil depleted of nutrients?

Intensive farming practices have led to a depletion of key nutrients such as magnesium, calcium and vitamin C in soil.1,2 The decreased mineral content in the soil could make it challenging to obtain optimal levels from food sources alone, and this may have a significant impact on human health.

While fertilization techniques developed as part of the Green Revolution have increased the production of food since the late 1960s, one consequence has been a reduction in the amounts of minerals and vitamins in our food. The result? More food, fewer nutrients. Since the revolution, magnesium levels in wheat, for example, have declined by an average of 19.6%.On the plus side, the introduction of GM crops has played a role in reducing topsoil damage, which is beneficial to the environment.

Does climate change affect our food supply?

The rising levels of carbon dioxide in the atmosphere that accompany climate change are affecting the nutrient status of our food.4 The analogy put forth by the blog article from Scientific American entitled “Vanishing Nutrients” is that too much carbon dioxide is as unhealthy for plants as too many carbohydrates are for humans.5 Intriguingly, the article goes on to explain: “Extra carbon dioxide acts like empty calories or ‘junk food’ for the plants, which gorge themselves on it to grow bigger and faster, consequently getting larger but less nutrient-packed. Just like America’s obesity epidemic, which is partially due to people’s increased access to an abundance of calorie-rich but nutrient-poor food, more is not always better.”

Related Article: 5 Foods You Aren't Eating Enough

I asked Nall Moonilall, a Ph.D student at the Ohio State University Carbon Management and Sequestration Center, for his insight on this topic. He recommends we protect the soil, keep it covered, maintain a healthy and active soil microbial community and add more organic matter. “Sequestering more carbon in soil will help to build the soil and improve overall soil health. Adding organic matter, reducing tillage, adding manures, and promoting diversified cropping systems are all management practices that assist to sequester more carbon and improve soil quality. This in turn will enhance better nutrient cycling in the soil.”

Sequestering carbon (capturing and storing atmospheric carbon dioxide, which is converted to a stable, solid form in soil) is one method of reducing the amount of carbon dioxide in the atmosphere with the goal of reducing global climate change—and the added benefits of decreasing nutrient loss and improving soil and water quality.6

Is organic produce healthier (more nutritious) than conventional produce?

We’ve seen how farming practices have been shown to have an influence on the nutrient content of our food, and the use of pesticides in conventional growing methods is yet another scenario that has been shown to have a negative impact.7 I find the effect on the antioxidant status of plants particularly interesting.8 First off, the fact that plants produce antioxidants to protect themselves from the environment, and then we, in turn, inherit those same protective benefits by eating the plant, is amazing. Knowing this, the explanation as to why there are more antioxidants in organic produce makes perfect sense: Organic crops need to fend for themselves more than conventional crops, which have strong, synthetic pesticides to help defend them. Organic crops, therefore, are under a higher level of stress and have to produce more antioxidants to deter pests. However, certain pesticides (typically non-man-made) are used on organic crops, especially for large-scale crop production. So how do we get the most nutrients from produce? I suggest buying from your local organic farmer and growing some of your own food.

About the author: Holli Ryan, RD, LD/N is a Social Media Content Specialist at Life Extension®. She is a Registered and Licensed Dietitian Nutritionist residing in the South Florida area. Holli believes that quality dietary supplements are an essential tool that have a variety of applications, from maintaining good health to managing chronic disease.



References:


  1. Rosanoff A. Changing crop magnesium concentrations: impact on human health. Plant and Soil. 2012;368(1-2):139-153.
  2. Davis DR, Epp MD, Riordan HD. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999. Journal of the American College of Nutrition. 2004;23(6):669-682.
  3. Guo W, Nazim H, Liang Z, et al. Magnesium deficiency in plants: An urgent problem. The Crop Journal. 2016;4(2):83-91.
  4. Zhu C, Kobayashi K, Loladze I, et al. Carbon dioxide (Co2) levels this century will alter the protein, micronutrients, and vitamin content of rice grains with potential health consequences for the poorest rice-dependent countries. Science Advances. 2018;4(5): eaaq1012.
  5. https://blogs.scientificamerican.com/observations/vanishing-nutrients/
  6. Lal R, Negassa W, Lorenz K. Carbon sequestration in soil. Current Opinion in Environmental Sustainability. 2015;15:79-86.
  7. https://www.npr.org/sections/thesalt/2016/02/18/467136329/is-organic-more-nutritious-new-study-adds-to-the-evidence
  8. Barański M, Srednicka-Tober D, Volakakis N, et al. Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: a systematic literature review and meta-analyses. British Journal of Nutrition. 2014;112(5):794-811.

Live Foreverish Podcast: New Treatments for Chronic Pain Relief

New Treatments for Chronic Pain Relief

The latest research shows that natural medicine could be the best place to look for new chronic pain treatments. Researchers recently discovered an intrinsic fatty acid, called PEA (Palmitoylethanolamide), that inhibits peripheral nerve inflammation—theorized as the first step in developing chronic pain.


Additionally, a little-known plant extract called honokiol improves GABA signaling in the brain, thus restoring a normalized perception of pain—an important step for chronic pain relief.

The newest approach to finding relief might include supplementing with PEA and honokiol. Life Extension®’s Michael A. Smith, MD, and Crystal Gossard, DCN, CNS, LDN, discuss chronic pain and readily available solutions that don’t involve opioids in this episode of Live Foreverish.

What is Chronic Pain?

Chronic Pain Definition

Did you know that chronic pain is not only long-term, day-in-and-day-out pain, but a diagnosis in its own right?

Chronic pain is defined as persistent or recurrent pain lasting longer than 3 months.1 While acute pain is the temporary pain that is the result of numerous possible occurrences or conditions, chronic pain is something that many people live with 24 hours a day, often for years. It is a condition that involves more than the site of the initial insult to the body and includes changes that occur in the spinal cord and the brain.

Chronic pain is now recognized as a diagnosis that is separate from any disease or condition that may have initiated it. As an article published recently in the journal Postgraduate Medicine noted, “Evidence supports the redefinition of chronic pain as a distinct disease entity, not simply a symptom of injury or illness.”2

According to a recent review, “If one views chronic pain as a single disease entity, then it is the most common and costly medical condition.”3

Chronic pain symptoms

In addition to persistent, significant pain, people suffering from chronic pain unsurprisingly endure other symptoms, including a significant amount of stress which, in turn, can aggravate their pain.4 Depression, anxiety, insomnia, physical disability and even cognitive changes can also be experienced by those suffering from chronic pain.

Current chronic pain treatment

Chronic pain is generally treated with prescription and nonprescription pain-relieving drugs. Nonprescription drugs include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil) and naproxen (Aleve). NSAIDs also include the prescription drugs celecoxib (Celebrex), diclofenac (Voltaren), indomethacin and others. While prescription opioid derivatives—including hydrocodone, fentanyl, codeine, morphine, and oxycontin—are considered good at relieving pain, some people become addicted in a matter of weeks of regular use and experience other significant side effects.

Local anesthetic injections that can be administered by a physician are sometimes an option. There are also pain-relieving patches, balms, lotions and ointments that can be applied topically.

Natural therapies for chronic pain include acupuncture, spinal adjustments, exercise, physical therapy, meditation, massage and specific plant compounds.5

PEA and Honokiol–Exciting New Options for Pain Relief

How does PEA work?

Palmitoylethanolamide, which (fortunately) is referred to by its acronym PEA, is a fatty acid produced in the human body that also occurs in small amounts in egg yolk, milk, soy and other foods.6 Available clinical data support the ability of PEA to relieve discomfort.7 The compound targets the mast cells activated peripherally during the initial insult to the body that is the first step in the development of chronic pain, thereby reducing the release of inflammatory mediators. PEA’s action against mast-cell driven localized inflammation is what makes it different from other compounds—natural and otherwise—that have an anti-inflammatory action.6

PEA also targets the nuclear receptor peroxisome proliferator-activated receptor-alpha (PPAR-alpha) to support a healthy level of inflammation. According to a recent review, “Synergistic interactions among several mechanisms often seem necessary so that PEA can produce its important therapeutic effects, both in the central and the peripheral nervous system.”6

Human studies have revealed benefits for the use of PEA for sciatic nerve pain, carpal tunnel syndrome, temporomandibular joint (TMJ) syndrome and migraine.8- 11 Doses used in these trials range from 300 milligrams to 1,200 milligrams.

What is honokiol?

Honokiol is a compound derived from the magnolia tree. Honokiol targets resistance to the inhibitory gamma-aminobutyric acid (GABA) in brain—a phenomenon that occurs as the final stage in the development of chronic pain syndrome. GABA slows down the rate at which neurons fire, which results in a calming effect.12

“The results of anatomical, biochemical, molecular and pharmacological studies support the notion that generalized activation of GABA receptor systems dampens the response to painful stimuli,” write S. J. Enaa and K. E. McCarson in Advances in Pharmacology. “The data leave little doubt that, under certain circumstances, stimulation of neuroanatomically discreet GABA receptor sites could be of benefit in the management of pain.”13

Targeting the beginning and the end of the development of chronic pain is one way to break the pain cycle. Unlike NSAIDs, PEA and honokiol are safe on the stomach, and unlike opioid drugs, they’re nonaddictive.

Although chronic pain has frustrated patients and physicians alike, there are treatment options that don’t involve the use of dangerous and addictive drugs. Do you or someone you care about suffer from chronic pain?

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

References
  1. Nicholas M et al. Pain. 2019 Jan;160(1):28-37.
  2. Clauw DJ et al. Postgrad Med. 2019 Jan 31:1-14.
  3. Nicol AL et al. Anesth Analg. 2017 Nov;125(5):1682-1703.
  4. Crofford LJ. Trans Am Clin Climatol Assoc. 2015;126:167-83.
  5. Wylde V et al. Br J Surg. 2017 Sep;104(10):1293-1306.
  6. Petrosino S et al. Br J Pharmacol. 2017 Jun;174(11):1349-1365.
  7. Artukoglu BB et al. Pain Physician. 2017 Jul;20(5):353-362.
  8. Guida G et al. Dolor. 2010;25(1):35–42.
  9. Assini A et al. Eur J Neurol. 2010;17(S3):295.
  10. Marini I et al. J Orofac Pain. 2012 Spring;26(2):99-104.
  11. Chirchiglia D et al. Front Neurol. 2018 Aug 17;9:674.
  12. Ai J et al. Pharmacology. 2001 Jul;63(1):34-41.
  13. Enna SJ et al. Adv Pharmacol. 2006;54:1-27.

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